251
|
Zovich B, Block SJ, Borondy-Jenkins F, Moraras K, Chen T, Adedokun R, Hua D, Cohen C. The role of culturally appropriate interpersonal communication strategies to reduce hepatitis B and liver cancer disparities. Front Public Health 2024; 12:1377096. [PMID: 39185121 PMCID: PMC11341449 DOI: 10.3389/fpubh.2024.1377096] [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: 01/26/2024] [Accepted: 07/16/2024] [Indexed: 08/27/2024] Open
Abstract
Introduction Asian and Pacific Islander (API), African, and Caribbean immigrant groups in the U.S. are disproportionately impacted by chronic hepatitis B and hepatocellular carcinoma (primary liver cancer). Creating educational communication campaigns about hepatitis B and liver cancer for these communities is necessary to increase disease-related awareness and prompt health-promoting behaviors. Identifying interpersonal communication (IPC) preferences within diverse communities for integration into an educational campaign that emphasizes the link between hepatitis B and liver cancer can ultimately promote uptake of screening, vaccination and linkage to appropriate care. Methods Fifteen focus groups and two key informant interviews were conducted with participants from Micronesian, Chinese, Hmong, Nigerian, Ghanaian, Vietnamese, Korean, Somali, Ethiopian, Filipino, Haitian, and Francophone West African communities. Data were analyzed using thematic coding and analysis. Results Findings demonstrate that all communities preferred that materials be offered in both English and native languages and emphasized that campaigns highlight the connection between hepatitis B and liver cancer. Educational sessions should take place in settings where communities feel safe, including community-based organizations, religious establishments, and healthcare offices, and should be facilitated by trusted messengers, including patient navigators, doctors and faith leaders. Presenting accurate information and dispelling myths and misconceptions around hepatitis B, liver cancer, and their connection were the biggest needs identified across all focus groups. Discussion This study provides insight into community-specific preferences for learning about hepatitis B and liver cancer through IPC methods. The findings from this study can be used to design multi-platform, culturally and linguistically appropriate health education campaigns to facilitate improved diagnosis, prevention, and management of hepatitis B and liver cancer among heavily impacted communities in the U.S.
Collapse
Affiliation(s)
| | - Suzanne J. Block
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | | | - Kate Moraras
- Hepatitis B Foundation, Doylestown, PA, United States
| | - Thomas Chen
- Department of Internal Medicine, The Mount Sinai Hospital, New York, NY, United States
| | | | - Dung Hua
- Vital Access Care Foundation, Fountain Valley, CA, United States
| | - Chari Cohen
- Hepatitis B Foundation, Doylestown, PA, United States
| |
Collapse
|
252
|
Sheehan R, Ding J, White A, Magill N, Chauhan U, Marshall-Tate K, Strydom A. Specialist intellectual disability liaison nurses in general hospitals in England: cohort study using a large mortality dataset. BMJ Open 2024; 14:e077124. [PMID: 39122397 DOI: 10.1136/bmjopen-2023-077124] [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] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE Intellectual disability liaison nurses in general hospitals could enhance access to high-quality, adapted healthcare and improve outcomes. We aimed to explore associations between the input of intellectual disability liaison nurses and the quality of care in people with intellectual disability who are admitted to hospital. DESIGN Retrospective analysis of a national dataset of mortality reviews. SETTING General hospitals in England. PARTICIPANTS 4742 adults with intellectual disability who died in hospital between 2016 and 2021 and whose deaths were reviewed as part of the Learning from Lives and Deaths mortality review programme. OUTCOME MEASURES We used logistic regression to compare the sociodemographic and clinical characteristics of those who did, and did not, receive input from an intellectual disability liaison nurse. We explored associations between liaison nurse input, care processes and overall quality of care. RESULTS One-third of people with intellectual disability who died in hospital in England between 2016 and 2021 had input from an intellectual disability liaison nurse. Intellectual disability liaison nurse input was not evenly distributed across England and was more common in those who died of cancer. Having an intellectual disability liaison nurse involved in an individual's care was associated with increased likelihood of reasonable adjustments being made to care (adjusted OR (aOR) 1.95, 95% CI 1.63 to 2.32) and of best practice being identified (aOR 1.37, 95% CI 1.17 to 1.60) but was not associated with a rating of overall quality of care received (aOR 0.94, 95% CI 0.78 to 1.12). CONCLUSIONS Intellectual disability liaison nurses see only a minority of people with intellectual disability who are admitted to hospital in England. Increasing the availability of intellectual disability liaison nurses could improve care for this disadvantaged group.
Collapse
Affiliation(s)
- Rory Sheehan
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Oxleas NHS Foundation Trust, Dartford, UK
| | - Jonathon Ding
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Adam White
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Nicholas Magill
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Karina Marshall-Tate
- South London and Maudsley NHS Foundation Trust, London, UK
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - André Strydom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
253
|
Ulus M, Durmaz Edeer A. Delirium care burden of intensive care nurses caring for patients undergoing open-heart surgery: A mixed-method research. Nurs Crit Care 2024. [PMID: 39119786 DOI: 10.1111/nicc.13137] [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: 03/05/2024] [Revised: 06/19/2024] [Accepted: 07/20/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Delirium is an acute confusional state characterized by inattention, cognitive dysfunction and an altered level of consciousness. Delirium causes negative outcomes in patients, and patients with delirium increase the workload of nurses. Therefore, it is important to recognize the challenges and burdens experienced by nurses caring for patients with delirium. AIM To determine the subjective burden experienced by intensive care nurses caring for patients who have undergone open-heart surgery. STUDY DESIGN A mixed-method sequential explanatory design. A non-probability purposive sampling method was used for the quantitative stage. Using OpenEpi, we employed the method of sample calculation with an unknown universe. The sample size of the quantitive study comprised 130 nurses. Quantitative data were collected with Google survey. For gathering qualitative data, online video interviews were conducted with 10 nurses, an interpretive phenomenological approach was used and content analysis was performed. RESULTS In the quantitative phase, we found that the subjective burden was high. In the qualitative phase, five main themes emerged: difficulty in recognizing delirium, physical burden, emotional burden, burden in care management of patients with delirium and the effect of patients with delirium on other patients. The nurses experienced physical and emotional burden in delirium management and felt lonely while caring for patients with delirium. CONCLUSIONS Because nurses play a key role in the care of patients with delirium, reducing the burden nurses experience when caring for patients with delirium should be considered important in ensuring that this patient population receives adequate care. RELEVANCE TO CLINICAL PRACTICE Delirium patients create a care burden for intensive care nurses. To reduce this burden of care, in-service training in patient management and bedside teaching support should be provided to nurses. Furthermore, the use of a valid scale to diagnose delirium should be integrated into health policies. Nurses should not be left alone in the management of delirium. Managing delirium patients with a team including physicians, nurses and professionals from other health disciplines will ensure that patients receive high-quality care, thereby reducing the care burden of nurses.
Collapse
Affiliation(s)
- Meltem Ulus
- Department of Surgical Nursing, Dokuz Eylul University, Health Sciences Institute, Izmir, Turkey
| | - Aylin Durmaz Edeer
- Department of Surgical Nursing, Dokuz Eylül University Faculty of Nursing, Izmir, Turkey
| |
Collapse
|
254
|
Valero-Chillerón MJ, Soriano-Vidal FJ, Mena-Tudela D, Cervera-Gasch Á, Vila-Candel R, Llagostera-Reverter I, Andreu-Pejó L, Ortíz-Mallasén V, González-Chordá VM. Monitoring of the Main Reasons for Early Abandonment of Breastfeeding during the First Six Months of Life: A Secondary Analysis. NURSING REPORTS 2024; 14:1937-1947. [PMID: 39189274 PMCID: PMC11348122 DOI: 10.3390/nursrep14030144] [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: 06/10/2024] [Revised: 08/01/2024] [Accepted: 08/04/2024] [Indexed: 08/28/2024] Open
Abstract
The rate of six-month-old infants exclusively breastfed in Spain remains below the recommended rate. This study aimed to explore in detail the evolution of feeding during the first six months of life of a group of newborns, as well as to identify the reasons reported by the mothers for feeding change. A secondary analysis of two prospective longitudinal observational studies was conducted. In both studies, women participants, during the clinical puerperium, opted for exclusive breastfeeding for their newborns. The participants were followed up during the infants' first six months. A sample size of 314 participants was obtained, of which 77.1% (n = 232) were of Spanish origin, and 51% (n = 160) were primiparous. The prevalence of exclusive breastfeeding at six months was 55.4% (n = 174). During the first four months of life, the main reason for early abandonment of breastfeeding was the perception of insufficient milk production. After the fourth month, the predominant reason was starting work. Statistically significant differences were observed between the reasons for giving up and the total weeks of exclusive breastfeeding (p < 0.001) and total weeks of breastfeeding (p = 0.002). Early weaning from breastfeeding is a multifactorial phenomenon. However, depending on the moment cessation occurs, some reasons predominate over others and, in many cases, can be prevented. These results indicate the need to continue investing efforts to promote and protect breastfeeding in Spain.
Collapse
Affiliation(s)
- María Jesús Valero-Chillerón
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
| | - Francisco Javier Soriano-Vidal
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
- Department of Nursing, Universitat de València, 46010 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Lluis Alcanyis, 46800 Xàtiva, Spain
| | - Desirée Mena-Tudela
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
- Feminist Institute, Universitat Jaume I, 12071 Castellón, Spain
| | - Águeda Cervera-Gasch
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
| | - Rafael Vila-Candel
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
- La Ribera Primary Health Department, 46600 Alzira, Spain
- Faculty of Health Sciences, Universidad Internacional de Valencia (VIU), 46002 Valencia, Spain
| | - Irene Llagostera-Reverter
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
| | - Laura Andreu-Pejó
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
| | - Víctor Ortíz-Mallasén
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
| | - Víctor Manuel González-Chordá
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
- Nursing and Healthcare Research Unit (INVESTÉN-ISCIII), Institute of Health Carlos III, 28029 Madrid, Spain
| |
Collapse
|
255
|
Sharp D, McKenzie D, Padayachee L, Subramaniam A. Frailty as a trigger for goals-of-care discussions in rapid response calls: A single-centre retrospective cohort study. Aust Crit Care 2024:S1036-7314(24)00200-5. [PMID: 39127605 DOI: 10.1016/j.aucc.2024.06.011] [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: 05/08/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Timely goals-of-care (GOC) discussions are essential for end-of-life planning, particularly during acute hospital admissions, where ambiguity often persists. Frailty, prevalent in the ageing population and linked to adverse outcomes, underscores the need to align treatment strategies with quality of life. Recognising frailty as a trigger for GOC discussions during rapid response calls (RRCs) is critical for efficient resource management and improving patient outcomes. METHODS This single-centre retrospective cohort study included all hospitalised patients aged ≥65 years admitted between September 2021 and June 2023 who experienced an RRC. Frailty was assessed using the Clinical Frailty Scale (CFS) during the RRC. The primary outcome was to investigate whether frailty, specifically assessed by the CFS as screened during an RRC, could be a suitable clinical trigger for initiating GOC discussions. We also aimed to identify the proportion of patients with frailty (CFS score: ≥5) and predictors at the time of RRC, resulting in recommendations for GOC discussions. RESULTS Among 4954 patients, 1685 (34.0%) were classified as frail (CFS score: ≥5). Recommendations increased with frailty levels (nonfrail [CFS score: 1-4]: 6.6%, mildly frail [CFS score: 5]: 19.3%, moderate-to-severely frail [CFS score: 6-9]: 32.2%; p < 0.001). Frailty independently increased the probability of GOC recommendations during an RRC (area under the receiver operating characteristic curve = 0.71). The CFS cut-off point for GOC recommendations was ≥5. The presence of frailty was associated with higher odds of receiving GOC recommendations for mildly frail (CFS score: 5; odds ratio [OR] = 2.53; 95% confidence interval: 1.96-3.27) and moderate-to-severely frail (CFS score: 6-9; OR = 4.69; 95% confidence interval: 3.81-5.78) compared to nonfrail patients. CONCLUSION Frailty, identified during an RRC, served as a robust trigger for GOC recommendations, highlighting the importance of tailored proactive discussions before episodes of deterioration. Higher levels of frailty (CFS score: ≥5) demonstrate practical markers for aiding clinicians with proactive GOC discussions.
Collapse
Affiliation(s)
- D Sharp
- Department of Intensive Care, Epworth HealthCare, Richmond, Victoria, Australia; Department of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia; Department of Intensive Care, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia; Department of Intensive Care, Victorian Heart Hospital, Monash Health, Clayton, Victoria, Australia.
| | - D McKenzie
- Research Development and Governance Unit, Epworth HealthCare, Richmond, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - L Padayachee
- Department of Intensive Care, Epworth HealthCare, Richmond, Victoria, Australia
| | - A Subramaniam
- Department of Intensive Care, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Intensive Care Medicine, Dandenong Hospital, Monash Health, Dandenong, Victoria, Australia; Department of Intensive Care, Epworth HealthCare, Geelong, Victoria, Australia; Department of Medicine, Peninsula Clinical School, Monash University, Frankston, Victoria, Australia; Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
256
|
Choi MH, Kim HJ, Yoo HJ. Nurses' perspectives about end-of-life care when family presence is restricted during a pandemic: A qualitative study. Aust Crit Care 2024:S1036-7314(24)00201-7. [PMID: 39127604 DOI: 10.1016/j.aucc.2024.06.012] [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: 04/08/2024] [Revised: 06/22/2024] [Accepted: 06/24/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND To prevent the infection from spreading, patients who were dying from COVID-19 were treated in isolation with restricted family access, which differed from existing end-of-life care procedures. This was a significant change that affected the care provided by nurses. OBJECTIVES This study explored nurses' end-of-life care experiences in a limited family visitation setting during the COVID-19 pandemic. METHODS A descriptive qualitative study was conducted. Data were collected through individual, in-depth, semistructured interviews with ten critical care nurses who provided end-of-life care to patients with COVID-19 in South Korea. The data were analysed using thematic analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used to assess the study's rigour. FINDINGS Three themes were identified: 'Witnessing patients' and families' heartbreak over separation', 'The gaps between the ideals and realities of end-of-life care', and 'Efforts to provide patients with a comfortable final journey'. Nurses realise the importance of their central role in supporting interactions between patients and families during end-of-life care. CONCLUSIONS Family participation, facilitated by nurses' interest and efforts as mediators connecting patients and families, is essential for achieving high-quality care for inpatients facing end of life. This study is significant as it emphasises that the direction of end-of-life care should be family centric, even in a pandemic situation with limited family participation. To improve interaction between patients and families, creating an environment based on family participation that builds trust and strengthens communication is essential. Additionally, hospital support, such as professional education and counselling, should be provided to strengthen nurses' end-of-life care competency.
Collapse
Affiliation(s)
- Myung Hui Choi
- Department of Nursing, Dankook University Hospital, Cheonan, Republic of Korea
| | - Hyun Jung Kim
- Department of Nursing, Dankook University Hospital, Cheonan, Republic of Korea
| | - Hye Jin Yoo
- College of Nursing, Dankook University, Cheonan, Republic of Korea.
| |
Collapse
|
257
|
Patterson C, Roberts M, Yousiph T, Robson G, Lewer K, Jay EK, Moxham L. Non-traditional mental health clinical placements: An effective means for reducing self-stigma in pre-registration nursing students. J Psychiatr Ment Health Nurs 2024. [PMID: 39118420 DOI: 10.1111/jpm.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 06/25/2024] [Accepted: 07/20/2024] [Indexed: 08/10/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT Pre-registration nursing students report high rates of stigma, leading to low help-seeking attitudes when seeking help for mental health issues. Traditional mental health clinical placements can improve stigma related to attitudes and social distance for pre-registration nursing students. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE There are nil recorded clinical placement interventions that have decreased self-stigma for pre-registration nursing students, with this study highlighting a clinical placement model that is effective in significantly decreasing self-stigma. IMPLICATIONS FOR PRACTICE The knowledge around the mental health struggles experienced by pre-registration nursing students, and the effect of a non-traditional mental health placement in decreasing self-stigmatizing attitudes in this population, is important for the future of retaining mental health nurses. There is an opportunity to use the clinical placement model presented, and design interventions for nursing students that aims to promote help-seeking behaviours. ABSTRACT INTRODUCTION: Traditional mental health clinical placements can improve pre-registration nurse stigma toward mental illness, particularly in measures of attitudes and social distance. However, they have not yet been shown to improve self-stigma, which affects mental health disclosure and help-seeking behaviour. AIM The present study investigates nursing students' stigma following a non-traditional mental health placement immersed alongside people living with mental illness. METHODS Three stigma subtypes were measured using the Opening Minds Scale for Healthcare Providers: Attitudes, Social Distance, and Disclosure/Help-seeking. RESULTS Pre-registration nurses (N = 848) completed the instrument pre- and post-placement. A multivariate analysis of variance (MANOVA) identified a large effect of placement on stigma (p < .001,η p 2 $$ {\eta}_p^2 $$ = .101). Post hoc pairwise comparisons revealed all three types of stigma decreased after the non-traditional placement (Attitudes: p < .001,η p 2 $$ {\eta}_p^2 $$ = 0.09, Social Distance: p < .001,η p 2 $$ {\eta}_p^2 $$ = 0.07, Disclosure/Help-seeking: p < .001,η p 2 $$ {\eta}_p^2 $$ = 0.04). DISCUSSION These findings emphasize that attending a non-traditional mental health clinical placement can effectively reduce multiple types of nursing student stigma. LIMITATIONS Further research in this area could focus on which attributes of the clinical placement setting foster positive help-seeking. IMPLICATIONS These results are noteworthy for stigma surrounding disclosure/help-seeking, as traditional (i.e. hospital-based) mental-health clinical placements have been found ineffective in reducing nursing student stigma in this domain. RECOMMENDATIONS Further research into the effectiveness of non-traditional clinical placements in reducing nursing students' stigma regarding mental health disclosure and help-seeking, is required.
Collapse
Affiliation(s)
- Christopher Patterson
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Michelle Roberts
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Taylor Yousiph
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Georgia Robson
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kelly Lewer
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elissa-Kate Jay
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lorna Moxham
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| |
Collapse
|
258
|
Chen J, Tan B, Chen Y, Song Y, Li L, Yu L, Feng Y, Zhou Y, Jiang W. A randomized controlled trial of low-frequency repeated transcranial magnetic stimulation in patients with poststroke neurogenic bladder. Sci Rep 2024; 14:18404. [PMID: 39117697 PMCID: PMC11310514 DOI: 10.1038/s41598-024-69345-z] [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: 04/24/2024] [Accepted: 08/03/2024] [Indexed: 08/10/2024] Open
Abstract
Urinary incontinence is a common complication in stroke survivors for whom new interventions are needed. This study investigated the therapeutic effect of low-frequency (LF) repeated transcranial magnetic stimulation (rTMS) on the contralesional primary motor cortex (M1) in patients with poststroke urinary incontinence (PSI). A total of 100 patients were randomly assigned to the rTMS group or sham-rTMS group on basis of the intervention they received. Both groups underwent five treatment sessions per week for 4 weeks. Data from the urodynamic examination were used as the primary outcome. The secondary outcome measures were questionnaires and pelvic floor surface electromyography. After 4 weeks of intervention, the maximum cystometric capacity (MCC), maximum detrusor pressure (Pdet.max), residual urine output, overactive bladder score (OABSS) (including frequency, urgency, and urgency urinary incontinence), and the ICIQ-UI SF improved significantly in the rTMS group compared with those in the sham-rTMS group (P < 0.05). However, no changes in pelvic floor muscle EMG were detected in patients with PSI (both P > 0.05). Our data confirmed that 4 weeks of LF-rTMS stimulation on the contralateral M1 positively affects poststroke urinary incontinence in several aspects, such as frequency, urgency urinary incontinence, MCC, end-filling Pdet, OABSS, and ICIQ-UI SF scores.
Collapse
Affiliation(s)
- Jialu Chen
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Botao Tan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Yuling Chen
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Yunling Song
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Lang Li
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Lehua Yu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Yali Feng
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Yueshan Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Wei Jiang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
| |
Collapse
|
259
|
Pien LC, Cheng Y, Lee FC, Cheng WJ. The effect of multiple types of workplace violence on burnout risk, sleep quality, and leaving intention among nurses. Ann Work Expo Health 2024; 68:678-687. [PMID: 38888222 DOI: 10.1093/annweh/wxae052] [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: 01/10/2024] [Accepted: 05/30/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE The aim of our study is to explore the associations between multiple types of workplace violence (WPV) and burnout risk, sleep problems, and leaving intention among nurses. METHODS This cross-sectional survey recruited 1,742 nurses, and data on WPV experiences were collected through self-administered questionnaires. Work conditions, burnout risk scales, sleep quality, and leaving intentions were also evaluated. Multivariate logistic regression analyses were performed to examine the associations of WPV with burnout risk, sleep quality, and leaving intentions, adjusting for demographic characteristics and work conditions. RESULTS The study found that 66.7% of nurses reported experience of WPV, with 26.9% experiencing both physical and nonphysical forms. Those who experienced multiple types of WPV reported worse work conditions, higher burnout risk, poorer sleep quality, and a stronger leaving intention compared to those without such experiences. Adjusting for working conditions, logistic regression analysis showed that nurses who experienced multiple types of WPV had 2.12-fold higher odds of high personal burnout risk, 2.36-fold higher odds of high client-related burnout risk, 1.95-fold higher odds of poor sleep quality, and 1.80-fold higher odds of high leaving intention, compared to those without WPV experiences. CONCLUSIONS Strategies by hospital managers and policymakers to monitor and reduce workplace violence are vital for sustaining nurses' mental health, well-being, and preventing early attrition from the profession.
Collapse
Affiliation(s)
- Li-Chung Pien
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, 250 Wuxing St., Taipei, 11031, Taiwan
- Psychiatric Research Center, Wanfang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Taipei, 116079, Taiwan
- Department of Nursing, Wanfang Hospital, Taipei Medical University, No. 111, Sec. 3, Xinglong Rd., Taipei, 116079, Taiwan
| | - Yawen Cheng
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, 17 Xuzhou Road, Taipei 100, Taiwan
| | - Fang-Chun Lee
- Nursing Department, Taipei City Hospital Songde Branch, 145 Zhengzhou Rd., Taipei, 103212, Taiwan
| | - Wan-Ju Cheng
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, 35 Keyan Rd., Zhunan, Miaoli County, 35053, Taiwan
- Department of Psychiatry, China Medical University Hospital, 2 Yude Rd., Taichung, 404327, Taiwan
- Department of Public Health, China Medical University, 100 Sec. 1, Jingmao Rd., Taichung, 706040, Taiwan
| |
Collapse
|
260
|
Werkheiser C, Cullen M. Maximizing the scope of the outpatient endocrine nurse. J Pediatr Nurs 2024:S0882-5963(24)00293-8. [PMID: 39122580 DOI: 10.1016/j.pedn.2024.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
|
261
|
El Chamaa A, Kowalski K, Parikh P, Rushton A. Patients' experiences with musculoskeletal spinal pain: A qualitative systematic review protocol. PLoS One 2024; 19:e0306993. [PMID: 39116059 PMCID: PMC11309383 DOI: 10.1371/journal.pone.0306993] [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: 02/28/2024] [Accepted: 06/25/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Musculoskeletal (MSK) spinal pain encapsulates various conditions including lumbar (low back), cervical (neck), and thoracic pain that significantly impact individual and global health. While clinical aspects of spinal pain have been well-studied, understanding patients' personal narratives and lived experiences remains essential for enhancing patient-centered care, improving treatment adherence, and informing healthcare policies. It provides deep insights into the impacts of spinal pain, guiding more effective and empathetic treatment approaches. This systematic review aims to synthesize qualitative evidence on patients' experiences with MSK spinal pain, providing insight into the challenges faced, coping strategies, daily life impacts, and healthcare interactions. The objective of this review is to synthesize the qualitative evidence regarding the lived experiences of patients with MSK spinal pain. METHODS This systematic review will use a meta-aggregation approach to synthesize data from qualitative studies, that will be identified through a comprehensive search of electronic databases and supplemented by grey literature searches. Two independent reviewers will screen, identify, and extract data from eligible studies. In cases of disagreement, conflicts will be resolved by consulting a third reviewer. These same reviewers will then use the Joanna Briggs Institute (JBI) qualitative quality assessment tool to evaluate the methodological quality of the identified studies, with the derived scores informing the synthesis process, that will involve extracting each study's findings along with their supporting illustrations, then grouped into categories based on similarity in meaning. These categories will then be aggregated to form synthesized findings. IMPLICATIONS Synthesized findings on patients' lived experiences with MSK spinal pain including key themes, patterns, and insights will be presented. By emphasizing patient narratives, the results of the review can contribute to the optimization of outcomes, and to enhance patient-provider relations and improve quality of care in MSK spinal health.
Collapse
Affiliation(s)
- Alaa El Chamaa
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Katie Kowalski
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Pulak Parikh
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Alison Rushton
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| |
Collapse
|
262
|
Prieto J, Wilson J, Tingle A, Cooper E, Handley M, Rycroft Malone J, Bostock J, Loveday H. Preventing urinary tract infection in older people living in care homes: the 'StOP UTI' realist synthesis. BMJ Qual Saf 2024:bmjqs-2023-016967. [PMID: 39122359 DOI: 10.1136/bmjqs-2023-016967] [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: 11/28/2023] [Accepted: 08/01/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Urinary tract infection (UTI) is the most diagnosed infection in older people living in care homes. OBJECTIVE To identify interventions for recognising and preventing UTI in older people living in care homes in the UK and explain the mechanisms by which they work, for whom and under what circumstances. METHODS A realist synthesis of evidence was undertaken to develop programme theory underlying strategies to recognise and prevent UTI. A generic topic-based search of bibliographic databases was completed with further purposive searches to test and refine the programme theory in consultation with stakeholders. RESULTS 56 articles were included in the review. Nine context-mechanism-outcome configurations were developed and arranged across three theory areas: (1) Strategies to support accurate recognition of UTI, (2) care strategies for residents to prevent UTI and (3) making best practice happen. Our programme theory explains how care staff can be enabled to recognise and prevent UTI when this is incorporated into care routines and activities that meet the fundamental care needs and preferences of residents. This is facilitated through active and visible leadership by care home managers and education that is contextualised to the work and role of care staff. CONCLUSIONS Care home staff have a vital role in preventing and recognising UTI in care home residents.Incorporating this into the fundamental care they provide can help them to adopt a proactive approach to preventing infection and avoiding unnecessary antibiotic use. This requires a context of care with a culture of personalisation and safety, promoted by commissioners, regulators and providers, where leadership and resources are committed to support preventative action by knowledgeable care staff.
Collapse
Affiliation(s)
| | - Jennie Wilson
- Richard Wells Research Centre, University of West London-Brentford Site, Brentford, UK
| | - Alison Tingle
- Richard Wells Research Centre, University of West London-Brentford Site, Brentford, UK
| | | | | | | | | | - Heather Loveday
- Richard Wells Research Centre, University of West London-Brentford Site, Brentford, UK
| |
Collapse
|
263
|
Seibel K, Rios CLO, Sparna T, Becker C, Gaertner J, Becker G, Boehlke C. Implementation of a digital distress detection system in palliative care: qualitative data on perspectives of a multiprofessional palliative care team. BMC Palliat Care 2024; 23:203. [PMID: 39113031 PMCID: PMC11304939 DOI: 10.1186/s12904-024-01530-3] [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: 06/18/2024] [Accepted: 07/23/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Digital health technologies such as sensor systems are intended to support healthcare staff in providing adequate patient care. In the Department of Palliative Medicine (University Medical Center Freiburg), we developed and implemented a noninvasive, bed-based sensor system in a pilot study. The aim was to detect distress in patients who were no longer able to express themselves by monitoring heart and respiratory rates, vocalizations, and movement measurements. The sensor system was intended to supplement standard care, which generally cannot guarantee constant monitoring. As there is a lack of data on how healthcare professionals experience such a techno-digital innovation, the aim of this study was to explore how the multiprofessional palliative care team who piloted the sensor system perceived its potential benefits and limitations, and how they experienced the broader context of healthcare technology and research in palliative care. METHODS We conducted a qualitative interview study with 20 members of the palliative care team and analyzed the recorded, verbatim transcribed interviews using qualitative content analysis. RESULTS The sensor system was described as easy to use and as helpful support for patients, care staff, and relatives, especially against the backdrop of demographic change. However, it could not replace human interpretation of stress and subsequent treatment decisions: this remained the expertise of the nursing staff. A potential reduction in personnel was expected to be a risk of a digital monitoring system. The special conditions of research and digital health technologies in an end-of-life context also became clear. Specifically, healthcare staff were open to health technologies if they benefited the patient and were compatible with professional nursing and/or palliative care attitudes. Additionally, a patient-protective attitude and possible interprofessional differences in priorities and the resulting challenges for the team became apparent. CONCLUSIONS A potential digital solution for distress monitoring was considered useful by palliative care practitioners. However, interprofessional differences and compatibility with existing palliative care practices need to be considered before implementing such a system. To increase user acceptability, the perspectives of healthcare professionals should be included in the implementation of technological innovations in palliative care.
Collapse
Affiliation(s)
- Katharina Seibel
- Department of Palliative Medicine, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
| | - Claudia Lorena Orellana Rios
- Department of Palliative Medicine, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
- Current address: Helios Klinikum Bonn/Rhein-Sieg, Bonn, Germany
| | - Titus Sparna
- Department of Palliative Medicine, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Carola Becker
- Department of Palliative Medicine, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Jan Gaertner
- Current address: Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Palliative Care Center Basel, Basel, Switzerland
| | - Gerhild Becker
- Department of Palliative Medicine, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Christopher Boehlke
- Department of Palliative Medicine, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
- Current address: Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
| |
Collapse
|
264
|
Azimi H, Rezapour-Nasrabad R, Borhani F, Sadat-Hoseini AS, Momeni M. The model of solving ethical challenges with nursing based on faith in God: a new model for nurses to care during epidemics. BMC Nurs 2024; 23:538. [PMID: 39112997 PMCID: PMC11304786 DOI: 10.1186/s12912-024-02207-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 07/26/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND The existence of various ethical challenges, the inability to resolve ethical conflicts, and, as a result, the low quality of care and the occurrence of dissatisfaction in patients and nurses have been discussed for years. By creating new ethical challenges, the Covid-19pandemic has played an important role in making the process of care for these patients more difficult and complicated. This study was conducted with the aim of designing a prescriptive model to help provide ethical-care and resolve ethical conflicts during the Covid-19pandemic. METHODS In this two-stage qualitative study, a grounded theory research method was used in the first stage, and data were collected through semi-structured interviews. Sampling started purposefully and continued theoretically. In the second step, the appropriate model was designed using the three-step method proposed by Walker and Avant. RESULTS The core concept was "behavior based on faith in God", based on which the grounded theory of "faithful nursing" and then "model of solving ethical challenges with nursing based on faith in God" were presented. The strategies of the model in three parts are strengthening the beliefs of nurse, strengthening environmental facilitators to help nurse, and strengthening situational analysis in duty diagnosis in nurse were presented. CONCLUSIONS According to this model, nurses' beliefs play a key role, and the strengthening of environmental factors play a secondary role in ethical-care.
Collapse
Affiliation(s)
- Hamideh Azimi
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rafat Rezapour-Nasrabad
- Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fariba Borhani
- Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akram Sadat Sadat-Hoseini
- Pediatric and NICU Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Momeni
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| |
Collapse
|
265
|
Babaei F, Nayeri ND, Hajibabaee F, Sharifi F. Investigating the relationship between missed/rationed nursing care and organizational commitment in Iranian nurses. BMC Nurs 2024; 23:540. [PMID: 39113029 PMCID: PMC11304906 DOI: 10.1186/s12912-024-02199-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 07/24/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND AND OBJECTIVE The primary objective of the nursing profession is to provide comprehensive and appropriate nursing care that meets the individual needs of patients. However, instances of missed/rationed nursing care can jeopardize the delivery of complete and safe healthcare, potentially putting patients' lives at risk. The level of organizational commitment demonstrated by nurses is likely to impact various personnel and organizational factors. Therefore, this study aims to predict instances of missed/rationed nursing care by examining the influence of organizational commitment. METHOD This descriptive and cross-sectional study will be conducted in 2023. Three hundred nurses working in general and intensive critical care units at Tehran University of Medical Sciences hospitals were randomly selected. Data collection included Allen and Mayer's organizational commitment questionnaires, Kalish's missed care questionnaire, and demographic variables. A multiple linear regression model was used to analyze the prediction of missed care by commitment and other variables. The relationship between these variables was also explored using SPSS version 26 software. FINDINGS Half of the nurses reported occasionally missing nursing care. Moreover, more than half of the nurses reported moderate organizational commitment in all dimensions. The most significant reasons identified by nurses for missed care were financial resources, human resources, and communication (p < 0.001). There was a significant relationship between missed/rationed nursing care and organizational commitment (p = 0.042). In the multiple regression equation, a significant portion of missed care due to commitment was predicted when considering demographic variables (p < 0.001). CONCLUSION By understanding the relationship between organizational commitment and missed care, and identifying the factors contributing to missed/rationed care, managers can improve the efficiency of human resources and allocate appropriate financial resources. Establishing effective communication with employees can also enhance their commitment to addressing neglected care, ultimately reducing instances of oversight.
Collapse
Affiliation(s)
- Faranak Babaei
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Department of Nursing Management, School of Nursing & Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Hajibabaee
- Department of Nursing Management, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
266
|
Traulsen P, Kitschke L, Steinhäuser J. Perceptions Toward Telemedicine of Health Care Staff in Nursing Homes in Northern Germany: Cross-Sectional Study. JMIR Aging 2024; 7:e47072. [PMID: 39113368 PMCID: PMC11322793 DOI: 10.2196/47072] [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: 03/07/2023] [Revised: 06/12/2024] [Accepted: 06/25/2024] [Indexed: 08/16/2024] Open
Abstract
Background Digitalization in the German health care system is progressing slowly, even though it offers opportunities for improvement of care. In nursing homes, most of the staff's work is paper based. Following the pandemic, there has been a decrease in the use of telemedicine applications. To ensure long-term implementation, the views of users, in this case nurses, are of interest. Objective This cross-sectional study was conducted to describe which digital applications are already being used at inpatient care facilities, the attitude of nurses toward telemedicine, and for which areas the use of telemedicine in the facilities is considered appropriate by the participants. Methods All inpatient care facility staff in Schleswig-Holstein were invited to participate in the survey from August 1 to October 31, 2022. The questionnaire consists of 17 determinants that ask about the attitude, use, and possible applications of telemedicine. In addition to a descriptive analysis, the influence of the general attitude toward telemedicine on various determinants was examined using the Fisher exact test for nominal variables and Spearman correlation coefficient for metric variables. Results A total of 425 caregivers participated in the survey. Of these respondents, 10.7% (n=41) currently used video consultations, and 76.1% (n=321) of the respondents were in favor of video consultations being practiced in training. Furthermore, 74.8% (n=312) of the respondents would attend a training on telephone medical consultation. Respondents indicated that video consultations have a small added value compared to asynchronous telemedicine (eg, sending photos). However, video consultations were perceived as somewhat less time-consuming than other communication channels. Video consultations are perceived as most useful for clarifying urgent problems. The respondents estimated that one in five paramedic calls at their facilities could be reduced through telemedicine approaches. It was important to the participants that telemedicine is as simple as possible and that there is a high level of data security. Conclusions Although many caregivers have a positive attitude toward telemedicine and perceive its advantages, communication channels such as video consultation are still used infrequently in care facilities. To promote the use of telemedicine applications, it is important to emphasize their benefits. The presumed saving of paramedic calls thus represents a benefit, and it is crucial to train caregivers in the use of telemedicine to avoid uncertainties in dealing with the newer technologies. It is important to give them enough time and repetitions of the training.
Collapse
Affiliation(s)
- Pia Traulsen
- Institute for Family Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Luebeck, Germany
| | - Lisa Kitschke
- Institute for Family Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Luebeck, Germany
| | - Jost Steinhäuser
- Institute for Family Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Luebeck, Germany
| |
Collapse
|
267
|
Huang H, Li F, Huangfu Y. How time pressure affects promotive and prohibitive voice of emergency nurse: A cross-sectional study. Work 2024:WOR230708. [PMID: 39121146 DOI: 10.3233/wor-230708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND As a developing country, the number of emergency nurses in China is not growing nearly as rapidly as the number of patients, which puts a great deal of stress on emergency nurses' working hours and may thus impede care quality and patient safety. OBJECTIVE This study aims to investigate the relationship between time pressure and voice behavior and to explore whether temporal leadership acts as a moderator in the relationship between time pressure and voice behavior. METHODS Data were collected using scales that have been published in authoritative foreign journals and translated and validated by Chinese scholars. To examine the results more accurately, this paper used the partial least squares (PLS) approach to analyze the research model and verify the research hypothesis. RESULTS The results of the path analysis and hypothesis testing showed that challenge time pressure and hindrance time pressure both positively and significantly influenced prohibitive voice and promotive voice, while the moderating effect of temporal leadership on the relationship between time pressure and voice behavior was not significant. CONCLUSIONS Our study revealed that challenge time pressure positively influences emergency nurses' promotive voice and motivates them to provide their opinions in a reasonable way, while hindrance time pressure motivates emergency nurses' prohibitive voice, which is not conducive to the improvement of overall organizational functioning and may even damage otherwise good organizational relationships. Furthermore, the study found that the level of temporal leadership does not affect the strength of the relationship between time pressure and voice behavior.
Collapse
Affiliation(s)
- Huaqian Huang
- Guangdong Polytechnic of Industry and Commerce, Guangzhou, China
| | - Fuda Li
- Business School, Hunan Normal University, Changsha, China
| | - Yaojia Huangfu
- Business School, Hunan Normal University, Changsha, China
| |
Collapse
|
268
|
Holdsworth-Carson SJ, Chung J, Machalek DA, Li R, Jun BK, Griffiths MJ, Churchill M, McCaughey T, Nisbet D, Dior U, Donoghue JF, Montgomery GW, Reddington C, Girling JE, Healey M, Rogers PAW. Predicting disease recurrence in patients with endometriosis: an observational study. BMC Med 2024; 22:320. [PMID: 39113136 PMCID: PMC11304583 DOI: 10.1186/s12916-024-03508-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/01/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Despite surgical and pharmacological interventions, endometriosis can recur. Reliable information regarding risk of recurrence following a first diagnosis is scant. The aim of this study was to examine clinical and survey data in the setting of disease recurrence to identify predictors of risk of endometriosis recurrence. METHODS This observational study reviewed data from 794 patients having surgery for pelvic pain or endometriosis. Patients were stratified into two analytic groups based on self-reported or surgically confirmed recurrent endometriosis. Statistical analyses included univariate, followed by multivariate logistic regression to identify risk factors of recurrence, with least absolute shrinkage and selection operator (Lasso) regularisation. Risk-calibrated Supersparse Linear Integer Models (RiskSLIM) and survival analyses (with Lasso) were undertaken to identify predictive features of recurrence. RESULTS Several significant features were repeatedly identified in association with recurrence, including adhesions, high rASRM score, deep disease, bowel lesions, adenomyosis, emergency room attendance for pelvic pain, younger age at menarche, higher gravidity, high blood pressure and older age. In the surgically confirmed group, with a score of 5, the RiskSLIM method was able to predict the risk of recurrence (compared to a single diagnosis) at 95.3% and included adenomyosis and adhesions in the model. Survival analysis further highlighted bowel lesions, adhesions and adenomyosis. CONCLUSIONS Following an initial diagnosis of endometriosis, clinical decision-making regarding disease management should take into consideration the presence of bowel lesions, adhesions and adenomyosis, which increase the risk of endometriosis recurrence.
Collapse
Affiliation(s)
- Sarah J Holdsworth-Carson
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia.
- The Julia Argyrou Endometriosis Centre, Epworth HealthCare, Ground Floor, 185-187 Hoddle Street, Richmond, VIC, 3121, Australia.
| | - Jessica Chung
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
- Melbourne Bioinformatics, University of Melbourne, 21 Bedford St, North Melbourne, VIC, 3051, Australia
| | - Dorothy A Machalek
- The Kirby Institute, University of New South Wales, High Street, Kensington, NSW, 2052, Australia
- Centre for Women's Infectious Diseases, The Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
| | - Rebecca Li
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
| | - Byung Kyu Jun
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
| | - Meaghan J Griffiths
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
| | - Molly Churchill
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
| | - Tristan McCaughey
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
| | - Debbie Nisbet
- Ultrasound Services, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
- Department of Radiology, University of Melbourne, Royal Melbourne Hospital, Royal Parade, Parkville, VIC, 3050, Australia
| | - Uri Dior
- Faculty of Medicine, Department of Obstetrics and Gynaecology, Hadassah Medical Center, P.O Box 12000, Jerusalem, 91120, Israel
| | - Jacqueline F Donoghue
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
| | - Grant W Montgomery
- Institute for Molecular Bioscience, University of Queensland, 306 Carmody Road, St Lucia, Brisbane, QLD, 4072, Australia
| | - Charlotte Reddington
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
| | - Jane E Girling
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
- Department of Anatomy, School of Biomedical Sciences, University of Otago, 270 Great King Street, Dunedin, 9016, New Zealand
| | - Martin Healey
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
- The Julia Argyrou Endometriosis Centre, Epworth HealthCare, Ground Floor, 185-187 Hoddle Street, Richmond, VIC, 3121, Australia
| | - Peter A W Rogers
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and Gynaecology Research Centre, Royal Women's Hospital, Grattan St & Flemington Rd, Parkville, VIC, 3052, Australia
| |
Collapse
|
269
|
Zhou L, Li Y, Zhang Y, Chen X, Zhang S, Hu X. Perceptions of Telehealth Services Among Rural Lung Cancer Patients in China: A Qualitative Study Using the Technology Acceptance Model. Semin Oncol Nurs 2024:151710. [PMID: 39117510 DOI: 10.1016/j.soncn.2024.151710] [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: 01/15/2024] [Revised: 06/25/2024] [Accepted: 07/17/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVES To describe the perceptions of telehealth services among lung cancer patients in rural areas of China, as well as to explore the potential of telemedicine to improve long-term health recovery at home for rural lung cancer patients. METHODS A qualitative descriptive study design was used in this study and we conducted semi-structured interviews with 14 rural Chinese lung cancer patients between December 2022 and March 2023. Interview content was analyzed using Nvivo software and a framework analysis was performed using the Technology Acceptance Model to identify meaningful themes. RESULTS Participants identified perceptual and technical factors related to perceived ease of use, benefits and drawbacks related to perceived usefulness, and facilitators and barriers related to intention to use. However, regional and disease features including literacy barriers, medical insurance condition, symptom burden, and rural cultural health seeking behavior conduct must be taken into account. CONCLUSIONS Lung cancer patients in rural China believe that telehealth services could be an alternative solution for addressing health and care needs, but various aspects, such as user interface design, cost-effectiveness, and technological anxiety, need to be optimized. IMPLICATIONS FOR NURSING PRACTICE More highly specialized nursing team, friendly telecare lung function modules, and media technology training courses should be developed for rural lung cancer patients to enhance the quality of their home care, meet their information needs and better control their disease progression.
Collapse
Affiliation(s)
- Lin Zhou
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yunhuan Li
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yun Zhang
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Shu Zhang
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China; Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Sichuan, China.
| |
Collapse
|
270
|
Gong P, Shen J, Yang Y, Xue D, Lu H, Zhuang Q, Wang X, Tian Z, Chen Y, Chen C, Cao Y. Knowledge, Attitude, and Practice Toward Varicocele in Patients with Varicoceles: A Cross-Sectional Study in Chinese Patients. Int J Gen Med 2024; 17:3423-3432. [PMID: 39130488 PMCID: PMC11317042 DOI: 10.2147/ijgm.s471004] [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: 03/27/2024] [Accepted: 08/04/2024] [Indexed: 08/13/2024] Open
Abstract
Objective To explore patients' knowledge, attitude, and practice (KAP) toward varicocele in China and the relationship between treatment selection and KAP. Methods This cross-sectional study enrolled varicocele patients at the Third Affiliated Hospital of Soochow University (September to October 2023). Structural equation modeling (SEM) was used to explore the relationship between clinical factors and KAP. A score >mean score for each dimension was defined as adequate knowledge, positive attitude, and proactive practice. The patients were grouped according to varicocelectomy vs no surgery. Univariable and multivariable logistic regression analyses were used to identify the factors independently associated with KAP. A structural equation modeling (SEM) analysis was performed to examine how the KAP dimensions influenced each other. Results Among 502 patients, 44.02%, 35.86%, and 20.12% were ≤30, 31-40, and >40 years old, respectively. Those who underwent varicocelectomy (n=407) had significantly higher knowledge (20 (15-22) vs 0 (0-6), P<0.001), attitude (26 (24-26) vs 14 (10-18), P<0.001), and practice (20 (17-24) vs 8 (6-16), P<0.001) than those who did not. A higher proportion of patients with varicocelectomy were <40 years old, more educated, had higher income, and were unmarried compared with those without surgery (all P<0.001). High school or higher education level and varicocelectomy (irrespective of type) were independently associated with adequate knowledge (all P<0.001). Knowledge, college/bachelor's degree education, and varicocelectomy type (irrespective of type) were associated with positive attitudes (all P<0.05). In the SEM, knowledge directly influenced attitude, knowledge directly influenced practice, and attitude directly influenced practice (all P<0.001). Having knowledge of the subject may direct varicocele patients to varicocelectomy. Conclusion Chinese patients who underwent varicocelectomy exhibit appropriate KAP regarding varicocele, while non-surgery patients have poorer KAP. These results suggest that patients who did not undergo surgery should nevertheless be properly informed about their disease.
Collapse
Affiliation(s)
- Pengfeng Gong
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People’s Republic of China
| | - Jie Shen
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People’s Republic of China
| | - Yu Yang
- Department of Hepato-Pancreato-Biliary Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, People’s Republic of China
| | - Dong Xue
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People’s Republic of China
| | - Hao Lu
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People’s Republic of China
| | - Qianfeng Zhuang
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People’s Republic of China
| | - Xiaogang Wang
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People’s Republic of China
| | - Zinong Tian
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People’s Republic of China
| | - Yiming Chen
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People’s Republic of China
| | - Cheng Chen
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People’s Republic of China
| | - Yunjie Cao
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People’s Republic of China
| |
Collapse
|
271
|
Price O, Armitage CJ, Bee P, Brooks H, Lovell K, Butler D, Cree L, Fishwick P, Grundy A, Johnston I, Mcpherson P, Riches H, Scott A, Walker L, Papastavrou Brooks C. De-escalating aggression in acute inpatient mental health settings: a behaviour change theory-informed, secondary qualitative analysis of staff and patient perspectives. BMC Psychiatry 2024; 24:548. [PMID: 39107709 PMCID: PMC11301843 DOI: 10.1186/s12888-024-05920-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/19/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND De-escalation is often advocated to reduce harm associated with violence and use of restrictive interventions, but there is insufficient understanding of factors that influence de-escalation behaviour in practice. For the first time, using behaviour change and implementation science methodology, this paper aims to identify the drivers that will enhance de-escalation in acute inpatient and psychiatric intensive care mental health settings. METHODS Secondary analysis of 46 qualitative interviews with ward staff (n = 20) and patients (n = 26) informed by the Theoretical Domains Framework. RESULTS Capabilities for de-escalation included knowledge (impact of trauma on memory and self-regulation and the aetiology and experience of voice hearing) and skills (emotional self-regulation, distress validation, reducing social distance, confirming autonomy, setting limits and problem-solving). Opportunities for de-escalation were limited by dysfunctional risk management cultures/ relationships between ward staff and clinical leadership, and a lack of patient involvement in safety maintenance. Motivation to engage in de-escalation was limited by negative emotion associated with moral formulations of patients and internal attributions for behaviour. CONCLUSION In addition to training that enhances knowledge and skills, interventions to enhance de-escalation should target ward and organisational cultures, as well as making fundamental changes to the social and physical structure of inpatient mental health wards. Psychological interventions targeting negative emotion in staff are needed to increase motivation. This paper provides a new evidence-based framework of indicative changes that will enhance de-escalation in adult acute mental health inpatient and PICU settings.
Collapse
Affiliation(s)
- Owen Price
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England.
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, Nelson Street, Manchester, M13 9NQ, England
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Debbie Butler
- Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, England
| | - Lindsey Cree
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Paul Fishwick
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Andrew Grundy
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Isobel Johnston
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Peter Mcpherson
- Division of Psychiatry, University College London, Tottenham Court Road, London, W1T 7NF, England
| | - Holly Riches
- Merseycare NHS Foundation Trust, Kings Business Park, Prescot, L34 1PJ, England
| | - Anne Scott
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, England
| | - Lauren Walker
- School of Health and Psychological Sciences, City, University of London, Northampton Square, London, EC1V 0HB, England
| | - Cat Papastavrou Brooks
- Population Health Sciences, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, England
| |
Collapse
|
272
|
Kosydar-Bochenek J, Religa D, Iwanicka K, Szczupak M, Krupa-Nurcek S. Burnout among Polish paramedics: insights from the Oldenburg Burnout Inventory. Front Public Health 2024; 12:1444833. [PMID: 39165774 PMCID: PMC11333246 DOI: 10.3389/fpubh.2024.1444833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 07/29/2024] [Indexed: 08/22/2024] Open
Abstract
Introduction Emergency medical services rely heavily on paramedics who, as frontline responders, face unique stressors that can potentially lead to burnout. This pilot study utilizes the Oldenburg Burnout Inventory (OLBI) to assess burnout levels among Polish paramedics. The aim is to contribute to the understanding of burnout in this specific professional context and identify key factors influencing burnout dimensions. Future research will build on these preliminary findings. Materials and methods A cross-sectional study was conducted from March 01 to April 30, 2023, utilizing an online survey accessible to Polish paramedics. The OLBI, a validated tool, was employed to measure burnout, focusing on two dimensions: exhaustion and withdrawal of involvement. Results Among the 147 participating paramedics, the majority were male (65.99%). Paramedics exhibited burnout symptoms across both dimensions measured by The Oldenburg Burnout Inventory scale (OLBI), with an average level for lack of commitment recorded at 20.09, an average level for exhaustion at 20.60. The study revealed that 41.5% of paramedics experienced low burnout, 44.9% reported moderate burnout, and 13.6% faced high burnout risks. Analysis showed that women experienced significantly higher levels of exhaustion compared to men (p = 0.01). Conclusion This pilot study provides valuable initial insights into burnout among Polish paramedics. The OLBI's two-factor structure, evaluating exhaustion and disengagement, proved reliable and valid in this context. The prevalence of burnout, with over 60% of paramedics experiencing moderate to high levels, highlights the urgency of addressing burnout in this profession. Future research will be essential to explore the underlying causes and develop targeted interventions. Practical implications Understanding the factors contributing to burnout among paramedics is crucial for developing targeted interventions. Strategies should focus on stress management training, organizational support, and well-being initiatives. Addressing gender-specific differences in burnout experiences is essential for tailoring interventions effectively. Proactive psychological support mechanisms and optimized working conditions can enhance paramedics' overall well-being, ensuring their continued effectiveness in providing emergency medical services.
Collapse
Affiliation(s)
- Justyna Kosydar-Bochenek
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszów, Rzeszów, Poland
| | - Dorota Religa
- Deputy Head of Division for Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Stockholm, Sweden
| | - Kamila Iwanicka
- Students of the Innovative Research in Emergency Medicine Student Club at the University of Rzeszów, Rzeszów, Poland
| | - Mateusz Szczupak
- Department of Anesthesiology and Intensive Care, Copernicus Hospital, Gdańsk, Poland
| | - Sabina Krupa-Nurcek
- Department of Surgery, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| |
Collapse
|
273
|
Aroniadou-Anderjaska V, Figueiredo TH, De Araujo Furtado M, Pidoplichko VI, Lumley LA, Braga MFM. Alterations in GABA A receptor-mediated inhibition triggered by status epilepticus and their role in epileptogenesis and increased anxiety. Neurobiol Dis 2024; 200:106633. [PMID: 39117119 DOI: 10.1016/j.nbd.2024.106633] [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: 05/13/2024] [Revised: 07/31/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024] Open
Abstract
The triggers of status epilepticus (SE) in non-epileptic patients can vary widely, from idiopathic causes to exposure to chemoconvulsants. Regardless of its etiology, prolonged SE can cause significant brain damage, commonly resulting in the development of epilepsy, which is often accompanied by increased anxiety. GABAA receptor (GABAAR)-mediated inhibition has a central role among the mechanisms underlying brain damage and the ensuing epilepsy and anxiety. During SE, calcium influx primarily via ionotropic glutamate receptors activates signaling cascades which trigger a rapid internalization of synaptic GABAARs; this weakens inhibition, exacerbating seizures and excitotoxicity. GABAergic interneurons are more susceptible to excitotoxic death than principal neurons. During the latent period of epileptogenesis, the aberrant reorganization in synaptic interactions that follow interneuronal loss in injured brain regions, leads to the formation of hyperexcitable, seizurogenic neuronal circuits, along with disturbances in brain oscillatory rhythms. Reduction in the spontaneous, rhythmic "bursts" of IPSCs in basolateral amygdala neurons is likely to play a central role in anxiogenesis. Protecting interneurons during SE is key to preventing both epilepsy and anxiety. Antiglutamatergic treatments, including antagonism of calcium-permeable AMPA receptors, can be expected to control seizures and reduce excitotoxicity not only by directly suppressing hyperexcitation, but also by counteracting the internalization of synaptic GABAARs. Benzodiazepines, as delayed treatment of SE, have low efficacy due to the reduction and dispersion of their targets (the synaptic GABAARs), but also because themselves contribute to further reduction of available GABAARs at the synapse; furthermore, benzodiazepines may be completely ineffective in the immature brain.
Collapse
Affiliation(s)
- Vassiliki Aroniadou-Anderjaska
- Department of Anatomy, Physiology, and Genetics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA; Department of Psychiatry, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
| | - Taiza H Figueiredo
- Department of Anatomy, Physiology, and Genetics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
| | - Marcio De Araujo Furtado
- Department of Anatomy, Physiology, and Genetics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Volodymyr I Pidoplichko
- Department of Anatomy, Physiology, and Genetics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
| | - Lucille A Lumley
- U.S. Army Medical Research Institute of Chemical Defense, Aberdeen, Proving Ground, MD, USA.
| | - Maria F M Braga
- Department of Anatomy, Physiology, and Genetics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA; Department of Psychiatry, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
| |
Collapse
|
274
|
Mirhosseini S, Khajeh M, Sharif-Nia H, Hosseini FS, Ebrahimi H. Psychometric Properties of the Revised Version of the Prolonged Grief Disorder Scale (PG-13-R): A Methodological Study in the Iranian Population. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241272579. [PMID: 39106332 DOI: 10.1177/00302228241272579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
Prolonged grief disorder has recently been officially introduced as a new mental disorder. This study aimed to validate the Persian version of the revised Prolonged Grief Scale (PG-13-R). This study was conducted among the general population in Shahroud, Iran, during 2023. Employing face and content validity, along with exploratory and confirmatory factor analyses (EFA), the study validates the PG-13-R. Average variance extracted value showed an acceptable convergent validity. The EFA reveals a singular factor structure explaining 60.541% of the variance in prolonged grief disorder, and the confirmatory factor analysis demonstrates an excellent model fit. Internal consistency, evaluated through Cronbach's alpha and MacDonald's omega, highlights the scale's reliability. The Persian version of PG-13-R had acceptable composite reliability. Stability is confirmed by an intra-class correlation coefficient. In conclusion, the Persian PG-13-R displays satisfactory validity and reliability to assessing prolonged grief symptoms in the Iranian population.
Collapse
Affiliation(s)
- Seyedmohammad Mirhosseini
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahboobeh Khajeh
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hamid Sharif-Nia
- Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Sadat Hosseini
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Ebrahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| |
Collapse
|
275
|
Ataiyero Y, Stimpson E, Hall H, Ashby H, Dube A, Carter V, Smith HA, Ross A, Copping J, Morris P, Jones S. Evaluating the impact of a ward environment with 20 single occupancy rooms and two four-bedded bays on patient and staff experiences and outcomes in an acute NHS Trust: a mixed-methods study protocol. BMJ Open 2024; 14:e085528. [PMID: 39107022 PMCID: PMC11308872 DOI: 10.1136/bmjopen-2024-085528] [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: 02/19/2024] [Accepted: 06/28/2024] [Indexed: 08/09/2024] Open
Abstract
INTRODUCTION Traditionally, wards in acute care hospitals consist predominately of multioccupancy bays with some single rooms. There is an increasing global trend towards a higher proportion of single rooms in hospitals, with the UK National Health Service (NHS) advocating for single-room provision in all new hospital builds. There is limited evidence on the impact of a ward environment incorporating mostly single and some multioccupancy bays on patient care and organisational outcomes. METHODS AND ANALYSES This study will assess the impact of a newly designed 28-bedded ward environment, with 20 single rooms and two four-bedded bays, on patient and staff experiences and outcomes in an acute NHS Trust in East England. The study is divided into two work packages (WP)-WP1 is a quantitative data extraction of routinely collected patient and staff data while WP2 is a mixed-methods process evaluation consisting of one-to-one, in-depth, semistructured interviews with staff, qualitative observations of work processes on the ward and a quantitative data evaluation of routinely collected process evaluation data from patients and staff. ETHICS AND DISSEMINATION Ethical approval was obtained from the UK Health Research Authority (IRAS ID: 334395). Study findings will be shared with key stakeholders, published in peer-reviewed high-impact journals and presented at relevant conferences.
Collapse
Affiliation(s)
- Yetunde Ataiyero
- Centre for Health Innovation, School of Health, Education, Policing and Sciences, Staffordshire University, Stafford, UK
| | - Emma Stimpson
- James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
| | - Helen Hall
- James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
| | - Helen Ashby
- James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
| | - Alisen Dube
- Centre for Health Innovation, School of Health, Education, Policing and Sciences, Staffordshire University, Stafford, UK
| | - Vanda Carter
- Centre for Health Innovation, School of Health, Education, Policing and Sciences, Staffordshire University, Stafford, UK
| | - Hazel A Smith
- Centre for Health Innovation, School of Health, Education, Policing and Sciences, Staffordshire University, Stafford, UK
| | - Al Ross
- Centre for Health Innovation, School of Health, Education, Policing and Sciences, Staffordshire University, Stafford, UK
| | - Jacky Copping
- James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
| | - Paul Morris
- James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
| | - Sarahjane Jones
- Centre for Health Innovation, School of Health, Education, Policing and Sciences, Staffordshire University, Stafford, UK
| |
Collapse
|
276
|
Medina V, Watts A, Fracachán-Cabrera M, Hazlewood C, Ramirez-Mantilla M, Vidoni ED, Perales-Puchalt J. Analysis of the intensity of engagement with CuidaTEXT, a text message intervention for dementia caregiver support among Latinos/as. ETHNICITY & HEALTH 2024:1-22. [PMID: 39107055 DOI: 10.1080/13557858.2024.2387111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 07/27/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVES To examine the associations between participant intensity of engagement with a text message intervention, CuidaTEXT, and socio-demographic factors, acceptability measures, and clinical outcomes among Latino/a caregivers of individuals with dementia. METHODS CuidaTEXT is a six-month, bilingual, and bidirectional intervention. We enrolled 24 Latino/a caregivers in a one-arm feasibility trial. Participants received approximately one automatic daily text message and could engage with the intervention by texting specific keywords (e.g. STRESS to receive messages about stress-coping), and by chat-texting with a live coach. We used metrics and psychometric scales to quantify variables. RESULTS Participants sent a total of 1847 messages to CuidaTEXT. Higher intensity of engagement was associated with higher intervention satisfaction (r = 0.6, p = 0.007), as were several other acceptability outcomes. We found no associations between intensity of engagement with CuidaTEXT and sociodemographic or clinical outcomes (p > 0.05). CONCLUSION Encouraging more intense engagement with CuidaTEXT might lead to higher levels of satisfaction with the intervention. However, it is possible that those who are highly satisfied, engage more intensely with CuidaTEXT. Future research should determine the directionality of these associations to optimize text message interventions. CLINICAL IMPLICATIONS Creating more opportunities to increase the intensity of text message engagement with caregiver support interventions may improve caregiver satisfaction with them.
Collapse
Affiliation(s)
- Valerie Medina
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Amber Watts
- Department of Psychology, University of Kansas, Lawrence, KS, USA
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
| | | | - Cameo Hazlewood
- Internal Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Eric D Vidoni
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
| | - Jaime Perales-Puchalt
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
| |
Collapse
|
277
|
Chen Q, Chen Q, Ma C, Zhang Y, Gou M, Yang W. Moral sensitivity, moral courage, and ethical behaviour among clinical nurses. Nurs Ethics 2024:9697330241259150. [PMID: 39105607 DOI: 10.1177/09697330241259150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
Background: Ethical behaviour in nursing practice is integral to establishing a harmonious nurse-patient relationship and improving the quality of care. A multitude of factors shapes such behaviour. Therefore, it is crucial to understand the interplay between these factors. Research objectives: This study aimed to explore the mechanisms underlying the influence of moral sensitivity on nurses' ethical behaviour and clarify the mediating role of moral courage. Research design: This cross-sectional quantitative study was conducted between July and August 2023. Participants and Research Context: The sample comprised 465 clinical nurses from three tertiary hospitals in Zhengzhou City, Henan Province, China. Data were collected using the Chinese version of the Moral Sensitivity Questionnaire-Revised Version, Nurses' Moral Courage Scale, and Ethical Behaviour Scale for Nurses. Data analysis was performed with SPSS 26.0 and AMOS 24.0, using descriptive statistics, Pearson correlation analysis, structural equation modelling, and bootstrapping methods. Ethical considerations: This study was approved by the Ethical Review Committee of Life Sciences of Zhengzhou University, China. Results: The participants were predominantly female (95.1%), with a mean age of 31.9 years. Moral courage and moral sensitivity were positively correlated with ethical behaviour. Moral sensitivity was positively associated with moral courage. Moral courage partially mediates the relationship between moral sensitivity and ethical behaviour. The indirect effect of nurses' moral sensitivity on ethical behaviour was quantified through moral courage (indirect effect = 0.290). Conclusion: Moral courage intermediates nurses' moral sensitivity and ethical behaviour. This conclusion provides nursing administrators with the insight that improving clinical nurses' moral sensitivity and courage can contribute to ensuring appropriate ethical behaviour.
Collapse
|
278
|
Levin C, Suliman M, Naimi E, Saban M. Augmenting intensive care unit nursing practice with generative AI: A formative study of diagnostic synergies using simulation-based clinical cases. J Clin Nurs 2024. [PMID: 39101368 DOI: 10.1111/jocn.17384] [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: 04/01/2024] [Revised: 05/14/2024] [Accepted: 07/15/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND As generative artificial intelligence (GenAI) tools continue advancing, rigorous evaluations are needed to understand their capabilities relative to experienced clinicians and nurses. The aim of this study was to objectively compare the diagnostic accuracy and response formats of ICU nurses versus various GenAI models, with a qualitative interpretation of the quantitative results. METHODS This formative study utilized four written clinical scenarios representative of real ICU patient cases to simulate diagnostic challenges. The scenarios were developed by expert nurses and underwent validation against current literature. Seventy-four ICU nurses participated in a simulation-based assessment involving four written clinical scenarios. Simultaneously, we asked ChatGPT-4 and Claude-2.0 to provide initial assessments and treatment recommendations for the same scenarios. The responses from ChatGPT-4 and Claude-2.0 were then scored by certified ICU nurses for accuracy, completeness and response. RESULTS Nurses consistently achieved higher diagnostic accuracy than AI across open-ended scenarios, though certain models matched or exceeded human performance on standardized cases. Reaction times also diverged substantially. Qualitative response format differences emerged such as concision versus verbosity. Variations in GenAI models system performance across cases highlighted generalizability challenges. CONCLUSIONS While GenAI demonstrated valuable skills, experienced nurses outperformed in open-ended domains requiring holistic judgement. Continued development to strengthen generalized decision-making abilities is warranted before autonomous clinical integration. Response format interfaces should consider leveraging distinct strengths. Rigorous mixed methods research involving diverse stakeholders can help iteratively inform safe, beneficial human-GenAI partnerships centred on experience-guided care augmentation. RELEVANCE TO CLINICAL PRACTICE This mixed-methods simulation study provides formative insights into optimizing collaborative models of GenAI and nursing knowledge to support patient assessment and decision-making in intensive care. The findings can help guide development of explainable GenAI decision support tailored for critical care environments. PATIENT OR PUBLIC CONTRIBUTION Patients or public were not involved in the design and implementation of the study or the analysis and interpretation of the data.
Collapse
Affiliation(s)
- Chedva Levin
- Nursing Department, Faculty of School of Life and Health Sciences, The Jerusalem College of Technology-lev Academic Center, Jerusalem, Israel
- Department of Vascular Surgery, The Chaim Sheba Medical Center, Ramat Gan, Tel Aviv, Israel
| | - Moriya Suliman
- Intensive Care Unit, The Chaim Sheba Medical Center, Ramat Gan, Tel Aviv, Israel
| | - Etti Naimi
- Department of Nursing, School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Mor Saban
- Department of Nursing, School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
279
|
Ahmadzadeh-Zeidi MJ, Rooddehghan Z, Haghani S. The relationship between nurses' professional commitment and missed nursing care: a cross-sectional study in Iran. BMC Nurs 2024; 23:533. [PMID: 39103786 DOI: 10.1186/s12912-024-02196-1] [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: 05/11/2024] [Accepted: 07/23/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND & AIMS Missed nursing care is a global challenge that can have many consequences and it's known as a common threat to the patient safety and quality of nursing care. The nurses' professional commitment plays the final role in the occurrence of this issue. This study aimed to investigate the relationship between nurses' professional commitment and missed nursing care in Iran. MATERIALS & METHODS This cross-sectional descriptive-analytical study was conducted on 270 nurses working in two hospitals affiliated to Tehran University of Medical Sciences (Sina & Shariati) from September to December 2023. The research community included all nurses working in medical-surgical wards in the designated hospitals. The research samples were included in a targeted and quota method after obtaining organizational permits, ethical approval and informed consent. Data collection was done using three questionnaires including demographic information form, Nursing Professional Commitment Scale, and MISSCARE Questionnaire. The collected data was analyzed in SPSS software, version 25. RESULTS The results of Pearson's correlation test showed that there is a significant negative relationship between nurses' professional commitment and missed nursing care scores (r=-0.23) (p < 0.001). The mean score of nurses' professional commitment was reported at a moderate to high level (83.72 ± 16.02) and the mean score of missed nursing care was reported at a low level (47.84 ± 16.48). Nurses over 40 years old, morning shift and employed nurses showed higher professional commitment. Also, nurses under 29 years old and male nurses had more missed nursing care other than their participants. No relationship was observed between other demographic variables with nurses' professional commitment and missed nursing care. CONCLUSION The results of this study showed that higher nurses' professional commitment leads to higher quality of care and less missed nursing care. Based on findings of this research, it is recommended for health care providers and nursing managers to adopt programs to increase nurses' professional commitment and consequently reduce missed nursing care.
Collapse
Affiliation(s)
- Mohammad Javad Ahmadzadeh-Zeidi
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Rooddehghan
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | - Shima Haghani
- Department of Biostatistics, Nursing and Midwifery Research Center, Faculty of Nursing and Midwifery, University Of Medical Sciences, Tehran, Iran
| |
Collapse
|
280
|
Ferraro T, Samaha NL, Tannan U, Sookram S, Wong K, Hwa TP. Use of Speech-to-Text Translation Resources to Address Communication Barriers in Patients With Hearing Loss: A Systematic Review. Otol Neurotol 2024:00129492-990000000-00598. [PMID: 39118242 DOI: 10.1097/mao.0000000000004272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Patients with concomitant limited English proficiency (LEP) and hearing loss may experience communication barriers, not fully mitigated by traditional interpreter services. Although there is no clear consensus on the most reliable and optimal resources for these patients, speech-to-text (STT) applications with translation capability may bridge these barriers. We review the existing literature applying STT translation programs in clinical settings and identify commercially available STT translation resources to evaluate their prospective application in the otology setting. DATABASES REVIEWED PubMed MEDLINE, Embase, and Web of Science. METHODS A systematic review of English language peer-reviewed literature was conducted, examining STT translation in clinical settings. An additional search identifying STT software with translation capabilities was completed. RESULTS Seven out of 591 unique citations met the inclusion criteria, and 29 unique STT translation applications were identified, supporting up to 140 languages. Stakeholders endorse positive perceptions of STT translation programs. Facilitators to implementation included time and cost feasibility, whereas barriers included risk of mistranslation and inability to assess accuracy. Ongoing machine-learning efforts are underway for developing and improving STT translation technologies, but there is paucity of literature evaluating their application in patients with hearing loss. CONCLUSIONS Small studies have suggested an acceptable level of accuracy for STT translation programs as adjunctive to standard of care services. Further work should proactively address implementation challenges with special attention to use of these technologies for patients with concomitant LEP and HL, while supporting additional technological advancement for application of these technologies in otology practice.
Collapse
Affiliation(s)
- Tatiana Ferraro
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Nadia L Samaha
- Georgetown University School of Medicine, Washington, DC
| | | | | | - Kevin Wong
- Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - Tiffany Peng Hwa
- Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| |
Collapse
|
281
|
Wei T, Guo M, Jin H, Zhang B. Attachment styles and empathy in trainee nurses: the mediating and moderating roles of attitudes toward death. Front Psychol 2024; 15:1445587. [PMID: 39161685 PMCID: PMC11331402 DOI: 10.3389/fpsyg.2024.1445587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 07/11/2024] [Indexed: 08/21/2024] Open
Abstract
Aim A growing body of evidence has shown that attachment styles and death attitudes have a significant impact on empathy. This study aimed to explore the precise role of death attitudes in the relationship between attachment styles and empathy levels among trainee nurses. Methods A total of 626 Chinese trainee nurses with different attachment types were enrolled, and their attachment styles, death attitudes, and empathy levels were assessed using the Revised Adult Attachment Scale, the Death Attitude Profile-Revised, and the Jefferson Scale of Empathy-Healthy Professionals, and finally, data from 566 participants were included for statistical analysis. Results We found that among trainee nurses with secure attachment type, fear of death, approach acceptance, escape acceptance, and neutral acceptance (-) mediated the relationships between attachment-related avoidance/anxiety and their overall empathy levels and all its dimensions; in the preoccupied type, only neutral acceptance (-) mediated the relationships between attachment-related avoidance and their overall empathy levels and compassionate care; and in the fearful type, only fear of death mediated the relationship between attachment-related avoidance and compassionate care. Furthermore, in the secure type, neutral acceptance attenuated the negative predictions of attachment-related avoidance on overall empathy level and perspective taking. Conclusion Attitudes toward death played different mediating and moderating roles in the relationship between attachment styles and empathy among trainee nurses with different attachment types. In addition to acculturated empathy-specific training, targeted education related to death for trainee nurses with different attachment types is needed to prevent their compassion fatigue.
Collapse
Affiliation(s)
- Ting Wei
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Meiyi Guo
- Affiliated Hospital (School of Clinical Medicine), Hangzhou Normal University, Hangzhou, China
| | - Huanle Jin
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Bingren Zhang
- Affiliated Hospital (School of Clinical Medicine), Hangzhou Normal University, Hangzhou, China
| |
Collapse
|
282
|
Yang L, Zeng Q, Wang Y, Zhou J, Zeng Y. Why nursing students do not report workplace bullying during clinical practice: A mixed methods systematic review. NURSE EDUCATION TODAY 2024; 142:106341. [PMID: 39128402 DOI: 10.1016/j.nedt.2024.106341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 07/24/2024] [Accepted: 08/04/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND Workplace bullying in clinical nurse education significantly threatens students' well-being and professional development. Despite its prevalence, many incidents go unreported, exacerbating the issue and compromising the quality of care. A significant gap exists in the literature regarding comprehensive mixed-methods systematic reviews on unreported bullying incidents among nursing students. This review aims to address this knowledge gap and propose effective strategies to tackle this pervasive problem. AIM This mixed-methods systematic review aimed to explore the factors influencing the non-reporting of workplace bullying incidents among nursing students during clinical practice. DESIGN Mixed-methods systematic review. REVIEW METHODS AND DATA SOURCES An extensive literature search was conducted across ten databases, including PubMed, Cochrane, Embase, Web of Science, CINAHL, PsycINFO, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG, from database inception to November 1, 2023. Google Scholar and reference lists of included studies were also searched. Studies were selected based on eligibility criteria regarding population, phenomena of interest, and context. Two researchers independently assessed study quality, with disagreements resolved by a third reviewer. Relevant data were extracted and synthesized using the Joanna Briggs Institute's convergent integrated approach, ensuring a comprehensive integration of qualitative and quantitative findings. RESULTS Twenty-one studies met the inclusion criteria, comprising six qualitative, twelve quantitative, and three mixed-methods studies. Four integrated themes emerged from nursing students' perspectives on reasons for not reporting workplace bullying during clinical practice: (i) fear and concerns related to reporting, (ii) concerns about professional image, (iii) barriers and challenges in reporting, and (iv) perceived ineffectiveness of reporting. CONCLUSIONS This systematic review provides valuable insights into nursing students' perspectives on the non-reporting of workplace bullying incidents during clinical practice. Understanding these reasons enables stakeholders to collaboratively develop interventions to create a safer and more supportive environment for nursing students, ultimately enhancing quality care and the well-being of healthcare professionals.
Collapse
Affiliation(s)
- Liping Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China; College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qinglin Zeng
- Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Yuqiang Wang
- Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Jing Zhou
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China; Dazhou Vocational and Technical College, Dazhou, Sichuan, China
| | - Yanli Zeng
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| |
Collapse
|
283
|
Li C, Wu M, Zeng L, Yu Y, Qiu Y, Liu J, Yang F, Han Y. The chain mediating role of rumination and social withdrawal in the relationship between smartphone distraction and depression among Chinese nursing students. Sci Rep 2024; 14:18116. [PMID: 39103574 PMCID: PMC11300441 DOI: 10.1038/s41598-024-69278-7] [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: 04/09/2024] [Accepted: 08/02/2024] [Indexed: 08/07/2024] Open
Abstract
Smartphone distraction (SD) is closely related to depression, and the prevalence of SD among nursing students is gradually increasing. However, the potential mechanism of the effect of SD on nursing students' depression is unclear. A total of 574 nursing students were assessed using Smartphone Distraction Scale, Ruminative Response Scale, Hikikomori Questionnaire, and Patient Health Questionnaire-9. The results indicated that SD among nursing students had an impact on depression through four pathways: (1) SD was positively associated with depression (β = 0.353, P < 0.001); (2) Rumination (β = 0.199, 95% CI: 0.081 to 0.162) and social withdrawal (β = 0.061, 95% CI: 0.034 to 0.091) mediated the effects of SD on depression, respectively; and (3) Rumination and social withdrawal played a chain mediating role in the effect of SD on nursing students' depression (β = 0.027, 95% CI: 0.015 to 0.042). The negative impact of SD on nursing students' mental health should not be taken lightly. Schools and hospitals should guide nursing students to use smartphones correctly, including providing mental health education and professional psychological counselling; families could play a supervisory role and communicate regularly to understand the psychological state and learning of nursing students. These measures can help nursing students cope with stress and reduce the risk of depression.
Collapse
Affiliation(s)
- Chaoyang Li
- Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Man Wu
- Department of Nursing, The Third People's Hospital of Chengdu, Chengdu, China
| | - Lijuan Zeng
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yiqing Yu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yufei Qiu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Jiali Liu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Fen Yang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China.
- Hubei Shizhen Laboratory, Wuhan, China.
| | - Yangyang Han
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China.
| |
Collapse
|
284
|
Cussen J, Mukpradab S, Tobiano G, Haines KJ, O'Connor L, Marshall AP. Exploring critically ill patients' functional recovery through family partnerships: A descriptive qualitative study. Aust Crit Care 2024:S1036-7314(24)00120-6. [PMID: 39107155 DOI: 10.1016/j.aucc.2024.06.007] [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: 11/29/2023] [Revised: 05/02/2024] [Accepted: 06/11/2024] [Indexed: 08/09/2024] Open
Abstract
BACKGROUND Early mobilisation interventions play a role in preventing intensive care unit-acquired weakness in critically ill patients and may contribute to improved recovery. Patient-and-family-centred care includes collaborative partnerships between healthcare professionals and families and is a potential strategy to promote early mobilisation in critical care; however, we currently do not know family member preferences for partnering and involvement in early mobilisation interventions. OBJECTIVES The objective of this study was to explore family member perspectives on the acceptability and feasibility of partnering with healthcare professionals in early mobilisation interventions for adult critically ill patients. METHODS A descriptive qualitative design. Semistructured interviews were conducted with family members of adult critically ill patients admitted to an intensive care unit. Data were collected through individual audio-recorded interviews. Interview data were analysed using the six phases of thematic analysis described by Braun and Clark. This study is reported following the Consolidated Criteria for Reporting Qualitative Research guidelines. RESULTS Most family members of critically ill patients found the idea of partnering with healthcare professionals in early mobilisation interventions acceptable and feasible, although none had ever considered a partnership before. Participants thought their involvement in early mobilisation would have a positive impact on both the patient's and their own wellbeing. Themes uncovered showed that understanding family-member readiness and their need to feel welcome and included in the unfamiliar critical care environment are required before family member and healthcare professional partnerships in early mobilisation interventions can be enacted. CONCLUSIONS Family members found partnering with healthcare professionals in early mobilisation interventions acceptable and feasible to enact, but implementation is influenced by their readiness and sense of belonging.
Collapse
Affiliation(s)
- Julie Cussen
- Gold Coast University Hospital, Southport, Queensland, Australia; Griffith University, Southport, Queensland, Australia.
| | - Sasithorn Mukpradab
- Griffith University, Southport, Queensland, Australia; Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand.
| | - Georgia Tobiano
- Gold Coast University Hospital, Southport, Queensland, Australia; Griffith University, Southport, Queensland, Australia.
| | - Kimberley J Haines
- Physiotherapy Department, Western Health, Melbourne, Victoria, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Victoria, Australia.
| | - Lauren O'Connor
- Gold Coast University Hospital, Southport, Queensland, Australia.
| | - Andrea P Marshall
- Gold Coast University Hospital, Southport, Queensland, Australia; Griffith University, Southport, Queensland, Australia.
| |
Collapse
|
285
|
Kanwel S, Ma Z, Li M, Hussain A, Erum N, Ahmad S. The influence of hospital services on patient satisfaction in OPDs: evidence from the transition to a digital system in South Punjab, Pakistan. Health Res Policy Syst 2024; 22:93. [PMID: 39103868 DOI: 10.1186/s12961-024-01178-8] [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: 03/23/2024] [Accepted: 07/03/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Pakistani's health services delivery system has been rarely evaluated regarding patient satisfaction. This study examined the performance of the Pakistani health system from the perspective of doctor services (DS), digital payment system (DPS), nurses' services (NS), laboratory services (LS), pharmacy services (PHS), registration services (RS), physical services (environmentally and tangible) and doctor-patient communication (DPC) about patient satisfaction. A random sampling technique was adopted for data collection. METHODOLOGY The Social Science Statistical Package (SPSS), analysis of moment structures (AMOS), and structural equation modeling were used to analyze the data for reliability, validity, correlations, and descriptive findings. The 879 responses were used for study analysis. RESULTS The study revealed that patient satisfaction was found to be significantly affected positively by LS, PHS, DS, NS, and DPS, while DPC, RS, and PF were impacted non-significantly. Consequently, there is a considerable communication gap in the doctor-patient interaction, and Pakistan's healthcare system is confronted with a shortage of physical infrastructure and challenges in the digital system. CONCLUSION Furthermore, the insufficient emphasis on registration services necessitates immediate action to improve the entire patient experience and satisfaction. Identifying these shortcomings has the potential to result in a healthcare system that is more efficient and focused on the needs of the patients.
Collapse
Affiliation(s)
- Shahida Kanwel
- School of Management, Jiangsu University, Zhenjiang, 212013, People's Republic of China
| | - Zhiqiang Ma
- School of Management, Jiangsu University, Zhenjiang, 212013, People's Republic of China.
| | - Mingxing Li
- School of Management, Jiangsu University, Zhenjiang, 212013, People's Republic of China
| | - Abid Hussain
- School of Management, Jiangsu University, Zhenjiang, 212013, People's Republic of China.
| | - Naila Erum
- Accounting Research Institute (HiCOE), Universiti Teknologi MARA (UiTM), Shah Alam, Malaysia
| | - Saif Ahmad
- Department of Public Administration, The Islamia University, Bahawalpur, Pakistan
| |
Collapse
|
286
|
McMahon J, Thompson DR, Brown Wilson C, Hill L, Tierney P, Cameron J, Yu DSF, Moser DK, Spilsbury K, Srisuk N, Schols JMGA, van der Velden-Daamen M, Mitchell G. Determining the Key Education Priorities Related to Heart Failure Care in Nursing Homes: A Modified Delphi Approach. Healthcare (Basel) 2024; 12:1546. [PMID: 39120249 PMCID: PMC11311690 DOI: 10.3390/healthcare12151546] [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: 06/07/2024] [Revised: 07/31/2024] [Accepted: 08/03/2024] [Indexed: 08/10/2024] Open
Abstract
There is currently a limited understanding of what nurses in nursing homes view as the key education priorities to support their ability to provide the appropriate care for residents with heart failure (HF). A modified Delphi technique was utilized to gain a consensus on the key education priorities for nurses working in nursing homes in Northern Ireland. An initial list of items (n = 58), across 19 domains, was generated using the findings of a scoping review and stakeholder interviews, and a review of available clinical guidelines. Two rounds of surveys were undertaken. Items were presented using a 5-point Likert scale, with an additional exercise in the second round to rank the domains in order of importance. Fifty-four participants completed the first-round survey and 34 (63%) returned to complete the second. The findings highlight the importance of providing nurses in nursing home settings with general HF education and the delivery of person-centered care. Participants perceived education around technology for the management of HF and quality improvement or research methodologies associated with HF in nursing homes as lower priorities. This study illuminates key priorities from nursing home nurses regarding HF education that are applicable to this care setting.
Collapse
Affiliation(s)
- James McMahon
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (D.R.T.); (C.B.W.); (L.H.); (P.T.); (G.M.)
| | - David R. Thompson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (D.R.T.); (C.B.W.); (L.H.); (P.T.); (G.M.)
| | - Christine Brown Wilson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (D.R.T.); (C.B.W.); (L.H.); (P.T.); (G.M.)
| | - Loreena Hill
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (D.R.T.); (C.B.W.); (L.H.); (P.T.); (G.M.)
| | - Paul Tierney
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (D.R.T.); (C.B.W.); (L.H.); (P.T.); (G.M.)
| | - Jan Cameron
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC 3168, Australia;
| | - Doris S. F. Yu
- School of Nursing, University of Hong Kong, Hong Kong, China;
| | - Debra K. Moser
- College of Nursing, University of Kentucky, Lexington, KY 40536, USA;
| | - Karen Spilsbury
- School of Healthcare, University of Leeds, Leeds LS2 9DA, UK;
| | - Nittaya Srisuk
- Faculty of Nursing, Rajamangala University of Technology, Thanyaburi, Pathum Thani 12110, Thailand;
| | - Jos M. G. A. Schols
- Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 Maastricht, The Netherlands; (J.M.G.A.S.); (M.v.d.V.-D.)
| | - Mariëlle van der Velden-Daamen
- Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 Maastricht, The Netherlands; (J.M.G.A.S.); (M.v.d.V.-D.)
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (D.R.T.); (C.B.W.); (L.H.); (P.T.); (G.M.)
| |
Collapse
|
287
|
Grano C. A Qualitative Study of School Nurses' Experience of Secondary Trauma. Creat Nurs 2024:10784535241268094. [PMID: 39099538 DOI: 10.1177/10784535241268094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
This qualitative descriptive study explored school nurses' experiences of exposure to reports of trauma from those in their care. Online interviews of school nurses practicing in NJ, USA, were recorded and transcribed verbatim. The study found that school nurses were exposed to reports of others' trauma to varying degrees, with those serving in urban settings reporting more stories of exposure than those in suburban settings. Reports included numerous, layered traumas at the community and individual levels, including students' poverty-related adversity and psychological distress. Qualitative content analysis revealed four categories: Health Office as Safe Haven, Challenges Working Within the School Model, Things That We Hear: Reports of Trauma, and The Ripple Effect of Trauma. School-based challenges included a lack of collaboration, misunderstanding of the school nurse's role, and workload issues such as competing demands and limited time and resources. School nurses reported focusing on the individual's immediate needs and processing the experience afterward. They acknowledged they can only do so much, and shared stories of coping and resilience. Additional education, resources, and support in addressing student trauma can enhance the provision of school nursing services and support the well-being of school nurses, students, and staff. Further research is warranted with a larger and more diverse sample of school nurses, including attention to school nurse wellness and resilience strategies.
Collapse
|
288
|
Abu-Ras W, Aboul-Enein BH, Almoayad F, Benajiba N, Dodge E. Mosques and Public Health Promotion: A Scoping Review of Faith-Driven Health Interventions. HEALTH EDUCATION & BEHAVIOR 2024:10901981241252800. [PMID: 39099318 DOI: 10.1177/10901981241252800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
BACKGROUND Religious institutions play a crucial role in health promotion and hold significant influence in the public health field. AIM The aim of this review is to examine outcomes of health-promoting interventions involving the use of mosques as the intervention venue, its role in promoting health behavior change, and the role of theory in each intervention. METHODS A scoping review was conducted across 17 databases for relevant publications published up to and including August 2023 that involved the use of mosques as the intervention venue. Fourteen articles met inclusion criteria and were reviewed. RESULTS The studies featured a wide range of interventions. However, only eight of these studies integrated theoretical frameworks into their approaches, indicating a need for more structured guidance in this field. These theoretical frameworks included Participatory Action Research (PAR), the theory of planned behavior, behavior-change constructs, the patient-centered outcomes research (PCOR) framework, and prolonged exposure techniques within Islamic principles. The review identified three main health-focused intervention categories: mental health, prevention, and communication, each providing valuable insights into initiatives within Muslim communities. CONCLUSIONS This review underscores the significance of inclusive and culturally sensitive health interventions, emphasizing the effectiveness of faith-based approaches in improving health outcomes, promoting positive health behaviors, and addressing communication and cultural barriers. The reviews findings stress the need for further research that incorporates theoretical frameworks and tailored interventions to meet the specific cultural needs of these communities, ultimately contributing to enhanced well-being within them.
Collapse
Affiliation(s)
| | | | - Fatmah Almoayad
- Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | | |
Collapse
|
289
|
Alan Dikmen H, Gönenç İM, Ataş AN. Effects of peanut ball use on perceived labor pain, fatigue, and mother's perception of childbirth: a randomized controlled trial. Arch Gynecol Obstet 2024:10.1007/s00404-024-07656-2. [PMID: 39103620 DOI: 10.1007/s00404-024-07656-2] [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: 02/26/2024] [Accepted: 07/17/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE The aim of this study was to evaluate the effects of using peanut balls on labor pain, fatigue, and the mother's perception of labor. METHODS This is a randomized controlled intervention trial. Data were collected from the Intervention (peanut ball) and Control groups between July 2022 and June 2023, with 45 pregnant women in each group. Data were collected using a personal information form, the Visual Analog Scale-Pain (VAS-P), the Visual Analog Scale for Fatigue (VAS-F), and the Maternal Perception of Childbirth Scale (MPCS). RESULTS The VAS-P scores of the intervention group were statistically significantly lower than those of the control group 15 min after peanut ball application (p = .000). Immediately after and 15 min after peanut ball application, the mean fatigue score of the Intervention group was statistically significantly lower than that of the Control group (p = .000). There was no statistically significant difference between the mean duration of labor minutes in the two groups (p = .177). The mean MPCS scores of the intervention group and control groups were 62.73 + 7.30 and 47.17 + 9.12, respectively, and the difference was statistically significant (p = .000). CONCLUSIONS The findings of this study indicate that the use of peanut balls during labor can effectively reduce labor pain and fatigue in pregnant women, without affecting the duration of labor. Additionally, the use of peanut balls has been shown to positively influence the perception of labor among pregnant women. Therefore, it is recommended that midwives educate pregnant women about the use of peanut balls during labor and provide support in their use.
Collapse
Affiliation(s)
- Hacer Alan Dikmen
- Faculty of Health Sciences, Department of Midwifery, Selcuk University, Selcuklu, 42250, Konya, Turkey.
| | | | - Ayşe Nur Ataş
- Faculty of Health Sciences, Department of Midwifery, Selcuk University, Konya, Turkey
| |
Collapse
|
290
|
Zhang J, Ye J, Zhang R, Liu J, Yanhua N, Wang J. High stress during clinical practicum placement is associated with bullying among nursing students: A mixed-method study. NURSE EDUCATION TODAY 2024; 142:106327. [PMID: 39153352 DOI: 10.1016/j.nedt.2024.106327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/09/2024] [Accepted: 07/30/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Nursing students are often subjected to bullying during their clinical practices, but few study has examined associations of bullying with psychological status among these groups, and how they cope with the bullying. OBJECTIVES This study aimed to evaluate the experience and psychological status of clinical placement setting bullying among nursing students attending clinical practices, and explore students' coping strategies when bullied. DESIGN A mixed methods. SETTINGS Six tertiary hospitals in Northwest China. PARTICIPANTS A total of 687 nursing students completed the questionnaire survey, of which 18 nursing students participated in the qualitative interview. METHODS A two-phase hybrid study was produced. During first phase, data were collected by using the Bullying Behavior Scale in Nursing Education (BNEQ) and the Depression, Anxiety and Stress Scale (DASS-21). Subsequently, those who have experienced bullying in the workplace were invited to participate in a face-to-face interview (second phase) which focused on exploring students' deeper insights. RESULTS Of the 687 students involved, 72.19 % had experienced various types of bullying. Of them, 92.11 % experienced implicit violence. Those with higher education levels and from rural were more likely to experience bullying. Students were prone to greater psychological stress when exposed to bullying. "Pretending not to see" (33.16 %), "reporting to superiors" (30.10 %), and "doing nothing" were the most common ways students responded. Four themes were obtained from the qualitative interviews: (a) impaired self-esteem; (b) career rejection; (c) psychological stress; and (d) the decline of humanistic care. CONCLUSION Our findings suggest that senior nursing students experience multiple types of bullying during the clinical practices, leading to a high level of psychological stress, which further effect students' professional approval and self-esteem. To prevent such incidents, we need to call on university and hospitals' support to help students successfully cope with bullying.
Collapse
Affiliation(s)
- Juxia Zhang
- Educational Department, Gansu Provincial Hospital, Lanzhou, China
| | - Jianying Ye
- Nursing Department, Ningxia Hui Autonomous Region Hospital of Integrated Traditional Chinese and Western Medicine, China
| | - Rong Zhang
- Nursing Department, Gansu Provincial Hospital, Lanzhou, China
| | - Jiarui Liu
- Nursing Department, Gansu Provincial Hospital, Lanzhou, China
| | - Nin Yanhua
- School of Nursing, Ninxia Medical University, Yinchuan, China
| | - Jiancheng Wang
- Department of General Practice Medicine, Hospital of Gansu Health Vocational College, Lanzhou, China.
| |
Collapse
|
291
|
Sadeghi-Mahalli N, Mohammadi-Shahboulaghi F, Arsalani N, Fallahi-Khoshknab M, Foroughan M, Atazadeh M. Factors affecting support: experiences of Iranian older spousal caregivers of people with Alzheimer's disease and their support resources. Aging Ment Health 2024:1-9. [PMID: 39097934 DOI: 10.1080/13607863.2024.2385453] [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: 02/22/2024] [Accepted: 07/22/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVES Older spouses are a significant part of family caregivers of patients with Alzheimer's disease (AD) and need support. Evidence suggests that different factors influence the support of older spousal caregivers. However, there is little evidence about these factors in developing countries like Iran. This study aimed to identify the factors affecting the support of Iranian older spousal caregivers of people with AD. METHOD This qualitative study used Graneheim and Lundman's conventional content analysis approach. Through purposive sampling, 10 caregivers, three family members, and three professionals were recruited from various cognitive clinics and centers. In-depth and semi-structured interviews were used to collect data and continued until conceptual saturation was achieved. RESULTS Two themes were derived from the data as factors affecting support, which included (1) caregiver's support-seeking (complexity of the patient's condition, caregiver's geriatric health, the burden of caring for a spouse with AD, marital bond quality, caregiver's support-phobic beliefs, caregiver's awareness of care) and (2) capacities of support resources (supportive family, supportiveness of society, formal systems' capability to provide support services). CONCLUSION The present study provided practical information about the factors influencing the support of older spousal caregivers. Healthcare providers and policymakers can use these concepts to improve the support process by strengthening caregivers' support-seeking motivation and enhancing capacities in support resources.
Collapse
Affiliation(s)
- Nasim Sadeghi-Mahalli
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farahnaz Mohammadi-Shahboulaghi
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Narges Arsalani
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Mahshid Foroughan
- Geriatric Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Musa Atazadeh
- Iran Dementia and Alzheimer's Association, Tehran, Iran
| |
Collapse
|
292
|
Li X, Hathaway CA, Small BJ, Tometich DB, Gudenkauf LM, Hoogland AI, Fox RS, Victorson DE, Salsman JM, Gonzalez BD, Jim HSL, Siegel EM, Tworoger SS, Oswald LB. Social isolation, depression, and anxiety among young adult cancer survivors: The mediating role of social connectedness. Cancer 2024. [PMID: 39097814 DOI: 10.1002/cncr.35508] [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: 04/22/2024] [Revised: 06/21/2024] [Accepted: 07/10/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Social isolation and social connectedness are health determinants and aspects of social well-being with strong associations with psychological distress. This study evaluated relationships among social isolation, social connectedness, and psychological distress (i.e., depression, anxiety) over 1 year in young adult (YA) cancer survivors 18-39 years old. METHODS Participants were YAs in a large cohort study that completed questionnaires every 2 months for 1 year. Social isolation, aspects of social connectedness (i.e., companionship, emotional support, instrumental support, and informational support), depression, and anxiety were assessed with Patient-Reported Outcomes Measurement Information System short form measures. Mixed-effect models were used to evaluate changes over time. Confirmatory factor analysis and multilevel structural equation modeling were used to define social connectedness as a latent construct and determine whether relationships between social isolation and psychological distress were mediated by social connectedness. RESULTS Participants (N = 304) were mean (M) = 33.5 years old (SD = 4.7) and M = 4.5 years (SD = 3.5) post-initial cancer diagnosis. Most participants were female (67.4%) and non-Hispanic White (68.4%). Average scores for social well-being and psychological distress were within normative ranges and did not change (p values >.05). However, large proportions of participants reported at least mild social isolation (27%-30%), depressive symptoms (36%-37%), and symptoms of anxiety (49%-51%) at each time point. Across participants, more social isolation was related to less social connectedness (p values <.001), more depressive symptoms (p < .001), and more symptoms of anxiety (p < .001). Social connectedness mediated the relationship between social isolation and depression (p = .004), but not anxiety (p > .05). CONCLUSIONS Social isolation and connectedness could be intervention targets for reducing depression among YA cancer survivors.
Collapse
Affiliation(s)
- Xiaoyin Li
- Moffitt Cancer Center, Tampa, Florida, USA
| | | | - Brent J Small
- University of North Carolina Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA
| | | | | | | | - Rina S Fox
- University of Arizona College of Nursing, Tucson, Arizona, USA
- University of Arizona Cancer Center, Tucson, Arizona, USA
| | - David E Victorson
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, USA
| | - John M Salsman
- Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina, USA
| | | | | | | | - Shelley S Tworoger
- Division of Oncological Sciences and the Knight Cancer Institute, School of Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | | |
Collapse
|
293
|
Dai Z, Tran BNH, Watson DE, Tan ECK. The association between patient-reported experiences with hospital food services and recovery outcomes - A population survey of patients from 75 public hospitals. Clin Nutr ESPEN 2024; 63:688-693. [PMID: 39098606 DOI: 10.1016/j.clnesp.2024.07.1062] [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: 03/12/2024] [Revised: 07/14/2024] [Accepted: 07/31/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND The quality of food service is vital to patients' experiences in care and recovery in hospitals. This study aimed to identify opportunities for improving hospital food services to enhance overall patient experiences and outcomes. METHODS This retrospective cross-sectional study uses the Adult Admitted Patient Survey in 2019. Adult patients discharged from acute or rehabilitation care across 75 public hospitals were surveyed about their in-hospital experiences, including ratings of hospital food services, overall ratings of hospital care, complications acquired, and delayed discharge due to feeling unwell. Population weighting was applied in descriptive and multivariable logistic regression analyses. We used adjusted odds ratios (AORs) and 95% confidence intervals (CIs) to estimate the association between hospital food service and the overall rating of hospital care and two recovery outcomes. RESULTS Eight in ten participants (weighted, 16,919/21,900) consumed food in a hospital [mean age: 60.6 years (SE:0.5; SD: 18.3), 53% female]. Compared to a fair rating, adults who rated "poor/very poor" of hospital food service were 2.7 times more likely to report dissatisfaction with overall care in the hospital [Adjusted Odds Ratio (AOR) (95% CI): 2.73 (1.49, 4.99)], 1.4 times more likely to report complications [AOR:1.43 (1.11, 1.83)] and 1.9 times more likely to report delayed discharge [AOR 1.85 (1.30, 2.62)]. More moderate ratings were associated with attenuation of risk for these outcomes. Furthermore, the magnitude of the effect for these associations was more substantial among patients from non-English-speaking backgrounds (n = 1,759) after controlling for patient characteristics. Food service attributes, including received food as ordered, food delivered within reach, the taste of the meals, and meal interruption, were significant factors for the outcomes assessed. CONCLUSION These findings underscore the importance of patients' positive experiences of hospital food service in recovery outcomes and identify several food service indicators that can be used to monitor and improve patient experiences and recovery outcomes in hospitals.
Collapse
Affiliation(s)
- Zhaoli Dai
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Sydney, NSW, Australia; UNSW Ageing Futures Institute, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
| | - Bich N H Tran
- Bureau of Health Information, Sydney, New South Wales, Australia
| | - Diane E Watson
- Bureau of Health Information, Sydney, New South Wales, Australia
| | - Edwin C K Tan
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Sydney, NSW, Australia
| |
Collapse
|
294
|
McCabe G, Lavery J. Self-neglect as a significant public health issue: exploring the responsibility of the SPCDN. Br J Community Nurs 2024; 29:378-382. [PMID: 39072738 DOI: 10.12968/bjcn.2024.0001] [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] [Indexed: 07/30/2024]
Abstract
Self-neglect is a recognised form of abuse affecting individuals across the lifespan. Gaps are evident within current data to support its prevalence; thus, it is considered to be an under-researched and under-reported phenomenon. Evidence suggests that there are multiple risk factors which contribute to self-neglect and sources recognise it leads to poorer health outcomes. Specialist Community Practitioner District Nurses (SCPDNs) deliver care across a diverse demographic and continuously assess risk for individuals in complex environments leading and managing the care of individuals who self-neglect. It is therefore essential that SCPDNs are equipped with the knowledge and skills required to therapeutically assess the health needs of this patient group and lead on the coordination of care. This article aims to explore the subject of self-neglect as a public health concern and appraise the role and responsibilities of the SCPDN within community nursing practice.
Collapse
Affiliation(s)
- Georgia McCabe
- Specialist community practitioner district nursing student, Liverpool John Moores University; Community nurse, Wirral Community Foundation Trust
| | - Joanna Lavery
- Senior Lecturer Post graduate nursing, Programme Lead Advanced Clinical Practitioner Apprenticeship, Liverpool John Moores University
| |
Collapse
|
295
|
Bu T, Peng C, Liu J, Qiu X, Qiao Z, Zhou J, Ke S, Kan Y, Hu X, Qiao K, Liu X, Cao D, Yang Y. Nurse burnout: deep connections and solutions revealed by network analysis. BMC Nurs 2024; 23:531. [PMID: 39095727 PMCID: PMC11297739 DOI: 10.1186/s12912-024-02190-7] [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: 05/24/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Burnout is very important to nurses' physical and mental health and career development. Current approaches to assessing nurse burnout tend to use a total score modeling paradigm to explore the impact of external factors on burnout. The purpose of this study is to delve into the item-level relationship between nurse burnout and its influencing factors at both the social and psychological levels using a network analysis approach. METHODS This study was conducted in June 2023 and 1,005 nurses from 4 hospitals out of 8 tertiary care hospitals in Harbin were selected to participate in this study using whole cluster sampling method. Measurements included a general demographic questionnaire, Trait coping styles questionnaire, Organizational commitment questionnaire, Work-family conflict scale, Transformational leadership questionnaire, and Maslach Burnout Inventory-General Survey. RESULTS Our results suggest that "C1 Time-Based work interference with family" showed the strongest centrality and bridging in the overall network. This finding underscores its centrality to burnout. Other strongest bridge symptoms included "E2 Reduced personal accomplishment" and "A1 Positive coping styles" indicating their strongest connections to other clusters. CONCLUSIONS Nurse administrators should be encouraged to pay more attention to nurses' work situations and family distress, and to help nurses in a flexible way.
Collapse
Affiliation(s)
- Tianyi Bu
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China
| | - Chundi Peng
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiangheng Liu
- Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Xiaohui Qiu
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhengxue Qiao
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiawei Zhou
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China
| | - Siyuan Ke
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yuecui Kan
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiaomeng Hu
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China
| | - Kexin Qiao
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xuan Liu
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China
| | - Depin Cao
- Department of Medical Education Management, School of Health management, Harbin Medical University, Harbin, Heilongjiang, China.
| | - Yanjie Yang
- Psychology and Health Management Center, Harbin Medical University, Harbin, Heilongjiang, China.
| |
Collapse
|
296
|
Güveli R, Balci E, Bayraktar M. Nomophobia, loneliness and depressive symptom levels of adults living in a district of Türkiye. Medicine (Baltimore) 2024; 103:e38921. [PMID: 39093730 PMCID: PMC11296433 DOI: 10.1097/md.0000000000038921] [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: 05/04/2024] [Accepted: 06/21/2024] [Indexed: 08/04/2024] Open
Abstract
This study was conducted to evaluate whether smart cell phones detach people from social life, make them lonely, cause depressive symptoms and whether there is a relationship between them. This is a cross-sectional study using face-to-face survey method. The sample was determined as 376 participants, with 95% confidence interval, 50% probability depending on the probability of having a smartphone or not. Participants in the sample were determined by systematic random sampling from adults aged 20 and over in Çiftlik district of Niğde province. The NMP-Q, DASS-42 and UCLA-LS were used. The median age of the 376 participants (192 male, 184 female) was 30 and the mean age was 32.0 (±10.94) years. Participants that had social media accounts were 68.9% of the population. Over 70% of the participants had mild, moderate or severe nomophobia. Nomophobia status of the participants was affected by the mean duration of the first-time smartphone use (P = .017), the mean daily smartphone usage time of the participants (P < .001), the mean number of smartphone users in the participants' families (P = .003), the mean depression and stress scores of the participants (P < .001), having social media account (P = .001), and declaration of smart phone dependency (P = .005). Nomophobia status was not affected by participants' gender, mean age, educational level, employment status, economic status and marital status (P > .05). The duration of daily smartphone use, the duration of first-time smartphone use, and having multiple smartphone users in family increased nomophobia. Also, having active social media accounts and self-reported smartphone addiction found correlated to nomophobia. Smartphone addiction increases depression, anxiety, and stress scores of the participants.
Collapse
Affiliation(s)
- Rifat Güveli
- Kitreli Family Health Center, Niğde Provincial Directorate of Health, Niğde, Türkiye
| | - Elçin Balci
- Faculty of Medicine, Department of Public Health, Erciyes University, Kayseri, Türkiye
| | - Muhammet Bayraktar
- Faculty of Medicine, Department of Public Health, Ömer Halisdemir University, Niğde, Türkiye
| |
Collapse
|
297
|
Medel D, Cemeli T, Sanromà-Ortíz M, Jimenez-Herrera M, Bonet A, Torné-Ruiz A, Roca J. Exploring communicative interactions in debriefing sessions with nursing students: A qualitative study. NURSE EDUCATION TODAY 2024; 142:106334. [PMID: 39137449 DOI: 10.1016/j.nedt.2024.106334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 07/17/2024] [Accepted: 08/01/2024] [Indexed: 08/15/2024]
Abstract
INTRODUCTION Debriefing as a learning activity aims to elevate participants' competence through communicative interaction. This activity is an integral component of any formative simulation. Thus, the primary objective of this study was to explore debriefing as a communicative experience in nursing students within the context of interactive virtual simulation. The secondary objectives were: 1) To investigate the typology of interactions based on participants' discourse and 2) To identify the actions that students use to develop knowledge during debriefing. METHOD A qualitative exploratory study design involving six debriefing groups was conducted with 105 s-year nursing students. The debriefing sessions were analyzed following interactive virtual simulations in an in-person setting in the classroom. All sessions were recorded and transcribed verbatim. A mixed (deductive and inductive) content analysis approach was used. RESULTS A total of 2187 units of meaning were identified and categorized into 3 themes (interaction by participant, interaction by communicative action, and interaction by participant's communicative goal); nine subthemes (facilitator-student, student-student and student-facilitator; declarative - unidirectional, reactive - bidirectional and multidirectional-interactive; individualistic, competitive, and collaborative), and 5 categories (providing information; generating creative solutions; processing critical and deliberative information; positive interdependence and psychosocial relationships). CONCLUSION The students developed knowledge and practical communication skills, particularly reinforcing soft skills through collaborative interactions, predominantly multidirectional-interactive in nature. The facilitator and the interpersonal relationships among the participants fostered a safe and positive environment.
Collapse
Affiliation(s)
- Daniel Medel
- Department of Nursing and Physiotherapy, University of Lleida, Igualada, Spain.
| | - Tània Cemeli
- Department of Nursing and Physiotherapy, University of Lleida, Igualada, Spain.
| | | | | | - Aida Bonet
- Department of Nursing and Physiotherapy, University of Lleida, Igualada, Spain; Health Education, Nursing, Sustainability and Innovation Research Group (GREISI), Spain.
| | - Alba Torné-Ruiz
- Department of Nursing and Physiotherapy, University of Lleida, Igualada, Spain; Hospital Sant Joan de Déu of Manresa, Manresa, Spain.
| | - Judith Roca
- Department of Nursing and Physiotherapy, University of Lleida, Igualada, Spain; Health Education, Nursing, Sustainability and Innovation Research Group (GREISI), Spain; Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, Spain.
| |
Collapse
|
298
|
Menear M, Ashcroft R, Dahrouge S, Silveira J, Booton J, Emode M, McKenzie K. Person-centered care for common mental disorders in Ontario's primary care patient-centered medical homes: a qualitative study of provider perspectives. BMC PRIMARY CARE 2024; 25:278. [PMID: 39095749 PMCID: PMC11295484 DOI: 10.1186/s12875-024-02519-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 07/10/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND For more than a decade, the Patient-Centered Medical Home model has been a guiding vision for the modernization of primary care systems. In Canada, Ontario's Family Health Teams (FHTs) were designed in the mid-2000s with the medical home model in mind. These primary care clinics aim to provide accessible, comprehensive, and person-centered primary care services to communities across Ontario. Their services typically include mental health care for people experiencing common mental disorders, such as depression and anxiety disorders. It remains unclear, however, whether the mental health care delivered within FHTs is consistent with person-centered care approaches. In the current study, we aimed to explore the perspectives of FHT providers on the care delivered to people with common mental disorders to determine whether, and to what extent, they believed this care was person-centered. METHODS We conducted a qualitative grounded theory study involving interviews with 65 health professionals and administrators from 18 FHTs across Ontario. Transcripts were coded using a three-step process of initial, focused, and axial coding that mixed inductive and deductive approaches informed by sensitizing concepts on person-centeredness. RESULTS Practices and challenges associated with the delivery of mental health care in a person-centered way were captured by several themes regrouped into five domains: (1) patient as unique person, (2) patient-provider relationship, (3) sharing power and responsibility, (4) connecting to family and community, and (5) creating person-centered care environments. FHT providers perceived that they delivered person-centered care by delivering mental health care that was responsive, flexible, and consistent with biopsychosocial approaches. They emphasized the importance of creating long-lasting relationships with patients grounded in empathy and trust. Their challenges included being able to ensure continuity of care, adequately prioritizing patients' mental health issues, and meaningfully engaging patients and families as partners in care. CONCLUSIONS Our findings suggest that FHT providers have adopted a range of person-centered practices for people with common mental disorders. However, greater attention to practices such as shared decision making, supporting self-management, and involving families in care would strengthen person-centeredness and bring teams closer to the Patient-Centered Medical Home vision.
Collapse
Affiliation(s)
- Matthew Menear
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada.
- VITAM Centre de recherche en santé durable, Quebec City, Canada.
| | - Rachelle Ashcroft
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Simone Dahrouge
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Jose Silveira
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jocelyn Booton
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Monica Emode
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Kwame McKenzie
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Wellesley Institute, Toronto, Canada
| |
Collapse
|
299
|
Li H, Guo J, Ren Z, Bai D, Yang J, Wang W, Fu H, Yang Q, Hou C, Gao J. Moral courage level of nurses: a systematic review and meta-analysis. BMC Nurs 2024; 23:530. [PMID: 39090605 PMCID: PMC11295526 DOI: 10.1186/s12912-024-02082-w] [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: 07/24/2023] [Accepted: 06/10/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Moral distress occurs in daily nursing work and plagues nurses. Improving the level of moral courage is one of the main strategies to reduce moral distress, and low levels of moral courage may lead to nurse burnout, increased turnover, and reduced quality of care. METHODS Nine electronic databases in Chinese and English were searched for the level of moral courage among nurses, including PubMed, Web of Science, EMBASE, CINAHL, CNKI, Wan fang, Wei pu, CBM and Cochrane Library, for the period from the date of database creation to April 5, 2023. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the methodological quality of the included studies, followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Meta-analysis and Systematic Reviews of Observational Studies guidelines, and data from the included studies were meta-analyzed in STATA version 15 using a fixed-effects model. RESULTS Seventeen cross-sectional studies of moderate or high quality met the eligibility criteria and involved 7718 nurses, and the Nurses' Moral Courage Scale (NMCS) was used to measure the self-assessed moral courage level of nurses. Eleven of these studies reported total scores for nurses' moral courage, and the meta-analysis results showed a pooled mean score of 78.94 (95% CI: 72.17, 85.72); Fourteen studies reported mean entry scores for nurses' moral courage, and the meta-analysis results showed a pooled mean score of 3.93 (95% CI: 3.64, 4.23). CONCLUSION The results of the meta-analysis showed that nurses' moral courage levels were in the medium to high range, among the nurses who seemed to be male, non-nursing managers, high school education, had not experienced ethical issues, and considering resignation had lower levels of moral courage. The results of the meta-analysis may provide some reference for nursing managers and even hospital administrators to develop strategies to optimize nursing quality.
Collapse
Affiliation(s)
- Hang Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - JuLan Guo
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - ZhiRong Ren
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- The Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Dingxi Bai
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wei Wang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Han Fu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qing Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Chaoming Hou
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Jing Gao
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| |
Collapse
|
300
|
Ayik C, Arslan GG. Effectiveness of caring behaviours course on decision-making and caring behaviours in undergraduate nursing students: An experimental study. Scand J Caring Sci 2024. [PMID: 39092534 DOI: 10.1111/scs.13288] [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: 02/22/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Although caring is a core principle of the nursing profession, students often lack the knowledge, comprehension and ability to integrate care into all aspects of nursing practice. Students may have few opportunities to practise caring behaviours on patients who create the impression of providing care and elicit a feeling of receiving care. Studies of strategies to enhance caring behaviours in nursing education are limited. AIM This experimental study aimed to examine the effect of nursing caring behaviours course based on interactive learning strategies on the caring behaviours and decision-making abilities of nursing students. METHODS A purposive sample of 50 undergraduate students was recruited from a faculty of nursing. Students in the intervention group (n = 24) received 2 h of training per week for 14 weeks in accordance with caring behaviours course based on interactive learning strategies including discussion, brainstorming, concept mapping, reflection and simulation training. Nursing students in the control group (n = 26) received training according to other elective courses in the curriculum. Data were measured at the baseline time point, 7th week and 14th week with the Caring Behaviours Inventory and Nursing Decision-Making Instrument. Chi-square test, Mann-Whitney U-test, Friedman test and mixed repeated measures ANOVA were used to assess the data. RESULTS No significant difference was determined in terms of baseline caring behaviours and decision-making scores between the intervention and control groups (p > 0.05). A significant difference in caring behaviours between the two groups and time effect was not found (p > 0.05). However, there was a significant interaction between time and groups (F = 3.484, p = 0.047). There was a significant increase in the decision-making in intervention groups over time (F = 9.372, p < 0.001) and interaction between time and groups (F = 4.160, p = 0.019). CONCLUSIONS A deliberate strategy to raise students' awareness of caring behaviours and incorporate interactive learning methods into education enhances both caring behaviours and clinical decision-making.
Collapse
Affiliation(s)
- Cahide Ayik
- Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | | |
Collapse
|