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Overpelt N, Kool-Goudzwaard N, Stringer B, van Meijel B. Nurses' Perspectives on Fostering Therapeutic Relationships While Working With Clients Who Display Conflict Behaviour. Int J Ment Health Nurs 2024. [PMID: 39333839 DOI: 10.1111/inm.13441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 08/30/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024]
Abstract
Therapeutic relationships are critical in the treatment of mental health disorders. Some clients experiencing mental health disorders display conflict behaviour-for example, suicidal or self-harming behaviour, threats of or actual aggression, and various psychotic behaviours-which presents significant challenges for care professionals. In inpatient mental health units, where interactions with mental health nurses are frequent, managing conflict behaviour is crucial to maintaining care quality and fostering therapeutic progress. This study aims to describe nurses' perspectives on fostering therapeutic relationships while working with clients who display conflict behaviour. Qualitative research was conducted in a specialised treatment setting for such clients by means of individual semi-structured interviews and a focus group interview with nurses. The results show that the nurses' primary focus is on cooperating with clients and colleagues. Regardless of conflict behaviour, nurses consistently invite clients to cooperate. To do so, they must manage their own emotions and expectations, emphasise the clients' responsibility and reduce the opportunities for conflict behaviour. The unit structure helps nurses by reducing ambiguity regarding treatment policies and inconsistencies in nurse-client interactions and allows nurses and clients to experience feelings of safety. To work with conflict behaviour, nurses need to feel valued and supported by their colleagues and have adequate time and resources. In conclusion, this study shows how nurses foster therapeutic relationships with clients who display conflict behaviour by focusing on cooperation, structure and safety.
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Affiliation(s)
- Nick Overpelt
- Centre for Intensive Treatment, Parnassia Group, The Hague, The Netherlands
| | | | | | - Berno van Meijel
- Department of Psychiatry, Amsterdam University Medical Centre, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Inholland University of Applied Sciences, Amsterdam, The Netherlands
- Parnassia Psychiatric Institute, The Hague, The Netherlands
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Mengesha YA, Wolle HS, Ayana DA, Belayneh AH, Yewogu SW, Gebremedhin SE, Worku AE, Desta AY, Yesufe AT. Farmers' traditional knowledge on seasonal frost management and their tree preferences in frost affected highlands of Amhara region, Ethiopia. Heliyon 2024; 10:e37174. [PMID: 39286081 PMCID: PMC11403045 DOI: 10.1016/j.heliyon.2024.e37174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 08/28/2024] [Accepted: 08/28/2024] [Indexed: 09/19/2024] Open
Abstract
Extreme environmental conditions, such as high temperature, frost, low humidity and desiccating winds, are the main causes for the failure of plantation forests in Ethiopia. Frost damage contributes to the low seedling survival and plantation success in frost affected highlands of Amhara region Ethiopia. Research outputs on farmers' traditional knowledge on frost management and technologies that curb frost related problems are limited in the country. This study was conducted to document the farmers' traditional knowledge on frost management and their tree preference in frost affected highlands of Amhara region. Sinan, Guna-begemder and Meket districts were selected purposively in 2020. One representative sample Kebele was selected in each district with a total of 204 households selected with systematic random sampling technique for interview. In addition to interview focus group discussion was also conducted. Both descriptive and inferential statistics data analysis method were employed. In this study, frost was found to be an important limiting factor for plantation development in the study area. Frost occurs, mainly, from September to January. The local community applies traditional frost management techniques. The seasonality of frost occurrence and type of traditional frost management practices varied among the studied Kebeles. Eucalyptus globulus, Oldeania alpina, Rhamnus prinoides and Chamaecytisus palmensis were preferred trees species due to their frost resistant performance. The effectiveness of identified traditional frost management techniques needs to be investigated before they can be promoting and disseminating. Farmers should also be trained in proper techniques to protect planted seedlings from frost damage. Adjusting the timing of planting may also help to mitigate the effect of frost damage.
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Affiliation(s)
| | - Hailie Shiferaw Wolle
- Ethiopian Forestry Development, Bahir Dar Center, Bahir Dar, Ethiopia, P.O. Box 2128
| | - Demelash Alem Ayana
- Ethiopian Forestry Development, Bahir Dar Center, Bahir Dar, Ethiopia, P.O. Box 2128
| | - Alayu Haile Belayneh
- Ethiopian Forestry Development, Bahir Dar Center, Bahir Dar, Ethiopia, P.O. Box 2128
| | | | | | | | - Anteneh Yenesew Desta
- Ethiopian Forestry Development, Bahir Dar Center, Bahir Dar, Ethiopia, P.O. Box 2128
| | - Abera Tesfaye Yesufe
- Ethiopian Forestry Development, Central Ethiopia Center, Addis Ababa, Ethiopia, P.O.Box 30708
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Magon A, Hendriks J, Caruso R. Developing and Validating a Self-Care Self-Efficacy Scale for Oral Anticoagulation Therapy in Patients With Nonvalvular Atrial Fibrillation: Protocol for a Mixed Methods Study. JMIR Res Protoc 2024; 13:e51489. [PMID: 39269742 PMCID: PMC11437320 DOI: 10.2196/51489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Oral anticoagulation therapy (OAC) is the cornerstone treatment for preventing venous thromboembolism and stroke in patients with nonvalvular atrial fibrillation (NVAF). Despite its significance, challenges in adherence and persistence to OAC regimens have been reported, leading to severe health complications. Central to addressing these challenges is the concept of self-efficacy (SE) in medication management. Currently, there is a noticeable gap in available tools specifically designed to measure SE in OAC self-care management, while such tools are crucial for enhancing patient adherence and overall treatment outcomes. OBJECTIVE This study aims to develop and validate a novel scale aimed to measure self-care self-efficacy (SCSE) in patients with NVAF under OAC, which is the patients' Self-Care Self-Efficacy Index in Oral Anticoagulation Therapy Management (SCSE-OAC), for English- and Italian-speaking populations. We also seek to assess patients' SE in managing their OAC treatment effectively and to explore the relationship between SE levels and sociodemographic and clinical variables. METHODS Using a multiphase, mixed methods observational study design, we first conceptualize the SCSE-OAC through literature reviews, patient focus groups, and expert consensus. The scale's content validity will be evaluated through patient and expert reviews, while its construct validity is assessed using exploratory and confirmatory factor analyses, ensuring cross-cultural applicability. Criterion validity will be examined through correlations with clinical outcomes. Reliability will be tested via internal consistency and test-retest reliability measures. The study will involve adult outpatients with NVAF on OAC treatment for a minimum of 3 months, using both e-surveys and paper forms for data collection. RESULTS It is anticipated that the SCSE-OAC will emerge as a reliable and valid tool for measuring SE in OAC self-care management. It will enable identifying patients at risk of poor adherence due to low SE, facilitating targeted educational interventions. The scale's validation in both English and Italian-speaking populations will underscore its applicability in diverse clinical settings, contributing significantly to personalized patient-centered care in anticoagulation management. CONCLUSIONS The development and validation of the SCSE-OAC represent a significant advancement in the field of anticoagulation therapy. Validating the index in English- and Italian-speaking populations will enable personalized patient-centered educational interventions, ultimately improving OAC treatment outcomes. The SCSE-OAC's focus on SCSE introduces a novel approach to identifying and addressing individual patient needs, promoting adherence, and ultimately improving health outcomes. Future endeavors will seek to extend the validation of the SCSE-OAC across diverse cultural and linguistic landscapes, broadening its applicability in global clinical and research settings. This scale-up effort is crucial for establishing a universal standard for measuring SCSE in OAC management, empowering clinicians and researchers worldwide to tailor effective and culturally sensitive interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT05820854; https://tinyurl.com/2mmypey7. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/51489.
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Affiliation(s)
- Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Jeroen Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Centre for Heart Rhythm Disorders, The University of Adelaide and the Royal Adelaide Hospital, Adelaide, Australia
| | - Rosario Caruso
- Clinical Research Service, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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Leach E, Cowley E, Bowen C. The experiences of podiatrists prescribing custom foot orthoses and patients using custom foot orthoses for foot pain management in the United Kingdom: A focus group study. J Foot Ankle Res 2024; 17:e12047. [PMID: 39169687 PMCID: PMC11339317 DOI: 10.1002/jfa2.12047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 08/01/2024] [Indexed: 08/23/2024] Open
Abstract
INTRODUCTION Foot pain can be a significant burden for patients. Custom foot orthoses (CFOs) have been a mainstay in podiatry treatment for foot pain management and improving foot function. However, little is known about podiatrists' experience of prescribing CFOs or patient experience of using foot orthoses (FOs), including CFOs, for foot pain. METHODS A focus group (FG) discussion with three FOs users (Female = 2 and Male = 1) was conducted in November 2022 within a private podiatry practice. This group represented non-experts from the general local population of individuals with existing or previous foot pain who have personally experienced using either over-the-counter FOs or CFOs. An online FG discussion with five musculoskeletal (MSK) specialist podiatrists (Female = 2 and Male = 3) was also conducted in December 2022. This group represented podiatrists with specialist knowledge in foot biomechanics and clinical experience in CFO provision. The FG discussions were recorded and lasted 49 and 57 min respectively. Transcribed data was manually coded, and a thematic analysis was undertaken to identify patterns within the collected data. RESULTS The participants in the patient FG detailed mixed experiences of the prescription process and CFOs received, with reports of limited involvement/input in their prescription, the need for frequent adjustments and high costs. The impact on footwear choices, replicability and transferability of CFOs into different types of shoes and technologies to aid design were also highlighted. In the podiatrist FG, lack of confidence in design and manufacture processes, prescription form language, relationship and communication building with manufacturers, variability in the CFOs issued and the need for better student education in CFO provision emerged as key themes. CONCLUSION Patients and podiatrists shared similar views on CFO provision, namely poor communication with manufacturers leading to dissatisfaction with the CFOs prescribed causing negative impacts on patient experiences. Podiatrists called for greater education at registration level to increase new graduate podiatrist knowledge in CFO design and manufacture and better collaboration with manufacturing companies.
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Affiliation(s)
- Emily Leach
- School of Health SciencesFaculty of Environmental and Life SciencesUniversity of SouthamptonSouthamptonUK
- Solent NHS Trust PodiatrySolent NHS Trust, SouthamptonSouthamptonUK
| | - Emma Cowley
- School of Health SciencesFaculty of Environmental and Life SciencesUniversity of SouthamptonSouthamptonUK
| | - Catherine Bowen
- School of Health SciencesFaculty of Environmental and Life SciencesUniversity of SouthamptonSouthamptonUK
- Centre for SportExercise and Osteoarthritis Versus ArthritisUniversity of SouthamptonSouthamptonUK
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Al-Motlaq M. "It's challenging but not impossible": Exploring clinical instructors' experiences of child and family centered care in clinical nursing education. J Pediatr Nurs 2024; 78:172-178. [PMID: 38970853 DOI: 10.1016/j.pedn.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/01/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Clinical instructors (CIs) assist student nurses within the context of their pediatric clinical education to assimilate into their new roles and develop their own clinical expertise. This involves acquisition of knowledge and skills including the adoption of Child and Family Centered Care (CFCC) principles. AIMS This study explored CIs experiences of CFCC in clinical settings by investigating their views and perceptions of its implementation within the clinical education process. METHODS A mixed-method approach was used. A focus group was employed to collect data from 7 participants recruited from one faculty of nursing. A questionnaire was also completed by 5 participants to enrich the data collection process. Descriptive statistics used to describe their perceived importance of CFCC, and conventional content analysis was used to organize data and identify themes. RESULTS While quantitative responses revealed discrepant findings, qualitative data resulted in three themes 1) Clinical instructors (CIs) know CFCC, acknowledge its importance, and take action for that 2) Facilitators and challenges of adopting CFCC in clinical education, and 3) CIs approaches to implement CFCC. CONCLUSIONS While CI's were able to facilitate the implementation of CFCC despite the barriers, their whole experience circulated around external factors including the clinical environment and its role in facilitating or hindering the educational process including CFCC implementation. IMPLICATIONS Program administrators should address clinical instructors concerns regarding barriers to CFCC implementation in clinical practice including the evaluation process. They should also ensure appropriate training is provided for healthcare professionals to enable them to effectively engage in CFCC.
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Affiliation(s)
- Mohammad Al-Motlaq
- Department of Maternal Child and Family Health, Faculty of Nursing, The Hashemite University, Zarqa, Jordan.
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Perdomo Sandoval LA, Goberna-Tricas J. Sexual health beliefs and prevention of sexually transmitted infections among cisgender women sex workers in Colombia. PLoS One 2024; 19:e0305293. [PMID: 38865312 PMCID: PMC11168633 DOI: 10.1371/journal.pone.0305293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION The stigma and social discrimination against cisgender women sex workers lead many of them to live in conditions characterized by social inequality, marginalization, persecution, and limited opportunities for sexual health literacy. Consequently, they are often compelled to establish a framework of preventive beliefs with little scientific validity, which they use to identify, mitigate, or avoid sexual health risks arising from their interactions with clients. This study investigates the sexual health beliefs that influence self-care practices aimed at preventing sexually transmitted infections among cisgender women sex workers in Colombia. METHODS We conducted a qualitative study framed in Hermeneutic Phenomenology. In-depth interviews and discussion groups were conducted with 34 cisgender women sex workers over 18 years of age in the center of the cities of Bogotá and Barranquilla in Colombia. RESULTS Seven themes emerged from the reflective and inductive thematic analysis of the narratives: (1) popular habits for the prevention of contagion, (2) ocular assessment of genitals, (3) condom lubrication, (4) suspicion of a hidden infection in the client, (5) saliva and oral contact as a source of contagion, (6) avoidance of semen contact, (7) and trust in God as protection. CONCLUSIONS The findings reflect the need for health and social professionals to promote participatory and inclusive cooperation with sex workers to update the framework of preventive beliefs that help them guide sexual health self-care with autonomy and self-efficacy, strengthening favorable beliefs and negotiating unfavorable ones. It is also essential to have a sex worker-informed sexual health policy that guides the promotion of sexual health that is sensitive to the needs and consistent with the risks of sex work and ensures friendly and non-oppressive preventive care environments for sex workers.
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Affiliation(s)
- Luis Albeiro Perdomo Sandoval
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing. Doctoral Program in Nursing and Health, University of Barcelona, Barcelona, Spain
| | - Josefina Goberna-Tricas
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing. ADHUC. Research Center for Theory, Gender, Sexuality. University of Barcelona, Barcelona, Spain
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Zlotnick C, Jabareen R, Madjar B, Hazoref RH, Gens I, Shachaf S. A country's efforts toward creating an advanced practice nurse in public health. Int Nurs Rev 2024; 71:396-406. [PMID: 38661535 DOI: 10.1111/inr.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
AIM The study goal was to inform the creation of a blueprint for an advanced practice nurse (APN) in public health. BACKGROUND No internationally accepted standard for an APN in public health exists. Activities of public health nurses (PHN) traditionally have centered on health promotion and disease prevention, but many have added other population-based activities such as chronic and acute disease treatment. INTRODUCTION An APN in public health is needed to address the global challenges threatening the physical, social, and mental health of populations worldwide. METHODS This qualitative study was comprised of six focus groups, each containing a different group of stakeholders (n = 40). Study results followed the requirements of the consolidated criteria for reporting qualitative research (COREQ). FINDINGS Two major themes emerged: the APN role in public health and core expectations. From the APN role theme, four subthemes emerged on APN domains of public health practice and functions. From the core expectations theme, nine subthemes emerged on the APN's qualifications and behaviors. DISCUSSION Agreement among stakeholders was found in the nine core expectations; however, among the four different visions of an APN in public health, two fit a population-based model rather than the traditional PHN model. CONCLUSIONS A single APN role in public health is insufficient to address the breadth and complexity of today's global challenges as detailed by the sustainable development goals. Due to the interaction between health and the biopsychosocial environments, we need APNs with different areas of expertise. IMPLICATION FOR NURSING POLICY Nurses working at universities, in public health services, and as healthcare policymakers are needed to create a multistage strategy that gradually introduces several different types of APNs in public health.
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Affiliation(s)
| | | | | | - Rivka Hazan Hazoref
- Department for Licensing and Nursing Exams, Nursing Division, Ministry of Health, Jerusalem, Israel
| | - Ilana Gens
- Chief Nurse of Public Health Services, Ministry of Health, Jerusalem, Israel
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Pallan M, Mason F, Parretti HM, Adab P, Abbott S, Jolly K. Supporting healthcare professionals to address child weight with parents: a qualitative study. Br J Gen Pract 2024; 74:e417-e425. [PMID: 38575182 PMCID: PMC11005922 DOI: 10.3399/bjgp.2023.0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/06/2023] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Primary care and community healthcare professionals (HCPs) are well placed to discuss child excess weight with parents and support them to make changes. However, HCPs have concerns about addressing this issue. There is a need to understand the factors that influence HCPs in initiating these conversations to inform strategies to support them. AIM To explore with HCPs, working in primary care and community settings, their experiences of having conversations about child weight with parents, and the factors that create barriers or facilitate them to have these conversations. DESIGN AND SETTING A qualitative study with GPs, primary care nurses (PNs), and school nurses (SNs) in England. METHOD GPs and PNs were recruited to participate in semi-structured interviews. SNs from a community healthcare NHS trust were recruited to participate in focus groups. Vignettes were used to stimulate discussion. Data were analysed guided by the Framework approach. RESULTS Thirteen GPs, seven PNs, and 20 SNs participated. The following three themes were identified regarding barriers to HCPs having conversations about child excess weight: structural and organisational; HCP related; and parent or family related. The themes identified for the factors that facilitate these conversations were: structural changes (for example, dedicated appointments, access to weight assessment data, joined-up working across agencies); HCP approaches (for example, providing appropriate dietary and physical activity advice); and HCP knowledge and skills (for example, enhancing HCPs' general and weight management-related skills and knowledge of child weight management services). CONCLUSION A range of barriers exist to HCPs addressing child excess weight with parents in primary care and community settings. Actions to effect structural changes and support HCPs in developing relevant knowledge and skills are required to overcome these barriers.
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Affiliation(s)
- Miranda Pallan
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham
| | - Frances Mason
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham
| | - Helen M Parretti
- Norwich Medical School, Faculty of Medicine and Health, University of East Anglia, Norwich
| | - Peymané Adab
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham
| | - Sally Abbott
- Research Centre for Healthcare and Communities, Institute for Health and Wellbeing, Coventry University, Coventry; Department of Dietetics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry
| | - Kate Jolly
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham
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Hevink M, Linden I, de Vugt M, Brodaty H, Low LF, Phillipson L, Jeon YH, Gresham M, Doucet S, Luke A, Vedel I, McAiney C, Szcześniak D, Błaszkiewicz M, Rymaszewska J, Verhey F, Wolfs C. Moving forward with dementia: an explorative cross-country qualitative study into post-diagnostic experiences. Aging Ment Health 2024:1-10. [PMID: 38656033 DOI: 10.1080/13607863.2024.2342968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES This explorative cross-country qualitative study aims to describe experiences of receiving a dementia diagnosis and experiences of support following a diagnosis in Australia, Canada, the Netherlands and Poland. METHOD Qualitative study using projective techniques during online focus groups, online and telephone interviews with people with dementia and caregivers. RESULTS Twenty-three people with dementia and 53 caregivers participated. Qualitative content analysis revealed five themes; (1) 'Coming to terms with dementia' helped people deal with complex emotions to move forward. (3) 'The social network as a source of support' and (4) 'The challenges and realities of formal support' and impacted 'Coming to terms with dementia'. (2) 'Navigating life with dementia as a caregiver' highlights caregiver burden and was impacted by (4) 'The challenges and realities of formal support'. People were (5) 'Self-caring and preparing for tomorrow' as they focused on maintaining current health whilst planning the future. Despite differences in healthcare and post-diagnostic support systems, there were more similarities across countries than differences. CONCLUSION Across countries, formal support and support from friends and family are crucial for people with dementia and caregivers to come to terms with dementia and maintain carer wellbeing to ultimately live well with dementia.
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Affiliation(s)
- Maud Hevink
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Iris Linden
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Lee-Fay Low
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lyn Phillipson
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Meredith Gresham
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Shelly Doucet
- Department of Nursing and Health Sciences, The Centre for Research in Integrated Care, University of New Brunswick, Saint John, Canada
| | - Alison Luke
- Department of Nursing and Health Sciences, The Centre for Research in Integrated Care, University of New Brunswick, Saint John, Canada
| | - Isabelle Vedel
- Department of Family Medicine, McGill University, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo and Schlegel-UW Research Institute for Aging, Waterloo, Canada
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | | | | | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Claire Wolfs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
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Parsons M. Nursing staff adherence to guidelines on nutritional management for critically ill patients with cancer: A service evaluation. Nurs Crit Care 2024. [PMID: 38508155 DOI: 10.1111/nicc.13062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 02/04/2024] [Accepted: 02/25/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Critically ill patients with cancer are at high risk of developing malnutrition, negatively affecting their outcome. AIM To critically analyse nursing staff's adherence to nutrition management guidelines for critically unwell patients with cancer and identify barriers which prevent this. Two areas of nutrition management were evaluated: early initiation (<48 h from admission) of enteral nutrition (EN) and continuation of EN without interruption. STUDY DESIGN A retrospective data analysis was performed on mechanically ventilated adult patients admitted to a single cancer centre. Data from electronic patient records (EPR) were collected. Health care professionals' (HCP) documentation was analysed, and a nursing staff focus group (n = 5) was undertaken. RESULTS Sixty-four patient records were included. Early EN was not administered in 67% (n = 43) of cases. The reasons for the three longest interruptions to EN feed were as follows: delays in EN tube insertion, gastric residual volumes (GRVs) less than the recommended feed discontinuation threshold and endotracheal intubation. Four main themes relating to barriers to practice were identified from the focus group data analysis: HCPs' approach towards nutrition management, the patient's physiological condition and stability, multi-disciplinary team (MDT) communication and guidance on nutrition management, and practical issues with patient care. CONCLUSIONS Multi-disciplinary communication difficulties, lack of clear guidelines and inadequate awareness of the importance of nutrition for critically ill patients with cancer were barriers identified preventing optimal nutrition management. RELEVANCE TO CLINICAL PRACTICE Nursing education is fundamental to help break down the barriers to practice which prevent critically ill patients from receiving optimal nutrition management.
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Affiliation(s)
- Marie Parsons
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
- The School of Biological Sciences, The University of Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland
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Hyvärinen S, Jarva E, Mikkonen K, Karsikas E, Koivunen K, Kääriäinen M, Meriläinen M, Jounila-Ilola P, Tuomikoski A, Oikarinen A. Healthcare professionals' experience regarding competencies in specialized and primary stroke units: A qualitative study. JOURNAL OF VASCULAR NURSING 2024; 42:26-34. [PMID: 38555175 DOI: 10.1016/j.jvn.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/20/2023] [Accepted: 11/18/2023] [Indexed: 04/02/2024]
Abstract
AIM To describe healthcare professionals' experience of needed competence in patient stroke care within specialist and primary healthcare. BACKGROUND Healthcare professionals who provide stroke care need multifaceted, multi-professional skills; ongoing training is important for competent stroke care. DESIGN A descriptive qualitative study. METHODS Six focus group interviews with semi-structured interviews were conducted in October and November 2020. Healthcare professionals (n = 25) working in stroke care units in both specialist and primary healthcare settings were interviewed. The interviews were recorded, transcribed and analyzed inductively by content analysis. The study was conducted, and results were reported according to the Consolidated Criteria for Reporting Qualitative Research. RESULTS Five main categories were identified: clinical competence; multiprofessional networking competence; competence in interaction skills; emotional and psychoeducational support competence; and self-management and development competence. CONCLUSION Competence in stroke care includes both in-depth and wide-ranging professional competences that require ongoing development. Utilizing various education models and collaborative learning approaches can help meet the requirements for developing competence in stroke care. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Satu Hyvärinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI- 90014 University of Oulu, Oulu, Finland.
| | - Erika Jarva
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI- 90014 University of Oulu, Oulu, Finland.
| | - Kristina Mikkonen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Eevi Karsikas
- Oulu University Hospital, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | | | - Maria Kääriäinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - Merja Meriläinen
- Oulu University Hospital, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | | | | | - Anne Oikarinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI- 90014 University of Oulu, Oulu, Finland.
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Arjama AL. Ethical issues in long-term care settings: Care workers' lived experiences. Nurs Ethics 2024; 31:213-226. [PMID: 37541651 PMCID: PMC11181730 DOI: 10.1177/09697330231191277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023]
Abstract
BACKGROUND Professional care workers face ethical issues in long-term care settings (LTCS) for older adults. They need to be independent and responsible, despite limited resources, a shortage of skilled professionals, global and societal changes, and the negative reputation of LTCS work. RESEARCH AIM Our aim was to describe the care workers' lived experiences of ethical issues. The findings can be used to gain new perspectives and to guide decision-making to improve the quality of care, occupational well-being and nursing education. RESEARCH DESIGN Focus group interviews were analyzed using a hermeneutic-phenomenological method. The analysis comprised three steps: naïve reading, structural analysis, and comprehensive understanding. PARTICIPANTS AND RESEARCH CONTEXT We randomly sampled LTCS service providers in Finland and 53 care workers with different educational backgrounds from seven organizations participated in focus group interviews in 2021. ETHICAL CONSIDERATIONS This was a sensitive study, which was connected to the participants' individual views of the world, professional ethics and social and health care legislation. The participants' provided informed consent and their anonymity was guaranteed. FINDINGS Care workers spoke about their lived experiences of ethical issues in an emotional way, using practical examples. They talked about how they were experts at caring and advocating for residents, balanced the responsibilities of their different roles, and defended their work to the wider society. The care workers said that ethical aspects of their work were too difficult to solve on their own. There were elements of their working environment and practices that caused unnecessary strain and they needed the commitment of managers, organizations, and society to solve ethical issues in LTCS. CONCLUSIONS Ethical issues were related to the well-being of both residents and care workers and reflected both internal and external pressures. Some issues could not be resolved by individuals and needed input from managers, organizations, and society.
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Kolstad LR, Tjugum V, Rød I, Skedsmo K, Stenseth HV, Reime MH. Postgraduate Operating Room Nursing Students' Experiences with Blended Learning Combining Digital Learning Paths and Basic Skills Training as Preparation for Internship: A Qualitative Study. SAGE Open Nurs 2024; 10:23779608241278541. [PMID: 39258220 PMCID: PMC11384518 DOI: 10.1177/23779608241278541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 07/22/2024] [Accepted: 08/12/2024] [Indexed: 09/12/2024] Open
Abstract
Introduction Numerous pedagogical practices ought to be contemplated for the acquisition of practical aptitudes imperative to postgraduate operating room nursing education. The employment of digital technologies has emerged as a strategic focus in higher education and learning paths exhibit potential as a digital approach in nursing education. Objective This study aimed to investigate the experiences of postgraduate OR nursing students who underwent a blended learning approach, which combines digital learning paths with skills training, and to explore how this approach prepares students to attain specific learning outcomes during their internship period. Methods This qualitative study employed a descriptive, exploratory design and utilized focus group interviews facilitated by an interview guide to gather qualitative data. A purposive sampling strategy was employed, and the collected data were analyzed using a systematic text condensation approach. Results The analysis of the data revealed two main categories and five subgroups. The first category, "Blended learning serves as adequate preparation for internship," includes subgroups that highlight the advantages of diverse learning activities that aid in the development of a strong foundation in practical skills. The positive influence of peer collaboration fosters improved learning through social interaction, while the organization of the curriculum has a significant impact on students' learning experiences. The second category, "The importance of skills training and behaving in an operating theater context," consists of subgroups that emphasize the necessity of progressing from basic technical skills training to simulation pedagogy to ensure appropriate behavior in the operating room. Small group sizes, close monitoring, and assessment by educators contribute to effective learning. Conclusion The integration of digital learning paths with skills training fosters a problem-solving approach and encourages active and collaborative learning. Skills training in small groups, timely feedback, and coordination among subject managers to handle the students' workload can create an optimal learning environment.
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Affiliation(s)
| | - Vibeke Tjugum
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Irene Rød
- Lovisenberg Diaconal University College, Oslo, Norway
| | | | | | - Marit Hegg Reime
- Lovisenberg Diaconal University College, Oslo, Norway
- Department of Health and Social Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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14
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Anbari AB, Sandheinrich T, Hulett J, Salerno E. Understanding advanced practice registered nurse perspectives on providing care to people with a history of breast cancer. J Am Assoc Nurse Pract 2023; 35:804-812. [PMID: 37560998 DOI: 10.1097/jxx.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/23/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND People with a history of breast cancer (PHBC) face a lifelong risk of treatment-related sequelae affecting their quality of life. Stakeholders advocate for improving breast cancer survivorship outcomes by increasing clinicians' knowledge of cancer survivorship issues. In Missouri, advanced practice registered nurses (APRNs) in nononcology settings provide routine survivorship care to PHBC; however, little is known about how they approach survivorship care planning for PHBC. PURPOSE Examine perspectives of Missouri APRNs practicing in nononcology settings about providing survivorship care to PHBC. METHODS A combination of grounded theory and thematic analysis techniques was used for focus groups and semistructured interviews. The interviews were audio-recorded, transcribed, and analyzed using grounded theory coding methods. RESULTS Nineteen nononcology Missouri-based APRNs (18 NPs, 1 CNS/DNP) shared their perspectives about managing care for PHBC. We identified four major themes. Our participants (1) attuned their baseline assessment techniques to a history of breast cancer; (2) were prepared to order additional evaluations; (3) were willing to proactively figure out next best steps for PHBC beyond theneed for breast cancer recurrence surveillance; and (4) suggest that streamlining cancer survivorship care resources would benefit both clinicians and PHBC. CONCLUSIONS Our findings shed light on how APRNs approach care planning for PHBC and the needs of nononcology APRNs for managing PHBC. IMPLICATIONS FOR PRACTICE Advanced practice registered nurses are well-positioned to improve cancer survivorship care. Increasing knowledge of cancer survivorship care guidelines could improve long-term health outcomes of PHBC. Access to cancer survivorship resources or experts via telehealth/technology for both APRNs and patients could improve survivorship care and overall health of PHBC.
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Affiliation(s)
- Allison B Anbari
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri
| | | | - Jennifer Hulett
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri
| | - Elizabeth Salerno
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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McKay V, Carothers B, Graetz D, Malone S, Puerto-Torres M, Prewitt K, Cardenas A, Chen Y, Devidas M, Luke DA, Agulnik A. Sustainability determinants of an intervention to identify clinical deterioration and improve childhood cancer survival in Latin American hospitals: the INSPIRE study protocol. Implement Sci Commun 2023; 4:141. [PMID: 37978404 PMCID: PMC10657009 DOI: 10.1186/s43058-023-00519-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND More than 90% of children with cancer live in low-resourced settings, where survival is only 20%. Sustainable evidence-based (EB) interventions yielding ongoing beneficial patient outcomes are critical to improve childhood cancer survival. A better understanding of factors promoting intervention sustainability in these settings is urgently needed. The aim of this study is to provide an empirical understanding of how clinical capacity for sustainability, or the resources needed to sustain an intervention, impacts the sustainment of Pediatric Early Warning System (PEWS), an EB intervention that improves pediatric oncology outcomes in low-resource hospitals by detecting clinical deterioration and preventing the need for more intense treatment. METHODS We will conduct a prospective, longitudinal study of approximately 100 resource-variable hospitals implementing and sustaining PEWS participating in Proyecto EVAT, a quality improvement collaborative of Latin American pediatric oncology centers. Aim 1: We will evaluate how clinical capacity for sustainability changes over time through 5 to 9 prospective measurements of capacity via survey of clinical staff using PEWS (approximately n = 13 per center) during the phases of PEWS adoption, implementation, and sustainability using the Clinical Sustainability Assessment Tool (CSAT). Aim 2: We will determine the relationship between capacity and a) PEWS sustainment and b) clinical deterioration mortality among pediatric oncology patients at centers sustaining PEWS for 2 to 10 years using chart review and an existing patient outcomes registry. Aim 3: We will develop novel strategies to promote sustainability by gaining a deeper understanding of perceived challenges to building capacity and PEWS sustainment. In combination with quantitative outcomes, we will conduct 24 focus groups with staff (doctors, nurses, and administrators) from hospitals with both high (n = 4) and low capacity (n = 4). We will then use implementation mapping to generate theoretically driven, empirically-supported sustainability strategies. DISCUSSION This study will advance implementation science by providing a theoretically driven, foundational understanding of factors that predict sustainability among a large, diverse cohort of hospitals. We will then use this knowledge to develop sustainability evidence-informed strategies that optimize capacity and promote long-term sustainment of PEWS and improvements in patient outcomes, thus promoting equity in childhood cancer care globally.
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Affiliation(s)
- Virginia McKay
- Brown School, Washington University in St. Louis, St. Louis, MO, USA.
| | - Bobbi Carothers
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Dylan Graetz
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sara Malone
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
- Division of Population Health Science, Washington University in St. Louis School of Medicine, St Louis, MO, United States
| | - Maria Puerto-Torres
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kim Prewitt
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Adolfo Cardenas
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Yichen Chen
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Douglas A Luke
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Asya Agulnik
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
- Division of Critical Care, St. Jude Children's Research Hospital, Memphis, TN, USA
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Briley AL, Silverio SA, Shennan AH, Tydeman G. Experiences of Impacted Foetal Head: Findings from a Pragmatic Focus Group Study of Mothers and Midwives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7009. [PMID: 37947566 PMCID: PMC10647298 DOI: 10.3390/ijerph20217009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/29/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION We aimed to explore the lived experiences of caesarean birth complicated by impaction of the foetal head, for mothers and midwives. METHODS A pragmatic, qualitative, focus group study of mixed-participants was conducted, face-to-face. They were postpartum women (n = 4), midwives (n = 4), and a postpartum midwife (n = 1) who had experience of either providing care for impacted foetal head, and/or had experienced it during their own labour, in Fife, United Kingdom. Data were transcribed and were analysed using template analysis. RESULTS Three main themes emerged through analysis: (i) current knowledge of impacted foetal head; (ii) current management of impacted foetal head; and (iii) experiences and outcomes of impacted foetal head. Each theme was made up of various initial codes when data were analysed inductively. Finally, each theme could be overlaid onto the three core principles of the Tydeman Tube: (1) to improve outcomes for mother and baby in the second stage of labour; (2) to reduce the risk of trauma to mother and baby in complicated births; and (3) to increase respectful care for women in labour; thus allowing for a neat analytic template. CONCLUSION A lack of consensus regarding definition, management, and training were highlighted by the midwives. Women anticipated caesarean birth in late labour as straightforward and were therefore unaware of this potential complication. Women and midwives would welcome any new device to facilitate delivery of the impacted foetal head (IFH) as long as it is fully evaluated prior to widespread introduction. Women were not averse to being part of this evaluation process.
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Affiliation(s)
- Annette L. Briley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia;
| | - Sergio A. Silverio
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London SE1 1UL, UK;
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Andrew H. Shennan
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London SE1 1UL, UK;
| | - Graham Tydeman
- Maternity Services, Victoria Hospital, NHS Fife, Kirkcaldy KY2 5AH, UK;
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Petry H, Ernst J, Naef R. Participatory development and implementation of a dementia care pathway with intervention bundles in acute care during the coronavirus pandemic: A process evaluation study. J Clin Nurs 2023; 32:7193-7208. [PMID: 37317613 DOI: 10.1111/jocn.16799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/13/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Abstract
AIMS To explore the implementation of a dementia care pathway in an acute care setting. BACKGROUND Dementia care in acute settings is often constrained by contextual factors. We developed an evidence-based care pathway with intervention bundles, and implemented it on two trauma units, with the aim to empower staff and improve quality care. DESIGN Process evaluation using quantitative and qualitative methods. METHODS Pre-implementation, unit staff completed a survey (n = 72) assessing family and dementia care skills and level of evidence-based dementia care. Post-implementation, champions (n = 7) completed the same survey, with additional questions on acceptability, appropriateness and feasibility, and participated in a focus group interview. Data were analysed using descriptive statistics and content analysis guided by the Consolidated Framework for Implementation Research (CFIR). REPORTING GUIDELINE Standards for Reporting Qualitative Research Checklist. RESULTS Pre-implementation, staff's perceived skills in family and dementia care were moderate overall, with high skills in 'building relationships' and 'sustaining personhood'. Evidence-based interventions were delivered seldom to frequent, with 'individualized care' scoring lowest and 'assessing cognition' scoring highest. Implementation of the care pathway/intervention bundles was overshadowed by the pandemic, and failed due to major organisational- and process-related barriers. Acceptability scored highest and feasibility lowest, with concerns relating to complexity and compatibility of pathways/bundles when introduced into clinical routines. CONCLUSIONS Our study implies that organisational and process factors are the most influential determinants to the implementation of dementia care in acute settings. Future implementation efforts should draw on the evolving evidence within implementation science and dementia care research to ensure effective integration and improvement process. RELEVANCE TO CLINICAL PRACTICE Our study provides important learning around improving care for persons with dementia and their families in hospitals. PATIENT OR PUBLIC CONTRIBUTION A family caregiver was involved in the development of the education and training programme.
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Affiliation(s)
- Heidi Petry
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Jutta Ernst
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Rahel Naef
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
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Chen L, Yang H, Cui S, Ye D. Impact of Target Management Card on Patient Safety in the Emergency Department: A Mixed Methods Study. Risk Manag Healthc Policy 2023; 16:1905-1914. [PMID: 37746044 PMCID: PMC10516123 DOI: 10.2147/rmhp.s427988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023] Open
Abstract
Purpose This study aimed to investigate the potential impact of the Target Management Card on patient safety in the emergency department. Patients and Methods A mixed method design was developed, combining a one-group pretest-posttest design with a qualitative study. Target Management Cards were formulated for 32 emergency nurse practitioners and focus group interviews were conducted after the intervention. Wilcoxon's signed rank test was used to compare pre-test and post-test scores. The interview data were subject to content analysis. Results After developing the Target Management Card, there were significant improvements in safety behaviors (Z = 4.709, p < 0.01) and perception of patient safety (Z = 4.257, p < 0.01) among emergency nurse practitioners. The nurses in the focus group interviews agreed that the Target Management Card could improve patient safety by warning and supervising nursing work in the emergency department, promoting a positive change in nurses' attitudes and behaviors toward patient safety. Conclusion Our study found that nurses and nursing managers jointly formulating Target Management Cards in emergency departments significantly enhances patient safety.
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Affiliation(s)
- Lixia Chen
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Heng Yang
- Department of Emergency, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Shaomei Cui
- Department of Emergency, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
| | - Danjuan Ye
- Department of Emergency, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, People’s Republic of China
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Dowling T, Kennedy S, Foran S. Who Bears Responsibility for the Post-Acute Older Adult: Patient, Family or State? Br J Community Nurs 2023; 28:376-383. [PMID: 37527224 DOI: 10.12968/bjcn.2023.28.8.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
AIM This study explores the perceptions of hospital discharge coordinators on the issues raised for the post-acute older adult and their family, using the lens of assisted decision-making and advance directives. BACKGROUND New legislation has been developed in Ireland to support assisted decision-making and advance directives that is largely consistent with other countries around the world. The Assisted Decision-Making Act of 2015 was fully commeced in April 2023, following lengthy debate. However, there is a lot of professional uncertainty regarding how to support and integrate Advance Healthcare Directives and assisted decision-making into the care of adults and into the role of nurses working in the community. METHODS Utilising a qualitative approach, this study conducted a series of five focus groups, with 23 participants, across the South-East of Ireland. Thematic analysis was used to interpret results. The 32-item consolidated criteria for reporting qualitative research checklist was utilised. FINDINGS The central finding in this study concerned the locus of control, as well as findings on burden of care and the role of the nurse. A stark incongruence of beliefs among patient, family and State was identified. CONCLUSION Nurses must learn to circumnavigate the complex terrain involved in supporting the older adult's advance decision-making and advance healthcare directives.
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Affiliation(s)
- Teresa Dowling
- Postgraduate Researcher, Department of Nursing and Healthcare, South East Technological University, Ireland
| | - Sara Kennedy
- Head of Department, Department of Nursing and Healthcare, South East Technological University, Ireland
| | - Sinéad Foran
- Lecturer, Department of Nursing, Dublin City University, Ireland
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Yiu HC, Zang AY, Chau JPC. Understanding the experience of family caregivers of people with dementia in a culturally tailored support group programme: A qualitative study. Geriatr Nurs 2023; 52:133-141. [PMID: 37301077 DOI: 10.1016/j.gerinurse.2023.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
Studies on support group interventions for family caregivers of people with dementia have not explicitly reported on the incorporation of cultural elements. This study evaluates the impact of a culturally tailored intervention (a six-session programme called 'Cultivate Yourself: Support for Caregivers of Persons with Dementia') that integrates Chinese philosophies for psychosocial well-being among target caregivers in Hong Kong. Thirty-three family caregivers of people with dementia from two older adult centres in Hong Kong participated in the programme from October 2020 to September 2021. Multiple benefits from the programme, namely improvements in family caregivers' psychosocial well-being, caring process and supporting values, were identified during six focus group interviews with 29 participants who attended at least four of the six sessions. Our findings provide insight into strategies for developing a culturally tailored support group programme for Chinese caregivers.
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Affiliation(s)
- Hing Cheung Yiu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 6/F Esther Lee Building, Shatin, New Territories, Hong Kong.
| | - Amy Yuli Zang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, 8/F Esther Lee Building, Shatin, New Territories, Hong Kong
| | - Janita P C Chau
- The Nethersole School of Nursing, Assistant Dean (Alumni Affairs), Faculty of Medicine, The Chinese University of Hong Kong, 8/F Esther Lee Building, Shatin, New Territories, Hong Kong
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Dymchuk E, Mirhashemi B, Chamberlain S, Beeber A, Hoben M. The impact of COVID-19 on relationships between family/friend caregivers and care staff in continuing care facilities: a qualitative descriptive analysis. BMC Nurs 2023; 22:121. [PMID: 37059999 PMCID: PMC10102683 DOI: 10.1186/s12912-023-01289-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/04/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and related public health measures added a new dynamic to the relationship between caregivers and care staff in congregate care settings. While both caregivers and staff play an important role in resident quality of life and care, it is common for conflict to exist between them. These issues were amplified by pandemic restrictions, impacting not only caregivers and care staff, but also residents. While research has explored the relationship between caregivers and care staff in long-term care and assisted living homes, much of the research has focused on the caregiver perspective. Our objective was to explore the impact of COVID-19-related public health measures on caregiver-staff relationships from the perspective of staff in long-term care and assisted living homes. METHODS We conducted 9 focus groups and 2 semi-structured interviews via videoconference. RESULTS We identified four themes related to caregiver-staff relationships: (1) pressure from caregivers, (2) caregiver-staff conflict, (3) support from caregivers, and (4) staff supporting caregivers. CONCLUSIONS The COVID-19 pandemic disrupted long-standing relationships between caregivers and care staff, negatively impacting care staff, caregivers, and residents. However, staff also reported encouraging examples of successful collaboration and support from caregivers. Learning from these promising practices will be critical to improving preparedness for future public health crises, as well as quality of resident care and life in general.
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Affiliation(s)
- Emily Dymchuk
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Bita Mirhashemi
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Chamberlain
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Anna Beeber
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthias Hoben
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada.
- School of Health Policy and Management, Faculty of Health, York University, Room 301E Stong College 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
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22
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Berg J, Lipponen E, Sailas E, Soininen P, Varpula J, Välimäki M, Lahti M. Nurses' perceptions of nurse-patient communication in seclusion rooms in psychiatric inpatient care: A focus group study. J Psychiatr Ment Health Nurs 2023. [PMID: 36718606 DOI: 10.1111/jpm.12907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 12/16/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Communication between nurses and patients is essential in mental health nursing. In coercive situations (e.g. seclusion), the importance of nurse-patient communication is highlighted. However, research related to nurses' perceptions of nurse-patient communication during seclusion is scant. AIM The aim of this study was to describe nurses' perceptions of nurse-patient communication during patient seclusion and the ways nurse-patient communication can be improved. METHOD A qualitative study design using focus group interviews was adopted. Thirty-two nurses working in psychiatric wards were recruited to participate. The data were analysed using inductive qualitative content analysis. RESULTS Nurses aimed to communicate in a patient-centred way in seclusion events, and various issues affected the quality of communication. Nurses recognized several ways to improve communication during seclusion. DISCUSSION Treating patients in seclusion rooms presents highly demanding care situations for nurses. Seclusion events require nurses to have good communication skills to provide ethically sound care. CONCLUSION Improved nurse-patient communication may contribute to shorter seclusion times and a higher quality of care. Improving nurses' communication skills may help support the dignity of the secluded patients. Safewards practices, such as respectful communication and recognizing the effect of non-verbal behaviour, could be considered when developing nurse-patient communication in seclusion events. RELEVANCE STATEMENT This study deepens the understanding of nurse-patient communication during seclusion events from the perspective of nurses. Caring for patients in seclusion presents challenging situations for nurses and demands that they have good communication skills. To enhance their communication skills in seclusion events, nurses require opportunities to take part in further training after education related to communication skills for demanding care situations. Knowing the appropriate ways to interact with individual patients during seclusion can help nurses create and maintain communication with patients. For mental health nursing, nurses' enhanced communication may promote increased use of noncoercive practices in psychiatric settings. For patients, improving nurses' communication skills may help support dignity and autonomy during seclusion and shorten the time spent in seclusion, resulting in a better quality of care and more positive patient experiences related to care offered in seclusion. In this, the perspectives of people with lived experience of mental health problems should be acknowledged. Components of Safewards practices, such as using respectful and individual communication and paying attention to one's non-verbal communication (Soft Words), could be useful when developing nurse-patient communication in seclusion events.
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Affiliation(s)
- Johanna Berg
- Turku University of Applied Sciences, Turku, Finland
| | | | - Eila Sailas
- Helsinki University Hospital, Kellokoski Hospital, Kellokoski, Finland
| | - Päivi Soininen
- Helsinki University Hospital, Kellokoski Hospital, Kellokoski, Finland.,Department of Nursing Science, University of Turku, Turku, Finland
| | - Jaakko Varpula
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,Xiangya Nursing School, Central South University, Changsha, China
| | - Mari Lahti
- Turku University of Applied Sciences, Turku, Finland.,Department of Nursing Science, University of Turku, Turku, Finland
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Davis SD, Bayes S, Geraghty S. Development of a tool to identify barriers and enablers to practice innovation in midwifery: A participatory action research study. Eur J Midwifery 2023; 7:1. [PMID: 36761447 PMCID: PMC9885374 DOI: 10.18332/ejm/157459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 03/18/2022] [Accepted: 12/14/2022] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Transferring research evidence into midwifery practice is fraught with challenges and obstacles. Implementation tools can streamline the process and are most effective when they are discipline-specific; however, there are currently no midwifery specific implementation tools. The aim of this study was to develop a midwifery specific tool to identify barriers and enablers to evidence-informed practice change within the clinical setting. METHODS Participatory action research methodology was employed to ensure potential end-users contributed to content and format of the tool. Purposeful sampling ensured participants were selected from a range of midwifery practice settings in Western Australia and the United Kingdom. Data were collected through stakeholder advisory groups (SAGs) and online surveys. RESULTS Ten midwives participated in this project. Consultation occurred through face-to-face SAG meetings and online surveys until consensus was reached among participants about the content, format, and functionality of the end product which we called the 'Midwifery Tool for Change' (MT4C). CONCLUSIONS To our knowledge, the MT4C is the first readiness for change context assessment tool specific to midwifery practice settings. Evaluation of the MT4C in real-world practice change implementation initiatives will enable further refinement of the tool.
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Affiliation(s)
- Sara D. Davis
- School of Nursing and Midwifery, Edith Cowan University, Perth, Australia
| | - Sara Bayes
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Australia
| | - Sadie Geraghty
- School of Nursing, Midwifery, Health Sciences and Physiotherapy, University of Notre Dame Australia, Fremantle, Australia
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Stirling FJ, Monteux S, Stoll M. Receiving thank you letters in inpatient child and adolescent mental health services (CAMHS): A qualitative study of nurse's experiences. J Psychiatr Ment Health Nurs 2023. [PMID: 36650671 DOI: 10.1111/jpm.12899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 12/20/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Previous research has found that nurses in inpatient CAMHS can struggle to define their role and contribution to patient care. While gratitude has received increased attention in relation to subjective well-being in healthcare settings, the receipt of gratitude in the form of thank you letters is currently unexplored in the CAMHS context. AIM/QUESTION To gain an understanding of how inpatient CAMHS nursing staff experience receiving expressions of gratitude from patients. METHOD Adopting an exploratory qualitative approach, two focus group interviews were conducted. Participants completed a brief online follow-up questionnaire. Data were examined using thematic analysis. RESULTS Reflecting on expressions of gratitude improved understanding of professional identity, enhanced reflexivity, enhanced team cohesion and increased professional and personal confidence and motivation. DISCUSSION Expressions of gratitude appear to offer meaningful sources of feedback for nurses and support a greater sense of personal accomplishment, professional role and the relational impact of care for patients. When nurses share and discuss expressions of gratitude with colleagues this brings benefits additional to the initial receipt. IMPLICATIONS FOR MENTAL HEALTH NURSING Nurses should be supported to engage in discussing and reflecting upon receiving thank you letters and other tokens of gratitude although care should be taken to support those who might experience unease or increased self-doubt.
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Waldby C, Noble‐Carr D, Carroll K. Mothers, milk and mourning: The meanings of breast milk after loss of an infant. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:109-127. [PMID: 36193004 PMCID: PMC10092727 DOI: 10.1111/1467-9566.13551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 08/15/2022] [Indexed: 06/16/2023]
Abstract
Breast milk is a highly valued substance, immunologically and nutritionally, which also signifies maternal care and love for the infant. This intersection of biological and cultural qualities confers breast milk with complex meanings, which necessarily shape the experience of breastfeeding. Our research, investigating the experience of lactation after the loss of an infant, casts a novel light on these meanings. This article analyses the experience of 17 Australian bereaved mothers and 114 health professionals charged with their care. We find that while all the mothers found post-loss lactation emotionally painful, many also found redemptive meaning in their milk-production, as a bond with the lost child, as confirmation of their maternal competence and as a life giving substance that they could donate to other needy infants. These complex meanings and positive connotations were at odds with hospital cultures that regard post-loss lactation as valueless and best dealt with through medical suppression, despite the more complex insights of individual health-care professions.
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Affiliation(s)
- Catherine Waldby
- Research School of Social SciencesCollege of Arts & Social SciencesThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Debbie Noble‐Carr
- Research School of Social SciencesCollege of Arts & Social SciencesThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Katherine Carroll
- Research School of Social SciencesCollege of Arts & Social SciencesThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
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O'Neill J, Devsam B, Kinney S, Hawley M, Richards S, Newall F. Exploring the impact of the COVID-19 environment on nursing delivery of family-centred care in a paediatric hospital. J Adv Nurs 2023; 79:320-331. [PMID: 36253941 PMCID: PMC9874628 DOI: 10.1111/jan.15469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/05/2022] [Accepted: 10/03/2022] [Indexed: 01/27/2023]
Abstract
AIMS AND OBJECTIVES To understand how the pandemic environment impacted the delivery of FCC of children and families from a nursing perspective in a major tertiary paediatric hospital. BACKGROUND Family-centred care (FCC) is a well-established framework to promote parental involvement in every aspect of a child's hospitalization, however, rules and restrictions in place during the COVID-19 pandemic affected the ways in which Family-centred Care could be delivered in practice. DESIGN This is a qualitative exploratory descriptive study to elicit the perspective of paediatric nurses delivering care to children in a hospital during the COVID-19 pandemic in Victoria, Australia. METHODS Nurses from all subspecialties in a tertiary paediatric hospital were invited to participate in virtual focus groups to discuss their experience of delivering FCC during the COVID-19 pandemic. Focus groups were recorded and transcribed, then analysed using Framework Analysis. RESULTS Nineteen nurses participated across seven focus groups during June and July 2020. The four themes-Advocating with empathy, Enabling communication, Responding with flexibility, and Balancing competing considerations-and the eight subthemes that were generated, outline how nurses deliver FCC, and how these FCC actions were impacted by the COVID-19 environment and the related hospital restrictions. CONCLUSION This study documents the experiences, resilience and resourcefulness of paediatric nurses in Australia during the COVID-19 pandemic as well as moving Family-centred Care from a theoretical framework into a practical reality. IMPACT The findings from this study should inform consideration of the impacts of public health policies during infectious disease outbreaks moving forward. In addition by describing the core actions of Family-centred Care, this study has implications for educational interventions on how to translate FCC theory into practice. No public or patient contribution as this study explored nursing perceptions only.
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Affiliation(s)
- Jenny O'Neill
- Department of Nursing ResearchThe Royal Children's HospitalMelbourneVictoriaAustralia,Department of Nursing, Melbourne School of Health SciencesThe University of MelbourneMelbourneVictoriaAustralia
| | - Bianca Devsam
- Department of Nursing ResearchThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Sharon Kinney
- Department of Nursing ResearchThe Royal Children's HospitalMelbourneVictoriaAustralia,Department of Nursing, Melbourne School of Health SciencesThe University of MelbourneMelbourneVictoriaAustralia
| | - Meaghan Hawley
- Department of Nursing ResearchThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Stacey Richards
- Department of Nursing ResearchThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Fiona Newall
- Department of Nursing ResearchThe Royal Children's HospitalMelbourneVictoriaAustralia,Department of Nursing, Melbourne School of Health SciencesThe University of MelbourneMelbourneVictoriaAustralia,Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia
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Slusser K, Knobf MT, Linsky S, Kaisen A, Parkosewich J, Sterne P, Johnson C, Carley J, Beckman B. A Focus Group Study of Retirement-Age Nurses: Balancing Tension and a Love of Nursing in a Changing Healthcare Environment. J Nurs Adm 2022; 52:646-652. [PMID: 36409257 DOI: 10.1097/nna.0000000000001226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aims of this study were to explore the experience of retirement-age nurses and identify decision-making factors and innovations to enhance retention. BACKGROUND A national shortage of nurses has created challenges to preserving quality patient care and level of nursing competency and managing turnover costs. METHODS A qualitative study using focus groups was conducted of nurses 55 years or older who were working or recently retired. Data were audiotaped and transcribed verbatim, with content analysis used to code in an iterative process until consensus was reached. RESULTS The tension of balancing the love of patient care within a changing healthcare system was described. Patient acuity, competing roles, and the centrality of computers were stressors and integrally related. Flexibility in work schedules and new practice models were important to retirement decision making for work-life balance and retention. CONCLUSION Passion for patient care dominated decisions to continue working. Innovations in practice models and scheduling offer opportunities to enhance the retention of experienced nurses.
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Affiliation(s)
- Kim Slusser
- Author Affiliations: Vice President, Patient Care Services (Ms Slusser) and Senior Administrative Assistant (Ms Carley), Smilow Cancer, Yale New Haven Hospital; Professor (Dr Knobf) and Research Associate II (Ms Linsky), Yale University School of Nursing, New Haven; Senior Manager, Corporate Supply Chain (Ms Kaisen), Nurse Researcher (Dr Parkosewich), and Patient Services Manager (Ms Johnson), Yale New Haven Hospital; Director, Nursing Operations and Magnet (Dr Sterne), Greenwich Hospital; and Chief Nurse Executive (Dr Beckman), Yale New Haven Health System, New Haven, Connecticut
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Ojifinni OO, Ibisomi L. Perception of men's need for preconception care-A qualitative exploration among health care providers and community members. Front Public Health 2022; 10:958618. [PMID: 36523582 PMCID: PMC9745313 DOI: 10.3389/fpubh.2022.958618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background Several studies have shown that suboptimal health in men can result in poor reproductive health outcomes. The factors associated include lifestyle exposures and poor health-seeking behavior. The poor reproductive health outcomes can be mitigated through preconception care (PCC). PCC services for men are however rare. This qualitative study explored views about men's need for PCC in Nigeria. Methods This exploratory qualitative study was done in Ibadan North Local Government Area, Oyo State, Nigeria. Focus group discussions were held with 12 religious leaders, 22 men and 23 women of reproductive age at the community level. There were key informant interviews with two community leaders and 26 health workers including specialist physicians and nurses at the primary, secondary, and tertiary health care levels. Transcribed data were analyzed thematically using inductive coding on MAXQDA. Results The reasons participants proffered for men's health requiring attention included men's genetic contribution to pregnancy, treatment of low sperm count, and preventing transmission of infection to their partners. Participants stated however that men are often reluctant about accessing health services until complications arise. Opinions differed on men's need for PCC: while some believed that men need PCC, others expressed contrary views stating that men do not require PCC as the service is more appropriate for women. Conclusion Successful deployment and uptake of PCC services require the availability of the services and improved awareness about the need to optimize men's health along with that of their partners.
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Affiliation(s)
- Oludoyinmola O. Ojifinni
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Latifat Ibisomi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Monitoring and Evaluation Department, Nigerian Institute of Medical Research, Lagos, Nigeria
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Clinical Perspectives on the Development of a Gamified Heart Failure Patient Education Web Site. COMPUTERS, INFORMATICS, NURSING : CIN 2022:00024665-990000000-00075. [PMID: 36730077 DOI: 10.1097/cin.0000000000000983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Heart failure is a complex, chronic disease that requires self-care to manage, and patients need support and education to perform adequate self-care. Although electronic health interventions to support behavior change and self-care in cardiovascular disease are gaining traction, there is little engaging online education specifically designed for heart failure patients. This paper describes the design and development of a heart failure self-care patient education Web site that integrated gamification, meaning the use of game design elements in a non-game context. We sought feedback on the Web site from a group of heart failure clinicians in a focus group using a semi-structured interview guide, and data were analyzed thematically. Clinician input during the design phase touched on themes such as patients' decision-making in heart failure and older adults' adoption of technology. Clinicians recommended that a narrative gamification technique should reflect real-life dilemmas patients encounter in their self-care. Clinicians also discussed the need to carefully plan reward-based gamification techniques to avoid unintended effects. Overall, a gamified Web site has the potential to support heart failure self-care, but efforts are needed to address the disparity of those with limited computer literacy or access.
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Schoenmaekers JJO, Bruinsma J, Wolfs C, Barberio L, Brouns A, Dingemans AMC, Hendriks LE. Screening for Brain Metastases in Patients With NSCLC: A Qualitative Study on the Psychologic Impact of Being Diagnosed With Asymptomatic Brain Metastases. JTO Clin Res Rep 2022; 3:100401. [PMID: 36188631 PMCID: PMC9516448 DOI: 10.1016/j.jtocrr.2022.100401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/02/2022] [Accepted: 08/15/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction The brain is a frequent site of metastases in NSCLC, and screening for asymptomatic brain metastases (BM) is increasingly advised in NSCLC guidelines. An asymptomatic BM diagnosis may trigger anxiety for future neurologic problems and can negatively affect quality of life of patients and their relatives. Therefore, we performed this qualitative study. Methods Three focus group discussions were organized with patients with NSCLC and asymptomatic BM (N = 3–4 per group) and separately with their relatives, to explore this psychosocial impact. Two researchers independently performed an inductive content analysis. Results A total of 10 patients and 10 relatives participated in six focus groups. A diagnosis of BM caused feelings of distress and anxiety in both patients and relatives. These feelings diminished over time in case of a tumor responding to systemic therapy. The diagnosis of BM was not perceived as more distressful than other metastases, and scan-related anxiety was not experienced. Although magnetic resonance imaging screening and follow-up were thought of as burdensome, follow-up was valued. The coping strategies of both groups seemed related to personality and to the efficacy of the given systemic therapy. Relatives appreciated peer support of other relatives during the focus groups, and they seemed open for future psychological support. Conclusions Asymptomatic BM diagnosis can cause anxiety and distress, but this diminishes over time with effective systemic treatment. Although patients perceive magnetic resonance imaging as burdensome, they value follow-up screening and imaging. Relatives highly appreciated peer support, and psychological distress of relatives should not be overlooked.
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Mayer KA, Linehan KJ, MacMillan NK. Student perspectives on potential sources of trauma exposure during nursing school. Nurs Forum 2022; 57:833-842. [PMID: 35485449 DOI: 10.1111/nuf.12728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 03/01/2022] [Accepted: 04/03/2022] [Indexed: 06/14/2023]
Abstract
Adverse effects of events experienced by nursing students as harmful during nursing school have included moral distress, prolonged grief reactions, secondary traumatic stress, and anxiety and depression during nursing school. Nursing student perceptions of potential sources of trauma exposure also known as potentially traumatic events (PTEs) during nursing school are lacking in the literature. The purpose of this study was to describe nursing students' perceptions of potential sources of trauma exposure during nursing school at one private school of nursing. Four online, synchronous focus groups with undergraduate nursing students were conducted in April 2020. Four themes emerged from analysis of focus group transcripts related to potential sources of trauma exposure: Individual-oriented interpersonal sources, nursing student-oriented interpersonal sources, nursing student-oriented institutional and organizational sources, and individual-oriented community sources. Participants focused on nursing student-oriented, interpersonal, and institutional and organizational potential sources of trauma exposure, while minimizing individual-oriented, community, and macro-level potential sources of student trauma exposure during nursing school. Findings advance discussions of organizational, systems, and community PTEs in nursing education. Trauma-informed educational and healthcare systems that promote the academic and career success of nursing students should be considered in PTE prevention efforts.
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Affiliation(s)
- Kala A Mayer
- School of Nursing, University of Portland, Portland, OR, USA
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Naidoo V, Stewart AV, Maleka ME. A tool to evaluate physiotherapy clinical education in South Africa. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022; 78:1759. [PMID: 36092966 PMCID: PMC9453145 DOI: 10.4102/sajp.v78i1.1759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/10/2022] [Indexed: 11/08/2022] Open
Abstract
Background Physiotherapy clinical education is complex. The dynamic learning milieu is fluid and multidimensional, which contributes to the complexity of the clinical learning experience. Consequently, there are numerous factors which impact the clinical learning experience which cannot be measured objectively - a gap which led to the development of our study. Objectives To develop, validate, and test the reliability of an assessment tool that evaluates the effectiveness and quality of physiotherapy clinical education programmes. Method A mixed methods approach in three phases included physiotherapy academics, clinical educators, and clinicians throughout South Africa. Phase One was a qualitative study: focus group discussions determined items and domains of the tool. Phase Two established the content and construct validity of the tool, a scoring system and a name for the tool, using the Delphi method. In Phase Three, factor analysis reduced the number of items, and the feasibility and utility of the tool was determined cross-sectionally. Results The Vaneshveri Naidoo Clinical Programme Evaluation Tool (VN-CPET) of 58 items and six domains was developed and found to be valid, reliable (α = 0.75) and useful. The six domains of VN-CPET include governance; academic processes; learning exposure; clinical orientation; clinical supervision and quality assurance and monitoring and evaluation. Conclusion The Vaneshveri Naidoo Clinical Programme Evaluation Tool is a valid, reliable and standardised tool, that evaluates the quality and effectiveness of physiotherapy clinical education programmes. Clinical implications This tool can objectively evaluate the quality and effectiveness of physiotherapy clinical education programmes in South Africa, and other health science education programmes, both locally and globally, with minor modification.
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Affiliation(s)
- Vaneshveri Naidoo
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Aimée V. Stewart
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Morake E.D. Maleka
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Rowland M, Adefuye AO. An Evaluation of Pre-Hospital Emergency Care Personnel Knowledge About Crisis Resource Management and Perspectives of Educators About Inclusion of Crisis Resource Management in the Pre-Hospital Emergency Care Curriculum. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:849-864. [PMID: 35982855 PMCID: PMC9379110 DOI: 10.2147/amep.s365436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To evaluate the knowledge of pre-hospital emergency care personnel (PECP) in South Africa on the principles, practice of crisis resource management (CRM), and obtain emergency medical care (EMC) educators' views on the teaching and learning of CRM skills in the pre-hospital EMC curriculum. METHODS This research was designed as an exploratory study that used a semi-structured questionnaire administered to 2000 PECP and focus group discussion (FGD) with 19 emergency care educators. Chi-squared test and Cramér's V were used to examine the existence and the strength of an association between cross-tabulated variables. Responses to open-ended questions, as well as the data generated by the FGD, were analysed qualitatively using iterative inductive coding to identify themes. RESULTS A response rate of 76% was obtained for the survey. Findings are that the majority (64.5%) of the PECP were not familiar with CRM, though familiarity varied significantly across cadres of PECP (p <0.001). EMC educators reported that the concept of CRM must be thoroughly researched and developed in the emergency medical service (EMS) context before it is included in the EMC curriculum. The educators reported that early introduction of CRM in the EMC curriculum will have a positive effect on students' professional development. Difficulties with assessment, knowing what to teach, and lack of universally accepted guidelines or teaching modalities are some of the challenges identified by EMC educators in relation to teaching CRM in the EMC curriculum. CONCLUSION The findings of this study provide new insights into PECP's knowledge and EMC educators' views on the teaching and learning of CRM in the EMC curriculum. This study highlights that more research is needed to develop an EMS CRM curriculum. Investigation into the development of a teaching and learning framework for CRM in EMC education could be the focus of future studies.
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Affiliation(s)
- Mugsien Rowland
- Department of Emergency Medical Care, Boitekanelo College, Gaborone, Botswana
| | - Anthonio Oladele Adefuye
- Division of Health Sciences Education, Faculty of Health Sciences, University of the Free State, Bloemfontein, Free State, 9301, South Africa
- Western Atlantic University School of Medicine, Freeport, Bahamas
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Santos MJDO, Ferreira MMDC, Ferreira EMS. Sexual and reproductive health risk behaviours: higher education students' perceptions. Rev Bras Enferm 2022; 75:e20210712. [PMID: 35920496 DOI: 10.1590/0034-7167-2021-0712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/14/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to understand higher education students' perceptions of sexual and reproductive health risk behaviours. METHODS a descriptive study following a qualitative approach was conducted, using Pender's Health Promotion Model as a theoretical and methodological framework. A thematic analysis of the data obtained from different focus groups was performed. RESULTS participants consider that factors such as communication with their sexual partner, the ability to negotiate and a positive attitude regarding condoms are positive aspects that will encourage consistent use of condom. The embarrassment felt at the time of purchase, the reduction of sexual pleasure and the growing stability of the relationship are usually seen as barriers. FINAL CONSIDERATIONS the study was crucial to identify some strategies that will be considered in further health promotion programmes, namely peer education, and will help promote personal and social skills and the (re)organisation of healthcare services.
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Brenner G, Lobnig H. Das Krankenhaus als lernende Organisation während der Pandemie: Herausforderungen und Learnings. GIO-GRUPPE-INTERAKTION-ORGANISATION-ZEITSCHRIFT FUER ANGEWANDTE ORGANISATIONSPSYCHOLOGIE 2022. [PMCID: PMC9274637 DOI: 10.1007/s11612-022-00640-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Dieser Beitrag für die Zeitschrift Gruppe. Interaktion. Organisation fokussiert die außerordentlich hohen organisationalen Anforderungen an ein Universitätsspital im Umgang mit der Pandemie: Die medizinisch-pflegerische Versorgungsleistung für die Bevölkerung sowie die Verantwortung als Arbeitgeber für den Schutz der Mitarbeitenden erfordern, dass ein Spital in Krisenzeiten als lernende Organisation mit hoher organisationaler Resilienz agieren kann. Die Berufsgruppe der Pflege nimmt unter Pandemiebedingungen eine Schlüsselrolle in der gesamten Spitalorganisation ein. Dadurch ist es von tragender Bedeutung, organisationales Lernen und organisationale Resilienz insbesondere in der Pflege sichtbar und nachhaltig zu leben. Kliniken/Spitäler haben einen wertvollen Vorteil gegenüber anderen Organisationen: Sie sind vertraut mit Handeln und Entscheiden in außerordentlichen Lagen. Im klinischen Kontext spielen Konzepte wie Organizational Preparedness bzw. Disaster Preparedness seit jeher eine Rolle. Vor diesem Hintergrund zeigt der Beitrag auf, wie pandemiebezogene Erfahrungen im Kontext der universitären Pflege als Katalysatoren organisationaler Entwicklung wirken können: Agilere Arbeitsformen, flachere Hierarchien, intensivere Kommunikation und verstärkte interprofessionelle Zusammenarbeit werden möglich. Am Beispiel eines Schweizer Universitätsspitals fokussiert der Artikel fünf zentrale Herausforderungen und damit verbundene Learnings: (1) „Organisation und Zusammenarbeit spitalweit agiler ausrichten“, (2) „Pflege unter Krisenbedingungen proaktiv gestalten“, (3) „durch Kommunikation und Partizipation Zusammenhalt ermöglichen“, (4) „als Führungspersonen Sicherheit inmitten der Ungewissheit gewährleisten“ und (5) „eine resiliente bzw. sorgende Organisation (caring organization) nachhaltig fördern”.
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Affiliation(s)
- Gabi Brenner
- Direktion Pflege und MTTB, Universitätsspital Zürich, Rämistrasse 100, 8091 Zürich, Schweiz
| | - Hubert Lobnig
- Bertha von Suttner Privatuniversität, St. Pölten, Österreich
- Lemon Consulting, Wien, Österreich
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Pehlivan T, Güner P. Oncology-Hematology Nurses' Perspectives on the Compassion Fatigue Resiliency Program: A Qualitative Study. J Contin Educ Nurs 2022; 53:329-336. [PMID: 35858150 DOI: 10.3928/00220124-20220603-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Oncology-hematology nurses are at increased risk for compassion fatigue. It remains unclear whether the Compassion Fatigue Resiliency program is effective, and qualitative evidence from participant feedback is limited. This was a follow-up study to a quantitative study of the Compassion Fatigue Resiliency program. The aims of this study were to evaluate how the content of the program affects nurses' compassion fatigue and coping abilities and to obtain their views. Method This qualitative study was performed with 24 oncology-hematology nurses at two hospitals. Three focus groups were conducted using a semi-structured questionnaire. The data were analyzed using conventional content analysis. Results Four themes emerged: awareness; coping; not for others, for me; and training design. Nurses stated they had only just learned what compassion fatigue and its impact were and had gained more awareness. Conclusion The content of the Compassion Fatigue Resiliency program helped nurses learn effective coping skills; however, the program's design is important to its effectiveness. [J Contin Educ Nurs. 2022;53(7):329-336.].
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Shih YS, Lee TT, Mills ME. Critical Care Nurses' Perceptions of Clinical Alarm Management on Nursing Practice. Comput Inform Nurs 2022; 40:389-395. [PMID: 35234706 DOI: 10.1097/cin.0000000000000886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The alarm management of physiological monitoring systems is a key responsibility of critical care nurses. However, the high numbers of false and nonactionable (true but clinically irrelevant) alarms cause distractions to healthcare professionals, interruptions to nursing workflow, and ignoring of crucial tasks. Therefore, understanding how nurses manage large amounts of alarms in their daily work could provide a direction to design interventions to prevent adverse patient care effects. A qualitative design with focus group interviews was conducted with 37 nurses in Taiwan. Content analysis was performed to analyze the interview data, and four main themes were derived: (1) the foundation stone of critical care nursing practice; (2) a trajectory adaptation of alarms management; (3) adverse impacts on the quality of care and patient safety; and (4) a hope for multimodal learning alternatives and wireless technology. Nurses manage alarm parameter settings influenced not only by their knowledge and skills of patient care, but also in accordance with the three dimensions of technology, human, and organization evaluation framework. Customized alarm management training alternatives, patient-centered care values, and application of wireless technology are the suggested approaches to enhance nursing care and minimize the risk of adverse events.
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Affiliation(s)
- Yu-Shan Shih
- Author Affiliations: College of Nursing, National Yang Ming Chiao Tung University (Ms Shih and Dr Lee); Nursing Department, Shin Kong Wu Memorial Hospital (Ms Shih); and School of Nursing, University of Maryland, Baltimore, Maryland, MD (Dr Mills)
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Välimäki M, Lantta T, Lam YTJ, Cheung T, Cheng PYI, Ng T, Ip G, Bressington D. Perceptions of patient aggression in psychiatric hospitals: a qualitative study using focus groups with nurses, patients, and informal caregivers. BMC Psychiatry 2022; 22:344. [PMID: 35585520 PMCID: PMC9118596 DOI: 10.1186/s12888-022-03974-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aggression in psychiatric hospitals has been of interest to researchers. Information on how different stakeholders perceive patient aggression remains equivocal. Even less is known about possible similarities or differences in stakeholders' perceptions of how aggressive behaviour is understood, managed and prevented in psychiatric hospitals. We aimed to explore multiple viewpoints on patient aggression, its possible causes and outcomes, and development ideas for prevention and management. METHODS A qualitative design was adopted. The data were collected using focus group interviews. A thematic approach was used for interpretation. The data were collected on 15 adult wards in two inpatient psychiatric settings in Hong Kong. Participants were nurses working on the psychiatric inpatient wards, patients admitted to the wards, and informal caregivers visiting inpatient wards (N = 94). RESULTS Commonalities between all groups were found on how patient aggression is perceived, and why it occurs. Patients and especially nurses described how patient aggression occurred with no clear reason or forewarning and how patients were physically controlled or restricted after aggressive events. Only nurses and patients expressed experiencing physical burden, while all groups considered psychological burden to be a consequence of aggression. All groups proposed that helpful attitudes among nurses, better communication, structural changes, and better self-management skills would prevent patient aggression. Risk assessment was proposed only by nurses and patients, while safety measures were proposed by nurses and informal caregivers only. The use of restrictive interventions to manage aggressive events was proposed by all groups. CONCLUSIONS Despite the complex diversity of perspectives in different stakeholder groups regarding patient aggression, the findings highlighted that it is possible to achieve some mutual understanding of aggression in psychiatric hospitals and identify areas to be developed. Staffs' attitudes and skills for engagement and communication with patients and informal caregivers should be improved. There is also still room to develop the therapeutic environment and culture toward meaningful activities during the treatment period.
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Affiliation(s)
- Maritta Välimäki
- Xiangya School of Nursing, Xiangya Center for Evidence-Based Practice & Healthcare Innovation, Central South University, 172 Tongzipo Road, Changsha, 410013, Hunan, China. .,Department of Nursing Science, ICT-city, University of Turku, 20014, Turku, Finland.
| | - Tella Lantta
- grid.1374.10000 0001 2097 1371Department of Nursing Science, ICT-city, University of Turku, 20014 Turku, Finland
| | - Yuen Ting Joyce Lam
- grid.16890.360000 0004 1764 6123School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China
| | - Teris Cheung
- grid.16890.360000 0004 1764 6123School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China
| | - Po Yee Ivy Cheng
- grid.417134.40000 0004 1771 4093Community Psychiatric Services, 12/F, Block A, Pamela Youde Nethersole Eastern Hospital, Hospital Authority, Hong Kong (SAR), China
| | - Tony Ng
- grid.417134.40000 0004 1771 4093Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hospital Authority, Hong Kong (SAR), China
| | - Glendy Ip
- grid.415585.80000 0004 0469 9664Central Nursing Division, Kwai Chung Hospital, Hospital Authority, Hong Kong (SAR), China
| | - Daniel Bressington
- grid.1043.60000 0001 2157 559XCollege of Nursing and Midwifery, Charles Darwin University, Ellengowan Drive, Casuarine, Darwin, NT 0909 Australia
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Ventosa-Ruiz A, Moreno-Poyato A, Lluch-Canut T, Vaquerizo-Cubero A, Vidal-Pascual X, Gil-Guiñón F, Puig-Llobet M. Impact of collaborative nursing care on the recovery process of mental health day hospital users: a mixed-methods study protocol. BMJ Open 2022; 12:e057969. [PMID: 35354640 PMCID: PMC8968539 DOI: 10.1136/bmjopen-2021-057969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Very few collaborative nursing care interventions have been studied and shown to be effective in the context of the paradigm shift towards recovery in mental health nursing. Understanding the changes produced in the recovery process of people with mental health problems can contribute to the design and implementation of new methodologies to offer effective and person-centred care. METHODS AND ANALYSIS This is a mixed-methods study, which is structured in three phases. In phase one (baseline) and phase three (follow-up), quantitative data will be collected from patients at a mental health day hospitals based on a two-armed, parallel-design, non-randomised trial. In phase two, two groups will be established: an intervention group in which the intervention based on collaborative nursing care will be carried out through the codesign and implementation of activities through Participatory Action Research, and a control group in which the usual care dynamics will be continued. All the users of three mental health day hospitals who agree to participate in the study will be studied consecutively until the necessary sample size is reached. The outcomes used to evaluate the impact of the intervention will be the stage of the recovery process, the quality of the therapeutic relationship and the patient's level of positive mental health. ETHICS AND DISSEMINATION This study has been approved by the institutional review board of the reference hospital, FIDMAG Hermanas Hospitalarias (PR-2020-10) in July 2020. All participants will be able to voluntarily withdraw from the study at any time. For this reason, users will be given a sheet with all the precise information about the study to be carried out and written consent will be requested. Preliminary and final results will be published in peer-reviewed journals and presented at national and international congresses. TRIAL REGISTRATION NUMBER NCT04814576.
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Affiliation(s)
- Ana Ventosa-Ruiz
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Universitat de Barcelona, Barcelona, Catalunya, Spain
- Benito Menni Complex Assistencial en Salut Mental, Sant Boi de Llobregat, Catalunya, Spain
| | - Antonio Moreno-Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Universitat de Barcelona, Barcelona, Catalunya, Spain
| | - Teresa Lluch-Canut
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Universitat de Barcelona, Barcelona, Catalunya, Spain
| | | | - Xavier Vidal-Pascual
- Benito Menni Complex Assistencial en Salut Mental, Sant Boi de Llobregat, Catalunya, Spain
| | - Ferran Gil-Guiñón
- Benito Menni Complex Assistencial en Salut Mental, Sant Boi de Llobregat, Catalunya, Spain
| | - Montserrat Puig-Llobet
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Universitat de Barcelona, Barcelona, Catalunya, Spain
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Mbous YPV, Mohamed R, Rudisill TM. International students challenges during the COVID-19 pandemic in a university in the United States: A focus group study. CURRENT PSYCHOLOGY 2022; 43:1-13. [PMID: 35136332 PMCID: PMC8814793 DOI: 10.1007/s12144-022-02776-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2022] [Indexed: 12/18/2022]
Abstract
Research suggests that the COVID-19 pandemic has deeply impacted college students. However, very few studies have attended to the specific plight of international students . The purpose of this study was to document challenges international students may have encountered while studying in the United States during the pandemic. Focus groups (N = 4; 13 students total) were conducted with students who were ≥ 18 years of age, enrolled at least part-time, on an F1 visa, and non-resident alien, who did not have parents/guardians living in the United States and were able to read and write in English. Focus groups lasted 1.5-2 h in duration and followed a standardized script. These sessions were audio-recorded and professionally transcribed. Two researchers performed qualitative content analysis. Six themes emerged from the analysis and included residency challenges, lifestyle changes, coping, negative affect, social support, and university structure. It appears that the challenges associated with residency and lifestyle directly impacted students' negative affect. However, the remaining themes moderated this relationship. These findings highlight the role universities can play in providing relief to international students during these challenging times and suggest areas for improving their experiences. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12144-022-02776-x.
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Affiliation(s)
- Yves Paul Vincent Mbous
- School of Pharmacy, Department of Pharmaceutical Systems and Policy, Robert C. Byrd Health Sciences Center, West Virginia University, P.O. Box 9510, Morgantown, WV USA
| | - Rowida Mohamed
- School of Pharmacy, Department of Pharmaceutical Systems and Policy, Robert C. Byrd Health Sciences Center, West Virginia University, P.O. Box 9510, Morgantown, WV USA
| | - Toni Marie Rudisill
- School of Public Health, Department of Epidemiology & Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV 26506-9190 USA
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Hoffmann L, Seegers F, Stephan A. [Conduct and reporting of focus groups in the health and nursing sciences: a scoping review]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 168:65-74. [PMID: 35153161 DOI: 10.1016/j.zefq.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 09/30/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Focus groups are used in qualitative research and increasingly so in the health and nursing sciences. There has been no previous research on how focus groups are used and reported in this context. A scoping review was conducted to address this question. METHODS The databases MEDLINE via PubMed, CINAHL, and SSCI were searched for nursing and health science publications (2009-2019) that reported focus groups as a method. Due to the high number of hits, a one percent random sample was drawn per database. Two individuals checked the inclusion and exclusion criteria. Data extraction was performed using a literature-based matrix developed and discussed with experts. Results were content-analysed and quantified. RESULTS The random sample was n=408 publications, of which n=319 were included after reviewing the inclusion and exclusion criteria. The use of semi-structured interview guides was reported most frequently (43.9 %) (more often referred to as focus group interviews in the publications); open discussions (11 %) and discussions without any guiding questions (6.3 %) were reported less frequently (more often referred to as focus group discussions in the publications). In none of the publications was the aspect of group interaction included into the analysis. Although the reporting is based on international standards, some specific methodological aspects were often inadequately reported or not reported at all: in 92 % of the publications there is no information about the interaction of the participants, and in 72 % the role of the moderating person was not described in detail. DISCUSSION Semi-structured forms of focus groups predominate but open forms with only one introductory question are also used. It would have been expected that the interaction among the participants and group dynamic processes would have been considered in the more open approaches. Method-specific reporting items for focus groups have yet to be developed. This could contribute to an improvement of the reporting and critical reflection of, in particular, method-specific aspects. There is evidence that different nomenclature is used in the international literature, depending on the type of focus group. Researchers should choose the nomenclature carefully and describe the procedure precisely. CONCLUSION The scoping review provides first insights into how focus groups are conducted and reported in health and nursing science research. The potential of the method could be more fully exploited regarding the analysis of group interaction. Future methodological work dealing with the focus group method should promote the establishment of an internationally consented nomenclature and the development of criteria for transparent reporting for different types of focus groups.
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Affiliation(s)
- Lisa Hoffmann
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Halle (Saale), Deutschland
| | - Felix Seegers
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Halle (Saale), Deutschland
| | - Astrid Stephan
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Halle (Saale), Deutschland; Uniklinik RWTH Aachen, Stabsstelle Pflegewissenschaft der Pflegedirektion, Aachen, Deutschland.
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Moen ØL, Jacobsen ICR. School Nurses’ Experiences in Dealing with Adolescents Having Mental Health Problems. SAGE Open Nurs 2022; 8:23779608221124411. [PMID: 36090541 PMCID: PMC9449503 DOI: 10.1177/23779608221124411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction An increased number of adolescents experience mental health problems. School nurses
have described spending more than 50% of their time working with mental health in
students. The lack of knowledge and necessary training to meet students’ mental health
needs has been described previously. School nurses have a responsibility to find and
guide those who need help with mental health problems. Objectives The aim of this study was, therefore, to explore school nurses’ experiences with mental
health and how they in this work identify, talk, and intervene with adolescents having
mental health problems. Methods A qualitative study was conducted with 21 school nurses using focus group interviews
which were analyzed by means of content analysis. Results Three descriptive categories emerged: Health-promoting or preventive approaches,
Enabling students to talk about feelings, and Collaborating partners. Conclusion School nurses highlight their mandate to work with health promotion and prevention but
also draw attention to their difficulties in identifying those who need help. School
nurses use their creativity, intuition, and knowledge but have difficulty identifying
those students who need help with mental health problems. They also highlight
collaboration with other professionals both in schools and in the health system.
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Affiliation(s)
- Øyfrid Larsen Moen
- Faculty of Medicine and Health, Institute of Health Sciences, Gjøvik, Norway
- Norwegian University of Science and Technology (NTNU), Norway
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Santos MJDO, Ferreira MMDC, Ferreira EMS. Comportamentos de risco para a saúde sexual e reprodutiva: perceções dos estudantes do ensino superior. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0712pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: conhecer as perceções dos estudantes do ensino superior sobre comportamentos de risco sexual e reprodutivo. Métodos: estudo descritivo de abordagem qualitativa, usando como referencial teórico-metodológico o Modelo de Promoção da Saúde de Pender. Foi realizada uma análise temática dos dados obtidos através dos grupos focais. Resultados: os participantes consideram que fatores como a comunicação com o parceiro sexual, a capacidade de negociação e uma atitude positiva face ao uso do preservativo poderão constituir benefícios para uma utilização consistente do preservativo. Já o embaraço para comprar o preservativo, a alegada redução do prazer e a estabilidade da relação amorosa são entendidos como barreiras a esse uso consistente. Considerações finais: foram identificadas estratégias a considerar na criação de programas de promoção da saúde sexual, nomeadamente a educação pelos pares para promover competências pessoais e sociais e a (re)organização dos serviços de saúde.
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Birkeli GH, Jacobsen HK, Ballangrud R. Nurses' experience of the incident reporting culture before and after implementing the Green Cross method: A quality improvement project. Intensive Crit Care Nurs 2021; 69:103166. [PMID: 34895974 DOI: 10.1016/j.iccn.2021.103166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/04/2021] [Accepted: 10/16/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Adverse events are a leading cause of death worldwide, although many are considered preventable. Incident reporting is a prerequisite for preventing adverse events; however, underreporting is common. The Green Cross method is an alternative incident reporting process that includes a daily team meeting to discuss incidents and work on improvements. OBJECTIVES The aim of this quality improvement project was to improve the culture of incident reporting by implementing the Green Cross method and to evaluate the improvement by describing nurses' experience with the culture of incident reporting. METHODS The project included a three-month implementation of the method in a postanesthesia care unit, which was evaluated by focus group interviews (n = 22 nurses) and analysed by qualitative content analysis. FINDINGS Four focus group interviews were conducted before implementation (n = 19 nurses) and four after implementation (n = 16 nurses). Before implementation, Theme 1, "Incident reporting with potential for improvement", was constructed, describing a culture wherein nurses expressed motivation to report incidents but barriers, such as finding the system complicated and experiencing emotional obstacles towards reporting, prevented them. After implementation, Theme 2, "Increased focus on transparency", was constructed, describing a culture wherein nurses perceived an increased rate of incident reporting but still encountered barriers, such as finding reporting uncomfortable and demanding, experiencing a threatened working environment, and still wanting visible improvement. CONCLUSION The nurses in the postanesthesia care unit experienced the Green Cross method as a useful patient safety initiative for improving the rate of incident reporting, but barriers to reporting still existed.
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Affiliation(s)
- Gørill Helen Birkeli
- Akershus University Hospital, Postanesthesia Care Unit, Sykehusveien 25, 1478 Nordbyhagen, Norway.
| | - Hilde Kristin Jacobsen
- Akershus University Hospital, Neonatal Intensive Care Unit, Sykehusveien 25, 1478 Nordbyhagen, Norway.
| | - Randi Ballangrud
- Department of Health Science Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Sciences and Technology, Teknologivn. 22, 2815 Gjøvik, Norway.
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Assafi L, Evaristi D, Trevino CS, Larsen T. It's all about presence: Health professionals' experience of interprofessional collaboration when mobilizing patients with hip fractures. J Interprof Care 2021; 36:483-491. [PMID: 34702114 DOI: 10.1080/13561820.2021.1956444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Mobilization is an interprofessional task in the evidence-based care pathway 'Enhanced Recovery After Surgery'; multiple health professionals collaborate when mobilizing patients with hip fractures. Drawing on the theory of relational coordination, and focusing on relationships and communication, we set out to explore how health professionals experience and describe interprofessional collaboration when mobilizing patients with hip fractures treated according to Enhanced Recovery After Surgery. Two rounds of interviews were conducted with 27 participants from 11 different professional groups, and the data were analyzed thematically. The main findings were that functional goals characterize the collaboration on mobilization due to undefined roles and responsibilities, and that specialized knowledge leads to a need for physical presence and formalization of work procedures in the collaboration. We argue that the hospital as a workplace can be characterized by logics of production and belonging. These logics create care work managed by quality, efficacy and scales of fairness that install power relations that must be recognized when engaging in interprofessional collaboration. We conclude that a primary focus on relationships and communication, as suggested by relational coordination, cannot solve the challenges of interprofessional collaboration, as the context in which health professionals work must also be considered.
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Affiliation(s)
- Lone Assafi
- The Research Unit of Orthopaedic Nursing, Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
| | - Dorte Evaristi
- The Research Unit of Orthopaedic Nursing, Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
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Noble-Carr D, Carroll K, Waldby C. Mapping Hospital-Based Lactation Care Provided to Bereaved Mothers: A Basis for Quality Improvement. Breastfeed Med 2021; 16:779-789. [PMID: 34107776 DOI: 10.1089/bfm.2021.0089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: The study aimed to identify and map the factors that shape the delivery of hospital-based lactation care for bereaved mothers to inform quality improvement initiatives targeting hospital-based lactation care. Methods: Focus groups and interviews were conducted at three large hospitals in Australia with 113 health professionals including obstetricians, neonatologists, midwives, neonatal nurses, lactation consultants, social workers or pastoral care workers, Human Milk Bank (HMB) staff, and perinatal bereavement nurses. Thematic and interactional data analysis identified the nature, scope, and pattern of bereavement lactation care. Results: A bereaved lactation care pathway was generated from health professionals' reports. Bereaved lactation care, if provided, was limited to brief encounters aimed at facilitating lactation suppression. The type of lactation care offered, and any exploration of the variable biopsychosocial significance of lactation after infant death, was conditional on (i) availability of health professionals with suitable awareness, knowledge, capacity, confidence, and comfort to discuss lactation; (ii) hospital culture and mode of suppression primarily practiced; (iii) mother's breast milk being visible to hospital staff; (iv) mother expressing interest in expanded lactation management options; (v) availability of, and eligibility to, donate to a HMB; and (vi) support beyond the hospital setting being facilitated. Conclusion: Mothers should be presented with the full array of lactation management options available after stillbirth or infant death. Inclusion of evidence-based, biopsychosocial and patient-centered approaches to lactation care is urgently required in health professionals' bereavement training and in the policies of hospitals and HMBs.
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Affiliation(s)
- Debbie Noble-Carr
- School of Sociology, ANU College of Arts and Social Sciences, Australian National University, Acton, Australia
| | - Katherine Carroll
- School of Sociology, ANU College of Arts and Social Sciences, Australian National University, Acton, Australia
| | - Catherine Waldby
- Research School of Social Sciences, Australian National University, Acton, Australia
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Mauro AD, Cucolo DF, Perroca MG. Hospital - primary care articulation in care transition: both sides of the process. Rev Esc Enferm USP 2021; 55:e20210145. [PMID: 34545910 DOI: 10.1590/1980-220x-reeusp-2021-0145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/20/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze how the articulation between hospital and primary health care related to patient discharge and continuity of care after hospitalization takes place. METHOD Qualitative study, using the focus group technique to explore the experience of 21 nurses in hospitals (n = 10) and at primary care (n = 11) in a municipality in the northwest area of the State of São Paulo. Data collection took place between December 2019 and April 2020. Four focus groups were carried out (two in the hospital and two in the health units) and the findings underwent thematic analysis. RESULTS The categories identified were: Patient inclusion flow in the responsible discharge planning, Patient/family member/caregiver participation, Care planning, Communication between services, and Challenges in the discharge process. According to reports, the discharge process is centered on bureaucratic aspects with gaps in communication and coordination of care. CONCLUSION This research allowed understanding how nurses from different points of health care experience the discharge and (dis)articulation of the team work. The findings can equip managers in the (re)agreement of practices and integration of services to promote continuity of care.
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Affiliation(s)
- Adriéli Donati Mauro
- Faculdade de Medicina de São José do Rio Preto, Programa de Pós-graduação em Enfermagem, São José do Rio Preto, SP, Brazil
| | - Danielle Fabiana Cucolo
- Pontifícia Universidade Católica de Campinas, Programa de Pós-graduação, Campinas, SP, Brazil
| | - Marcia Galan Perroca
- Faculdade de Medicina de São José do Rio Preto, Programa de Pós-graduação em Enfermagem, São José do Rio Preto, SP, Brazil
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Ricci L, Beguinet M, Guillemin F, Klein S. French nurses' and allied health professionals' perception of research in their fields: A descriptive qualitative study. Int Nurs Rev 2021; 69:58-68. [PMID: 34514588 DOI: 10.1111/inr.12709] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 01/12/2023]
Abstract
AIM To gather information from nurses and allied health professionals in the French context of the emergence of research in the field so as to inform the development of a new tool: The research in nursing and allied health sciences' Ideas Generator (GénI) capable of sustaining the identification of research ideas from professionals in the field. BACKGROUND In many countries, research in nursing and allied health sciences remains underdeveloped. INTRODUCTION Before developing the Ideas Generator tool, it was essential to explore professionals' basis of reference in providing care, then investigate (1) their representation of research in this field of science and (2) their perception of needs for and obstacles to starting a research process. METHODS The qualitative research design used focus groups. The study population included 24 participants naive to research in four hospitals in eastern France (13 nurses and 11 allied health professionals). Thematic analysis was used to analyze the data. The study was reported in compliance with the consolidated criteria for reporting qualitative research criteria. FINDINGS Professionals used tacit knowledge and their experiences to address care, but the culture of scientific evidence was clearly missing (lack of knowledge of the origin of care guidelines, few bibliographic skills). Participation in a research process could hardly be envisaged without a supervised collaboration with a physician. Research was perceived not to be part of professionals' culture. They self-censured for lack of methodological competencies. DISCUSSION Findings underlined some leverage, obstacles, and need to consider to generate a stimulation in the field, especially in countries where such research is still in its infancy. IMPLICATION FOR NURSING, HEALTH, AND EDUCATION POLICY Strengthening the field of nursing and allied health research is essential to extend the skills of nurses and allied health workers and to improve the quality of patient care by taking into account results from the literature. The Ideas Generator tool will be implemented to sustain learning the skills of research through education and training.
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Affiliation(s)
- Laetitia Ricci
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | - Mélanie Beguinet
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | - Francis Guillemin
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France.,Université de Lorraine, APEMAC, Nancy, France
| | - Sylvie Klein
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
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Moilanen T, Rahkonen N, Kangasniemi M. Finnish adolescents' perceptions of their health choices: A qualitative study. Nurs Health Sci 2021; 23:834-842. [PMID: 34240794 DOI: 10.1111/nhs.12866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 01/10/2023]
Abstract
This study described adolescents' perceptions of the aims of their daily health choices and how they make them. We used a qualitative, explorative design, with 67 adolescents aged 15-16 years taking part in semi-structured focus groups in Finland in 2016. We analyzed the data with qualitative inductive content analysis. Adolescents perceived their health choices as automatic and driven by knowledge and mistakes, and these decisions reflected their values and feelings. Their health choices were based on immediate and long-term goals and they reported that making good choices improved their self-confidence and enhanced their individuality. Adolescents also used health choices to promote other people's health. Health choices were linked to parental help and restrictions, and seeking acceptance from friends. Adolescents' health choices were also enabled and limited by society and the environment that they lived in. In conclusion, adolescents' health choices were an integral part of their daily decision-making, reflected the environment they lived in, and aimed to promote their health and express their individuality.
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Affiliation(s)
- Tanja Moilanen
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Nina Rahkonen
- Women's Inpatient Ward, Obstetrics and Gynaecology, Kuopio University Hospital, Kuopio, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
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