9051
|
Abstract
An increased lifespan does not necessarily equate to a high quality of life. This article discusses strategies to help older adult patients cope with loneliness, social isolation, and chronic illness to improve their health and quality of life.
Collapse
Affiliation(s)
- Lori Hammond
- At Texas Tech University Health Sciences Center School in Lubbock, Tex., Lori Hammond is an associate professor and Richard L. Pullen, Jr., is a professor
| | | |
Collapse
|
9052
|
Schmidt J, Wartenberg-Demand A, Forstmeier S. Equine-assisted biographical work (EABW) with individuals in the second half of life: study protocol of a multicentre randomised controlled trial. Trials 2020; 21:857. [PMID: 33059730 PMCID: PMC7558734 DOI: 10.1186/s13063-020-04784-3] [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: 03/09/2020] [Accepted: 10/05/2020] [Indexed: 11/22/2022] Open
Abstract
Background Equine-assisted therapy is more often practiced with children and adolescents than with the elderly, although individuals in the second half of life could also profit from it. This group, from the age of 50, is characterised by increasing emotional, social, health-related and cognitive changes; a critical life event, such as a neurological illness or loss of a family member, can increase the likelihood of subclinical depression. Individuals who exhibit depressive symptoms not necessarily diagnosed with a major depression may suffer from relevant losses of quality of life (e.g. sleep disorders, memory disorders, feelings of guilt, hopelessness). Despite the fact that the various healthcare systems are in general more frequently used, such individuals often do not receive adequate therapy. The processing of one’s biography (reminiscence) is an elementary component of most psychotherapy approaches and has been demonstrated to treat and prevent the development of major depression. In this study, equine-assisted biographical work (EABW), a combination of equine-assisted therapy and biographical work, will be applied with individuals with subclinical depression in the second half of their life. Methods This is a multicentre, prospective, randomised, controlled and open phase III study in enrolling participants with subclinical depression. The aim of the study is to evaluate whether a preventive, equine-assisted, age-specific treatment combining elements of equine-assisted intervention with those of biographical work offers better treatment potentials in comparison to a control group with no intervention. Study participants in the intervention group will receive weekly equine-assisted biographical work over a period of 8 weeks. The primary endpoint is the change in Beck Depression Inventory-II (BDI-II) in a pre-post comparison. Secondary endpoints include other health-related questionnaires including quality of life, reminiscence functions and anxiety. Discussion The present study is the first randomised study examining the efficacy of biographical work with a horse and has the potential to establish an empirically based treatment for individuals in the second half of life and improving the symptoms of subclinical depression. Trial registration German Clinical Trials Register DRKS00017010. Registered on 01 April 2019
Collapse
|
9053
|
Oerther S, Oerther DB. Leading change during the convergence of an epidemic and a pandemic. J Adv Nurs 2020; 76:3215-3217. [PMID: 32996624 PMCID: PMC7537317 DOI: 10.1111/jan.14567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/09/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah Oerther
- Saint Louis University School of NursingSt. LouisMOUSA
| | - Daniel B. Oerther
- Environmental Health EngineeringMissouri University of Science and TechnologyRollaMOUSA
| |
Collapse
|
9054
|
Kjellsdotter A, Berglund M, Jebens E, Kvick J, Andersson S. To take charge of one's life - group-based education for patients with type 2 diabetes in primary care - a lifeworld approach. Int J Qual Stud Health Well-being 2020; 15:1726856. [PMID: 32046621 PMCID: PMC7034479 DOI: 10.1080/17482631.2020.1726856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2020] [Indexed: 10/26/2022] Open
Abstract
Background: The number of people suffering from diabetes worldwide, including Sweden, has increased. To strengthen the patient's empowerment and thus improve their ability to take care of their own health, patient education in self-care management plays a central role in diabetes care.Purpose: The specific aim in this study was to describe patients' experiences of group-based education using the Taking charge of one's life with type 2 diabetes model.Methods: A qualitative approach with a phenomenological lifeworld perspective was used. The study was based on group and individual interviews and reflection books.Results: The group-based education model made it possible for the patients to learn through reflection concerning their own and others' experiences. The learning that occurred with support from the group reflections and the reflection books contributed to the understanding of the complexity of the illness. This increased the motivation and desire to be responsible for the treatment and implementation of habits. The group contributed to a sense of belonging and community that inspired a continued and active learning.Conclusion: The results showed that from the patients' perspective, this didactic model was both suitable and appreciated, supporting and facilitating learning.
Collapse
Affiliation(s)
- Anna Kjellsdotter
- Skaraborg Hospital Skövde, Research and Development Centre, Skövde, Sweden
- School of Health Sciences, Skövde University, Skövde, Sweden
| | - Mia Berglund
- School of Health Sciences, Skövde University, Skövde, Sweden
| | | | - Jennie Kvick
- Primary Health Care Center Mösseberg, Falköping, Sweden
| | | |
Collapse
|
9055
|
Saban M, Dagan E, Drach-Zahavy A. The Effects of a Novel Mindfulness-based Intervention on Nurses' State Mindfulness and Patient Satisfaction in the Emergency Department. J Emerg Nurs 2020; 47:412-425. [PMID: 33272560 DOI: 10.1016/j.jen.2020.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 09/18/2020] [Accepted: 09/29/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The objective of this study was to examine the effect of a novel mindfulness-based time-out intervention on state of mindfulness among emergency nurses and, accordingly, on patient satisfaction. METHODS A pre-post intervention design among nurses in the emergency department was used with a between-subjects factor of patients who were nested within each nurse. The study was conducted between January 2017 and June 2018 among 48 nurses in the emergency department of a public tertiary academic hospital. For each nurse, a consecutive sample of 20 patients who attended the emergency department was recruited (n = 1920 patients; 960 in each phase). The mindfulness-based time-out intervention was based on theoretical mindfulness principles and carried out every 4 hours with direct communication to the patient at their bedside. Nurses' sociodemographic and professional characteristics and trait mindfulness were collected preintervention. Pre- and postintervention, data was collected on patients' sociodemographic and satisfaction, nurses' state mindfulness, and ED workload. RESULTS An increase in nurses' state mindfulness and patients' satisfaction was found after the mindfulness-based time-out intervention compared with before the intervention (4.35 [SD = 0.64] vs 4.03 [0.82], P < .001 and 4.03 [0.41] vs 3.16 [0.44], P < .001, respectively). A positive correlation was found between patients' satisfaction and nurses' state mindfulness (r = 0.29, P < .001). The findings also demonstrated that state mindfulness was higher among nurses, characterized by high trait mindfulness, after the mindfulness-based time-out intervention implementation. DISCUSSION By adapting mindfulness principles to the dynamic environment of the emergency department, we showed that the mindfulness-based time-out intervention was associated with a significant improvement in state mindfulness and patient satisfaction. The findings elucidate the interrelation among several conceptualizations of mindfulness that are increasingly reported in the literature, namely trait and state mindfulness, and interventions to promote mindfulness.
Collapse
|
9056
|
Kalogirou MR, Chauvet C, Yonge O. Including administrators in curricular redesign: How the academic-practice relationship can bridge the practice-theory gap. J Nurs Manag 2020; 29:635-641. [PMID: 33145824 DOI: 10.1111/jonm.13209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/26/2020] [Accepted: 11/02/2020] [Indexed: 11/30/2022]
Abstract
AIM Health care administrators provided information through semi-structured interviews as to how one faculty of nursing (FoN) was preparing students for practice. BACKGROUND There is a long-standing disconnect between the nursing education and the clinical arena known as the theory-practice gap. The FoN wanted to redevelop their curriculum to better prepare students for practice and bridge the gap. METHOD Using developmental evaluation, 36 administrators were interviewed and asked about their expectations of newly graduated nurses, the FoN curriculum, and changes to be made. RESULTS Four themes were identified: entry to programme; curricular content, delivery and structure; clinical recommendations; and stronger relationships. CONCLUSION Strong academic-practice partnerships are still needed. The current lack of communication and partnership has compromised students' quality of education and their transition into the workforce. IMPLICATIONS FOR NURSING MANAGEMENT Leaders in both the education and practice settings can better prepare newly graduated nurses and bridge the theory-practice gap by co-creating a joint committee and creating more touchpoints with one another. A joint committee can develop appropriate entry-to-programme guidelines, discuss relevant trends in practice and shape the curriculum. Clinical experiences for students may also act as extra touchpoints whereby the two groups can discuss clinical mentorship needs and build stronger academic-practice relationships.
Collapse
Affiliation(s)
| | - Christine Chauvet
- University of Alberta, Edmonton, AB, Canada.,Royal Alexandra Hospital, Edmonton, AB, Canada
| | | |
Collapse
|
9057
|
Cross-cultural adaptation of the caregiver contribution to heart failure self-Care into Brazilian Portuguese and content validation. Heart Lung 2020; 50:185-192. [PMID: 33271476 DOI: 10.1016/j.hrtlng.2020.11.004] [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: 07/28/2020] [Revised: 11/05/2020] [Accepted: 11/17/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The Caregiver Contribution to Heart Failure Self-Care (CACHS) is a Canadian instrument that assesses caregivers' (CGs) contributions to heart failure (HF) patients' self-care, but a Brazilian version was lacking. AIMS To adapt CACHS into Brazilian Portuguese and to estimate the content validity of the adapted version. METHODS A psychometric study of cross-cultural adaptation and content validation was conducted. Linguistic equivalence was assessed by eight professional experts. Content validity was assessed by an expert professional panel (n=8; for clarity, theoretical relevance and practical relevance) and a CG panel (n=46; for cognitive debriefing of the adapted instrument). In the cultural adaptation, the items were considered equivalent if experts reached an agreement ≥80%. In the content validation, the items were considered acceptable if content validity coefficients (CVC) were ≥0.70. RESULTS The translated version was considered consistent with the original CACHS by the authors. In the second round of linguistic equivalence assessment, all items achieved 100% agreement, except for one item, which presented 75% agreement in conceptual equivalence. The CVC in the first and second rounds of content validity assessment by experts was 0.80 to 0.90. During cognitive testing, the CGs requested explanations on three items, which were reformulated. All CGs then understood the Brazilian version of CACHS, named CACHS - Versão Brasileira (CACHS-Br). CONCLUSIONS CACHS-Br is equivalent to the original version and provided satisfactory evidence of content validity. Further psychometric testing of this version should allow for the measurement of the CG contributions to HF self-care in Brazil.
Collapse
|
9058
|
Klapwijk MS, Dekker NL, Caljouw MAA, Achterberg WP, van der Steen JT. Experiences with the Liverpool care pathway for the dying patient in nursing home residents: a mixed-method study to assess physicians' and nurse practitioners' perceptions. BMC Palliat Care 2020; 19:183. [PMID: 33256717 PMCID: PMC7706263 DOI: 10.1186/s12904-020-00686-y] [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: 03/20/2020] [Accepted: 11/18/2020] [Indexed: 08/29/2023] Open
Abstract
Background The Liverpool care pathway for the dying patient (LCP) is a multidisciplinary tool developed for the dying phase for use in palliative care settings. The literature reports divergent experiences with its application in a nursing home setting related to its implementation and staff competencies. The aim of this study is to understand how the LCP is being used in the context of the nursing home, including for residents with dementia, and experienced from the perspectives of those responsible for medical treatment in nursing homes. Methods A mixed-methods approach was used, consisting of a survey followed by interviews. A link to a 9-item online survey with closed and open-ended questions was emailed to all physicians and nurse practitioners of 33 care organisations with nursing homes in three regions of the Netherlands (North, West and South). In addition, 10 respondents with particularly positive or negative experiences were selected for semi-structured interviews. Results The survey was completed by 159 physicians and nurse practitioners. The respondents were very positive on the content and less positive on the use of the LCP, although they reported difficulties identifying the right time to start the LCP, especially in case of dementia. Also using the LCP was more complicated after the implementation of the electronic health record. The LCP was judged to be a marker of quality for the assessment of symptoms in the dying phase and communication with relatives. Conclusion An instrument that prompts regular assessment of a dying person was perceived by those responsible for (medical) care to contribute to good care. As such, the LCP was valued, but there was a clear need to start it earlier than in the last days or hours of life, a need for a shorter version, and for integration of the LCP in the electronic health record. Regular assessments with an instrument that focusses on quality of care and good symptom control can improve palliative care for nursing home residents with and without dementia.
Collapse
Affiliation(s)
- Maartje S Klapwijk
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300 RC, the Netherlands. .,Marente, Leiden, the Netherlands.
| | - Natashe Lemos Dekker
- Institute of Cultural Anthropology and Development Sociology, Leiden University, Leiden, the Netherlands
| | - Monique A A Caljouw
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300 RC, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300 RC, the Netherlands
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300 RC, the Netherlands
| |
Collapse
|
9059
|
Tools to Support Self-Care Monitoring at Home: Perspectives of Patients with Heart Failure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238916. [PMID: 33266245 PMCID: PMC7731418 DOI: 10.3390/ijerph17238916] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/04/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022]
Abstract
Self-care monitoring at home can be a challenge for patients with heart failure (HF). Tools that leverage information and communication technology (ICT), comprise medical devices, or have written material may support their efforts at home. The aim of this study was to describe HF patients’ experiences and their prioritization of tools that support, or could support, self-care monitoring at home. A descriptive qualitative design employing semi-structured interviews was used with HF patients living at home and attending an HF outpatient clinic in Norway. We used a deductive analysis approach, using the concept of self-care monitoring with ICT tools, paper-based tools, medical devices, and tools to consult with healthcare professionals (HCPs) as the categorization matrix. Nineteen HF patients with a mean age of 64 years participated. ICT tools are used by individual participants to identify changes in their HF symptoms, but are not available by healthcare services. Paper-based tools, medical devices, and face-to-face consultation with healthcare professionals are traditional tools that are available and used by individual participants. HF patients use traditional and ICT tools to support recognizing, identifying, and responding to HF symptoms at home, suggesting that they could be used if they are available and supplemented by in-person consultation with HCPs.
Collapse
|
9060
|
Hua W, Wang L, Li C, Simoni JM, Yuwen W, Jiang L. Understanding preparation for preterm infant discharge from parents' and healthcare providers' perspectives: Challenges and opportunities. J Adv Nurs 2020; 77:1379-1390. [PMID: 33249653 DOI: 10.1111/jan.14676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/03/2020] [Accepted: 10/30/2020] [Indexed: 11/29/2022]
Abstract
AIM To describe the facilitating/inhibiting factors of preparation for preterm infant discharge and recommendations for increasing discharge readiness from parents' and healthcare providers' perspectives based on Meleis's Transitions Theory. DESIGN A qualitative cross-sectional descriptive design. METHODS We selected a purposive sample of 17 parents (9 fathers and 8 mothers) and 13 healthcare providers (10 nurses and 3 clinicians) from the neonatal intensive care unit of a tertiary hospital in Eastern China. Data were collected between May -July 2018. Data from audio-recorded semi-structured individual interviews were coded with content analysis both inductively and deductively. RESULTS The analyses yielded four themes: personal conditions, community conditions, nursing therapeutics, and patterns of response. Parents and healthcare providers had unique opinions about the themes. CONCLUSION Meleis's Transitions Theory seems to be an applicable and practicable framework for understanding the discharge preparation of parents with preterm infants and may be used to help healthcare providers to develop appropriate interventions on discharge preparation practice. IMPACT To address the lack of discharge readiness of preterm infants in China and countries with a similar clinical context, healthcare providers should help parents play a more active role to promote their engagement in discharge preparation. In a wider global community, healthcare providers should consider parents' personal conditions and their practical needs in performing discharge preparation.
Collapse
Affiliation(s)
- Wenzhe Hua
- Shanghai Jiao Tong University School of Nursing, Shanghai, PR China
| | - Liying Wang
- Department of Psychology, University of Washington, Seattle, WA, USA
| | | | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Weichao Yuwen
- School of Nursing and Healthcare Leadership, University of Washington, Tacoma, WA, USA
| | - Liping Jiang
- Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| |
Collapse
|
9061
|
Afriyie D. International nurses and midwives require individualised support for successful transition to work in the UK. Evid Based Nurs 2020; 25:32. [PMID: 33246927 DOI: 10.1136/ebnurs-2020-103339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2020] [Indexed: 11/03/2022]
|
9062
|
Younas A. Examining progression and degeneration of nursing science using Imre Lakatos's methodology of scientific research programs. Nurs Philos 2020; 22:e12342. [PMID: 33248002 DOI: 10.1111/nup.12342] [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: 08/04/2020] [Revised: 10/30/2020] [Accepted: 11/15/2020] [Indexed: 11/30/2022]
Abstract
Over the years, nursing research and practice have been through remarkable transformations in response to evolving and emerging healthcare systems and practices. Regarding research, nurses moved beyond merely using the quantitative methodology to combining qualitative, quantitative and mixed methods. In practice, nurses have transitioned from the delivery of medical-based care to nursing theory-guided practice, evidence-based practice, knowledge translation and transformative practice. Some domains of nursing research and practice became progressive, while others degenerated. This paper aims to examine how different domains of nursing research and practice progress and degenerate using Imre Lakatos's methodology of scientific research programs. Lakatos differentiated scientific and pseudoscientific knowledge and coined the idea of scientific research programs. He believed that science in any discipline develops so that some programs are more progressive and others' degenerative. The degeneration and progression of programs occur steadily and rationally and are determined based on the extent of development and programs' potential to predict new solutions to old problems. Adopting this idea could enable nurses to critically analyse research programs in everyday knowledge development to use valid and legitimate programs for informing nursing practice.
Collapse
Affiliation(s)
- Ahtisham Younas
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, NL, Canada.,Swat College of Nursing, Swat, Pakistan
| |
Collapse
|
9063
|
Lefranc B, Martin-Krumm C, Aufauvre-Poupon C, Berthail B, Trousselard M. Mindfulness, Interoception, and Olfaction: A Network Approach. Brain Sci 2020; 10:brainsci10120921. [PMID: 33260427 PMCID: PMC7760383 DOI: 10.3390/brainsci10120921] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 12/02/2022] Open
Abstract
The fine-tuned interplay between the brain and the body underlies the adaptive ability to respond appropriately in the changing environment. Mindfulness Disposition (MD) has been associated with efficient emotional functioning because of a better ability to feel engaged by information from the body and to notice subtle changes. This interoceptive ability is considered to shape the ability to respond to external stimuli, especially olfaction. However, few studies have evaluated the relationships between interoception and exteroception according to MD. We conducted an exploratory study among 76 healthy subjects for first investigating whether MD is associated with better exteroception and second for describing the causal interactions network between mindfulness, interoception, emotion, and subjective and objective olfaction assessments. Results found that a high level of MD defined by clustering exhibited best scores in positive emotions, interoception, and extra sensors’ acuity. The causal network approach showed that the interactions between the interoception subscales differed according to the MD profiles. Moreover, interoception awareness is strongly connected with both the MD and the hedonic value of odors. Then, differences according to MD might provide arguments for a more mindful attention style toward interoceptive cues in relation to available exteroceptive information. This interaction might underlie positive health.
Collapse
Affiliation(s)
- Barbara Lefranc
- APEMAC/EPSAM, EA 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France; (C.M.-K.); (M.T.)
- French Armed Forces Biomedical Research Institute, BP73, CEDEX, 91223 Brétigny-sur-Orge, France
- Correspondence:
| | - Charles Martin-Krumm
- APEMAC/EPSAM, EA 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France; (C.M.-K.); (M.T.)
- French Armed Forces Biomedical Research Institute, BP73, CEDEX, 91223 Brétigny-sur-Orge, France
- Ecole de Psychologues Praticiens, Institut Catholique de Paris (Catholic Institute of Paris), VCR/ICP EA 7403-23, rue du Montparnasse, 75006 Paris, France
| | | | - Benoit Berthail
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France;
| | - Marion Trousselard
- APEMAC/EPSAM, EA 4360, Ile du Saulcy, BP 30309, CEDEX 1, 57006 Metz, France; (C.M.-K.); (M.T.)
- French Armed Forces Biomedical Research Institute, BP73, CEDEX, 91223 Brétigny-sur-Orge, France
- Ecole de Psychologues Praticiens, Institut Catholique de Paris (Catholic Institute of Paris), VCR/ICP EA 7403-23, rue du Montparnasse, 75006 Paris, France
- French Military Health Service Academy, 1 Place Alphonse Laveran, CEDEX 05, 75230 Paris, France;
- Réseau ABC des Psychotraumas, 34000 Montpellier, France
| |
Collapse
|
9064
|
Halberg N, Assafi L, Nørholm V. Understandings of and experiences with evidence-based practice in practice among nurses in a surgical department: A constructivist approach. J Clin Nurs 2020; 30:488-498. [PMID: 33174256 DOI: 10.1111/jocn.15563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/05/2020] [Accepted: 10/31/2020] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVES To explore nurses' constructions of the concept of evidence-based practice through their understandings of and experiences with evidence-based practice in a clinical care setting. BACKGROUND The primary purpose of evidence-based practice is high-quality patient outcomes. However, the adoption of evidence-based practice is described as a complex process, and research shows that evidence-based practice is not translated into practice. Research often explores facilitators and barriers of implementing and adopting evidence-based practice. Yet there is limited knowledge on how nurses construct the concept in practice. DESIGN This study has a constructivist approach and follows COREQ guidelines. METHOD Ten semi-structured interviews with 26 nurses were conducted in 2019. Data were analysed with an emic and inductive approach. RESULTS Three key constructions emerged. Understandings of evidence-based practice were based on the original concept of evidence-based medicine. This included the hierarchy of evidence which was perceived as an inflexible concept not encompassing the nursing care. However, while not using the term evidence-based practice, the nurses were doing evidence-based practice portrayed through outcomes from management-supported nursing-based projects and incorporated reflections and discussions into weekly meetings. A discrepancy between a theoretical understanding and a practical doing of evidence-based practice appeared and was especially evident when the nurses' primary evidence sources consisted of the immediate options, for example asking colleagues or following accessible guidelines. Searching for evidence was central in their theoretical understanding but not an incorporated part of their daily work tasks. CONCLUSION The nurses' constructions of evidence-based practice indicate a discrepancy between the theoretical understanding of evidence-based practice and the practical doing of evidence-based practice, which hinders the basis of working according to the concept. RELEVANCE TO CLINICAL PRACTICE Theoretical discussions of evidence-based practice within the nursing field remain academic, as nurses in practice construct the concept on standards from evidence-based medicine.
Collapse
Affiliation(s)
- Nina Halberg
- The Research Unit of Orthopaedic Nursing, Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark
| | - Lone Assafi
- The Research Unit of Orthopaedic Nursing, Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark
| | - Vibeke Nørholm
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark
| |
Collapse
|
9065
|
Tetteh L, Aziato L, Mensah GP, Vehviläinen-Julkunen K, Kwegyir-Afful E. Burns pain management: The role of nurse-patient communication. Burns 2020; 47:1416-1423. [PMID: 33277090 DOI: 10.1016/j.burns.2020.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/12/2020] [Accepted: 11/20/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Nursing is an embodiment of knowledge, clinical work, and interpersonal communication. Effective nursing care has a distinct influence on the overall satisfaction and experience of the patient. Communication is said to be indispensable in the delivery of quality healthcare. Effective communication between nurses and patients has proven to yield better results with pain control and improved psychological status of patients. OBJECTIVES The aim of the study is to explore nurses' perceptions on the role of communication in the management of burns pain. METHODS A qualitative design with purposive sampling was carried out to recruit 11 registered nurses from a Reconstructive Plastic Surgery and Burns Center in Ghana. To identify the participants' perception on the role of nurse-patient communication in the management of burns pain, a face to face semi-structured interviews were conducted using an interview guide to collect data. RESULTS Thematic analysis was done with various themes emerging. Helping patients manage pain, early detection of patient's distress, improved patient participation in their care were some of the positive effects of nurse-patient communication whiles reduced level of cooperation during caregiving, and endurance of pain by the patient were the results of poor nurse-patient communication. Language and time factor were the barriers that were identified to hinder effective communication between nurses and patients. CONCLUSIONS Due to the subjective nature of pain, the current study highlights the need for increased communication for an effective assessment and management of pain among patients with burns. It is, therefore, imperative that nurses be well trained in communication with an emphasis on patient-centered communication.
Collapse
Affiliation(s)
- Linda Tetteh
- University of Ghana College of Health Sciences, School of Nursing and Midwifery, P.O. Box LG 43, Legon, Accra, Ghana
| | - Lydia Aziato
- University of Ghana College of Health Sciences, School of Nursing and Midwifery, P.O. Box LG 43, Legon, Accra, Ghana
| | - Gwendolyn Patience Mensah
- University of Ghana College of Health Sciences, School of Nursing and Midwifery, P.O. Box LG 43, Legon, Accra, Ghana
| | - Katri Vehviläinen-Julkunen
- University of Eastern Finland, Faculty of Health Sciences, Department of Nursing Science, FI-70211, Kuopio, Finland; Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland
| | - Emma Kwegyir-Afful
- University of Salford, School of Health and Society, Manchester, Frederick Road, M6 6PU, United Kingdom.
| |
Collapse
|
9066
|
Phukuta NSJ, Omole OB. Prevalence and risk factors associated with postnatal depression in a South African primary care facility. Afr J Prim Health Care Fam Med 2020; 12:e1-e6. [PMID: 33354984 PMCID: PMC7736693 DOI: 10.4102/phcfm.v12i1.2538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/08/2020] [Accepted: 08/13/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The prevalence and factors that influence postnatal depression (PND) vary according to context. AIM To determine the prevalence and factors associated with PND in the postnatal clinic of a large community health centre. SETTING This study was conducted at Levai Mbatha Community healthcare centre, in Evaton, South of Gauteng. METHOD In a cross-sectional study, the Edinburg Postnatal Depression Scale (EPDS) was administered on 227 consecutive mothers during postnatal clinic visits. In addition, sociodemographic and clinical information were collected. Analysis included descriptive statistics, chi-square test and logistic regression. A score of greater than 13 on the EPDS screened positive for PND. RESULTS Participants' mean age was 27 years, and most completed less than grade 12 education (52.4%), were single (55.5%), were employed or had a working partner (60%) and had no previous PND (97%). The proportion of participants screening positive was 38.8%. In the adjusted logistic regression, completing only primary school education (odds ratio [OR]: 9.11; 95% confidence interval [CI]: 1.03-80.22; p = 0.047), using contraceptive prior to index pregnancy (OR: 2.05; 95% CI: 1.12-3.72; p = 0.019) and reporting a thought of self-harm or infanticide (OR: 7.08; 95% CI: 5.79-22.21; p = 0.000) significantly increased the risk of PND. In contrast, having a relationship with the father of the index child (OR: 0.42; 95% CI: 0.18-0.94; p = 0.037) mitigated this risk. CONCLUSION The proportion of women screening positive for PND was high in the study setting and was concomitant with significant risk of suicide or infanticide. This highlights the need to screen and consider PND as a vital sign during postnatal visits, especially in the face of low educational attainment, failed contraception and poor or no relationship with the father of the index child.
Collapse
Affiliation(s)
- Nyundu S J Phukuta
- Division of Family Medicine, Department of Family Medicine, Faculty of Sciences, University of The Witwatersrand, Johannesburg.
| | | |
Collapse
|
9067
|
Wilson AJ, Spark MJ. Understanding management of poorly controlled pain in community-dwelling analgesic users: a qualitative study. Int J Clin Pharm 2020; 43:928-937. [PMID: 33245520 DOI: 10.1007/s11096-020-01198-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 11/09/2020] [Indexed: 11/26/2022]
Abstract
Background Chronic pain is a prevalent and debilitating condition for many people. Globally it is the greatest contributor to years lived with disability. Management often includes pharmacotherapy and pharmacists are therefore well placed to contribute to chronic pain management. Objective To explore chronic pain management in community-dwelling analgesic users with poorly controlled pain and investigate potential barriers to adequate pain management. Setting Regional Victoria, Australia. Method A descriptive qualitative approach was used. People who had been prescribed an analgesic for at least 6 months and reported an average pain score over the last week of 4 or more out of 10 were interviewed about their pain management. Interviews followed a semi-structured interview guide. Thematic analysis of the data was undertaken followed by participant validation of the key themes. Main outcome measure Experience of chronic pain management. Results Three female and eight male people, aged between 34 and 77 years were interviewed. The study demonstrated that there was a diverse range of issues relating to chronic pain management that fitted into seven major themes: impact of pain on life, invisibility of pain, issues associated with healthcare professionals, general medication issues, attitude towards taking analgesics, medication adherence, and attitude towards other treatment options. Chronic pain had dramatically altered the lives of all participants and their families as they came to accept and learn to live with the pain they experienced. The main barrier to adequate pain management was the invisibility of pain, which resulted in health professionals undertreating the pain reported by participants. Participants desire to take as few analgesics as possible, the reluctance of GPs to prescribe opioids and healthcare professionals focus on misuse also contributed to poor pain management. Conclusion Participants were able to accept high levels of pain while minimizing analgesic use. The two main barriers to adequate pain management were the invisibility of pain, which resulted in health professionals not treating the pain reported by the participant and the perception of participants that analgesics should not need to be taken regularly in adequate doses for the rest of their lives.
Collapse
Affiliation(s)
- Andrea J Wilson
- Department of Pharmacy, Bendigo Health, Bendigo, VIC, Australia
- Department of Pharmacy and Biomedical Sciences, LaTrobe University, Bendigo, VIC, Australia
| | - M Joy Spark
- School of Rural Medicine, Faculty of Medicine and Health, University of New England, Armidale, NSW, 2351, Australia.
| |
Collapse
|
9068
|
Rasalingam A, Fegran L, Brekke I, Helseth S. Young people with long-term health challenges experiences in transition to adulthood: A qualitative metasynthesis. J Adv Nurs 2020; 77:595-607. [PMID: 33245156 DOI: 10.1111/jan.14641] [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: 06/19/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022]
Abstract
AIMS The aim of this study was to describe the experiences of the transition to adulthood for young people with long-term health challenges. DESIGN The metasynthesis approach was based on the guidelines by Sandelowski and Barroso for synthesizing qualitative research. DATA SOURCES Seven electronic databases: CINAHL, Medline, Embase, PsycINFO, Web of Science, Scopus, and SocIndex were searched on 6-10 February 2020. REVIEW METHODS Studies were critically appraised using the Joanna Briggs critical appraisal tool. Qualitative data were extracted, meta-summarised, then meta-synthesized. FINDINGS Nineteen qualitative studies were included in this review. Six themes illustrated experiences in the transition to adulthood: wishing for an 'ordinary' life, significance of close network, working towards independence, in need of systemic resources and services, psychosocial challenges and keeping a positive attitude. CONCLUSION Young people with long-term health challenges wished for as 'ordinary' a life as possible in the future. In the transition to adulthood, they gradually gained more competence in self-management skills and knowledge and strived to become more independent. By having a positive attitude and using other coping strategies, young people can work on some of the difficulties they experience in this phase. However, to achieve and maintain independence young people with long-term health challenges are dependent on the support of a close network and systemic support and services. IMPACT The findings highlight the need to help alleviate the fears and worries of young people with long-term health challenges and create opportunities for successful transition to adulthood by increased awareness and interventions from policy-makers and professionals in the health and social system.
Collapse
Affiliation(s)
- Anurajee Rasalingam
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Liv Fegran
- Faculty of Health and Sport Sciences, Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Idunn Brekke
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Division of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Sølvi Helseth
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
9069
|
Forsgärde ES, Elmqvist C, Fridlund B, Svensson A, Andersson R, Rööst M. Patients' aged ≥65 years dispositions during ambulance assignments, including factors associated with non-conveyance to hospital: a longitudinal and comparative study. BMJ Open 2020; 10:e038885. [PMID: 33243795 PMCID: PMC7692831 DOI: 10.1136/bmjopen-2020-038885] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES Patients ≥65 years old represent 30%-50% of all ambulance assignments (AAs), and the knowledge of which care level they are disposed to is limited and diverging. The aim of this study was therefore to describe and compare characteristics of patients' aged ≥65 years dispositions during AA, including determining changes over time and factors associated with non-conveyance to hospitals. DESIGN A longitudinal and comparative database study. SETTING Ambulance service in a Swedish region. PARTICIPANTS 32 085 AAs with patients ≥65 years old during the years 2014, 2016 and 2018. EXCLUSION CRITERIA AAs with interhospital patient transfers and lack of patients' dispositions data. OUTCOME MEASURES Dependent factors: conveyance and non-conveyance to hospitals. Independent factors: age, sex, symptom, triage level, scene, time, day and season. RESULTS The majority (n=29 060; 90.6%) of patients' dispositions during AA were conveyance to hospitals. In total, the most common symptoms were circulatory (n=4953; 15.5%) and respiratory (n=4529; 14.1%). A significant increase, p<0.01, of non-conveyance to hospitals was shown during 2014 and 2018, from 801 (7.8%) to 1295 (11.4%). Increasing age was associated with decreasing odds of non-conveyance, 85-89 years (OR=0.85, 95 % CI=0.72 to 0.99) and 90 years or older (OR=0.80, 95 % CI=0.68 to 0.93). Several factors were associated with non-conveyance, for example, symptoms of diabetes (OR=8.57, 95 % CI=5.99 to 12.26) and mental disorders (OR=5.71, 95 % CI=3.85 to 8.48) in comparison with infections. CONCLUSIONS The study demonstrates several patient characteristics, and factors associated with non-conveyance to hospitals, such as age, symptom, triage level, scene, time, day and season. The increasing non-conveyance trend highlights the importance of further studies on optimal care levels for patients ≥65 years old.
Collapse
Affiliation(s)
- Elin-Sofie Forsgärde
- Health and Caring Science, Linnaeus University Faculty of Health and Life Sciences, Växjö, Sweden
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University Faculty of Health and Life Sciences, Växjö, Sweden
| | - Carina Elmqvist
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University Faculty of Health and Life Sciences, Växjö, Sweden
- Department for Research and Development, Region Kronoberg, Växjö, Sweden
| | - Bengt Fridlund
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University Faculty of Health and Life Sciences, Växjö, Sweden
| | - Anders Svensson
- Health and Caring Science, Linnaeus University Faculty of Health and Life Sciences, Växjö, Sweden
- Ambulance Service, Region Kronoberg, Växjö, Sweden
| | | | - Mattias Rööst
- Department for Research and Development, Region Kronoberg, Växjö, Sweden
- Clinical Sciences Malmö, Lund University, Lund, Sweden
| |
Collapse
|
9070
|
Altman D. Lactation Care of Families in the Community Health Setting During the COVID Pandemic. CLINICAL LACTATION 2020. [DOI: 10.1891/clinlact-d-20-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundThe COVID pandemic challenged IBCLCs and other heathcare providers to determine how to meet the needs of new families while maintaining safety for both patients and caregivers. In addition, both workplace and personal stressors triggered by ongoing changes increased the risk of compassion fatigue.ProgramInitial patient support was offered at a free-standing lactation medicine clinic. After office closure, lactation services moved to multiple pediatric offices.ResultAlthough the worksite changed after the first six weeks of the pandemic, direct patient care providing lactation support remained uninterrupted, and continues to this day. The IBCLCs are addressing the issue of compassion fatigue with awareness along with peer to peer support.
Collapse
|
9071
|
Ramos SDA. Reminiscence in the Face of Death of a Filipino Elderly With Substance Use Disorder: The Case of Burt. OMEGA-JOURNAL OF DEATH AND DYING 2020; 86:413-433. [PMID: 33236656 DOI: 10.1177/0030222820976276] [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: 11/16/2022]
Abstract
Death is an important reality that the elderly face. In preparation for death, old people engage in reminiscence. However, the presence of addiction in the elderly may influence this process. The current study examined the life of Burt, a sixty-five year old man with substance use disorder, his reflections on death, and the different types of reminiscence he uses. Using a case study, six themes were uncovered. Burt's reflections on death revealed his awareness of his death, how he plans to spend his dying days, and his idea of a symbolic death by losing his loved ones. Burt engages in reminiscence patterns that are composed of identity recollections, life milestones, and painful experiences. These themes were examined in order to understand how an elderly person with addiction prepares for his own death. Research limitations, recommendations, and implications in clinical practice and human development research are also discussed.
Collapse
Affiliation(s)
- Sixtus Dane A Ramos
- Department of Psychology, De La Salle University Manila, Manila, Philippines
| |
Collapse
|
9072
|
Hodge SY, Ali MR, Gordon AL. Recognizing and responding to deterioration in care homes: a scoping review protocol. JBI Evid Synth 2020; 19:447-453. [PMID: 33230017 DOI: 10.11124/jbisrir-d-19-00413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To identify the available published primary research and any relevant policies, guidelines, or protocols regarding how care home staff recognize and respond to an acutely deteriorating resident. INTRODUCTION Older people living in care homes have complex health care needs. Chronic illnesses, comorbidities, frailty, cognitive impairment, and physical dependency can contribute to unpredictable changes in their health status that can lead to residents becoming unwell and acutely deteriorating. Exploring how care home staff recognize and respond to acutely deteriorating health among residents is important to understand whether opportunities exist to minimize these unpredictable changes in health. INCLUSION CRITERIA This scoping review will consider studies that feature the recognition and response to acute deterioration in care home residents. This review will consider qualitative and quantitative primary research. Non-indexed and gray literature such as policies, deterioration tools, and reports from health policy organizations will also be included. METHODS The searches will be conducted using bibliographic databases, university repositories, and non-indexed and gray literature, such as reports by health care and health policy organizations. The studies will be independently selected from the inclusion criteria by two researchers based on their title and abstract. In case of disagreement, a third researcher will be consulted. An adapted version of the JBI data extraction form will be used to extrapolate data from included studies. The results will be presented in tabular form, accompanied by a narrative summary related to the objectives of the scoping review.
Collapse
Affiliation(s)
- Sevim Y Hodge
- Division of Rehabilitation, Ageing and Well Being, University of Nottingham, Nottingham, UK.,Institute of Nursing and Midwifery Care Excellence, Nottingham University Hospital NHS Trust, Nottingham, UK
| | - Mohammad R Ali
- Nottingham Respiratory Research Unit, Nottingham University Hospital NHS Trust, Nottingham, UK
| | - Adam L Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
9073
|
Mathilde N, Catherine P, Pascale V, Xavier G. [Narrative inquiries from kidney transplant patients: From the onset of the disease to the transplant]. Nephrol Ther 2020; 16:359-363. [PMID: 33222804 DOI: 10.1016/j.nephro.2020.07.211] [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: 04/15/2020] [Revised: 07/03/2020] [Accepted: 07/08/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In 2018, we counted 14 291 patients on the French kidney transplantation waiting list, and 3546 grafted. The law applies the presumed consent and public surveys shows a desire for information. The objective of this research was to describe transplanted patients' lives history in order to cope with this need for information. METHODS Qualitative study, narrative inquiries, of French Auvergne-Rhône-Alpes transplanted patients' life story, between December 2016 and February 2019. Interviews were fully transcribed and analyzed by two researchers. The sampling was defined by gender, age, dialysis time and socio-professional categories. Notification to the French data protection authority was carried out. RESULTS With the ninth interview, sufficient data was collected. The start of the disease could be insidious or brutal. All interviewees changed lifestyle habits. Sometimes, the dialysis made the recovery of certain autonomy possible, but had nutritional and organizational constraints. Transplantation, without complications, reduced significantly the burden of the disease and its treatment. The difficult and agonizing expectancy of the transplant was then replaced by the patients' feeling of Damocles sword due to the uncertainty around the graft's life expectancy. The dialysis burdens were replaced by the immunosuppressive side effects. The patients' dependence on the graft resonated with a moral duty towards the donor, their relatives and themselves. CONCLUSION Renal insufficiency comprises alternations of autonomy and dependence.
Collapse
Affiliation(s)
- Naro Mathilde
- Département de médecine générale de la faculté Jacques Lisfranc de médecine de Saint-Étienne, France
| | - Plotton Catherine
- Département de médecine générale de la faculté Jacques Lisfranc de médecine de Saint-Étienne, France
| | - Vassal Pascale
- Service de soins palliatifs, Centre hospitalier universitaire de Saint-Étienne, avenue Albert Raimond, 42270 Saint-Priest-en-Jarez, France
| | - Gocko Xavier
- Département de médecine générale de la faculté Jacques Lisfranc de médecine de Saint-Étienne, France; Laboratoire SNA-EPIS EA4607, 42055 Saint-Étienne cedex 2, France; Health Services and Performance Research (HESPER), EA7425, 42055 Saint-Etienne cedex 2, France.
| |
Collapse
|
9074
|
Moreira CB, Dahinten VS, Howard AF, Fernandes AFC, Schirmer J. Factors related to mammography adherence among women in Brazil: A scoping review. Nurs Open 2020; 8:2035-2049. [PMID: 34388860 PMCID: PMC8363398 DOI: 10.1002/nop2.706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/30/2020] [Accepted: 11/04/2020] [Indexed: 01/24/2023] Open
Abstract
AIM To explore and synthesize the literature on factors related to mammography screening adherence among women in Brazil. DESIGN A scoping review. METHODS We searched 11 databases for studies published between 2006-January 2020. All identified articles were screened, and data were extracted from eligible studies. We used the UK Government Social Research Service weight of evidence appraisal tool to appraise the quality of the included study. RESULTS From a total of 1,384 identified articles, 22 were retained. All included studies used quantitative, non-experimental methods and all but two studies used cross-sectional data. Quality of evidence varied across studies. We identified 41 factors that were investigated across the set of studies. Demographic and socio-economic factors were the most commonly investigated, with older age, urban residence, living in the southeast of Brazil, higher level of education, higher income and private health insurance most consistently associated with mammography adherence.
Collapse
Affiliation(s)
- Camila Brasil Moreira
- School of Nursing, Federal University of São Paulo, São Paulo, Brazil.,School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - V Susan Dahinten
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - A Fuchsia Howard
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | | | - Janine Schirmer
- School of Nursing, Federal University of São Paulo, São Paulo, Brazil
| |
Collapse
|
9075
|
Preventing harm related to CBT supervision: a theoretical review and preliminary framework. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Like any treatment, cognitive behavioural therapy (CBT) may have negative as well as positive outcomes, and the same is true of CBT supervision. This is recognized in definitions of supervision, which prioritize helping supervisees to ‘do no harm’ to their patients. Client harm is associated with personal distress in supervisees (therapists), such as burnout, resulting in sub-standard therapy which causes harm to patients. Some supervisors have contributed to the supervisees’ distress, and consequently to patient harm. Harm may also arise from other staff members, or from situational factors that impact negatively on various aspects of the healthcare environment. At a more distal level, the host organization may create a context that allows such problems to go unchecked (e.g. a failure to train or support supervisors adequately). It follows that a large-scale framework is necessary to fully understand and address this multi-dimensional and systemic context for harm. Therefore, this theoretical review sketches out a preliminary ‘infidelity framework’ in order to classify ten types of problem behaviour that commonly contribute to harm that is linked to supervision. Drawing on related frameworks and neighbouring literatures, the infidelity framework also offers an understanding of the typical antecedents and consequences of each of these ten behaviours. This generic functional analysis leads to examples of evidence-based CBT supervision that might prevent or rectify harm.
Collapse
|
9076
|
Östman M, Bäck-Pettersson S, Sundler AJ, Sandvik AH. Nurses' experiences of continuity of care for patients with heart failure: A thematic analysis. J Clin Nurs 2020; 30:276-286. [PMID: 33141466 DOI: 10.1111/jocn.15547] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/06/2020] [Accepted: 10/23/2020] [Indexed: 01/04/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to describe nurses' experiences of continuity of care for patients with heart failure. BACKGROUND Heart failure is a life-influencing condition that causes varying care needs over time with risks of fragmentation. Nurses play an important role in caring for patients with heart failure. However, nurses' experiences of continuity of care seem to be less explored in this context. DESIGN A qualitative study with a descriptive design. METHODS Four focus groups were chosen to collect the data, and the analysis was made by using a method for thematic analysis. A purposeful sampling of nurses (n = 14) with experiences from hospital-connected heart failure clinics, primary healthcare centres and municipal home healthcare settings was recruited. The COREQ checklist was used in this study. RESULTS The nurses' experiences of continuity of care for patients with heart failure were described in four themes: access and flexibility, responsibility and transparency, trustful and caring relationships and communication and collaboration. CONCLUSIONS The results indicate that nurses have an excellent position to act as the "hub" in caring for patients with heart failure, but they need to have the possibility of networking and establishing trusting relationships with their colleagues. From the nurses' point of view, mutual trust between the nurse, the patient and the patient's next of kin is crucial for promoting and maintaining continuity of care in patients with heart failure. RELEVANCE TO CLINICAL PRACTICE To promote continuity of care for patients with heart failure, nurses expressed the necessity of establishing trusting relationships in a continuity-promoting organisation with seamless coordination. Nurses can be the "hub" supporting a person-centred care approach based on the patients' needs. There seems to be a need for better collaboration with common guidelines across and within primary healthcare centres, hospital-connected heart failure clinics and municipal home healthcare settings.
Collapse
Affiliation(s)
- Malin Östman
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Region Västra Götaland, Närhälsan Källstorp Health Centre, Trollhättan, Sweden.,Region Västra Götaland, Research and Development Primary Health Care, R, D&E Centre Fyrbodal, Västra Götaland, Sweden
| | - Siv Bäck-Pettersson
- Region Västra Götaland, Research and Development Primary Health Care, R, D&E Centre Fyrbodal, Västra Götaland, Sweden
| | - Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Ann-Helén Sandvik
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| |
Collapse
|
9077
|
Jiménez-Rodríguez D, Belmonte García MT, Santillán García A, Plaza del Pino FJ, Ponce-Valencia A, Arrogante O. Nurse Training in Gender-Based Violence Using Simulated Nursing Video Consultations during the COVID-19 Pandemic: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228654. [PMID: 33233390 PMCID: PMC7700114 DOI: 10.3390/ijerph17228654] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 01/10/2023]
Abstract
Gender-based violence (GBV) is a serious global public health problem that becomes aggravated during public health emergencies that involve quarantine measures. It is important to train nursing students on GBV, especially in vulnerable situations, such as the current COVID-19 pandemic. The purpose of our study is to explore the perceptions of third-year nursing students about simulated nursing video consultations for providing assistance to potential cases of GBV victims using a high-fidelity clinical simulation methodology. After all of the simulated scenarios were completed, 48 scripted interviews were carried out following a guide composed of four open-ended questions to facilitate in-depth discussion. A descriptive qualitative study based on the interpretative paradigm was conducted. The nursing students indicated that they improved their knowledge on GBV victim management (mainly their awareness of the problem, recognition of the role of nursing professionals, and performance of non-technical skills), although they also mentioned the need for continuous training (particularly in socio-emotional skills, interview techniques, a holistic nursing care approach, and not presupposing). This innovative high-fidelity simulation methodology allows nursing students to improve their awareness of the GBV problem, acquire a realistic view about their role in addressing GBV, and build their non-technical skills (such as active listening, communication skills, empathy, and generating confidence) required to adequately care for victims of GBV.
Collapse
Affiliation(s)
- Diana Jiménez-Rodríguez
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (M.T.B.G.); (F.J.P.d.P.)
- Correspondence:
| | - María Teresa Belmonte García
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (M.T.B.G.); (F.J.P.d.P.)
| | | | - Fernando Jesús Plaza del Pino
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (M.T.B.G.); (F.J.P.d.P.)
| | - Alicia Ponce-Valencia
- Faculty of Nursing, Campus de los Jerónimos s/n, Catholic University of Murcia, 30107 Murcia, Spain;
| | - Oscar Arrogante
- University Centre of Health Sciences San Rafael, San Juan de Dios Foundation, Nebrija University, 28036 Madrid, Spain;
| |
Collapse
|
9078
|
Tollefsen S, Førland O, Deilkås ECT, Baste V, Bondevik GT. Patient Safety Culture in Norwegian Home Health Care – a study protocol. TIDSSKRIFT FOR OMSORGSFORSKNING 2020. [DOI: 10.18261/issn.2387-5984-2020-02-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
9079
|
Walters R, Leslie SJ, Sixsmith J, Gorely T. Health Literacy for Cardiac Rehabilitation: An Examination of Associated Illness Perceptions, Self-Efficacy, Motivation and Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228641. [PMID: 33233804 PMCID: PMC7699978 DOI: 10.3390/ijerph17228641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022]
Abstract
Following a diagnosis of cardiovascular disease there is a need for patients to self-manage. Health literacy has been shown to be lower in patients with cardiovascular disease, yet research into health literacy in this population is limited. This study used the Health Literacy Questionnaire (HLQ) to examine the health literacy and associated health, health behaviours and psychological profiles of cardiac rehabilitation patients from a remote and rural regional programme in the Scottish Highlands. Consecutive patients referred to the service in a calendar year were sent a cross-sectional questionnaire by post. Hierarchical cluster analysis grouped respondents based on their health literacy profile, and nonparametric methods were used to analyse differences between clusters on the other measures. A total of 282 participants responded (45.7%). Respondents were older (median: 71 years) and more likely to be from more affluent areas. Five health literacy clusters emerged with different profiles of health, physical activity, self-efficacy, motivation and illness perceptions. There was no difference in relation to cardiac rehabilitation attendance by health literacy cluster, but those with lower health literacy were less likely to be aware of the referral. Patterns of health literacy are associated with health, health behaviours and some psychological constructs. Knowledge of distinct cluster characteristics may help services better target interventions.
Collapse
Affiliation(s)
- Ronie Walters
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Inverness IV2 3JH, UK; (S.J.L.); (T.G.)
- Correspondence:
| | - Stephen J. Leslie
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Inverness IV2 3JH, UK; (S.J.L.); (T.G.)
- Cardiac Department, Raigmore Hospital, Inverness IV2 3UJ, UK
| | - Jane Sixsmith
- Health Promotion Research Centre, National University of Ireland Galway, H91 TK33 Galway, Ireland;
| | - Trish Gorely
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Inverness IV2 3JH, UK; (S.J.L.); (T.G.)
| |
Collapse
|
9080
|
Ree E, Wiig S, Braithwaite J, Aase I. To what degree and how do healthcare professionals in nursing homes and homecare practice user involvement? A mixed methods study. TIDSSKRIFT FOR OMSORGSFORSKNING 2020. [DOI: 10.18261/issn.2387-5984-2020-02-09] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
9081
|
Eghbali M, Bandari R, Heravi-Karimooi M, Ghaesemzadeh F, Montazeri A. Psychometric properties of the Persian version of Instrument of Professional Attitude for Student Nurses (IPASN). Nurs Open 2020; 8:784-791. [PMID: 33398934 PMCID: PMC7877126 DOI: 10.1002/nop2.682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/12/2020] [Accepted: 10/29/2020] [Indexed: 11/17/2022] Open
Abstract
Aim To evaluate nursing students’ professionalism attitude, it is necessary to use a validated and reliable instrument. Design This study aimed to develop the Persian version of the eight‐dimensional professionalism attitude questionnaire for student nurses (Instrument of Professional Attitude for Student Nurses). Methods In this cross‐sectional study during March to April 2017, after being translated into Persian and receiving experts’ comments face, content, and construct validity of the questionnaire were sought among nursing students. Internal consistency reliability was examined by estimating the Cronbach's alpha coefficient and stability was estimated by calculating intraclass correlation coefficinet. Results A total of 750 students with an average age of 24.15 (SD = 1.32) years participated in the study. Both exploratory and confirmatory factor analyses confirmed the construct of the questionnaire. Cronbach's alpha coefficient for the entire instrument was 0.89 and more than 0.70 for all dimensions. Also the intraclass correlation coefficient for the questionnaire was found to be 0.92, well above acceptable threshold. The findings approved that the Iranian version of Instrument of Professional Attitude for Student Nurses is a reliable and valid questionnaire. Hence, using this questionnaire to conduct studies is recommended.
Collapse
Affiliation(s)
- Mohammad Eghbali
- Student Research Committee, University Of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Razieh Bandari
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Majideh Heravi-Karimooi
- Elderly Care Research Center, College of Nursing & Midwifery, Shahed University, Tehran, Iran
| | | | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.,Faculty of Humanity Sciences, University of Science &Culture, ACECR, Tehran, Iran
| |
Collapse
|
9082
|
Kusi Amponsah A, Oduro E, Bam V, Kyei-Dompim J, Ahoto CK, Axelin A. Dynamics on the field: a focused study on the culture and context of pediatric pain management at four Ghanaian hospitals. BMC Pediatr 2020; 20:529. [PMID: 33218327 PMCID: PMC7678185 DOI: 10.1186/s12887-020-02399-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/21/2020] [Indexed: 11/10/2022] Open
Abstract
Background As part of efforts to develop and implement a short course educational program on pediatric pain management, the current study sought to understand the culture and contextual factors that influence children’s pain management in order to improve the practice in pediatric care settings. Methods Guided by Bourdieu’s theory of practice, a focused ethnographic study was conducted from October, 2018 to February, 2019. The study was contextualized at four Ghanaian hospitals among purposefully sampled nurses, physicians, hospitalized children and their families. During the 20-week study period, three ethnographers spent 144 h conducting participant-observation sessions. Formal and informal interviews were held with participants in addition to review of hospital records. Results Analysis of the field data resulted in four themes. “Children’s pain expression and response of caregivers” described the disposition (habitus) of both children and caregivers to act in particular ways due to children’s incomplete health status (bodily capital) which caused them pain and also resulted in discomforting procedures. “Pharmacological pain management practices and attitudes” elucidated the use of analgesics as the mainstay disposition (habitus) in children’s pain management due to high level of respect (symbolic capital) given to such interventions on the pediatric units (field). “Managing pain without drugs” illustrated healthcare providers and family caregivers’ disposition (habitus) of using diverse nonpharmacological methods in managing children’s pain. “Communication and interaction between pain actors” depicted how children’s access to care givers (social capital) can serve as a powerful tool in influencing pediatric pain assessment and management disposition (habitus) on the pediatric units (field). Conclusions The habitus of pediatric pain actors toward pain assessment and management practices are influenced by various forms of capital (social, cultural, symbolic, bodily and economic) operating at different levels on the pediatric care field. Quality improvement programs that seek to enhance pediatric pain management should use the insights obtained in this study to guide the development, implementation and evaluation stages. Supplementary Information Supplementary information accompanies this paper at 10.1186/s12887-020-02399-w.
Collapse
Affiliation(s)
- Abigail Kusi Amponsah
- Department of Nursing Sciences, Faculty of Medicine, University of Turku, Turku, Finland. .,Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Evans Oduro
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Victoria Bam
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joana Kyei-Dompim
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Collins Kwadwo Ahoto
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anna Axelin
- Department of Nursing Sciences, Faculty of Medicine, University of Turku, Turku, Finland
| |
Collapse
|
9083
|
Sogstad M, Skinner M. Samhandling og informasjonsflyt når eldre flytter mellom ulike helse- og omsorgstilbud i kommunen. TIDSSKRIFT FOR OMSORGSFORSKNING 2020. [DOI: 10.18261/issn.2387-5984-2020-02-10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
9084
|
Stokke R, Furnes M, Vifladt A, Ringsby Odberg K. Pasientsikkerhet og velferdsteknologi – parhester i utakt. TIDSSKRIFT FOR OMSORGSFORSKNING 2020. [DOI: 10.18261/issn.2387-5984-2020-02-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
9085
|
|
9086
|
Mélin M, Amieva H, Frasca M, Ouvrard C, Berger V, Hoarau H, Roumiguière C, Paternostre B, Stadelmaier N, Raoux N, Bergua V, Burucoa B. Support practices by an interdisciplinary team in a palliative-care unit for relatives of patients in agonal phase. BMC Palliat Care 2020; 19:173. [PMID: 33213448 PMCID: PMC7678093 DOI: 10.1186/s12904-020-00680-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/03/2020] [Indexed: 12/11/2022] Open
Abstract
Background In the absence of extant recommendations, the aim of this study was to formalise support practices used by an interdisciplinary team in a palliative-care unit (PCU) for the relatives of patients in the agonal phase preceding death. The secondary objective was to understand the expectations of relatives during this phase in terms of the support provided by professionals and volunteers. Methods Thirty-two people took part in this study; all were interviewed through focus groups (FGs). Each FG comprised one category of individuals working in the PCU: nurses, care- assistants, doctors, psychologists, other professionals, palliative-care volunteers, and relatives. Groups were surveyed using an interview guide, and the interviews were recorded and transcribed to enable identification and characterization of all practices. Care practices were classified into four categories: current consensual practices (i.e. performed by all team members), occasional consensual practices, non-consensual practices (performed by one or a few participants), and practices to be developed. Results In total, 215 practices were mentioned by professionals and palliative-care volunteers: 150 current consensual practices, 48 occasional consensual practices, 1 non-consensual practice, 16 practices yet to be developed, and 29 practices for relatives. Many practices were mentioned by different categories of participants; thus, after cross-checking, the number of practices decreased from 215 to 52. A list of practices deemed desirable by all was drawn up and then validated by the entire interprofessional team. These practices were organised around four themes: providing care and ensuring comfort; communicating, informing, and explaining; interacting; and mobilising interdisciplinary skills. Conclusions These results underline the importance of the quality of care provided to patients, the attention given to the relatives themselves, and they highlight the importance of the helping relationship. Following this study, which established a list of varied practices aimed at supporting the relatives of patients in agonal phase, it will be important to set up a broader study seeking to establish a consensus on these practices with an interprofessional group of experts from other PCUs using broad surveys and an adapted methodology. Such studies will make it possible to develop training modules for teams working with relatives. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-020-00680-4.
Collapse
Affiliation(s)
- M Mélin
- Palliative Care Service, Universitary Hospital Center Bordeaux, 1, rue Jean Burguet, 33075, Bordeaux, France.
| | - H Amieva
- Inserm 1219 Psycho-epidemiology of Aging and Chronic Diseases - Population Health Research Center-ISPED-University Bordeaux, Bordeaux, France
| | - M Frasca
- Palliative Care Service, Universitary Hospital Center Bordeaux, 1, rue Jean Burguet, 33075, Bordeaux, France
| | - C Ouvrard
- Inserm 1219 Psycho-epidemiology of Aging and Chronic Diseases - Population Health Research Center-ISPED-University Bordeaux, Bordeaux, France
| | - V Berger
- URISH, Universitary Hospital Center Bordeaux, Bordeaux, France
| | - H Hoarau
- URISH, Universitary Hospital Center Bordeaux, Bordeaux, France
| | - C Roumiguière
- Palliative Care Service, Universitary Hospital Center Bordeaux, 1, rue Jean Burguet, 33075, Bordeaux, France
| | - B Paternostre
- Palliative Care Service, Universitary Hospital Center Bordeaux, 1, rue Jean Burguet, 33075, Bordeaux, France
| | | | - N Raoux
- Inserm 1219 Psycho-epidemiology of Aging and Chronic Diseases - Population Health Research Center-ISPED-University Bordeaux, Bordeaux, France
| | - V Bergua
- Inserm 1219 Psycho-epidemiology of Aging and Chronic Diseases - Population Health Research Center-ISPED-University Bordeaux, Bordeaux, France
| | - B Burucoa
- Palliative Care Service, Universitary Hospital Center Bordeaux, 1, rue Jean Burguet, 33075, Bordeaux, France
| |
Collapse
|
9087
|
Mamalaki E, Balomenos V, Scarmeas N, Yannakoulia M. Type 2 Diabetes and Mediterranean Diet in Older Adults: a Brief Review of the Evidence. CURRENT GERIATRICS REPORTS 2020. [DOI: 10.1007/s13670-020-00340-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
9088
|
Hayajneh AA, Rababa M, Alghwiri AA, Masha'al D. Factors influencing the deterioration from cognitive decline of normal aging to dementia among nursing home residents. BMC Geriatr 2020; 20:479. [PMID: 33208090 PMCID: PMC7672837 DOI: 10.1186/s12877-020-01875-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A dearth of differential research exists regarding the determinants of mild cognitive impairment (MCI) and moderate cognitive impairment or dementia among nursing home residents. This study aimed to identify and examine the association between medical factors (number of comorbidities, hospitalization, disability, depression, frailty and quality of life) and moderate cognitive impairment or dementia in nursing homes residents. METHODS A cross-sectional design was used in this study. Convenience sampling of 182 participants was conducted in nursing homes located in the central part of Jordan. Montreal cognitive assessment (MoCA) was used to screen both MCI and moderate cognitive impairment or dementia. Bivariate analysis, including t-test and ANOVA test, and logistic and linear regression models were used to examine and identify the medical factors associated with moderate cognitive impairment or dementia compared to mild cognitive impairment. RESULTS Most nursing home residents had MCI (87.4%) compared to a few with moderate cognitive impairment or dementia. Age (t = - 2.773), number of comorbidities (t = - 4.045), depression (t = - 4.809), frailty (t = - 4.038), and quality of life physical (t = 3.282) and mental component summaries (t = 2.469) were significantly different between the stages of cognitive impairment. Marital status (t = - 4.050, p < 0.001), higher-income (t = 3.755, p < 0.001), recent hospitalization (t = 2.622,p = 0.01), depression (t = - 2.737, p = 0.007), and frailty (t = 2.852, p = 0.005) were significantly associated with mental ability scores among nursing home residents. CONCLUSION The coexistence of comorbidities and depression among nursing home residents with MCI necessitates prompt management by healthcare providers to combat depressive symptoms in order to delay the dementia trajectory among at-risk residents. TRAIL REGISTRATION ClinicalTrials.gov NCT04589637 , October 15,2020, Retrospectively registered.
Collapse
Affiliation(s)
- Audai A Hayajneh
- Adult health-nursing department, Faculty of Nursing, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan.
| | - Mohammad Rababa
- Adult health-nursing department, Faculty of Nursing, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan
| | - Alia A Alghwiri
- Department of Physiotherapy, School of Rehabilitation Sciences, University of Jordan, Amman, Jordan
| | - Dina Masha'al
- Adult health-nursing department, Faculty of Nursing, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan
| |
Collapse
|
9089
|
Students’ Social Construction of Knowledge through Cooperative Learning. SUSTAINABILITY 2020. [DOI: 10.3390/su12229606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this manuscript is twofold: to critically analyze the principles of epistemic diversity and democracy and perform an analysis of the social construction of knowledge by university students through cooperative learning. The semi-structured interview methodology employed in the research revealed that the students provided a positive assessment of the possibilities of cooperation in heterogeneous teams: the array of experiences that were emerging in the process helped the students in the tertiary systems transcend the boundaries of their knowledge, share experiences, and construct new knowledge together. The research also highlighted students’ critical attitudes towards previous teamwork experiences, which relied more on an individualist than social approaches to knowledge. It also reflected on the causes and consequences of those experiences. Student interviews revealed a variety of difficulties the students were facing during team cooperation. The unconventional study process, centred on active and independent performance, social construction of knowledge, triggered confusion of the students’ roles, dissatisfaction with the unequal contributions by the team members to the common work, and the lack of teachers’ intervention. The findings established the basis for the design of the educational approaches for university students to socially construct knowledge through cooperation.
Collapse
|
9090
|
Tetteh J, Ekem-Ferguson G, Swaray SM, Kugbey N, Quarshie ENB, Yawson AE. Marijuana use and repeated attempted suicide among senior high school students in Ghana: Evidence from the WHO Global School-Based Student Health Survey, 2012. Gen Psychiatr 2020; 33:e100311. [PMID: 33195989 PMCID: PMC7607604 DOI: 10.1136/gpsych-2020-100311] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/23/2020] [Accepted: 08/14/2020] [Indexed: 12/18/2022] Open
Abstract
Background The association between substance use including marijuana use and attempted suicide has been well documented. However, little is known about marijuana use and its association with attempted suicide repetition among young people in low-income and middle-income contexts. Aims This analysis was conducted to assess the factors associated with marijuana use and ascertain marijuana use as a determinant of repeated attempted suicide among senior high school (SHS) students in Ghana. Methods Data from the 2012 Global School-Based Student Health Survey in Ghana was used for this study. Modified Poisson, Logistic and Probit models weighted with Mahalanobis distance matching within propensity calliper were employed separately to determine the hypothetical association between marijuana use and repeated attempted suicide. All analysis was performed using Stata 16 and p≤0.05 was deemed statistically significant. Results The prevalence estimates of marijuana use and repeated attempted suicide among SHS students in Ghana were 3.4% (95% CI: 2.3 to 5.1) and 11.5% (95% CI: 9.1 to 14.4), respectively. The prevalence of marijuana use was significantly associated with school grade, smoking exposure, parent smoker, alcohol intake and truancy. Marijuana use was positively associated with repeated attempted suicide among SHS in Ghana (φ correlation=0.23, p<0.001). Repeated attempted suicide among students who use marijuana was approximately threefold and fivefold significant compared with non-marijuana use students, based on the Poisson (adjusted prevalence ratio: 3.02; 95% CI: 1.67 to 5.43, p<0.001) and Logistic (adjusted OR:5.06; 95% CI: 3.19 to 11.64, p<0.001) estimates respectively. Also, the Probit model showed that marijuana use significantly increased the log count of repeated attempted suicide by 95% (aβ: 0.95; 95% CI: 0.49 to 1.41, p<0.001). Conclusion Marijuana use does not only influence the onset of suicidal attempts but also repeated attempted suicide among SHS students in Ghana. Special attention is required for suicide attempters with a history of repeated attempts and current marijuana use among SHS students in Ghana. Early identification of the potential risk and protective factors is recommended to inform school-based interventions. National level structured school-based substance abuse interventions and health promotion programmes would be useful.
Collapse
Affiliation(s)
- John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - George Ekem-Ferguson
- Department of Psychiatry, Korle Bu Teaching Hospital, Accra, Greater Accra, Ghana
| | | | - Nuworza Kugbey
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Volta Region, Ghana
| | - Emmanuel Nii-Boye Quarshie
- Department of Psychology, School of Social Sciences, University of Ghana College of Humanities, Accra, Greater Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| |
Collapse
|
9091
|
Hakimi H, Joolaee S, Ashghali Farahani M, Rodney P, Ranjbar H. Moral neutralization: Nurses' evolution in unethical climate workplaces. BMC Med Ethics 2020; 21:114. [PMID: 33203415 PMCID: PMC7672869 DOI: 10.1186/s12910-020-00558-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 11/04/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction Good quality of care is dependent on nurses’ strong clinical skills and moral competencies, as well. While most nurses work with high moral standards, the moral performance of some nurses in some organizations shows a deterioration in their moral sensitivity and actions. The study reported in this paper aimed to explore the experiences of nurses regarding negative changes in their moral practice. Materials and methods This was a qualitative study utilizing an inductive thematic analysis approach, which was conducted from February 2017 to September 2019. Twenty-five nurses participated in semi-structured interviews. Results The main theme that emerged from our analysis was one of moral neutralization in the context of an unethical moral climate. We found five sub-themes, including: (1) feeling discouraged; (2) normalization; (3) giving up; (4) becoming a justifier; and (5) moral indifference. Conclusions Unethical moral climates in health organizations can result in deterioration of morality in nurses which can harm both patients and health systems. Some unethical behaviors in nurses can be explained by this process.
Collapse
Affiliation(s)
- Hamideh Hakimi
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Soodabeh Joolaee
- UBC Centre for Health Evaluation and Outcome Sciences (CHÉOS), Vancouver, BC, Canada
| | - Mansoureh Ashghali Farahani
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Patricia Rodney
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Hadi Ranjbar
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Science, Tehran, Iran.
| |
Collapse
|
9092
|
Arasli H, Furunes T, Jafari K, Saydam MB, Degirmencioglu Z. Hearing the Voices of Wingless Angels: A Critical Content Analysis of Nurses' COVID-19 Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8484. [PMID: 33207740 PMCID: PMC7696738 DOI: 10.3390/ijerph17228484] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/07/2020] [Accepted: 11/09/2020] [Indexed: 01/05/2023]
Abstract
The world has been affected by an outbreak of the novel coronavirus (COVID-19). Health care workers are among those most at risk of contracting the virus. In the fight against the coronavirus, nurses play a critical role. Still, most social media platforms demonstrate that nurses fear that their health is not being prioritized. The purpose of this study is to investigate nurses' experiences through analyzing the main themes shared on Instagram by nurses during the COVID-19 pandemic. In contrast with highly structured research, the current paper highlights nurses' natural language use in describing their experiences during the first months of the outbreak in their workplace. Instagram captions were utilized as a data source. Leximancer was utilized for the content analysis of nurses' narratives towards their coronavirus experience. We sought to accomplish three research objectives: the first was to identify the main themes in the descriptions of nurses' experiences shared via their social media, specifically Instagram; then, to determine the relationships among concepts, and finally, to give useful implications based on the findings. The current study uses a qualitative (i.e., narratives) approach to analyze the main components of the nurses' experiences during the pandemic. The Leximancer software analysis revealed nine major textual themes and the relationships among these themes. In order of the relative importance, the themes were "patients", "coronavirus", "exhaustion", "family", "hospital", "personal protective equipment" (PPE), "shift", "fear", and "uncertainty". The results offer practical implications based on the social media information regarding nurses' overall experiences.
Collapse
Affiliation(s)
- Huseyin Arasli
- Norwegian School of Hotel Management, University of Stavanger, 4036 Stavanger, Norway;
| | - Trude Furunes
- Norwegian School of Hotel Management, University of Stavanger, 4036 Stavanger, Norway;
| | - Kaveh Jafari
- Faculty of Tourism, Eastern Mediterranean University, TRNC, Via Mersin 10, Gazimagusa 99628, Turkey; (K.J.); (M.B.S.)
| | - Mehmet Bahri Saydam
- Faculty of Tourism, Eastern Mediterranean University, TRNC, Via Mersin 10, Gazimagusa 99628, Turkey; (K.J.); (M.B.S.)
| | - Zehra Degirmencioglu
- English Preparatory School, Cyprus West University, TRNC, Via Mersin 10, Gazimagusa 99450, Turkey;
| |
Collapse
|
9093
|
Ahlstedt C, Eriksson Lindvall C, Holmström IK, Muntlin Å. Flourishing at work: Nurses' motivation through daily communication - An ethnographic approach. Nurs Health Sci 2020; 22:1169-1176. [PMID: 33104296 PMCID: PMC7756815 DOI: 10.1111/nhs.12789] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/11/2020] [Accepted: 10/24/2020] [Indexed: 01/10/2023]
Abstract
Shortage and turnover of registered nurses are worldwide challenges, and work motivation is one factor in retaining staff in the healthcare sector. The aim of this study was to explore registered nurses' motivation expressed in daily communication, using the basic needs in self‐determination theory as a framework. A secondary analysis of ethnographic data, collected through participant observations, informal interviews during observations, and individual interviews, was used. A total sample of all registered nurses employed at a hospital unit in Sweden (n = 10) participated. The data were analyzed thematically through the lens of the basic needs in self‐determination theory: autonomy, competence, and relatedness. Self‐regulation of learning, the possibilities to discuss work‐related challenges with colleagues, and having registered nurses lead dialogues with physicians were factors connected to autonomy. Having a registered nurse and physician solve problems together was a factor connected to competence. A sense of belonging and security in a permissive climate between registered nurses was connected to relatedness. This paper has implications for increased awareness of the three basic motivational needs, which could be used in the development of attractive workplaces.
Collapse
Affiliation(s)
- Carina Ahlstedt
- Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden
| | | | - Inger K Holmström
- Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Åsa Muntlin
- Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden
| |
Collapse
|
9094
|
Chow KM, Tang FWK, Tang WPY, Leung AWY. Resilience-building module for undergraduate nursing students: A mixed-methods evaluation. Nurse Educ Pract 2020; 49:102912. [PMID: 33186821 DOI: 10.1016/j.nepr.2020.102912] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/08/2020] [Accepted: 10/26/2020] [Indexed: 12/30/2022]
Abstract
In nursing students, resilience is recognised as a critical quality that will enable them to face and solve the challenges encountered in their studies and future careers. This mixed-methods study aimed to develop a resilience-building module for university nursing students and evaluate its effects on resilience, well-being and mindfulness. We recruited a convenience sample of 195 nursing students and delivered a resilience-building module comprising three 90-minute workshops on the following topics: resilience and emotion regulation, stress management and mindfulness, and burnout and depression. The participants' views and perceptions of the module were explored using pre-test and post-test questionnaires and focus group interviews. No significant changes in outcomes were observed from the pre-test to the post-test. However, a multivariable linear regression analysis indicated that mindfulness was significantly associated with resilience. A qualitative data analysis revealed that the resilience-building module evoked the participants' awareness of resilience and was considered an enjoyable learning experience. In conclusion, although the quantitative results demonstrated no significant changes in outcomes after the module, the qualitative results suggested that the resilience-building module could have beneficial effects if included in the undergraduate nursing curricula. Finally, better mindfulness was identified as important for enhancing resilience among undergraduate nursing students.
Collapse
Affiliation(s)
- Ka Ming Chow
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Fiona W K Tang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Winnie P Y Tang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alice W Y Leung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
9095
|
Ligorio DV, Lyons GCB. Exploring differences in psychological professionals' attitudes towards and experiences of complementary therapies in clinical practice. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Daniela V. Ligorio
- School of Psychological Sciences, Australian College of Applied Psychology, Sydney, New South Wales, Australia
| | - Geoffrey C. B. Lyons
- School of Psychological Sciences, Australian College of Applied Psychology, Sydney, New South Wales, Australia
| |
Collapse
|
9096
|
Vaquero-Álvarez E, Cubero-Atienza A, Martínez-Jiménez MP, Vaquero-Abellán M, Redel-Macías MD, Aparicio-Martínez P. Occupational Safety and Health Training for Undergraduates Nursing Students: A Spanish Pilot. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8381. [PMID: 33198346 PMCID: PMC7696593 DOI: 10.3390/ijerph17228381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 12/28/2022]
Abstract
Most of blood borne and airborne pathogens are highly contagious, harmful and have prevalence among healthcare workers. In this group, healthcare students, especially nursing undergraduates, have even higher risk to be exposed and suffered a contagious accident. One of the main pillars to prevent exposure to such pathogens and decrease accidents seems to be through education. A prospective observational educational research focused on quantifying the students' knowledge, and prevention culture was carried out. The educational approach based on the development of a technological tool, its integration in the students' education, and posterior assessment. The Chi-square, ANOVA, Kruskal-Wallis, Man-Whitney U, and Spearman correlations were used to determine the effect of such educational methodology. The results, previous to the integration of the educational approach, showed differences between the elementary and proficient knowledge and correct procedure in each academic year (p < 0.05), being the best year the third academic year. The mean of elementary knowledge among second year students after the inclusion of the educational methodology improved for 2017/2018 with a mean of 7.5 (1.11) and in 2018/2019 with 7.87 (1.34). This study argued that the educational approach proposed could improve the prevention culture and knowledge among students and future healthcare professionals.
Collapse
Affiliation(s)
| | - Antonio Cubero-Atienza
- Departamento Ingeniería Rural, Ed Leonardo da Vinci, Campus de Rabanales, Universidad de Córdoba, 14071 Córdoba, Spain; (A.C.-A.); (M.D.R.-M.)
| | - María Pilar Martínez-Jiménez
- Applied Physics, Radiology and Physics Medicine Department, Albert Einstein Building, Campus de Rabanales, Universidad de Cordoba, 14014 Cordoba, Spain;
- Simulation Models in Energy, Transport, Physics, Engineering, Occupational Hazard Researcher Group, Junta de Andalucía, and Dpt. Applied Physics, Albert Einstein Building, Campus de Rabanales, Universidad de Cordoba, 14014 Cordoba, Spain
| | - Manuel Vaquero-Abellán
- GC12 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides, Campus de Menéndez Pidal, Universidad de Córdoba, 14071 Córdoba, Spain;
- Departamento de Enfermería, Fisioterapia y Farmacología, Campus de Menéndez Pidal, Universidad de Córdoba, 14014 Córdoba, Spain
| | - María Dolores Redel-Macías
- Departamento Ingeniería Rural, Ed Leonardo da Vinci, Campus de Rabanales, Universidad de Córdoba, 14071 Córdoba, Spain; (A.C.-A.); (M.D.R.-M.)
| | - Pilar Aparicio-Martínez
- GC12 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides, Campus de Menéndez Pidal, Universidad de Córdoba, 14071 Córdoba, Spain;
- Departamento de Enfermería, Fisioterapia y Farmacología, Campus de Menéndez Pidal, Universidad de Córdoba, 14014 Córdoba, Spain
| |
Collapse
|
9097
|
Grov EK, Dahl AA. Is neuroticism relevant for old cancer survivors? A controlled, population-based study (the Norwegian HUNT-3 survey). Support Care Cancer 2020; 29:3623-3632. [PMID: 33174077 PMCID: PMC8163664 DOI: 10.1007/s00520-020-05870-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/30/2020] [Indexed: 11/12/2022]
Abstract
Purpose Personality traits, particularly neuroticism, have an impact on people’s health and lifestyle. Due to lack of previous studies, we examined old cancer survivors (OCSs) versus cancer-free age-matched controls aged ≥ 70 years, regarding prevalence of high neuroticism, health problems in those with high and low neuroticism, and sociodemographic and clinical variables that were significantly associated with high neuroticism. Methods We merged data from a Norwegian population–based health study (the HUNT-3) and from the Cancer Registry of Norway identifying OCSs. Three cancer-free controls were drawn at random for each OCS. Neuroticism was self-rated on a brief version of Eysenck Personality Questionnaire. Between-group statistical comparisons were made between OCS and controls, and among their subgroups with high and low neuroticism. Logistic regression analyses were used to investigate independent variables significantly associated with high neuroticism. Results Twenty-nine percent of OCSs reported high neuroticism while controls reported 30%. OCSs showed significantly lower rate of good life satisfaction than controls. All other between-group comparisons were nonsignificant. Being OCSs was not significantly related to high neuroticism in the regression analyses. Sociodemographic, general health, and lifestyle issues, lack of energy, and low life satisfaction remained significantly associated with high neuroticism in the multivariable analysis. Conclusions The prevalence of high neuroticism was similar in OCSs and controls. High neuroticism was associated with negative health and lifestyle issues in both groups. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-020-05870-7.
Collapse
Affiliation(s)
- Ellen Karine Grov
- Department of Health Sciences, Oslo Metropolitan University, POBox 4, St.Olavs plass, 0130, Oslo, Norway.
| | - Alv A Dahl
- National Advisory Unit for Late Effects after Cancer Therapy, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
9098
|
Gopee S. Letters to the Editor. ACTA ACUST UNITED AC 2020; 29:1209. [PMID: 33180601 DOI: 10.12968/bjon.2020.29.20.1209a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Serena Gopee
- Final-year Medical Student, University College London
| |
Collapse
|
9099
|
Duignan M, Drennan J, McCarthy VJC. Impact of clinical leadership in advanced practice roles on outcomes in health care: A scoping review. J Nurs Manag 2020; 29:613-622. [PMID: 33098329 DOI: 10.1111/jonm.13189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/19/2020] [Accepted: 10/15/2020] [Indexed: 11/27/2022]
Abstract
AIM To undertake a scoping review of the literature exploring the impact of clinical leadership in advanced practice roles in relation to patient, staff and organisational outcomes. BACKGROUND An increasing number of publications as well as job specifications have identified clinical leadership as a cornerstone of advanced practice roles. However, it is unclear whether embedding clinical leadership in such roles has led to improvements in patient, staff or organisational outcomes. Therefore, identifying the extent to which clinical leadership in advanced practice roles relates to patient, staff and organisational outcomes is needed. METHOD A scoping review examining the relationship between clinical leadership in advanced practice roles and health care outcomes. Searching in SCOPUS, PubMed, Psychinfo and CINAHL Plus and Web of Science identified 765 potential articles. Independent selection, data extraction tabulation of findings and analysis were completed. RESULTS Seven studies were identified that met the inclusion criteria. Only studies reporting on nurses in advanced practice roles were included; no studies were identified that reported on the advanced practice roles of allied health professionals. The results indicate that there is no objective evidence of the impact of advanced practitioners' clinical leadership on patient, staff or organisational outcomes. CONCLUSION There is a paucity of objective evidence to identify the extent to which clinical leadership is enacted in advanced practice roles. The review indicates a need for closer alignment of AP clinical leadership policy aspirations and formal operational leadership opportunities for APs. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers have a key role in supporting and equipping APs with leadership competencies and opportunities to enable both capability and capacity building of such roles. Nurse managers should involve APs in health care leadership at an organisational level to maximize their contribution to health, quality practice environments and health care reform. Additionally, a distinct involvement in staff development, change, operational strategic decisions and policy development should be part of the AP role, which is facilitated by management.
Collapse
Affiliation(s)
- Martin Duignan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland.,Emergency Department, Our Lady's Hospital, Navan, Ireland
| | - Jonathan Drennan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Vera J C McCarthy
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| |
Collapse
|
9100
|
Yeh TF, Chang YC, Hsu YH, Huang LL, Yang CC. Causes of nursing staff burnout: Exploring the effects of emotional exhaustion, work-family conflict, and supervisor support. Jpn J Nurs Sci 2020; 18:e12392. [PMID: 33174674 DOI: 10.1111/jjns.12392] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/22/2020] [Accepted: 10/04/2020] [Indexed: 01/21/2023]
Abstract
AIM Nursing staff burnout threatens not only nurses' health but also the safety and health of their patients. Organizations should be aware of how work-related conflict can affect this burnout. This study examined the effect of supervisor support and work-family conflict on resource loss and burnout. METHODS A cross-sectional method and quantitative approach were adopted. A total of 300 questionnaires were distributed to clinical nursing staff in two regional teaching hospitals, and 239 valid questionnaires were returned. RESULTS Work-family conflict had a mediating effect on the relationship between supervisor support and emotional exhaustion. Emotional exhaustion fully mediated the relationships between depersonalization, work-family conflict, and reduced professional efficacy. CONCLUSION The mediating effect of emotional exhaustion in work-family conflict results from depersonalization and reduced professional efficacy, whereas work-family conflict mediated the effect of supervisor support on emotional exhaustion. The findings indicate that the medical industry should implement supervisor support strategies to reduce nursing staff work-family conflict and improve interventions for emotional exhaustion.
Collapse
Affiliation(s)
- Te-Feng Yeh
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan (R.O.C.)
| | - Yu-Chia Chang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan (R.O.C.).,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan (R.O.C.)
| | - Ya-Hui Hsu
- Department of Emergency, Taichung Armed Forces General Hospital, Taiwan (R.O.C.)
| | - Li-Ling Huang
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan (R.O.C.)
| | - Cheng-Chia Yang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan (R.O.C.)
| |
Collapse
|