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Lindberg NE, Kynø NM, Billaud Feragen K, Pripp AH, Tønseth KA. Early Follow-up of Parents by a Specialized Cleft Nurse After the Birth of an Infant with Cleft lip and/or Palate. Cleft Palate Craniofac J 2024; 61:1369-1382. [PMID: 37151047 PMCID: PMC11308288 DOI: 10.1177/10556656231171750] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
OBJECTIVE To document the impact of early follow-up by specialized cleft nurses (SCNs) to families of infants with cleft lip and/or cleft palate (CL/P). DESIGN Prospective inclusion of a control group, which received standard care alone, followed by an intervention group, which in addition received early SCN follow-up. SETTING The cleft lip and palate team at a University hospital. PARTICIPANTS 70 families (69 mothers and 57 fathers); control group (n = 38); intervention group (n = 32). INTERVENTION SCNs offered a consultation at the maternity ward and follow-ups by phone or face-to-face at one, three, eight weeks and six months after birth. OUTCOME MEASURES Use of Internet-Questionnaire, Quality of discharge teaching scale (QDTS), Post discharge coping difficulty scale (PDCDS), Response on follow-up by health professionals. RESULTS Infants in the intervention group were admitted less frequently to a Neonatal Intensive Care unit (NICU); 21.9% vs 51.4%, P = .012. Parents in the intervention group used internet for cleft-related reasons less frequently (74.6% vs 85.9%), P = .112 and the mothers benefitted less from cleft-related activity on the internet (P = .013). The intervention group reported higher mean score for satisfaction with total cleft care (P = .001). There were no significant group differences regarding mean total score for discharge teaching (P = .315) and coping difficulties (P = .919). CONCLUSION Early follow-up by a SCN with expertise in cleft care is highly valued by parents. Closer cooperation between the cleft team and health professionals at birth hospitals and Child health centers is necessary for optimal follow-up.
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Affiliation(s)
- Nina Ellefsen Lindberg
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nina Margrete Kynø
- Department of Nursing and Health Promotion, Acute and Critical illness, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kim Alexander Tønseth
- Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Zhao Y, Lai X, Zheng D, Zhang H, Zhang X, Huo X. A core competency evaluation index system for the graded use of clinical nurse specialists: A Delphi study. J Clin Nurs 2024; 33:3101-3114. [PMID: 38764176 DOI: 10.1111/jocn.17200] [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: 01/25/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/21/2024]
Abstract
AIMS AND OBJECTIVES To describe a grading system that can be used to evaluate core competency of clinical nurse specialists (CNSs) at different levels. BACKGROUND Evaluate core competence of CNSs at different levels reflects the quality of nursing and the development of the nursing profession. DESIGN This research employed the Delphi method. METHODS The STROBE checklist for observational cross-sectional studies was followed to report this research study. This study consisted of two main phases: a literature review and semistructured interviews. Individual semistructured interviews were conducted with 11 healthcare experts and two patients. Two rounds of questionnaire surveys were administered to 21 nursing experts using the Delphi method. The CNSs were classified as primary, intermediate or advanced based on their years of work, professional titles and educational qualifications. RESULTS The graded competency evaluation system consisted of five first-level indicators (clinical practice, consulting guidance and teaching, scientific research innovation, management and discipline development, and ethical decision-making), 15 second level indicators, and 40 third-level indicators. The authority coefficients (Cr) of the experts were .865 and .901. The Kendall's concordance coefficients of the three-level indicators were .417, .289 and .316 for primary CNSs; .384, .294 and .337 for intermediate CNSs; and .489, .289 and .239 for advanced CNSs. CONCLUSION The graded use evaluation system in clinical practice initially involves a comprehensive evaluation of the core abilities of CNSs. This is a tool for cultivating and grading the abilities of specialised nurses that can promote a practical upwards spiral. RELEVANCE TO CLINICAL PRACTICE The evaluation system can promote the scientific management and continuous improvement of CNSs in clinical nursing and can serve as a practical and objective reference for the effective management and development of CNSs. PATIENT OR PUBLIC CONTRIBUTION Patients participated in the data collection process, during which they shared their health-seeking experience with our research team.
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Affiliation(s)
- Yafang Zhao
- Department of Ophthalmology, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China
| | - Xiaoxing Lai
- Department of Neurology, Chinese Academy of Medical Sciences &Peking Union Medical College Hospital, Beijing, China
| | - Danping Zheng
- International Medical Services, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China
| | - Hongmei Zhang
- Department of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China
| | - Xinyue Zhang
- Department of Medical Intensive Care Unit, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China
| | - Xiaopeng Huo
- Department of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China
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53
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Palermo M, Rancourt D. Examining compulsive exercise as a risk factor for eating disorder symptoms in first-year college students using a latent change score modeling approach. Int J Eat Disord 2024; 57:1680-1690. [PMID: 38619370 DOI: 10.1002/eat.24219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Research suggests that both compulsive exercise and eating disordered behaviors increase during college. Despite strong cross-sectional associations between compulsive exercise and eating disorders, it is unknown if compulsive exercise is a variable risk factor for eating disorders or simply a correlate. It was hypothesized that increases in compulsive exercise would significantly and prospectively predict increases in overall number of eating disorder symptoms over the study period. METHOD A total of 265 first year college students who did not meet criteria for a full or subthreshold eating disorder diagnosis at Time 1 (age M = 18.15; SD = 0.42; 122 female [46%] at Time 1) completed reports of compulsive exercise and eating disorder symptoms via online questionnaires at four timepoints over the 9-month 2021-2022 academic year (76% retention rate). Hypotheses were tested using a bivariate latent change score model. RESULTS Hypotheses were not supported. Change in compulsive exercise did not predict change in number of eating disorder symptoms. Change in number of eating disorder symptoms also did not predict change in compulsive exercise. CONCLUSIONS Compulsive exercise did not emerge as a variable risk factor for the development of eating disorder symptoms among first year college students. The relationship between these behaviors should be investigated at different developmental timepoints, such as early adolescence, and potential third variables that may explain the observed co-occurrence should be explored. PUBLIC SIGNIFICANCE This study investigated whether increases in compulsive exercise predicted increases in number of eating disorder symptoms among first year college students. Compulsive exercise did not significantly predict number of eating disorder symptoms. Additional research is warranted to clarify the relationship between compulsive exercise and eating disorder symptoms.
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Affiliation(s)
- Madeline Palermo
- Department of Psychology, University of South Florida, Tampa, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, USA
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Wright MMM, Kvist TA, Imeläinen SM, Jokiniemi KS. Continuing education for advanced practice nurses: A scoping review. J Adv Nurs 2024; 80:3037-3058. [PMID: 37902130 DOI: 10.1111/jan.15911] [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: 02/27/2023] [Revised: 09/22/2023] [Accepted: 10/15/2023] [Indexed: 10/31/2023]
Abstract
AIM The aim of the study was to identify the nature and extent of scientific research addressing continuing education for advanced practice nurses. DESIGN A scoping review. REVIEW METHODS The Joanna Briggs Institute's methodology for scoping reviews. DATA SOURCES Electronic search was conducted on 17 September 2023 via CINAHL, PsycINFO, PubMed, Scopus, Web of Science, Cochrane Library and the Joanna Briggs Institute's Evidence-Based Practice Database for research articles published between 2012 and 2023. RESULTS Nineteen papers were included in this review. Scientific research on continuing education for advanced practice nursing roles (i.e. nurse practitioner, clinical nurse specialist) has primarily been conducted in the United States and mostly addresses online-delivered continuing education interventions for clinical care competency. Most of the interventions targeted nurse practitioners. CONCLUSION Continuing education has a pivotal role in supporting advanced practice nursing competency development. In addition to clinical care, future continuing education research should focus on other advanced practice nursing competencies, such as education, leadership, supporting organizational strategies, research and evidence implementation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Continuing education programmes for advanced practice nurses should be rigorously developed, implemented and evaluated to support the quality and effectiveness of patient care. IMPACT Continuing education for advanced practice nursing roles is an understudied phenomenon. This review highlights future research priorities and may inform the development of continuing education programmes. REPORTING METHOD PRISMA-ScR.
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Affiliation(s)
| | - Tarja Anneli Kvist
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Sanna Marika Imeläinen
- Faculty of Health Care and Social Services, LAB University of Applied Sciences, Lappeenranta, Finland
| | - Krista Susanna Jokiniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Huberts AS, Vrancken Peeters NJMC, Pastoor H, Paez CG, Koppert LB. Let's talk about sex! Why should healthcare professionals address sexual distress in breast cancer patients and survivors? Eur J Oncol Nurs 2024; 71:102606. [PMID: 38909440 DOI: 10.1016/j.ejon.2024.102606] [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: 11/10/2023] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE Sexual distress impacts the quality of life (QoL) of breast cancer patients but is often overlooked in standard care pathways. This study evaluated the prevalence and factors of sexual distress among Dutch breast cancer patients, compared them to the general population, and explored how sexual distress is discussed in clinical settings from the perspectives of patients and healthcare professionals (HCPs). METHODS Questionnaires containing the Female Sexual Distress Scale (FSDS) and demographic variables were distributed to women with breast cancer. The effect of breast cancer on sexual distress was assessed with a Mann-Whitney U test. Multivariable linear regression was used to analyze variables associated with FSDS. The Sexuality Attitudes and Beliefs Survey (SABS) was sent to HCPs. RESULTS Breast cancer patients reported significantly higher sexual distress compared to a Dutch non-breast cancer cohort, respectively 16.38 (SD 11.81) and 23.35 (SD 11.39). Factors associated with higher sexual distress were psychological comorbidities, the body image scale, and being diagnosed >10 years ago. Sexual distress was not discussed as often as patients needed. Barriers to addressing sexual distress were time constraints, HCPs' confidence in their ability to address sexual distress, and uncertainty about who is responsible for initiation. CONCLUSIONS Breast cancer patients showed significantly higher sexual distress compared to the Dutch population. However, it was not frequently addressed in the consultation room. While some barriers have been identified, this study highlights the importance of further exploring obstacles to integrating discussions about sexual distress into routine care to improve QoL of breast cancer patients.
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Affiliation(s)
- Anouk S Huberts
- Department of Quality and Patientcare, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Noëlle J M C Vrancken Peeters
- Academic Breast Cancer Center, Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hester Pastoor
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Cristina Guerrero Paez
- Dutch Breast Cancer Society (BVN), Godebaldkwartier 363, 3511 DTR, Utrecht, the Netherlands
| | - Linetta B Koppert
- Department of Quality and Patientcare, Erasmus University Medical Center, Rotterdam, the Netherlands; Academic Breast Cancer Center, Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
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Xiong H, Zhang X, Zeng H, Xie S, Yi S. Experience of diet in patients with inflammatory bowel disease: A thematic synthesis of qualitative studies. J Clin Nurs 2024; 33:3283-3293. [PMID: 38661241 DOI: 10.1111/jocn.17186] [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: 09/19/2023] [Revised: 04/08/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
AIM To synthesise the dietary expesriences of patients with inflammatory bowel disease by reviewing relevant qualitative studies. BACKGROUND Diet plays a crucial role in the development and progression of inflammatory bowel disease (IBD). There is no specific diet that can be recommended for all patients. We conducted a synthesis of qualitative studies to gain a comprehensive understanding of the dietary management experience of patients with IBD, aiming to provide better dietary guidance in the future. DESIGN A qualitative synthesis was conducted following the Thomas and Harden method and reported following the ENTREQ statement. METHODS Qualitative studies were systematically searched in five electronic databases: PubMed, PsycINFO, Embase, CINAHL, and Web of Science. There was no time limit for publication, and all database searches were up to 10 May, 2023. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was utilised to appraise the quality of the included studies. Data for inclusion in articles were extracted and analysed using a thematic synthesis method. RESULTS Six studies involving 119 patients were eventually included. The studies were conducted in six different countries. Four major themes were identified: the diet of patients with IBD is completely different from the normal one; manage symptoms and live with the disease by modifying diet; psychological adjustment to eating (be frustrated; worried and afraid; feel ashamed; growth and resilience); barriers and challenges (barriers from perceived social support; conflicts between diet and nutrition; challenges from food hedonism and cravings). CONCLUSIONS Patients with IBD highlighted the distinction between their diet and the normal diet. Dietary modifications were used as a way to manage symptoms and live with the disease. In addition to physical symptoms, patients experienced diet-related psychological changes. Dietary modifications in patients with IBD encounters difficulties and challenges, necessitating prompt guidance and intervention. (1) The implementation of dietary modifications in patients with IBD encounters numerous obstacles and complexities, necessitating prompt guidance and intervention. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. REGISTRATION The protocol was registered with PROSPERO (CRD42023391545).
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Affiliation(s)
- Huan Xiong
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China
- Clinical Research Center for Gut Microbiota and Digestive Diseases of Fujian Province, Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Xiamen, Fujian Province, P.R. China
- Department of Digestive Disease, Institute for Microbial Ecology, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China
| | - Xu Zhang
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China
- Clinical Research Center for Gut Microbiota and Digestive Diseases of Fujian Province, Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Xiamen, Fujian Province, P.R. China
- Department of Digestive Disease, Institute for Microbial Ecology, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China
| | - Huiling Zeng
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China
| | - Shanshan Xie
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China
- Clinical Research Center for Gut Microbiota and Digestive Diseases of Fujian Province, Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Xiamen, Fujian Province, P.R. China
- Department of Digestive Disease, Institute for Microbial Ecology, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China
| | - Shuanglian Yi
- Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China
- Clinical Research Center for Gut Microbiota and Digestive Diseases of Fujian Province, Xiamen Key Laboratory of Intestinal Microbiome and Human Health, Xiamen, Fujian Province, P.R. China
- Department of Digestive Disease, Institute for Microbial Ecology, School of Medicine, Xiamen University, Xiamen, Fujian Province, P.R. China
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Hanson A, Jackson S, Laures E. Implementing an Evidence-Based Functional Pain Assessment Scale in an Adult Inpatient Unit. Pain Manag Nurs 2024; 25:330-337. [PMID: 38616456 DOI: 10.1016/j.pmn.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 02/26/2024] [Accepted: 03/09/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND The focus on pain assessment using a single, one-dimension pain assessment scale can be problematic. Locally, challenges we faced with this were; a) pain was percieved as not being effectively managed, b) patients with chronic pain were not having their pain adequately controlled, and c) misconceptions and subsequent confusion between health care teams and patients related to what pain intensity scores mean to each individual. AIMS The purpose of this paper is to describe an evidence-based practice project aiming at improving pain assessment through the implementation of a Functional Pain Scale (FPS) on an adult inpatient cardiothoracic unit. DESIGN The Iowa Model-Revised and the Implementation Strategies for Evidence- Based Practice Guide served as the framework for this project. SETTING Over an 18-month period at a academic tertiary medical center in the midwest. PARTICIPANTS/SUBJECTS Staff and patients on an adult inpatient 48-bed medical and surgical cardiothoracic unit. METHODS Following a synthesis of the evidence, implementation of the FPS required various strategies, such as, individualized patient and staff education, audit and feedback, a pain policy revision, and creating documentation in the electronic medical record. Evaluation of the FPS consisted of patient and staff surveys pre- and postimplementation to assess knowledge, attitudes, and behaviors. RESULTS After the pilot period, over 75% of the patients preferred to use the FPS and almost all the patients found the scale easy to use. Nurses reported an increase in perception that pain documentation was complete, that the FPS allowed them to accurately document their patients' pain experience, and that their patients were well informed of their pain management plan. CONCLUSIONS This project supports successful implementation of the FPS within nursing workflow. The goal of using the FPS is to change pain management discussions from an intensity reduction to meeting goals of care, aligning expectations, and creating common language among patients and providers.
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Affiliation(s)
- Allison Hanson
- From the University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242; Iowa City VA Medical Center, Iowa City, Iowa.
| | - Seth Jackson
- From the University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242
| | - Elyse Laures
- From the University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242
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Clari M, Riva-Rovedda F, Dimonte V, Matarese M. Self-care styles of patients with chronic obstructive pulmonary disease: A mixed methods case study. Heart Lung 2024; 68:231-241. [PMID: 39089076 DOI: 10.1016/j.hrtlng.2024.07.011] [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: 04/05/2024] [Revised: 07/12/2024] [Accepted: 07/22/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND In people affected by chronic obstructive pulmonary disease (COPD), self-care is crucial for improving quality of life, decreasing symptom burden, and reducing health care-related costs. Unlike other chronic conditions, little is known about the factors that influence different self-care styles in COPD patients. OBJECTIVES To explore the factors that could influence the self-care styles of patients with COPD. METHODS A mixed methods case study design was used. Quantitative and qualitative data were collected at the same stage in a purposive sample of patients with COPD through questionnaires, interviews, and focus groups. Data were analyzed separately and then integrated to compare the cases. RESULTS Thirty-seven patients with COPD were recruited from an outpatient clinic, pulmonary rehabilitation unit and online in a patient support group. On average, participants scored below the level of adequacy in all self-care dimensions. Self-care maintenance was influenced by patient age, education level, and economic status. Most participants reported performing self-care behaviors, while some did not because they found it difficult or because they did not recognize their importance. When the quantitative and qualitative data of patients with higher and lower levels of self-care were integrated, four different styles of self-care were identified according to COPD severity, psychological distress and level of self-efficacy: proactive, inactive, reactive, and hypoactive. CONCLUSIONS Personal, clinical, psychological, and social factors not only influence the level of self-care performed by COPD patients but also contribute to the understanding of different self-care styles. This knowledge could support health care professionals in tailoring educational interventions.
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Affiliation(s)
- Marco Clari
- Department of Public Health and Pediatrics, University of Torino, via Santena 5bis, 10126 Turin, Italy.
| | - Federica Riva-Rovedda
- Department of Public Health and Pediatrics, University of Torino, via Santena 5bis, 10126 Turin, Italy
| | - Valerio Dimonte
- Department of Public Health and Pediatrics, University of Torino, via Santena 5bis, 10126 Turin, Italy
| | - Maria Matarese
- Department of Medicine and Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy
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Miyagami T, Watari T, Nishizaki Y, Sekine M, Shigetomi K, Miwa M, Chopra V, Naito T. Survey on nurse-physician communication gaps focusing on diagnostic concerns and reasons for silence. Sci Rep 2024; 14:17362. [PMID: 39075186 PMCID: PMC11286969 DOI: 10.1038/s41598-024-68520-6] [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: 02/26/2024] [Accepted: 07/24/2024] [Indexed: 07/31/2024] Open
Abstract
Diagnosis improvement requires physician-nurse collaboration. This study explored nurses' concerns regarding physicians' diagnoses and how they were communicated to physicians. This cross-sectional study, employing a web-based questionnaire, included nurses registered on Japan's largest online media site from June 26, 2023, to July 31, 2023. The survey inquired whether participants felt concerned about a physician's diagnosis within a month, if they communicated their concerns once they arose, and, if not, their reasons. The reasons for not being investigated were also examined. The nurses' frequency of feeling concerned about a physician's diagnosis and the barriers to communicating these concerns to the physician were evaluated. Overall, 430 nurses answered the survey (female, 349 [81.2%]; median age, 45 [35-51] years; median years of experience, 19 [12-25]). Of the nurses, 61.2% experienced concerns about a physician's diagnosis within the past month; 52.5% felt concerned but did not communicate this to the physician. The most common reasons for not communicating included concern about the physician's pride, being ignored when communicating, and the nurse not believing that a diagnosis should be made. Our results highlight the need to foster psychologically safe workplaces for nurses and create educational programs encouraging nurse involvement in diagnosis.
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Affiliation(s)
- Taiju Miyagami
- Department of General Medicine, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Takashi Watari
- General Medicine Center, Shimane University Hospital, Izumo, Japan
| | - Yuji Nishizaki
- Department of General Medicine, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Miwa Sekine
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
- Medical Technology Innovation Center, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Kyoko Shigetomi
- Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Mamoru Miwa
- Nikkei Business Publications, Inc, Tokyo, Japan
| | - Vineet Chopra
- Department of Medicine, Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Toshio Naito
- Department of General Medicine, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
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Wang M, Li D, Li J, Zhang X. Professional competencies in geriatric nursing for geriatric nurses: a latent profile analysis. BMC Nurs 2024; 23:512. [PMID: 39075426 PMCID: PMC11288073 DOI: 10.1186/s12912-024-02157-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND As the global population continues to age, social realities such as advanced age, disability and living alone are coming to the fore, and the demand for medical care and health services for the elderly is increasing dramatically, especially in geriatrics. Given the important role geriatric nurses play in the diagnosis and treatment of diseases and rehabilitation of elderly patients, and due to the uniqueness and complexity of geriatric work, this requires geriatric nurses not only to have the competencies that are available in general nursing, but also to ensure that they have sufficient geriatric core competencies in order to effectively meet the needs of the patients and accelerate their recovery. Although previous studies have investigated the core competencies of nursing staff, there has been little research on geriatric nurses' core geriatric nursing competencies and their predictors. The aim of this study was to investigate the current status of the geriatric nursing competency inventory (GNCI) among geriatric nurses using latent profiling, to identify potential subgroups and their population characteristics, and to explore the factors that influence the potential subgroups. METHODS From January to March 2024, 1,313 geriatric nurses in Hefei City were selected by stratified cluster sampling method and surveyed with general information questionnaire, geriatric nursing competency inventory, and occupational coping self-efficacy scale for nurses(OCSE-N). Potential subgroups of GNCI differences among geriatric nurses were identified by latent profile analysis (LPA). Multiple logistic regression analyses were used to explore the factors influencing the GNCI of geriatric nurses with different latent profiles. RESULTS Geriatric nurses' OCSE-N was positively correlated with GNCI, and the GNCI score was 123.06(41.60), which indicated that geriatric nurses' GNCI was at an intermediate level. The OCSE-N score was 35.44(7.34), which was at a relatively high level. There was heterogeneity in the GNCI of geriatric nurses, which was classified into three subgroups i.e., Low-competency group, Medium-competency group, High-competency group. The results of multiple logistic regression analyses showed that OCSE-N, title, whether or not they attended geriatric nurse specialist training, and specialist nurse status were predictors of GNCI among geriatric nurses (P < 0.05). CONCLUSION The GNCI categorical characteristics of geriatric nurses are obvious, and nursing managers should adopt targeted interventions according to the characteristics of nurses in different profiles to improve the overall quality of care.
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Affiliation(s)
- Mengxue Wang
- Nursing Department, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230000, China
| | - Dongdong Li
- Nursing Department, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230000, China
- Department of Nursing, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Western District, 107 East Huanhu Road, Hefei, Anhui, 230031, China
| | - Jingjing Li
- Department of Nursing, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, Anhui, 230000, China.
| | - Xiumei Zhang
- Department of Nursing, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, Anhui, 230000, China.
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Murad MH, Vaa Stelling BE, West CP, Hasan B, Simha S, Saadi S, Firwana M, Viola KE, Prokop LJ, Nayfeh T, Wang Z. Measuring Documentation Burden in Healthcare. J Gen Intern Med 2024:10.1007/s11606-024-08956-8. [PMID: 39073484 DOI: 10.1007/s11606-024-08956-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 07/17/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND The enactment of the Health Information Technology for Economic and Clinical Health Act and the wide adoption of electronic health record (EHR) systems have ushered in increasing documentation burden, frequently cited as a key factor affecting the work experience of healthcare professionals and a contributor to burnout. This systematic review aims to identify and characterize measures of documentation burden. METHODS We integrated discussions with Key Informants and a comprehensive search of the literature, including MEDLINE, Embase, Scopus, and gray literature published between 2010 and 2023. Data were narratively and thematically synthesized. RESULTS We identified 135 articles about measuring documentation burden. We classified measures into 11 categories: overall time spent in EHR, activities related to clinical documentation, inbox management, time spent in clinical review, time spent in orders, work outside work/after hours, administrative tasks (billing and insurance related), fragmentation of workflow, measures of efficiency, EHR activity rate, and usability. The most common source of data for most measures was EHR usage logs. Direct tracking such as through time-motion analysis was fairly uncommon. Measures were developed and applied across various settings and populations, with physicians and nurses in the USA being the most frequently represented healthcare professionals. Evidence of validity of these measures was limited and incomplete. Data on the appropriateness of measures in terms of scalability, feasibility, or equity across various contexts were limited. The physician perspective was the most robustly captured and prominently focused on increased stress and burnout. DISCUSSION Numerous measures for documentation burden are available and have been tested in a variety of settings and contexts. However, most are one-dimensional, do not capture various domains of this construct, and lack robust validity evidence. This report serves as a call to action highlighting an urgent need for measure development that represents diverse clinical contexts and support future interventions.
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Affiliation(s)
- M Hassan Murad
- Mayo Clinic Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA.
| | - Brianna E Vaa Stelling
- Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Colin P West
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Bashar Hasan
- Mayo Clinic Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Suvyaktha Simha
- Mayo Clinic Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Samer Saadi
- Mayo Clinic Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Mohammed Firwana
- Mayo Clinic Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Kelly E Viola
- Mayo Clinic Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | | | - Tarek Nayfeh
- Mayo Clinic Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Zhen Wang
- Mayo Clinic Evidence-Based Practice Center, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
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Lima FCD, Sagica TDP, Souza JLM, Prado MLD, Santana MED, Peixoto IVP, Valois RC. Profile of scientific production on nursing technology construction, validity and application: a bibliometric study. Rev Bras Enferm 2024; 77:e20230452. [PMID: 39082547 PMCID: PMC11290734 DOI: 10.1590/0034-7167-2023-0452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 04/10/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE to analyze the profile of scientific production on nursing technology construction, validity and application. METHODS this is a bibliometric study, carried out in six databases, based on the Methodi Ordinatio application, arranged in nine stages. To represent the findings, the VOSviewer® software was used. RESULTS 346 studies were identified, obtained from BDENF, CINAHL, EMBASE, LILACS, PubMed/MEDLINE, Scopus and Web of Science. There was a predominance of the English language, and 20% of the authors hold more than 25% of studies. Only two journals account for 25% of studies in the period studied. Twenty-six studies were selected for the InOrdinatio classification. Nursing Process (23%) stood out among the studies. The most produced technology was software (27%), and 50% of works describe construction and validity. CONCLUSIONS there is an emphasis on the creation of educational technologies, especially information technology. The data demonstrates opportunities for future research in the area.
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Posluszny KM, Ho DC, Veerasammy S, Taylor C, McDougall R, Fischer SL. A mixed methods approach to describe the efficacy of lift assist device use to reduce low back musculoskeletal disorder risk factors during three common patient extrication scenarios. APPLIED ERGONOMICS 2024; 121:104361. [PMID: 39067283 DOI: 10.1016/j.apergo.2024.104361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 07/30/2024]
Abstract
This mixed-method study evaluated the efficacy of lift assist device use (Binder®, Eagle®, Maxi Air®) relative to manual lifting/care-as-usual in reducing low back muscle activity and perceived exertion during simulated patient extrication tasks. User feedback was recorded to identify factors that might influence use. Twenty paramedics performed a floor to stretcher lift, lateral transfer, and confined space extrication care-as-usual and with lift assist devices. Use of a lift assist reduced low back muscle activity during floor to stretcher and confined space tasks by 34-47%. Paramedics perceived exertion decreased from 'somewhat hard' to 'light' or 'very light' when using an assistive device. Paramedics noted that ease of use, patient comfort, task time, patient acuity, among other considerations would influence use decisions. Lift assist devices were efficacious at reducing low back muscle activity and perceived exertion during floor to stretcher and patient extrication tasks.
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Affiliation(s)
- Kate M Posluszny
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
| | - Daphne C Ho
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
| | - Sanjay Veerasammy
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
| | - Cindi Taylor
- Niagara Emergency Medical Services, Niagara Falls, Canada
| | | | - Steven L Fischer
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada.
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Tomson C, Neuschatz R, Teixeira da Silva D. Harm reduction nursing and the path toward developing best practice: Lessons from caring for people with xylazine-associated wounds in Philadelphia, PA. Nurs Outlook 2024; 72:102248. [PMID: 39067108 DOI: 10.1016/j.outlook.2024.102248] [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: 03/26/2024] [Revised: 07/06/2024] [Accepted: 07/07/2024] [Indexed: 07/30/2024]
Abstract
Xylazine-associated wounds are a distinct, novel clinical entity characterized by co-occurrence with substance use, progressive necrosis of skin, muscle, tendon, and bone, and slow healing. In Philadelphia, the specter of limb loss, stigma, and shame has hung over hospital-based care for xylazine-associated wounds among people who use drugs (PWUD) and kept many people away from engaging in care. Continued engagement in harm reduction wound care nursing, however, offers an opportunity for PWUD to address their wounds and their fears with members of the medical world. In the absence of established best practices, harm reduction's model of risk-reductive care offers a way forward for patients and practitioners alike. Here, "harm reduction" describes an ethic of practical, trauma-informed, patient-centered care. It is this integration of harm reduction into medicine and public health that effectively promotes the safety, survival, and recovery of PWUD across all spectrums of drug use habits and housing stability.
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Affiliation(s)
- Catherine Tomson
- Division of Substance Use Prevention and Harm Reduction, Philadelphia Department of Public Health, Philadelphia, PA.
| | - Rachel Neuschatz
- Division of Substance Use Prevention and Harm Reduction, Philadelphia Department of Public Health, Philadelphia, PA
| | - Daniel Teixeira da Silva
- Division of Substance Use Prevention and Harm Reduction, Philadelphia Department of Public Health, Philadelphia, PA
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Owen S, Page S, Ledingham K, Price S, Connell J, Quinn C, Clare L. Embodied leisure experiences of nature-based activities for people living with dementia. DEMENTIA 2024:14713012241262384. [PMID: 39058935 DOI: 10.1177/14713012241262384] [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: 07/28/2024]
Abstract
PURPOSE This article adopts an embodiment lens to explore the individual leisure experiences of people living with dementia when engaging in nature-based pursuits. It focuses on how people living with dementia frame their everyday experiences of nature and how these are shaped by any cognitive challenges and/or other comorbidities affecting physical health. DESIGN/METHODOLOGY/APPROACH Taking a phenomenological research approach, we interviewed 15 people living with dementia and 15 family carers of people with dementia to explore how people with dementia engage with nature as a subjective leisure experience. We analysed their accounts using reflexive thematic analysis. FINDINGS The findings reveal how people living with dementia frame their experiences of nature-based pursuits through three interlinked themes of 'bodily feelings and emotions', 'sense of self and identity' and 'connectivity to others'. ORIGINALITY/VALUE The paper contributes to knowledge by examining through the lens of embodiment a neglected and overlooked dimension of everyday leisure: how nature is encountered, negotiated and enjoyed. The paper illustrates how nature and the outdoors may help people living with dementia to continue to enjoy prior leisure pursuits and thus achieve a degree of continuity in their everyday lives.
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Affiliation(s)
| | | | | | | | | | - Catherine Quinn
- Centre for Applied Dementia Studies, Bradford University, UK; Wolfson Centre for Applied Health Research, Bradford, UK
| | - Linda Clare
- University of Exeter Medical School, UK; NIHR Applied Research Collaboration South-West Peninsula, UK
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Sanz-Calvo J, Rivera-Vicente LJ, García-Carrión MDC, Gómez Del Pulgar García-Madrid M. Reliability of the Mental Health Nurse Competency Assessment Tool (ECOEnfSM): A pilot study. ENFERMERIA CLINICA (ENGLISH EDITION) 2024:S2445-1479(24)00072-9. [PMID: 39067616 DOI: 10.1016/j.enfcle.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 05/21/2024] [Indexed: 07/30/2024]
Abstract
AIM To evaluate the reliability of the ECOEnfSM scale as a tool to assess the professional competencies of Mental Health Nurse Practitioners (MHNP) in their clinical practice. METHOD A pilot study, observational, descriptive and cross-sectional, focuses on MHNP who have completed their Specialized Health Training Program (SHTP) in Spain. The data were collected by general and collaborators mentors of the Multiprofessional Teaching Units (MTUs). The Mental Health Nursing Competency Assessment Tool (ECOEnfSM) was used, which consists of three subscales and eight Competence Units (CU). A reliability and validity analysis were conducted (Cronbach's alpha and Spearman's correlation coefficient). RESULTS The Rotation Assessment subscales showed excellent reliability (r > 0.90) with high and very high correlations (r > 0.6) in all UCs with high levels of significance (P < .01). The Annual Assessment subscale showed good reliability (r > 0.80) with a medium and very high correlation (r > 0.4) with high levels of significance (P < .01). All UCs showed a good to excellent consistency (r > 0.80). The "Home Visits" assessment criterion showed heterogeneity of data due to there are few MTUs that fully develop it. CONCLUSION The ECOEnfSM scale showed very high reliability in MHNP during their training program in Spain. The ECOEnfSM is considered the only objective tool in Spain to assess the professional competencies in this population.
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Affiliation(s)
- Javier Sanz-Calvo
- Centro de Salud Mental Miraflores, Servicio de Psiquiatría y Salud Mental, Hospital Universitario Infanta Sofía, Madrid, Spain.
| | - Luis Javier Rivera-Vicente
- Servicio de Psiquiatría y Salud Mental, Hospital Clínico San Carlos, Madrid, Spain; Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - María Del Carmen García-Carrión
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
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Obeng-Nyarko CN, Ralston PA, Wickrama KKAS, Lemacks JL, Ilich JZ. Health for Hearts United Longitudinal Trial: Improving Perceived Stress and Allostatic Load Outcomes of Mid-Life and Older African American Women. HEALTH EDUCATION & BEHAVIOR 2024:10901981241263027. [PMID: 39051464 DOI: 10.1177/10901981241263027] [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: 07/27/2024]
Abstract
Cardiovascular disease (CVD) continues to be the leading cause of death in the United States, with African Americans experiencing higher age-adjusted mortality compared to Whites. African American women in particular carry a high CVD burden due to more exposure to adverse personal and socioenvironmental challenges. Church-based interventions can improve health behaviors and health status of African Americans, yet few have addressed stress-related health. The purpose of this study was to determine the effectiveness of the 18-month Health for Hearts United intervention in relation to stress-related outcomes (perceived stress, allostatic load) of mid-life and older African American women (≥45 years of age; n = 152 overall sample, n = 65 clinical subsample). The results of the repeated measures analysis of variance (ANOVA) analyses showed overall significant decreases in perceived stress and allostatic load for both treatment and comparison groups over the measurement occasions (baseline and 18 months) with educational level remaining as a significant correlate over time. There was no significant interaction between treatment and time, yet there were trends in improvements for the treatment group compared to the comparison group. The findings demonstrate the potential of church-based interventions in reducing both self-reported stress and allostatic load in African American women, and highlight the need for further investigation of educational level and other possible factors influencing stress management in these settings.
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Scroggins JK, Bruce KE, Stuebe AM, Fahey JO, Tully KP. Identification of postpartum symptom informedness and preparedness typologies and their associations with psychological health: A latent class analysis. Midwifery 2024; 137:104115. [PMID: 39094534 DOI: 10.1016/j.midw.2024.104115] [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: 06/19/2023] [Revised: 07/10/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Birthing parents, defined as postpartum women and people with various gender identities who give birth, commonly experience challenging postpartum symptoms. However, many report feeling uninformed and unprepared to navigate their postpartum health. OBJECTIVE To identify typologies of postpartum symptom informedness and preparedness using latent class analysis (LCA) and to examine the associated patient and healthcare characteristics. METHODS We used survey data from a large, multi-method, longitudinal research project Postnatal Safety Learning Lab. Participants were recruited using convenience sampling and enrolled between November 2020 and June 2021. LCA was used to identify subgroups of birthing parents with different symptom informedness and preparedness using 10 binary variables (N = 148). Bivariate analysis was conducted to examine the association between characteristics and each typology. FINDINGS The 3-class models had better fit indices and interpretability for both informedness and preparedness typologies: High, High-moderate, and Moderate-low. The sample characteristics were different by typologies. In the modified discrimination in medical settings assessment, we found higher discrimination scores in the moderate-low informedness and preparedness typologies. The moderate-low preparedness typology had a higher percentage of birthing parents who did not have private insurance, underwent cesarean section, and planned for formula or mixed infant feeding. The median PHQ-4 scores at 4 weeks postpartum were lower among those in high informedness and preparedness typologies. CONCLUSION In our sample, 18 to 21 % of birthing parents were in the moderate-low informedness or preparedness typologies. Future research and practice should consider providing tailored information and anticipatory guidance as a part of more equitable and supportive care.
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Affiliation(s)
- Jihye Kim Scroggins
- School of Nursing, Columbia University, 560W 168th Street, New York, NY, USA.
| | - Katharine E Bruce
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, USA
| | - Alison M Stuebe
- Department of Obstetrics and Gynecology, Gillings School of Global Public Health, and Collaborative for Maternal and Infant Health, School of Medicine, University of North Carolina at Chapel Hill, 3010 Old Clinic Building, Chapel Hill, NC, USA
| | - Jenifer O Fahey
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Maryland, 655W. Baltimore Street, Baltimore, MD, USA
| | - Kristin P Tully
- Department of Obstetrics and Gynecology and Collaborative for Maternal and Infant Health, School of Medicine, University of North Carolina at Chapel Hill, 3009 Old Clinic Building, Chapel Hill, NC, USA
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Menza R, Bongiovanni T, Leutwyler H, Tang J, Johnson JK, Howie-Esquivel J. Music-Based Interventions for Symptom Management in Critically Ill, Mechanically Ventilated Adults: A Scoping Review of the Literature. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024. [PMID: 39046944 DOI: 10.1089/jicm.2023.0483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Background: Patients in intensive care units experience high symptom burden during mechanical ventilation (MV). Pharmacologic symptom management is associated with side effects and increased morbidity. Music-based interventions (MBIs) have been associated with reductions in both anxiety in MV adults and pain for critically ill adults, yet their use for the management of other burdensome symptoms has not been evaluated. The purpose of this scoping review is to map the state of evidence for the use of prerecorded music listening MBIs for symptom management in MV adults. Methods: A systematic search of the literature was conducted across four electronic databases (PubMed, EMBASE, CINAHL, and Web of Science) for experimental designed studies that measured the efficacy of MBIs for the management of physical and psychological symptoms including anxiety, sedation/agitation, dyspnea, distress, delirium, sleep, stress, fear, loneliness, or depression in critically ill, MV adults between January 1, 1998, and April 18, 2023. Results: A total of 643 abstracts and 29 clinical trials were included. Overall, the risk of bias, assessed using the Evidence Project tool, was moderate. MBIs were mostly delivered with headphones using music selected either by investigators or from a limited selection. MBIs were associated with reduced pain, agitation, dyspnea, distress and anxiety, and improved tolerance of MV and sedative weaning. Outcomes of delirium were mixed. No studies explored sleep disturbances, fear, or loneliness. Conclusions: Use of MBIs improved symptom experience for critically ill adults during MV. Future studies employing unrestricted patient-preferred music selections and exploring outcomes of sleep quality, psychological distress, and delirium are needed in this highly symptomatic patient population.
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Affiliation(s)
- Rebecca Menza
- Trauma Surgery Department, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Tasce Bongiovanni
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Heather Leutwyler
- School of Physiological Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Julin Tang
- Department of Anesthesia, University of California San Francisco, San Francisco, California, USA
| | - Julene K Johnson
- University of California San Francisco Institute for Health & Aging, San Francisco, California, USA
| | - Jill Howie-Esquivel
- School of Physiological Nursing, University of California San Francisco, San Francisco, CA, USA
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Wei R, Lv H, Jiang G, Wang X, Zhang N, Guo S. Constructing a Competency Evaluation Index System for Nursing Positions in a Chronic Kidney Disease Management Centre. J Multidiscip Healthc 2024; 17:3577-3588. [PMID: 39070692 PMCID: PMC11283799 DOI: 10.2147/jmdh.s466176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
Objective The Chronic Kidney Disease Management Centre (CKDMC) primarily focuses on developing a new system for early screening, standardised diagnosis, treatment, and the long-term follow-up management of patients with chronic kidney disease (CKD) to enhance CKD prevention and management. Nurses play a pivotal role in the comprehensive management of CKD, contributing considerably to the improvement of patient survival. Consequently, this study constructs an evaluation index system for nursing positions in the CKDMC, delineating the required competencies of nurses and providing a foundation for their targeted training. Methods A literature review and semi-structured interviews were used to develop the competency evaluation index system for nursing positions at the CKDMC. The Delphi method, involving expert correspondence, was employed over two rounds of inquiry with 16 experts, focusing on screening, modifying, and refining the indicators at all levels. Results The response rates for the first and second rounds of the questionnaire were 100% and 93.8%, respectively, with expert authority coefficients of 0.73 for both rounds. The finalised competency evaluation index system includes 3 primary indicators (theoretical knowledge, practical skills, and professional attitude), 10 secondary indicators, and 44 tertiary indicators. Conclusion The study successfully established a CKD specialist nurse competency evaluation index system comprising 3 primary, 10 secondary, and 44 tertiary indicators. The consensus among experts was high, rendering the results scientific, objective, and reliable. This system can serve as a basis for the training, selection, and competency evaluation of nursing professionals in CKDMCs.
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Affiliation(s)
- Ruxian Wei
- Nephrology Department, Shanxi Provincial People’s Hospital, Taiyuan, 030001, People’s Republic of China
| | - Huimei Lv
- Nephrology Department, Shanxi Provincial People’s Hospital, Taiyuan, 030001, People’s Republic of China
| | - Gaiying Jiang
- Nephrology Department, Shanxi Provincial People’s Hospital, Taiyuan, 030001, People’s Republic of China
| | - Xueqing Wang
- Nephrology Department, Shanxi Provincial People’s Hospital, Taiyuan, 030001, People’s Republic of China
| | - Nan Zhang
- Nephrology Department, Shanxi Provincial People’s Hospital, Taiyuan, 030001, People’s Republic of China
| | - Songjia Guo
- Nephrology Department, Shanxi Provincial People’s Hospital, Taiyuan, 030001, People’s Republic of China
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Conte G, Magon A, Palmeri MA, Paglione G, Baroni I, Belloni S, Angolani M, Arcidiacono MA, Arrigoni C, Stievano A, Caruso R. The Public's Perception of Florence Nightingale's Legacy in the Digital Media: A Critical Discourse Analysis. NURSING REPORTS 2024; 14:1838-1848. [PMID: 39189267 PMCID: PMC11348171 DOI: 10.3390/nursrep14030137] [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: 06/05/2024] [Revised: 07/19/2024] [Accepted: 07/23/2024] [Indexed: 08/28/2024] Open
Abstract
This study critically examines the public's perception of Florence Nightingale's legacy through a critical discourse analysis (CDA) of digital media, specifically podcasts and YouTube. Nightingale, who is often remembered as "The Lady with the Lamp", holds a complex identity within modern narratives that is celebrated for her pioneering contributions to nursing and public health, even if there are some disagreements about her, given the colonialist setting that may have shaped some of her opinions and decisions. This research employed CDA to analyze 25 podcasts and 18 YouTube videos, which were systematically included according to a priori inclusion criteria. The study synthesized how these media products portray Nightingale and, by extension, shape public discourse about the nursing profession. The findings reveal five thematic representations of Nightingale: as a legendary figure, a modern feminist, a dedicated statistician, a pioneer in public health, and a pivotal STEM contributor. These portrayals challenge traditional nursing stereotypes by emphasizing Nightingale's role as a rigorous scientist and reformer, suggesting broader perceptions of nurses that encompass leadership, analytical skills, and strategic thinking. The study supports the hypothesis that digital narratives significantly influence the public's understanding and appreciation of nursing, advocating for a more nuanced professional identity that integrates traditional caregiving roles with critical and analytical capabilities.
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Affiliation(s)
- Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.M.); (G.P.); (I.B.); (M.A.)
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.M.); (G.P.); (I.B.); (M.A.)
| | | | - Giulia Paglione
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.M.); (G.P.); (I.B.); (M.A.)
| | - Irene Baroni
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.M.); (G.P.); (I.B.); (M.A.)
| | - Silvia Belloni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy; (S.B.); (C.A.)
| | - Miriam Angolani
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.M.); (G.P.); (I.B.); (M.A.)
| | | | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy; (S.B.); (C.A.)
| | - Alessandro Stievano
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy;
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.M.); (G.P.); (I.B.); (M.A.)
- Department of Biomedical Science for Health, University of Milan, 20133 Milan, Italy
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Cadorin L, Mazzega-Fabbro C, Cedrone S. Cancer nurses' experience during the COVID-19 pandemic: Multicenter mixed-methods study on coping and resilience strategies. BMC Nurs 2024; 23:502. [PMID: 39039595 PMCID: PMC11264387 DOI: 10.1186/s12912-024-02085-7] [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: 03/11/2023] [Accepted: 06/10/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND In early 2020, the COVID-19 pandemic created severe difficulties in clinical and organizational fields. Healthcare workers needed to protect their health and avoid infecting their family members, but also limit the virus's spread among vulnerable oncology patients undergoing hospital treatment. OBJECTIVE To evaluate the resilience and coping strategies of nurses working in the oncology setting. METHODS A mixed-methods study was conducted. First, two questionnaires (CD-RISK and COPE- NVI-25) were used to assess nurses' resilience strategies and coping mechanisms quantitatively. Second, qualitative semi-structured interviews were conducted to explore the personal experiences of nurses who cared for patients during the pandemic, and Colaizzi's framework was used for content analysis. RESULTS The 164 participants, the majority of whom were women (88.4%), reported high resilience. The CD-RISK score varied according to education. With respect to COPE-NIV-25, transcendent orientation and avoidance strategies had the lowest mean scores, while problem orientation was higher in nurses aged ≥ 40. Five themes emerged: (1) changes in work and personal areas; (2) feelings/emotions, such as fear of infection of themselves or their loved ones, difficulty in using the face mask, relational repercussions with patients or their families; (3) personal and working group strategies used to counteract the suffering attributable to COVID-19; (4) professionalism/nursing responsibilities in developing new rules and protocols, and (5) metaphors to describe their experiences. CONCLUSIONS The COVID-19 pandemic led to major changes in the nurses' roles, but they showed resilience and generated a positive working climate. IMPLICATION FOR PRACTICE Even in emergency situations, nursing administrations and policymakers ought to ensure that nurses receive adequate training and support to develop resilience and coping strategies.
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Affiliation(s)
- Lucia Cadorin
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via F. Gallini, 2, Aviano, 33081, Italy.
| | - Cristina Mazzega-Fabbro
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via F. Gallini, 2, Aviano, 33081, Italy
- University of Udine, Viale Ungheria, 49, Udine, 33100, Italy
| | - Sonja Cedrone
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via F. Gallini, 2, Aviano, 33081, Italy
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Sim H, Park Y. Effects of Auricular Acupressure on Nurses' Perceived Stress, Sleep Quality, and Presenteeism: A Single-Blind, Randomized Controlled Trial. Holist Nurs Pract 2024:00004650-990000000-00027. [PMID: 39042725 DOI: 10.1097/hnp.0000000000000667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
The physical and psychological health management of nurses is very important not only for individual nurses but also for organizations and patients. However, nurses are exposed to high stress, sleep problems, and high presenteeism. Therefore, this study aimed to examine the effects of auricular acupressure (AA) on nurses' stress, sleep problems, and presenteeism. This randomized controlled trial encompassed 60 nurses divided into an experimental group (n = 30) and a control group (n = 30). Auricular acupressure using AA stickers with small magnets attached was performed in the experimental group, and a placebo AA using simple AA stickers (without the small magnets) was performed in the control group. The treatment lasted 7 weeks. To confirm the results, stress, sleep quality, and presenteeism were measured at pre- and posttest. There was a statistically significant difference in scores for sleep quality (t = -1.98, P = .047), health problems (z = -2.38, P = .017), and work impairment (t = -4.46, P < .001) between the experimental and control groups at posttest. Auricular acupressure increased sleep quality scores and decreased presenteeism. Auricular acupressure using AA stickers with small magnets attached was effective in improving sleep quality and reducing presenteeism in nurses.
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Affiliation(s)
- Hyunseo Sim
- Author Affiliations: College of Nursing, Graduate School, Dongguk University, Gyeongju, Gyeongsangbuk-do, Republic of Korea
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Jones LM, Monroe KE, Tripathi P, Bashshur MJ, Kavalakatt J, Tarrance K, Mitchell J, Hawkins J. Empowering WHISE women: usability testing of a mobile application to enhance blood pressure control. Mhealth 2024; 10:26. [PMID: 39114460 PMCID: PMC11304098 DOI: 10.21037/mhealth-24-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/25/2024] [Indexed: 08/10/2024] Open
Abstract
Background High blood pressure (hypertension) disproportionately affects African American/Black (Black) women. Previous research suggests that self-managing hypertension may be challenging, yet mobile applications (apps) can help to empower patients and increase medication adherence. We developed questions to test the usability of evaluating the WHISE (Wellness, Hypertension, Information Sharing, Self-Management, Education) mobile app for Black women with hypertension. Methods Fifteen participants completed usability testing; five were potential app users (Black women with hypertension); each invited two of their peers to participate. Each testing session (n=5) included a brief overview of the app, time for participants to complete surveys and have an active discussion about the app (concurrent and retrospective think-aloud, concurrent and retrospective probing, per usability.gov), and observation of participants' body language during the session. Testing sessions were designed to familiarize participants with the app's features and examine their navigating ability. Results The app received overwhelmingly positive feedback, with 80% of participants finding it to be a valuable tool in hypertension management. Participants praised the app's user-friendliness and educational value, with one stating, 'It is a good educational piece for helping people manage hypertension, at least to understand its basics.' Another participant highlighted the potential for community support, saying, 'Having a community, having some people to be accountable, to check in with and see how things are going, could encourage and motivate people to be more diligent about managing their hypertension.' Some participants also provided constructive feedback, suggesting font size adjustments (73%) and color scheme changes (60%) for certain screens. Conclusions Based on the feedback we received, we were able to mitigate the participants' concerns about font size and color and create tutorial videos to guide future users in using the app. We completed these changes prior to deploying the app in our randomized clinical controlled trial.
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Affiliation(s)
- Lenette M. Jones
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Korrey E. Monroe
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Priya Tripathi
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Mary J. Bashshur
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | | | - Kierra Tarrance
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Jamie Mitchell
- University of Michigan School of Social Work, Ann Arbor, MI, USA
| | - Jaclynn Hawkins
- University of Michigan School of Social Work, Ann Arbor, MI, USA
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Orfaly VE, Bash GN, Risotto-Urbanowicz E, Higgins CB, Santucci NM, Hoff AM, Ryan MM, Roscher AD, Kostur N, McCreary E, Aldous S, Chan CH, Reynolds B, Shettig A, Sisley J, Smith J, Young JN, Zhou AM, Koh E, Haag CK, Latour E, Callis SJ, Stoos E, Leachman SA. From sunbeds to sunscreen: A curriculum empowering oregon adolescents to take charge of their skin health. J Am Acad Dermatol 2024:S0190-9622(24)02534-9. [PMID: 39038556 DOI: 10.1016/j.jaad.2024.06.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/24/2024]
Affiliation(s)
- Victoria E Orfaly
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon
| | - Gina N Bash
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | | | - Claire B Higgins
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Nicole M Santucci
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Ashley M Hoff
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Mary M Ryan
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Adam D Roscher
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Nina Kostur
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Eleanor McCreary
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Stephen Aldous
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Candace H Chan
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Bailey Reynolds
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Abigale Shettig
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Jonathan Sisley
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Jacob Smith
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Jade N Young
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Allison M Zhou
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Erika Koh
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Carter K Haag
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon
| | - Emile Latour
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon; Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - Samuel J Callis
- Oregon Health & Science University, School of Medicine, Portland, Oregon
| | - Elizabeth Stoos
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon
| | - Sancy A Leachman
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon; Oregon Health & Science University, School of Medicine, Portland, Oregon; Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon.
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Rodríguez-Suárez CA, Hernández-De Luis MN. Evaluation of the appropriateness of nursing case studies using the CARE checklist. ENFERMERIA CLINICA (ENGLISH EDITION) 2024:S2445-1479(24)00069-9. [PMID: 39032784 DOI: 10.1016/j.enfcle.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 04/04/2024] [Indexed: 07/23/2024]
Abstract
Case report is a narrative description of the problem of one or several patients. The CARE checklist (CAse REport) is the consensus document for reporting clinical case reports and through adaptations to the different CARE disciplines is used to define standards for authors in scientific journals; however, the specificity of the nursing process makes it difficult to adjust nursing case reports to CARE. The aim was to analyze the publications of clinical cases with a nursing perspective in scientific journals, as well as the quality standards and evaluation systems used. Few journals reviewed agreed to publish nursing case reports or stated standards for authors to adjust to CARE. Preliminary results indicated average or poor adherence to CARE, with the most reported elements being: Keywords, patient information and introduction. Adherence was lower for the elements: Timeline, therapeutic intervention, follow-up and outcomes, and patient perspective. The characteristics of the nursing process implies a low adherence to CARE, so it is necessary to unify criteria to guide researchers, authors, reviewers and editors of scientific journals, as well as to improve the rigor and quality of the reports. Currently, there are no specific guidelines for reporting clinical case reports with a nursing perspective available. These normative gaps could be solved by developing a CARE extension adapted to the methodological characteristics of the nursing process.
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Affiliation(s)
- Claudio Alberto Rodríguez-Suárez
- Departamento de Enfermería, Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; Unidad de apoyo a la investigación del Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Servicio Canario de la Salud, Canary Islands, Spain.
| | - María Naira Hernández-De Luis
- Centro de Salud El Doctoral, Gerencia de Atención Primaria de Gran Canaria, Servicio Canario de la Salud, Canary Islands, Spain
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Waldemar A, Bremer A, Strömberg A, Thylen I. Family presence during in-hospital cardiopulmonary resuscitation: effects of an educational online intervention on self-confidence and attitudes of healthcare professionals. Eur J Cardiovasc Nurs 2024; 23:486-496. [PMID: 38165264 DOI: 10.1093/eurjcn/zvad111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/06/2023] [Accepted: 11/02/2023] [Indexed: 01/03/2024]
Abstract
AIMS Guidelines support family-witnessed resuscitation (FWR) during cardiopulmonary resuscitation in hospital if deemed to be safe, yet barriers amongst healthcare professionals (HCPs) still exist. This study aimed to evaluate the effects of an educational online video intervention on nurses' and physicians' attitudes towards in-hospital FWR and their self-confidence in managing such situations. METHODS AND RESULTS A pre- and post-test quasi-experimental study was conducted October 2022 to March 2023 at six Swedish hospitals involving the departments of emergency care, medicine, and surgery. The 10 min educational video intervention was based on previous research covering the prevalence and outcome of FWR, attitudes of HCP, patient and family experiences, and practical and ethical guidelines about FWR.In total, 193 accepted participation, whereof 91 answered the post-test survey (47.2%) with complete data available for 78 and 61 participants for self-confidence and attitudes, respectively. The self-confidence total mean scores increased from 3.83 to 4.02 (P < 0.001) as did the total mean scores for attitudes towards FWR (3.38 to 3.62, P < 0.001). The majority (71.0%) had positive views of FWR at baseline and had experiences of in-hospital FWR (58.0%). Self-confidence was highest amongst participants for the delivery of chest compressions (91.2%), defibrillation (88.6%), and drug administration (83.3%) during FWR. Self-confidence was lowest (58.1%) for encouraging and attending to the family during resuscitation. CONCLUSION This study suggests that a short online educational video can be an effective way to improve HCP's self-confidence and attitudes towards the inclusion of family members during resuscitation and can support HCP in making informed decisions about FWR.
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Affiliation(s)
- Annette Waldemar
- Department of Cardiology in Norrköping, and Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden
| | - Anders Bremer
- Faculty of Health and Life Sciences, Linnaeus University, SE-351 95 Växjö, Sweden
| | - Anna Strömberg
- Department of Cardiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden
| | - Ingela Thylen
- Department of Cardiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden
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Tang H, Zhang W, Shen H, Tang H, Cai M, Wang T, Yan P, Li L, Wang Y, Zhao H, Shang L. A protocol for a multidisciplinary early intervention during chemotherapy to improve dietary management behavior in breast cancer patients: a two-arm, single-center randomized controlled trial. BMC Cancer 2024; 24:859. [PMID: 39026219 PMCID: PMC11256492 DOI: 10.1186/s12885-024-12623-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 07/10/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Adverse reactions are prone to occur in the early stage of chemotherapy and can negatively affect the dietary intake and nutritional status of breast cancer (BC) patients. Consequently, they need to participate in health self-management and lifestyle promotion programs. Early multidisciplinary interventions aim to enhance dietary management behavior and quality of life in chemotherapy-treated BC patients. METHODS This single-blinded, single-center, randomized controlled trial will include 88 females who have not yet started the early or middle stage of the chemotherapy cycle. A random number table will be used randomly assign females to the intervention group or usual group at a 1:1 ratio. The intervention elements are based on the theoretical guidance of the Integrated Theory of Health Behavior Change (ITHBC). A multidisciplinary team (MDT) comprising oncologists, dietitians, nurses, traditional Chinese medicine (TCM) practitioners, and psychologists will provide the intervention. Intervention sessions will be conducted once a week for 8 weeks, beginning in the early or middle stage of the chemotherapy cycle and continuing through admission and a home-based interval chemotherapy period. The intervention includes face-to-face discussions, online meetings, WeChat messaging, and telephone calls. The themes target adverse reactions, dietary information and habits, self-care self-efficacy, treatment self-regulation, dietary supplement and TCM use, social support, weight management, and outcome expectations. The primary outcome is dietary management behavior measured by the Dietary Management Behavior Questionnaire (DMBQ). Secondary outcomes are self-care self-efficacy assessed by the Strategies Used by People to Promote Health (SUPPH); quality of life measured by the Functional Assessment of Cancer Therapy-Breast (FACT-B); and body mass index (BMI) measured by an electronic meter. All participants will be assessed at baseline and immediately, 1 month, 3 months, 6 months, and 12 months after the intervention. DISCUSSION Early dietary intervention is needed, as diet is one of the most common health self-management behaviors influenced by chemotherapy. Early multidisciplinary interventions may provide a foundation for dietary self-management and improve nutritional status in the survival period. TRIAL REGISTRATION This intervention protocol was registered with the Chinese Clinical Trials Registry (ChiCTR2300076503, October 10, 2023).
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Affiliation(s)
- Han Tang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China
- Department of Clinical Nursing, School of Nursing, The Fourth Military Medical University, Xi'an, 710032, China
| | - Wei Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China
| | - Haiyan Shen
- Department of Orthopedics 1, Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Haili Tang
- Department of General Surgery, the Second Affiliated Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Min Cai
- Department of Psychiatry, the First Affiliated Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Tao Wang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China
- The Medical Department, the First Affiliated Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Pei Yan
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China
- Department of Operation Room, the First Affiliated Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Liang Li
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China
| | - Yan Wang
- Department of Thoracic Surgery, the Second Affiliated Hospital, Air Force Medical University, Xi'an, 710038, China.
| | - Huadong Zhao
- Department of General Surgery, the Second Affiliated Hospital, Air Force Medical University, Xi'an, 710038, China.
| | - Lei Shang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China.
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Gao Y, Yang Y, Wang S, Zhang W, Lu J. Has China's hierarchical medical system improved doctor-patient relationships? HEALTH ECONOMICS REVIEW 2024; 14:54. [PMID: 39023676 PMCID: PMC11256484 DOI: 10.1186/s13561-024-00520-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 06/14/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND AND OBJECTIVE Developing harmonious doctor-patient relationships is a powerful way to promote the construction of a new pattern of medical reform in developing countries. We aim to analyze the effects of China's hierarchical medical system on doctor-patient relationships, thus contributing to China's medical and health system reform. METHODS With panel data on prefectural-level cities in China from 2012 to 2019, we used a time-varying difference-in-differences model to evaluate the effect of hierarchical medical treatment policy. RESULTS Hierarchical medical treatment policies can significantly improve doctor-patient relationships, and this conclusion is supported by various robustness tests. And improving doctor-patient relationships can be indirectly realized by the optimization of resource allocation and saving of medical costs. In addition, the marginal effect of the pilot policy on doctor-patient relationships decreased with age within the city population. In focal cities and cities with high levels of fiscal spending on health care, the effect of the pilot policy on doctor-patient relationships was stronger. CONCLUSION While reinforcing the literature on the doctor-patient relationship, this study also provides a reference for further exploration of the pilot policy of hierarchical medical treatment and the development of new medical and health system reform in developing countries.
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Affiliation(s)
- Yang Gao
- School of Economics and Management, Northwest University, Xi'an, Shaanxi, China
- School of Economics, Qufu Normal University, Rizhao, Shandong, China
| | - Yang Yang
- School of Economics, Qufu Normal University, Rizhao, Shandong, China
| | - Shoupeng Wang
- School of Economics and Management, Northwest University, Xi'an, Shaanxi, China
| | - Wenqian Zhang
- School of Economics, Qufu Normal University, Rizhao, Shandong, China
| | - Jiao Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xianning West Road 28#, Xi'an, 710049, Shaanxi, China.
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Chandrasekar A, Warren E, Free C, Mbogua J, Curtin E, Gazeley U, Wong G, Church K, McCarthy O. mHealth interventions for postpartum family planning in LMICs: A realist review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003432. [PMID: 39024319 PMCID: PMC11257288 DOI: 10.1371/journal.pgph.0003432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/26/2024] [Indexed: 07/20/2024]
Abstract
The unmet need for family planning is a pervasive public health concern in many low- and middle-income countries (LMICs). Mobile health (mHealth) interventions have been designed and implemented in LMIC settings to address this issue through health information dissemination via voice calls, apps, and short message services (SMS). Although the impact of mHealth programmes on postpartum family planning outcomes have been systematically reviewed, the contexts, conditions, and mechanisms underpinning programme engagement and their impact on outcomes remain unclear. This study aims to formulate hypotheses in the form of context-mechanism-outcome configurations (CMOCs) of whether, how, why, for whom, and in what contexts mHealth interventions implemented in LMICs influence postpartum family planning (PPFP) outcomes. We conducted a realist review of peer-reviewed and grey literature. Peer-reviewed literature was identified through MEDLINE, Embase, Global Health, Web of Science, and Google Scholar. Grey Literature was identified through The National Grey Literature Conference, FHI 360, Guttmacher Institute, Population Council, and MSI Reproductive Choices. Inclusion criteria were updated as the review progressed. Narrative data were analysed using dimensional analysis to build CMOCs. Two overarching concepts (underpinned by 12 CMOCs) emerged from the 37 included records: mobile phone access, use, and ownership as well as women's motivation. Women's confidence to independently own, access, and operate a mobile phone was a central mechanism leading to mHealth programme engagement and subsequent change in PPFP knowledge, awareness, and outcomes. Receiving family and social support positively interacted with this while low digital literacy and harmful gender norms pertaining to prescribed domestic duties and women's household influence were barriers to programme engagement. Intrinsic motivation for health improvement functioned at times both as a context and potential mechanism influencing mHealth programme engagement and PPFP outcomes. However, these contexts rarely occur in isolation and need to be evaluated as co-occurring phenomena. (Review registration: PROSPERO CRD42023386841).
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Affiliation(s)
- Abinaya Chandrasekar
- Department of Population Health, The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Emily Warren
- Department of Public Health, Environments and Society, The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Caroline Free
- Department of Population Health, The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Judie Mbogua
- Department of Population Health, The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Esther Curtin
- Department of Population Health, The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ursula Gazeley
- Department of Population Health, The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Geoffrey Wong
- Nuffield Department of Primary Care Health Sciences, The University of Oxford, Oxford, United Kingdom
| | - Kathryn Church
- Department of Population Health, The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ona McCarthy
- Department of Population Health, The London School of Hygiene & Tropical Medicine, London, United Kingdom
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Kühn L, Kleist L, Weißenstein F, Choi KEA. Biomedical Dogmas Still Influence the Delivery of Exercise Therapy in Chronic Low Back Pain Management: Mixed-Methods Study. Patient Prefer Adherence 2024; 18:1493-1507. [PMID: 39050274 PMCID: PMC11268774 DOI: 10.2147/ppa.s462689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/20/2024] [Indexed: 07/27/2024] Open
Abstract
Purpose Non-specific, chronic low back pain (NSCLBP) is a leading cause of disability, prompting long-term rehabilitation. Positive patient beliefs and expectations towards lasting exercise engagement play a crucial role for a successful management of this condition. The aim was to investigate beliefs, unmet needs and expectations of NSCLBP patients for exercise-related health behaviour change in the context of rehabilitative care. Patients and Methods In a mono-centric mixed-methods study, we conducted semi-structured interviews with NSCLBP patients and care providers. We recruited in a rehabilitation clinic which is specialized in orthopaedics and internal medicine. Interviews were analysed deductively by combining health behaviour change theories with Donabedian's quality model of care. In a patient survey, disability (RMDQ), exercise behaviours, fear avoidance beliefs (FABQ), self-efficacy in chronic disease management (SES6G), process- and outcome-expectations (OEE-2) were queried and analysed descriptively. Results Twenty-two interviews were conducted and 40 questionnaires completed. Qualitative results revealed that NSCLBP patients had persistent biomedical perspectives on their health condition, marked by strong preferences for biomedical diagnostics and beliefs in the superiority of specific exercise regimes. Based on met expectations and positive movement experiences, patients' motivation was successfully fostered in the motivational phase of health behavior change. In the volitional phase, the postulated desire to receive self-management strategies was largely unmet. Psychosocial aspects of care were not widely accepted. The survey study sample showed a disability score (RMDQ) of M = 6.8 (±4.6). Mean scores of validated scales reflecting on attitudes, beliefs and expectations of chronic NSCLBP management were at FABQ-pa M = 15.4 (±6.0), FABQ-w M = 24.0 (±12.1), SES6G M = 6.4 (±2.3), and OEE-2 M = 2.7 (±0.5). Conclusion In this sample, patients' understanding of NSCLBP was still dominated by biomedical dogmas and perspectives. Inpatient rehabilitation predominantly addressed expectations towards the motivational phase of exercise-related health behaviour change.
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Affiliation(s)
- Lukas Kühn
- Center for Health Services Research, Brandenburg Medical School, Rüdersdorf bei Berlin, 15562, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, 16816, Germany
| | - Lara Kleist
- Center for Health Services Research, Brandenburg Medical School, Rüdersdorf bei Berlin, 15562, Germany
| | - Franziska Weißenstein
- Center for Health Services Research, Brandenburg Medical School, Rüdersdorf bei Berlin, 15562, Germany
| | - Kyung-Eun Anna Choi
- Center for Health Services Research, Brandenburg Medical School, Rüdersdorf bei Berlin, 15562, Germany
- Health Services Research, Research Center MIAAI (Medical Image Analysis & Artificial Intelligence), Danube Private University, Faculty of Medicine/Dentistry, Krems-Stein, 3500, Austria
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Abram MD, Marzano M, Caniano L, Searby A. Nurse led models of care for outpatient substance use disorder treatment: A scoping review. J Clin Nurs 2024. [PMID: 39020508 DOI: 10.1111/jocn.17377] [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: 03/04/2024] [Revised: 06/13/2024] [Accepted: 07/04/2024] [Indexed: 07/19/2024]
Abstract
AIM To map key characteristics and describe nurse led models of care for the treatment of persons with substance use disorders (SUDs) in the outpatient setting. DESIGN A scoping review. METHODS Conducted in accordance with the JBI methodology. The PRISMA-ScR checklist was used. DATA SOURCES Pubmed, CINAHL Complete (EBSCOhost), Cochrane Library, APA PsycNet and Scopus were searched from 1999 to May 2022 and updated on 28 November 2023. A handsearch and a grey literature search was conducted. RESULTS Title and abstract screening was performed on 774 articles resulting in 88 articles for full text screening. Full text screening yielded 13 articles that met inclusion criteria. CONCLUSION Existing nurse-led models of care for SUDS are scarce and limited in scope, with the majority focused on treating opioid use disorder. Additional research is needed to develop, test, and implement efficacious nurse-led models of care for the treatment and management of SUDs. IMPLICATIONS TO CLINICAL PRACTICE Nurse led models of care have demonstrated their efficacy and quality in the management of other chronic diseases. As we move forward with innovative solutions for individuals with addiction, nurse led models of care can be a mechanism to deliver high quality, evidence-based care for SUDs. IMPACT SUDs are chronic diseases that impact individuals, families, and communities. SUDs require a biopsychosocial approach to treatment. Globally, nurses are well positioned to provide high quality care to mitigate the impact of SUDs. This scoping review mapped the extant literature on nurse led models of care for substance use disorder treatment in the outpatient setting finding that additional research is needed to develop, test and implement evidence-based interventions to care for individuals, families, and communities experiencing SUDs. REPORTING METHOD PRISMA checklist for scoping reviews. No patient or public contribution were part of this study. PROTOCOL REGISTRATION Open Science Framework accessible at: https://doi.org/10.17605/OSF.IO/NSW7V.
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Affiliation(s)
- Marissa D Abram
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Maryta Marzano
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA
- Stony Brook Population and Preventive Medicine, East Setauket, New York, USA
| | - Lori Caniano
- University Libraries, Adelphi University, Garden City, New York, USA
| | - Adam Searby
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
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Lv YS, Xue J, Meng Z, Zhang Q, Liu XH. Value of improved nursing measures and enhanced nursing management to reduce the occurrence of adverse events in pediatric infusion. World J Clin Cases 2024; 12:4130-4136. [PMID: 39015921 PMCID: PMC11235543 DOI: 10.12998/wjcc.v12.i20.4130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/01/2024] [Accepted: 05/23/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Intravenous infusion is a common method of drug administration in clinical practice. Errors in any aspect of the infusion process, from the verification of medical orders, preparation of the drug solution, to infusion by nursing staff, may cause adverse infusion events. AIM To analyzed the value of improving nursing measures and enhancing nursing management to reduce the occurrence of adverse events in pediatric infusion. METHODS The clinical data of 130 children who received an infusion in the pediatric department of our hospital from May 2020 to May 2021 were analyzed and divided into two groups according to the differences in nursing measures and nursing management: 65 patients in the control group received conventional nursing and nursing management interventions, while 65 patients in the observation group received improved nursing measure interventions and enhanced nursing management. The occurrence of adverse events, compliance of children, satisfaction of children's families, and complaints regarding the transfusion treatment were recorded in both groups. RESULTS The incidence of fluid extravasation and infusion set dislodgement in the observation group were 3.08% and 1.54%, respectively, which were significantly lower than 12.31% and 13.85% in the control group (P < 0.05), while repeated punctures and medication addition errors in the observation group were 3.08% and 0.00%, respectively, which were lower than 9.23% and 3.08% in the control group, but there was no significant difference (P > 0.05). The compliance rate of children in the observation group was 98.46% (64/65), which was significantly higher than 87.69% (57/65) in the control group, and the satisfaction rate of children's families was 96.92% (63/65), which was significantly higher than 86.15% (56/65) in the control group (P < 0.05). The observation group did not receive any complaints from the child's family, whereas the control group received four complaints, two of which were due to the crying of the child caused by repeated punctures, one due to the poor attitude of the nurse, and one due to medication addition errors, with a cumulative complaint rate of 6.15%. The cumulative complaint rate of the observation group was significantly lower than that of the control group (P < 0.05). CONCLUSION Improving nursing measures and enhancing nursing management can reduce the incidence of fluid extravasation and infusion set dislodgement in pediatric patients, improve children's compliance and satisfaction of their families, and reduce family complaints.
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Affiliation(s)
- Yan-Song Lv
- Department of Pediatrics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Jv Xue
- Department of Pediatrics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhu Meng
- Department of Pediatrics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Qing Zhang
- Department of Pediatrics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Xiao-Hong Liu
- Department of Obstertrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
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DeRidder LB, Hare KA, Lopes A, Jenkins J, Fitzgerald N, MacPherson E, Fabian N, Morimoto J, Chu JN, Kirtane AR, Madani W, Ishida K, Kuosmanen JLP, Zecharias N, Colangelo CM, Huang HW, Chilekwa M, Lal NB, Srinivasan SS, Hayward AM, Wolpin BM, Trumper D, Quast T, Rubinson DA, Langer R, Traverso G. Closed-loop automated drug infusion regulator: A clinically translatable, closed-loop drug delivery system for personalized drug dosing. MED 2024; 5:780-796.e10. [PMID: 38663403 DOI: 10.1016/j.medj.2024.03.020] [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: 10/27/2023] [Revised: 01/26/2024] [Accepted: 03/21/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Dosing of chemotherapies is often calculated according to the weight and/or height of the patient or equations derived from these, such as body surface area (BSA). Such calculations fail to capture intra- and interindividual pharmacokinetic variation, which can lead to order of magnitude variations in systemic chemotherapy levels and thus under- or overdosing of patients. METHODS We designed and developed a closed-loop drug delivery system that can dynamically adjust its infusion rate to the patient to reach and maintain the drug's target concentration, regardless of a patient's pharmacokinetics (PK). FINDINGS We demonstrate that closed-loop automated drug infusion regulator (CLAUDIA) can control the concentration of 5-fluorouracil (5-FU) in rabbits according to a range of concentration-time profiles (which could be useful in chronomodulated chemotherapy) and over a range of PK conditions that mimic the PK variability observed clinically. In one set of experiments, BSA-based dosing resulted in a concentration 7 times above the target range, while CLAUDIA keeps the concentration of 5-FU in or near the targeted range. Further, we demonstrate that CLAUDIA is cost effective compared to BSA-based dosing. CONCLUSIONS We anticipate that CLAUDIA could be rapidly translated to the clinic to enable physicians to control the plasma concentration of chemotherapy in their patients. FUNDING This work was supported by MIT's Karl van Tassel (1925) Career Development Professorship and Department of Mechanical Engineering and the Bridge Project, a partnership between the Koch Institute for Integrative Cancer Research at MIT and the Dana-Farber/Harvard Cancer Center.
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Affiliation(s)
- Louis B DeRidder
- Harvard-MIT Division of Health Science Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Kyle A Hare
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Aaron Lopes
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Josh Jenkins
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Nina Fitzgerald
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Emmeline MacPherson
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Niora Fabian
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Josh Morimoto
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jacqueline N Chu
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Harvard Medical School, Boston, MA 02115, USA; Division of Gastroenterology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Ameya R Kirtane
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Wiam Madani
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Keiko Ishida
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Johannes L P Kuosmanen
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Naomi Zecharias
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | | | - Hen-Wei Huang
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Makaya Chilekwa
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Nikhil B Lal
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Shriya S Srinivasan
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Alison M Hayward
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Brian M Wolpin
- Harvard Medical School, Boston, MA 02115, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - David Trumper
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Troy Quast
- College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Douglas A Rubinson
- Harvard Medical School, Boston, MA 02115, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Robert Langer
- Harvard-MIT Division of Health Science Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Giovanni Traverso
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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Aubrey-Basler K, Bursey K, Pike A, Penney C, Furlong B, Howells M, Al-Obaid H, Rourke J, Asghari S, Hall A. Interventions to improve primary healthcare in rural settings: A scoping review. PLoS One 2024; 19:e0305516. [PMID: 38990801 PMCID: PMC11239038 DOI: 10.1371/journal.pone.0305516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 06/01/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Residents of rural areas have poorer health status, less healthy behaviours and higher mortality than urban dwellers, issues which are commonly addressed in primary care. Strengthening primary care may be an important tool to improve the health status of rural populations. OBJECTIVE Synthesize and categorize studies that examine interventions to improve rural primary care. ELIGIBILITY CRITERIA Experimental or observational studies published between January 1, 1996 and December 2022 that include an historical or concurrent control comparison. SOURCES OF EVIDENCE Pubmed, CINAHL, Cochrane Library, Embase. CHARTING METHODS We extracted and charted data by broad category (quality, access and efficiency), study design, country of origin, publication year, aim, health condition and type of intervention studied. We assigned multiple categories to a study where relevant. RESULTS 372 papers met our inclusion criteria, divided among quality (82%), access (20%) and efficiency (13%) categories. A majority of papers were completed in the USA (40%), Australia (15%), China (7%) or Canada (6%). 35 (9%) papers came from countries in Africa. The most common study design was an uncontrolled before-and-after comparison (32%) and only 24% of studies used randomized designs. The number of publications each year has increased markedly over the study period from 1-2/year in 1997-99 to a peak of 49 papers in 2017. CONCLUSIONS Despite substantial inequity in health outcomes associated with rural living, very little attention is paid to rural primary care in the scientific literature. Very few studies of rural primary care use randomized designs.
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Affiliation(s)
- Kris Aubrey-Basler
- Discipline of Family Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
- Division of Public Health and Applied Health Sciences, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Krystal Bursey
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Andrea Pike
- Discipline of Family Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Carla Penney
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Bradley Furlong
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Mark Howells
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Harith Al-Obaid
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - James Rourke
- Discipline of Family Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Shabnam Asghari
- Discipline of Family Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
- Division of Public Health and Applied Health Sciences, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Amanda Hall
- Discipline of Family Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
- Division of Public Health and Applied Health Sciences, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
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Lin L, Fang Y, Huang F, Zhang X, Zheng J, Xiao H. Discharge teaching quality positively predicts quality of life in colorectal cancer patients with temporary enterostomy: The mediating role of readiness for hospital discharge and stoma self-efficacy. PLoS One 2024; 19:e0306981. [PMID: 38990912 PMCID: PMC11238961 DOI: 10.1371/journal.pone.0306981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024] Open
Abstract
OBJECTIVES This study aimed to examine the mediating role of readiness for hospital discharge (RHD) and stoma self-efficacy (SSE) in the relationship between quality of discharge teaching (QDT) and health-related quality of life (HRQOL) in colorectal cancer patients with temporary enterostomy, and the gender difference of mediating effect. BACKGROUND It is not clear how RHD, QDT, SSE and HRQOL interact in colorectal cancer patients with temporary enterostomy. METHODS This was a prospective follow-up survey. 221 colorectal cancer patients with temporary enterostomy were conveniently recruited from a general hospital in Southeast China. The Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Stoma Self-Efficacy Scale, and Stoma Quality of Life Scale were used to collect data. Pearson's correlation and structural equation models were used to analyze the data. SPSS 26.0 and Amos 28.0 software were used for analysis the collected data. RESULTS Regarding the relationship of QDT and HRQOL, only QDT-T had a direct effect among colorectal cancer patients with stomas (b = 0.233, P<0.001, percentile 95% CI = [0.145, 0.314]). However, both QDT-T and QDT-R can predict HRQOL indirectly through three paths: (1) the mediating role of SSE (b = 0.050, P = 0.009, percentile 95% CI = [0.013, 0.098]; b = 0.077, P = 0.008, percentile 95% CI = [0.021, 0.164]), (2) the mediating role of RHD (b = 0.044, P = 0.004, percentile 95% CI = [0.014, 0.085]; b = 0.044, P = 0.005, percentile 95% CI = [0.010, 0.102]), and (3) the chain mediating role of SSE and RHD (b = 0.030, P = 0.003, percentile 95% CI = [0.011, 0.059]; b = 0.047, P = 0.003, percentile 95% CI = [0.015, 0.103]). The similar chain mediating effect in male stoma patients was also found (b = 0.041, P = 0.002, percentile 95% CI = [0.016, 0.080]; b = 0.046, P = 0.004, percentile 95% CI = [0.011, 0.114]). CONCLUSIONS Stoma self-efficacy and readiness for hospital discharge played important intermediary roles in the relationship between quality of discharge teaching and health-related quality of life in colorectal cancer patients with stomas. Health care providers can design SSE-enhancing and RHD-enhancing discharge planning for colorectal cancer patients with temporary enterostomies.
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Affiliation(s)
- Liying Lin
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yifang Fang
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xiaoying Zhang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jianwei Zheng
- Department of Oncology, The Union Hospital Affiliated with Fujian Medical University, Fuzhou, China
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, Fuzhou, China
- Research Center for Nursing Humanity, Fujian Medical University, Fuzhou, China
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Loura D, Ferreira AM, Romeiro J, Charepe Z. Health-illness transition processes in children with complex chronic conditions and their parents: a scoping review. BMC Pediatr 2024; 24:446. [PMID: 38992610 PMCID: PMC11238377 DOI: 10.1186/s12887-024-04919-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/01/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND The prevalence of complex chronic conditions (CCC), which cause serious limitations and require specialized care, is increasing. The diagnosis of a CCC is a health-illness transition for children and their parents, representing a long-term change leading to greater vulnerability. Knowing the characteristics of these transitional processes is important for promoting safe transitions in this population. This scoping review aimed to map the available evidence on health-illness transition processes in children with complex chronic conditions and their parents in the context of healthcare. METHODS Six databases were searched for studies focusing on children aged 0-21 years with CCC and their parents experiencing health-illness transition processes, particularly concerning adaptation to illness and continuity of care, in the context of healthcare. Studies within this scope carried out between 2013 and 2023 and written in Portuguese or English were identified. The articles were selected using the PRISMA methodology. The data were extracted to an instrument and then presented with a synthesizing approach supporting the interpretation of the results. RESULTS Ninety-eight methodologically broad but predominantly qualitative articles were included in this review. Children with CCC have specific needs associated with complex and dynamic health-illness transitions with a multiple influence in their daily lives. Several facilitating factors (p.e. positive communication and a supportive therapeutic relationship with parents and professionals, as well as involvement in a collaborative approach to care), inhibiting factors (p.e. the complexity of the disease and therapeutic regime, as well as the inefficient organization and coordination of teams) and both positive (p.e. well-being and better quality of life) and negative response patterns (p.e. negative feelings about the chronic illness) were identified. Some interventions to support the transitional process also emerged from the literature. Pediatric palliative care is seen as a good practice and an integrative approach for these children and families. CONCLUSION Health professionals play a fundamental role in supporting the transitional process and promoting positive response patterns. More significant investment is needed at the clinical and academic levels regarding production and dissemination of knowledge in this area to ensure the awareness of children with CCC and that their needs are fully enhanced. REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/QRZC8 .
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Affiliation(s)
- David Loura
- Local Health Unit of São José, Dona Estefânia Hospital, St. Jacinta Marto, N. 8A, 1150-192, Lisbon, Portugal.
- Faculty of Health Sciences and Nursing, Catholic University of Portugal, Lisbon, Portugal.
| | - Ana Margarida Ferreira
- Faculty of Health Sciences and Nursing, Catholic University of Portugal, Lisbon, Portugal
- Local Health Unit of Arco Ribeirinho, Nossa Senhora Do Rosário Hospital, Setúbal, Portugal
| | - Joana Romeiro
- Faculty of Health Sciences and Nursing, Catholic University of Portugal, Lisbon, Portugal
- Center for Interdisciplinary Health Research (CIIS), Lisbon, Portugal
- Catholic University of Portugal, Postdoc-Fellowship Program in Integral Human Development (IHD), CADOS, Lisbon, Portugal
| | - Zaida Charepe
- Faculty of Health Sciences and Nursing, Catholic University of Portugal, Lisbon, Portugal
- Center for Interdisciplinary Health Research (CIIS), Lisbon, Portugal
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Minamizaki M, Doi M, Kanoya Y. Development of management indicators of nursing for minimizing physical restraints focused on older adult patients hospitalized in acute care settings: A Delphi consensus study. PLoS One 2024; 19:e0306920. [PMID: 38985753 PMCID: PMC11236117 DOI: 10.1371/journal.pone.0306920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 06/25/2024] [Indexed: 07/12/2024] Open
Abstract
Nursing management activities are important in influencing staff nurses' action to prevent or withdraw physical restraints. However, limited studies have been conducted empirically to determine the nursing management activities required for minimizing physical restraints. Therefore, there is a need for basic standards of nursing management activities to minimize physical restraints in acute care settings. This study aimed to develop nursing management indicators to minimize physical restraint (MaIN-PR) in hospitalized older adult patients in an acute care setting. It was conducted between June and October 2021 in Japan using a Delphi consensus approach. Fifty nurses working at top or middle management levels or as certified nurse specialists in gerontological nursing enrolled as participants. The potential indicators obtained from the literature review and interviews were organized inductively to develop two types of draft indicators: (1) 35 items for top management and (2) 33 items for middle management. We asked the nursing managers and certified nurse specialists in gerontological nursing to assess the validity of each indicator in three rounds. Of the 50 initial panelists, 12 from top management and 13 from middle management continued till the third round. MaIN-PR contained 35 indicators for top management and 28 indicators for middle management and were classified into the following six metrics: planning, motivating, training, commanding, organizing, and controlling. To the best of our knowledge, the current MaIN-PR are the first set of nursing management indicators for minimizing physical restraint, including perspectives on geriatric nursing in acute care settings. These indicators could guide both top and middle nursing management, thus supporting staff nurses' judgment in minimizing physical restraints to enhance the quality of older adult patient care.
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Affiliation(s)
- Maya Minamizaki
- Nursing Course, School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Mana Doi
- Chiba Faculty of Nursing, Tokyo Healthcare University, Funabashi, Chiba, Japan
| | - Yuka Kanoya
- Nursing Course, School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
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89
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Baronetto A, Graf L, Fischer S, Neurath MF, Amft O. Multiscale Bowel Sound Event Spotting in Highly Imbalanced Wearable Monitoring Data: Algorithm Development and Validation Study. JMIR AI 2024; 3:e51118. [PMID: 38985504 PMCID: PMC11269970 DOI: 10.2196/51118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/29/2024] [Accepted: 04/24/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND Abdominal auscultation (i.e., listening to bowel sounds (BSs)) can be used to analyze digestion. An automated retrieval of BS would be beneficial to assess gastrointestinal disorders noninvasively. OBJECTIVE This study aims to develop a multiscale spotting model to detect BSs in continuous audio data from a wearable monitoring system. METHODS We designed a spotting model based on the Efficient-U-Net (EffUNet) architecture to analyze 10-second audio segments at a time and spot BSs with a temporal resolution of 25 ms. Evaluation data were collected across different digestive phases from 18 healthy participants and 9 patients with inflammatory bowel disease (IBD). Audio data were recorded in a daytime setting with a smart T-Shirt that embeds digital microphones. The data set was annotated by independent raters with substantial agreement (Cohen κ between 0.70 and 0.75), resulting in 136 hours of labeled data. In total, 11,482 BSs were analyzed, with a BS duration ranging between 18 ms and 6.3 seconds. The share of BSs in the data set (BS ratio) was 0.0089. We analyzed the performance depending on noise level, BS duration, and BS event rate. We also report spotting timing errors. RESULTS Leave-one-participant-out cross-validation of BS event spotting yielded a median F1-score of 0.73 for both healthy volunteers and patients with IBD. EffUNet detected BSs under different noise conditions with 0.73 recall and 0.72 precision. In particular, for a signal-to-noise ratio over 4 dB, more than 83% of BSs were recognized, with precision of 0.77 or more. EffUNet recall dropped below 0.60 for BS duration of 1.5 seconds or less. At a BS ratio greater than 0.05, the precision of our model was over 0.83. For both healthy participants and patients with IBD, insertion and deletion timing errors were the largest, with a total of 15.54 minutes of insertion errors and 13.08 minutes of deletion errors over the total audio data set. On our data set, EffUNet outperformed existing BS spotting models that provide similar temporal resolution. CONCLUSIONS The EffUNet spotter is robust against background noise and can retrieve BSs with varying duration. EffUNet outperforms previous BS detection approaches in unmodified audio data, containing highly sparse BS events.
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Affiliation(s)
- Annalisa Baronetto
- Hahn-Schickard, Freiburg, Germany
- Intelligent Embedded Systems Lab, University of Freiburg, Freiburg, Germany
| | - Luisa Graf
- Chair of Digital Health, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarah Fischer
- Medical Clinic 1, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Erlangen, Germany
| | - Markus F Neurath
- Medical Clinic 1, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Erlangen, Germany
| | - Oliver Amft
- Hahn-Schickard, Freiburg, Germany
- Intelligent Embedded Systems Lab, University of Freiburg, Freiburg, Germany
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Drummond N, Bailey J, Majszak C, Zielinski R. Implementation of Virtual Antenatal and Postnatal Urgent Midwifery Visits: Evaluation of a Quality Improvement Initiative. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:903. [PMID: 39063480 PMCID: PMC11277117 DOI: 10.3390/ijerph21070903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
Women seeking care during the perinatal period often face delays or long waits at healthcare facilities due to lack of providers and/or resources, leading to sub-optimal outcomes. We implemented a program whereby patients with concerns could receive same-day care virtually from a midwife rather than presenting to the clinic or hospital for care. Implementation strategies included virtual training, a staged increase in patient volume, and frequent communication between the midwives via text, email, and monthly meetings. Virtual visits included a variety of complaints, the five most common being to establish care, first-trimester bleeding, nausea and vomiting, mental health concerns, and postnatal breast problems. There was a threefold increase in virtual visits during the first 6 months with 92% of patients not requiring urgent face-to-face follow-up. Midwives were able to provide high-quality telehealth care that met the patients' needs and decreased the demand on hospital-based services. With the growing ubiquity of mobile phones and internet access, this strategy may be effective in providing quality care while decreasing demands on physical infrastructure. More research is needed to assess acceptability in other contexts. Reproducibility in low-resource settings may be limited if women lack access to video conferencing on phones or laptops.
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Affiliation(s)
- Nora Drummond
- School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Joanne Bailey
- University of Michigan Health—Midwifery Service, University of Michigan, Ann Arbor, MI 48109, USA; (J.B.); (C.M.)
| | - Christina Majszak
- University of Michigan Health—Midwifery Service, University of Michigan, Ann Arbor, MI 48109, USA; (J.B.); (C.M.)
| | - Ruth Zielinski
- School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA;
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91
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Stadler RD, Sudah SY, Moverman MA, Denard PJ, Duralde XA, Garrigues GE, Klifto CS, Levy JC, Namdari S, Sanchez-Sotelo J, Menendez ME. Identification of ChatGPT-Generated Abstracts Within Shoulder and Elbow Surgery Poses a Challenge for Reviewers. Arthroscopy 2024:S0749-8063(24)00495-X. [PMID: 38992513 DOI: 10.1016/j.arthro.2024.06.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
PURPOSE To evaluate the extent to which experienced reviewers can accurately discern between AI-generated and original research abstracts published in the field of shoulder and elbow surgery and compare this to the performance of an AI-detection tool. METHODS Twenty-five shoulder and elbow-related articles published in high-impact journals in 2023 were randomly selected. ChatGPT was prompted with only the abstract title to create an AI-generated version of each abstract. The resulting 50 abstracts were randomly distributed to and evaluated by 8 blinded peer reviewers with at least 5 years of experience. Reviewers were tasked with distinguishing between original and AI-generated text. A Likert scale assessed reviewer confidence for each interpretation and the primary reason guiding assessment of generated text was collected. AI output detector (0-100%) and plagiarism (0-100%) scores were evaluated using GPTZero. RESULTS Reviewers correctly identified 62% of AI-generated abstracts and misclassified 38% of original abstracts as being AI-generated. GPTZero reported a significantly higher probability of AI output among generated abstracts (median 56%, IQR 51-77%) compared to original abstracts (median 10%, IQR 4-37%; p < 0.01). Generated abstracts scored significantly lower on the plagiarism detector (median 7%, IQR 5-14%) relative to original abstracts (median 82%, IQR 72-92%; p < 0.01). Correct identification of AI-generated abstracts was predominately attributed to the presence of unrealistic data/values. The primary reason for misidentifying original abstracts as AI was attributed to writing style. CONCLUSIONS Experienced reviewers faced difficulties in distinguishing between human and AI-generated research content within shoulder and elbow surgery. The presence of unrealistic data facilitated correct identification of AI abstracts, whereas misidentification of original abstracts was often ascribed to writing style.
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Affiliation(s)
- Ryan D Stadler
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
| | - Suleiman Y Sudah
- Department of Orthopaedic Surgery, Monmouth Medical Center, Monmouth, NJ, USA
| | - Michael A Moverman
- Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah
| | | | | | - Grant E Garrigues
- Midwest Orthopaedics at Rush University Medical Center, Chicago, IL, USA
| | - Christopher S Klifto
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Jonathan C Levy
- Levy Shoulder Center at Paley Orthopedic & Spine Institute, Boca Raton, FL, USA
| | - Surena Namdari
- Rothman Orthopaedic Institute at Thomas Jefferson University Hospitals. Philadelphia, PA, USA
| | | | - Mariano E Menendez
- Department of Orthopaedics, University of California Davis, Sacramento, CA, USA
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92
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Zhao Y, Quadros W, Nagraj S, Wong G, English M, Leckcivilize A. Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review. BMC Med 2024; 22:286. [PMID: 38978070 PMCID: PMC11232288 DOI: 10.1186/s12916-024-03509-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 07/01/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Advanced practice providers (APPs), including physician assistants/associates (PAs), nurse practitioners (NPs) and other non-physician roles, have been developed largely to meet changing healthcare demand and increasing workforce shortages. First introduced in primary care in the US, APPs are prevalent in secondary care across different specialty areas in different countries around the world. In this scoping review, we aimed to summarise the factors influencing the development, recruitment, integration, retention and career development of APP roles in hospital health care teams. METHODS We conducted a scoping review and searched Ovid MEDLINE, Ovid Embase, Ovid Global Health, Ovid PsycINFO and EBSCOhost CINAHL to obtain relevant articles published between Jan 2000 and Apr 2023 that focused on workforce management of APP roles in secondary care. Articles were screened by two reviewers independently. Data from included articles were charted and coded iteratively to summarise factors influencing APP development, recruitment, integration, retention and career development across different health system structural levels (macro-, meso- and micro-level). RESULTS We identified and analysed 273 articles that originated mostly from high-income countries, e.g. the US (n = 115) and the UK (n = 52), and primarily focused on NP (n = 183) and PA (n = 41). At the macro-level, broader workforce supply, national/regional workforce policies such as work-hour restrictions on physicians, APP scope of practice regulations, and views of external collaborators, stakeholders and public representation of APPs influenced organisations' decisions on developing and managing APP roles. At the meso-level, organisational and departmental characteristics, organisational planning, strategy and policy, availability of resources, local experiences and evidence as well as views and perceptions of local organisational leaders, champions and other departments influenced all stages of APP role management. Lastly at the micro-level, individual APPs' backgrounds and characteristics, clinical team members' perceptions, understanding and relationship with APP roles, and patient perceptions and preferences also influenced how APPs are developed, integrated and retained. CONCLUSIONS We summarised a wide range of factors influencing APP role development and management in secondary care teams. We highlighted the importance for organisations to develop context-specific workforce solutions and strategies with long-term investment, significant resource input and transparent processes to tackle evolving healthcare challenges.
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Affiliation(s)
- Yingxi Zhao
- Nuffield Department of Medicine Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK.
| | | | - Shobhana Nagraj
- Nuffield Department of Medicine Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mike English
- Nuffield Department of Medicine Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Attakrit Leckcivilize
- Nuffield Department of Medicine Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK
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93
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Migdanis A, Migdanis I, Gkogkou ND, Papadopoulou SK, Giaginis C, Manouras A, Polyzou Konsta MA, Kosti RI, Oikonomou KA, Argyriou K, Potamianos S, Kapsoritakis A. The Relationship of Adherence to the Mediterranean Diet with Disease Activity and Quality of Life in Crohn's Disease Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1106. [PMID: 39064535 PMCID: PMC11279084 DOI: 10.3390/medicina60071106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: Emerging evidence is placing the Mediterranean diet (MD) in the spotlight as a potential dietary model that could benefit inflammatory bowel disease (IBD) patients in terms of prevention and progress of the disease. The main aim of the present study is to shed some light on the relationship between the adherence to the MD and the degree of disease activity, as well as the quality of life in patients with Crohn's disease (CD). Materials and Methods: An administered questionnaire was used to assess and record a number of parameters, including recent medical and weight history, anthropometric characteristics, disease activity (in remission or active disease), and quality of life of both male and female CD patients. Moreover, the level of compliance of the participants to the Mediterranean diet model was evaluated and its relationship with disease activity and quality of life was investigated. Results: Adherence to the MD was significantly higher in patients with inactive disease than in those with active disease (p = 0.019). According to the correlation analysis conducted, adherence to the MD was negatively correlated with disease activity (p = 0.039) and positively correlated with quality of life (QoL) (p = 0.046) of the participants. Intake of fruits, vegetables, and dairy products was significantly higher in remission patients (p = 0.046, p = 0.001, p = 0.041, respectively). Conclusions: We conclude, according to the findings of the study, that adherence to the MD is associated with disease activity and QoL in patients with CD. Future research should focus on MD intervention studies on IBD patients in order to assess its effect on modulating disease activity/course and related inflammatory biomarkers.
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Affiliation(s)
- Athanasios Migdanis
- Nutrition and Dietetics Department, University of Thessaly, Argonafton 1C, 42132 Trikala, Greece; (I.M.); (A.M.); (R.I.K.)
- Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece; (S.P.); (A.K.)
| | - Ioannis Migdanis
- Nutrition and Dietetics Department, University of Thessaly, Argonafton 1C, 42132 Trikala, Greece; (I.M.); (A.M.); (R.I.K.)
- Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece; (S.P.); (A.K.)
| | - Nikoleta D. Gkogkou
- MSc Program Nutrition in Health and Disease, Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece;
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Nea Moudania, 57001 Thessaloniki, Greece;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, University of the Aegean, Myrina, 81400 Lemnos, Greece;
| | - Athanasios Manouras
- Nutrition and Dietetics Department, University of Thessaly, Argonafton 1C, 42132 Trikala, Greece; (I.M.); (A.M.); (R.I.K.)
| | | | - Rena I. Kosti
- Nutrition and Dietetics Department, University of Thessaly, Argonafton 1C, 42132 Trikala, Greece; (I.M.); (A.M.); (R.I.K.)
| | - Konstantinos A. Oikonomou
- Department of Gastroenterology, University Hospital of Larissa, Viopolis Mezourlo, 41110 Larissa, Greece; (K.A.O.); (K.A.)
| | - Konstantinos Argyriou
- Department of Gastroenterology, University Hospital of Larissa, Viopolis Mezourlo, 41110 Larissa, Greece; (K.A.O.); (K.A.)
| | - Spyridon Potamianos
- Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece; (S.P.); (A.K.)
- MSc Program Nutrition in Health and Disease, Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece;
- Department of Gastroenterology, University Hospital of Larissa, Viopolis Mezourlo, 41110 Larissa, Greece; (K.A.O.); (K.A.)
| | - Andreas Kapsoritakis
- Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece; (S.P.); (A.K.)
- MSc Program Nutrition in Health and Disease, Faculty of Medicine, University of Thessaly, Viopolis Mezourlo, 41110 Larissa, Greece;
- Department of Gastroenterology, University Hospital of Larissa, Viopolis Mezourlo, 41110 Larissa, Greece; (K.A.O.); (K.A.)
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94
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Ngai SSY, Cheung CK, Ng YH, Lee BJ, Dupéré V, Wang M, Chen C, Li Y, Zhou Q, Wong LM, Zhang X. Pathways from school to work: A sequence analysis of non-engaged youth. J Adolesc 2024. [PMID: 38976404 DOI: 10.1002/jad.12372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/10/2024]
Abstract
INTRODUCTION Research on heterogeneous pathways in school-to-work transitions (SWT), particularly longitudinal research, has been limited, as have empirical studies examining effective interventions for facilitating multiple SWT pathways among non-engaged youth (NEY), who are generally at risk of being not in education, employment, or training (NEET). METHODS To develop a typology of SWT pathways, we conducted sequence analysis with longitudinal data from a sample of 630 NEY aged 14-29 (M = 19.78; 63.65% males) in Hong Kong during a 22-month period beginning in September 2020. We also performed multinomial logistic regressions to assess the impact of career and life development (CLD) interventions on SWT outcomes. RESULTS Our analysis yielded a fivefold typology of SWT pathways: the Employment/Entrepreneurship cluster (31.27%), the Vocational Education and Training cluster (13.49%), the Generic Education cluster (16.83%), the Serious Leisure Development cluster (15.24%), and the long-term NEET cluster (23.17%). NEY in the intervention group receiving CLD services, inspired by the expanded notion of work (ENOW) and youth development and intervention framework (YDIF), demonstrated significantly higher likelihoods of being in the Employment/Entrepreneurship (OR = 34.5, 95% CI [10.53, 105.08]), Generic Education (OR = 3.74, 95% CI [1.81, 7.74]), Vocational Education and Training (OR = 1.55, 95% CI [1.05, 6.26]), and Serious Leisure Development (OR = 1.77, 95% CI [1.04, 4.46]) clusters than the long-term NEET cluster. CONCLUSIONS Our findings highlight the dynamic, heterogeneous nature of NEY's CLD journeys, including that CLD interventions based on ENOW-YDIF have had a beneficial effect on NEY's multiple SWT pathways.
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Affiliation(s)
- Steven Sek-Yum Ngai
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Chau-Kiu Cheung
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong, China
| | - Yuen-Hang Ng
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Bong Joo Lee
- Department of Social Welfare, Seoul National University, Seoul, South Korea
| | - Véronique Dupéré
- School of Psychoeducation, Université de Montréal, Montreal, Canada
| | - Miao Wang
- Department of Social Work and Social Policy, School of Sociology, Nankai University, Nankai, China
| | - Chen Chen
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Yunjun Li
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Qiushi Zhou
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Laing-Ming Wong
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Xuyang Zhang
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
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95
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Coelho V. Imposter phenomenon: recognising and addressing it among nurses. Nurs Stand 2024:e12277. [PMID: 38973488 DOI: 10.7748/ns.2024.e12277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 07/09/2024]
Abstract
Imposter phenomenon is described as persistently doubting one's accomplishments, leading to an internalised fear of being exposed as a 'fraud'. This article identifies the nature and prevalence of imposter phenomenon among nursing students, newly registered nurses and senior nurses. It also explores the effects of this phenomenon for nurses and healthcare organisations, including its potential association with burnout, suboptimal performance and a lack of career development. Evidence suggests that addressing imposter phenomenon is not something individuals can accomplish by themselves, but that it requires system-level interventions from healthcare organisations and higher education institutions. This could raise awareness, promote recognition and improve resources and training to mitigate the detrimental effects of this phenomenon on healthcare provision.
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96
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Drake C, Wang V, Stechuchak KM, Sperber N, Bruening R, Coffman CJ, Choate A, Van Houtven CH, Allen KD, Colon-Emeric C, Jackson GL, Tucker M, Meyer C, Kappler CB, Hastings SN. Enhancing team communication to improve implementation of a supervised walking program for hospitalized veterans: Evidence from a multi-site trial in the Veterans Health Administration. PM R 2024. [PMID: 38967454 DOI: 10.1002/pmrj.13190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 07/06/2024]
Abstract
INTRODUCTION The timely translation of evidence-based programs into real-world clinical settings is a persistent challenge due to complexities related to organizational context and team function, particularly in inpatient settings. Strategies are needed to promote quality improvement efforts and implementation of new clinical programs. OBJECTIVE This study examines the role of CONNECT, a complexity science-based implementation intervention to promote team readiness, for enhancing implementation of the 'Assisted Early Mobility for Hospitalized Older Veterans' program (STRIDE), an inpatient, supervised walking program. DESIGN We conducted a stepped-wedge cluster randomized trial using a convergent mixed-methods design. Within each randomly assigned stepped-wedge sequence, Veterans Affairs Medical Centers (VAMCs) were randomized to receive standardized implementation support only or additional training via the CONNECT intervention. Data for the study were obtained from hospital administrative and electronic health records, surveys, and semi-structured interviews with clinicians before and after implementation of STRIDE. SETTING Eight U.S. VAMCs. PARTICIPANTS Three hundred fifty-three survey participants before STRIDE implementation and 294 surveys after STRIDE implementation. Ninety-two interview participants. INTERVENTION CONNECT, a complexity-science-based intervention to improve team function. MAIN OUTCOME MEASURES The implementation outcomes included STRIDE reach and fidelity. Secondary outcomes included validated measures of team function (i.e., team communication, coordination, role clarity). RESULTS At four VAMCs randomized to CONNECT, reach was higher (mean 12.4% vs. 3.8%), and fidelity was similar to four non-CONNECT VAMCs. VAMC STRIDE delivery teams receiving CONNECT reported improvements in team function domains, similar to non-CONNECT VAMCs. Qualitative findings highlight CONNECT's impact and the influence of team characteristics and contextual factors, including team cohesion, leadership support, and role clarity, on reach and fidelity. CONCLUSION CONNECT may promote greater reach of STRIDE, but improvement in team function among CONNECT VAMCs was similar to improvement among non-CONNECT VAMCs. Qualitative findings suggest that CONNECT may improve team function and implementation outcomes but may not be sufficient to overcome structural barriers related to implementation capacity.
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Affiliation(s)
- Connor Drake
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Virginia Wang
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Karen M Stechuchak
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
| | - Nina Sperber
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Rebecca Bruening
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
| | - Cynthia J Coffman
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ashley Choate
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
| | - Courtney Harold Van Houtven
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kelli D Allen
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Medicine and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cathleen Colon-Emeric
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Geriatrics Research Education and Clinical Center, Durham VA Health Care System, Durham, North Carolina, USA
| | - George L Jackson
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Matthew Tucker
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
| | - Cassie Meyer
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
| | - Caitlin B Kappler
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
| | - Susan N Hastings
- ADAPT Center of Innovation, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Geriatrics Research Education and Clinical Center, Durham VA Health Care System, Durham, North Carolina, USA
- Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina, USA
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Gustavson AM, Horstman MJ, Cogswell JA, Holland DE, Vanderboom CE, Mandrekar J, Harmsen WS, Kaufman BG, Ingram C, Griffin JM. Caregiver recruitment strategies for interventions designed to optimize transitions from hospital to home: lessons from a randomized trial. Trials 2024; 25:454. [PMID: 38965624 PMCID: PMC11223294 DOI: 10.1186/s13063-024-08288-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024] Open
Abstract
Challenges to recruitment of family caregivers exist and are amplified when consent must occur in the context of chaotic healthcare circumstances, such as the transition from hospital to home. The onset of the COVID-19 pandemic during our randomized controlled trial provided an opportunity for a natural experiment exploring and examining different consent processes for caregiver recruitment. The purpose of this publication is to describe different recruitment processes (in-person versus virtual) and compare diversity in recruitment rates in the context of a care recipient's hospitalization. We found rates of family caregiver recruitment for in-person versus virtual were 28% and 23%, respectively (p = 0.01). Differences existed across groups with family caregivers recruited virtually being more likely to be younger, white, have greater than high school education, and not be a spouse or significant other to the care recipient, such as a child. Future work is still needed to identify the modality and timing of family caregiver recruitment to maximize rates and enhance the representativeness of the population for equitable impact.
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Affiliation(s)
- Allison M Gustavson
- Veterans Affairs Health Services Research and Development Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, 55417, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Molly J Horstman
- Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Jodie A Cogswell
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Research, Rochester, MN, 55905, USA
| | - Diane E Holland
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Research, Rochester, MN, 55905, USA
| | - Catherine E Vanderboom
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Research, Rochester, MN, 55905, USA
| | - Jay Mandrekar
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, 55905, USA
| | - William S Harmsen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, 55905, USA
| | - Brystana G Kaufman
- Department of Population Health Sciences, Duke University, Durham, NC, USA
- Duke-Margolis Institute for Health Policy, Duke University, Durham, NC, USA
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
| | - Cory Ingram
- Department of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, 55905, USA
| | - Joan M Griffin
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Research, Rochester, MN, 55905, USA.
- Division of Health Care Delivery Research (HCDR), Mayo Clinic, Rochester, MN, 55905, USA.
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98
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Fekonja Z, Kmetec S, Fekonja U, Reljić NM, Pajnkihar M, Strnad M. Emergency triage nurses' perceptions of caring behaviors and the safety of the patient during triage encounters: a grounded theory study. BMC Nurs 2024; 23:453. [PMID: 38961433 PMCID: PMC11221186 DOI: 10.1186/s12912-024-02122-5] [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: 07/05/2023] [Accepted: 06/24/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Triage is a dynamic process prioritising the patient coming to the emergency department. Caring behaviour and patient safety during the triage process are essential for ensuring a good care experience and treatment outcome. OBJECTIVE To describe triage nurses' perceptions on caring behaviors and patient safety in the triage area. DESIGN Strauss and Corbin's Grounded theory method was used to develop the model. METHODS The study was conducted in the emergency department in northeastern Slovenia. Semi-structured interviews were used for data collection, and 19 triage nurses were selected by theoretical sampling, guided by emerging categories between November 2021 and July 2022. The data analysis was conducted according to Strauss and Corbin's coding framework. RESULTS The analysis of the interviews generated one category: The process of creating a caring and safe triage encounter for the patient, together with two categories that explain the key phenomenon: (1) Triage caring and (2) Safety in the triage process. Within the category "Triage caring", four subcategories were developed: (1) Assurance of triage nurses' presence, (2) Connectedness, (3) Respectful attitude, and (4) Knowledge and skills. The category Safety in the triage process consists of three identified subcategories: (1) Conception and perception of safety, (2) Factors influencing patient safety, and (3) Improving the triage safety. CONCLUSIONS The triage nurses' perceptions about caring for the patient and his safety in the triage area show that caring and safety are inseparably linked and coincide when triaging a patient. Namely, caring for the patient means ensuring the patient's safety at the same time. IMPLICATIONS FOR THE NURSING FIELD A better understanding of the importance of triage nurses' caring behavior and patient safety emerges from the findings, highlighting the challenges faced in a busy emergency department where nurses must balance providing care and responding to patients' needs while ensuring safety. Findings in the study show that patient care and safety are inseparably linked and coincide when triaging a patient. Moreover, applying caring behaviour during triage encounter results in greater patient safety. NO PATIENT OR PUBLIC CONTRIBUTION The study's design, evaluation of the findings, and execution did not need the involvement of patients or the general public. Participants were triage nurses working in the emergency department. Triage nurses were interviewed about their perceptions of triage nurses on caring behaviors and patient safety during triage encounter.
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Affiliation(s)
- Zvonka Fekonja
- Faculty of Health Science, University of Maribor, Žitna ulica 15, Maribor, 2000, Slovenia.
| | - Sergej Kmetec
- Faculty of Health Science, University of Maribor, Žitna ulica 15, Maribor, 2000, Slovenia
| | - Urška Fekonja
- Emergency Department, University Medical Centre Maribor, Maribor, Slovenia
| | - Nataša Mlinar Reljić
- Faculty of Health Science, University of Maribor, Žitna ulica 15, Maribor, 2000, Slovenia
| | - Majda Pajnkihar
- Faculty of Health Science, University of Maribor, Žitna ulica 15, Maribor, 2000, Slovenia
| | - Matej Strnad
- Emergency Department, University Medical Centre Maribor, Maribor, Slovenia
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
- Prehospital Unit, Department for Emergency Medicine, Community Healthcare Center Maribor, Maribor, Slovenia
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Välimäki M, Hu S, Lantta T, Hipp K, Varpula J, Chen J, Liu G, Tang Y, Chen W, Li X. The impact of evidence-based nursing leadership in healthcare settings: a mixed methods systematic review. BMC Nurs 2024; 23:452. [PMID: 38961494 PMCID: PMC11221094 DOI: 10.1186/s12912-024-02096-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/13/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The central component in impactful healthcare decisions is evidence. Understanding how nurse leaders use evidence in their own managerial decision making is still limited. This mixed methods systematic review aimed to examine how evidence is used to solve leadership problems and to describe the measured and perceived effects of evidence-based leadership on nurse leaders and their performance, organizational, and clinical outcomes. METHODS We included articles using any type of research design. We referred nurses, nurse managers or other nursing staff working in a healthcare context when they attempt to influence the behavior of individuals or a group in an organization using an evidence-based approach. Seven databases were searched until 11 November 2021. JBI Critical Appraisal Checklist for Quasi-experimental studies, JBI Critical Appraisal Checklist for Case Series, Mixed Methods Appraisal Tool were used to evaluate the Risk of bias in quasi-experimental studies, case series, mixed methods studies, respectively. The JBI approach to mixed methods systematic reviews was followed, and a parallel-results convergent approach to synthesis and integration was adopted. RESULTS Thirty-one publications were eligible for the analysis: case series (n = 27), mixed methods studies (n = 3) and quasi-experimental studies (n = 1). All studies were included regardless of methodological quality. Leadership problems were related to the implementation of knowledge into practice, the quality of nursing care and the resource availability. Organizational data was used in 27 studies to understand leadership problems, scientific evidence from literature was sought in 26 studies, and stakeholders' views were explored in 24 studies. Perceived and measured effects of evidence-based leadership focused on nurses' performance, organizational outcomes, and clinical outcomes. Economic data were not available. CONCLUSIONS This is the first systematic review to examine how evidence is used to solve leadership problems and to describe its measured and perceived effects from different sites. Although a variety of perceptions and effects were identified on nurses' performance as well as on organizational and clinical outcomes, available knowledge concerning evidence-based leadership is currently insufficient. Therefore, more high-quality research and clinical trial designs are still needed. TRAIL REGISTRATION The study was registered (PROSPERO CRD42021259624).
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Affiliation(s)
- Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, FI-20014, Finland
- School of Public Health, University of Helsinki, Helsinki, FI-00014, Finland
| | - Shuang Hu
- Xiangya Nursing, School of Central South University, Changsha, 410013, China
| | - Tella Lantta
- Department of Nursing Science, University of Turku, Turku, FI-20014, Finland
| | - Kirsi Hipp
- Department of Nursing Science, University of Turku, Turku, FI-20014, Finland
- School of Health and Social Services, Häme University of Applied Sciences, Hämeenlinna, Finland
| | - Jaakko Varpula
- Department of Nursing Science, University of Turku, Turku, FI-20014, Finland
| | - Jiarui Chen
- Xiangya Nursing, School of Central South University, Changsha, 410013, China
| | - Gaoming Liu
- Hunan Cancer Hospital, Changsha, 410008, China
| | - Yao Tang
- Xiangya Nursing, School of Central South University, Changsha, 410013, China
| | - Wenjun Chen
- Xiangya Nursing, School of Central South University, Changsha, 410013, China
| | - Xianhong Li
- Xiangya Nursing, School of Central South University, Changsha, 410013, China.
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Kim E, Durning SJ, Dupont J, Bulaklak J, Crosier A, Soh M. Exploring Impostor Phenomenon During Onboarding Into a Military Medical School. Mil Med 2024; 189:e1653-e1660. [PMID: 38109724 DOI: 10.1093/milmed/usad466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/23/2023] [Accepted: 11/22/2023] [Indexed: 12/20/2023] Open
Abstract
INTRODUCTION Impostor phenomenon (IP) is an experience where an individual believes that their success was because of chance or luck and was not associated with the mastery of skills. There is a gap in the literature in understanding what role, if any, onboarding (e.g., orientation weeks) into a military medical school plays into student experiences with IP. For many, onboarding serves as the first exposure to the climate, culture, and learning environment of both medical school and the military. Prevention, or early intervention, of IP may reduce potential effects on a medical trainee's confidence and competence in their profession, which may ultimately enhance health care team performance and impact patient outcomes. This study explores if and why military medical students experience IP during a 2-week-long orientation into a military medical school. MATERIALS AND METHODS The study participants were medical students at a military medical school. Researchers conducted semi-structured interviews in August 2022 to explore if and why students experienced IP and deployed the Clance IP Scale as a measure with validity evidence for ascertaining the presence and magnitude of IP. Researchers calculated total scores from the Clance IP Scale and thematically analyzed interview transcripts. RESULTS Researchers interviewed 29 matriculating military medical students. Twenty-one (75%) students reported frequent or intense IP experiences on the Clance IP Scale indicating that IP was present in our study sample. Thematic analysis identified six themes that drove one's experience with IP: reevaluation of merit, individualized diversity and inclusion experiences, administrative and financial support, preconceived expectations, building relationships, and new community roles. CONCLUSIONS Our identified themes provide us with a better understanding of if and why military medical students experience IP during onboarding. Our findings are also consistent with the situated learning theory, which places emphasis on the sense of belonging and may provide a unique and insightful lens through which IP can be further explored and studied, particularly at a military medical school where various identities, dynamics, and aspirations can converge simultaneously. Additionally, our findings suggest that existing practices may benefit from a number of improvements including, but not limited to, tailoring onboarding activities to entail more reflective discussion using small groups, especially for topics related to diversity and inclusion, revisiting areas where students may feel inadequately prepared to transition and perform well in a medical school, reevaluating administrative and financial support that can be roadblocks to a student's transition into the new environment and removing these barriers, and ensuring cultural coherence (organizational alignment of vision and mission) among faculty, staff, and upperclassmen. Future research directions include better understanding how developing single or multiple, identities can impact a medical students' experience with IP during onboarding, pre-clerkship, clerkship, or post-clerkship period, if at all.
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Affiliation(s)
- Eungjae Kim
- F. Edward Hebert School of Medicine Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Steven J Durning
- F. Edward Hebert School of Medicine Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Jinbum Dupont
- F. Edward Hebert School of Medicine Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Jezreelyn Bulaklak
- F. Edward Hebert School of Medicine Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Abigail Crosier
- F. Edward Hebert School of Medicine Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Michael Soh
- Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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