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Hehmeyer KN, Zierhut H, Dedrick R, Dean M, Schwarting K, Bellia KS, Cragun D. The development and preliminary evaluation of the Genetic Counseling Skills Checklist. J Genet Couns 2024; 33:578-591. [PMID: 37529972 DOI: 10.1002/jgc4.1758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023]
Abstract
Genetic counseling (GC) relies on communication to help people understand and adapt to genetic contributions of disease, and there is need for a practical and reliable method of comprehensively documenting GC communication skills without intensive coding. To this end, we created a novel process measure called the Genetic Counseling Skills Checklist (GCSC), utilizing previously validated measures, communication/counseling frameworks, and prior research findings. A multistage iterative process was used to develop, evaluate, and modify the GCSC to improve its clarity, usability, and content validity. To assess interrater reliability, randomly assigned, untrained individuals (i.e., coders) used the GCSC version 3 to code multiple simulated GC sessions. Average measures intraclass correlation coefficients (ICCs) were calculated for each of the 8 GCSC process categories using one-way, random effects models. After relatively minor modifications to the GCSC, two pairs of experienced coders used GCSC version 4 to independently code additional GC sessions and Cohen's Kappa coefficients (κ) were calculated to assess interrater reliability for each process category. The GCSC contains five to eight items within each category and demonstrates good content validity given its ability to capture nearly all GC skills that genetic counselors reported using in a prior qualitative study. Interrater reliability of GCSC version 3 among coders with limited experience was moderate or good for 6 out of the 8 process categories as evidenced by ICCs ranging from 0.55 to 0.86. Average interrater reliability of GCSC version 4 among one pair of experienced coders was strong for all eight process categories (κ ranging from 0.82 to 0.94); among the second pair of experienced coders scores were strong for six categories (κ ranging from 0.80 to 0.87) and moderate for two categories (κ of 0.77 and 0.78). The results suggest the need for training and experience to assure adequate interrater reliability across GCSC coders. Future work is needed to create a formalized training program for coders, complete a larger study to further validate the measure, and use the GCSC to document variability in skills used across providers and sessions.
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Affiliation(s)
| | - Heather Zierhut
- Department of Genetics, Cell Biology, and Development, University of Minnesota - Twin Cities, Minneapolis, Minnesota, USA
| | - Robert Dedrick
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, Florida, USA
| | - Marleah Dean
- Department of Communication, University of South Florida, Tampa, Florida, USA
- Health Outcomes & Behavior Program, Moffitt Cancer Center, Tampa, Florida, USA
| | | | - Katie Sullivan Bellia
- Orlando Health Winnie Palmer Hospital Center for Maternal Fetal Medicine, Orlando, Florida, USA
| | - Deborah Cragun
- College of Public Health, University of South Florida, Tampa, Florida, USA
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Zhang Y, Flannery M, Zhang Z, Underhill-Blazey M, Bobry M, Leblanc N, Rodriguez D, Zhang C. Digital Health Psychosocial Intervention in Adult Patients With Cancer and Their Families: Systematic Review and Meta-Analysis. JMIR Cancer 2024; 10:e46116. [PMID: 38315546 PMCID: PMC10877499 DOI: 10.2196/46116] [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: 02/01/2023] [Revised: 11/13/2023] [Accepted: 12/06/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Patients with cancer and their families often experience significant distress and deterioration in their quality of life. Psychosocial interventions were used to address patients' and families' psychosocial needs. Digital technology is increasingly being used to deliver psychosocial interventions to patients with cancer and their families. OBJECTIVE A systematic review and meta-analysis were conducted to review the characteristics and effectiveness of digital health interventions on psychosocial outcomes in adult patients with cancer and their family members. METHODS Databases (PubMed, Cochrane Library, Web of Science, Embase, CINAHL, PsycINFO, ProQuest Dissertations and Theses Global, and ClinicalTrials.gov) were searched for randomized controlled trials (RCTs) or quasi-experimental studies that tested the effects of a digital intervention on psychosocial outcomes. The Joanna Briggs Institute's critical appraisal checklists for RCTs and quasi-experimental studies were used to assess quality. Standardized mean differences (ie, Hedges g) were calculated to compare intervention effectiveness. Subgroup analysis was planned to examine the effect of delivery mode, duration of the intervention, type of control, and dosage on outcomes using a random-effects modeling approach. RESULTS A total of 65 studies involving 10,361 patients (mean 159, SD 166; range 9-803 patients per study) and 1045 caregivers or partners (mean 16, SD 54; range 9-244 caregivers or partners per study) were included in the systematic review. Of these, 32 studies were included in a meta-analysis of the effects of digital health interventions on quality of life, anxiety, depression, distress, and self-efficacy. Overall, the RCT studies' general quality was mixed (applicable scores: mean 0.61, SD 0.12; range 0.38-0.91). Quasi-experimental studies were generally of moderate to high quality (applicable scores: mean 0.75, SD 0.08; range 0.63-0.89). Psychoeducation and cognitive-behavioral strategies were commonly used. More than half (n=38, 59%) did not identify a conceptual or theoretical framework. Most interventions were delivered through the internet (n=40, 62%). The median number of intervention sessions was 6 (range 1-56). The frequency of the intervention was highly variable, with self-paced (n=26, 40%) being the most common. The median duration was 8 weeks. The meta-analysis results showed that digital psychosocial interventions were effective in improving patients' quality of life with a small effect size (Hedges g=0.05, 95% CI -0.01 to 0.10; I2=42.7%; P=.01). The interventions effectively reduced anxiety and depression symptoms in patients, as shown by moderate effect sizes on Hospital Anxiety and Depression Scale total scores (Hedges g=-0.72, 95% CI -1.89 to 0.46; I2=97.6%; P<.001). CONCLUSIONS This study demonstrated the effectiveness of digital health interventions on quality of life, anxiety, and depression in patients. Future research with a clear description of the methodology to enhance the ability to perform meta-analysis is needed. Moreover, this study provides preliminary evidence to support the integration of existing digital health psychosocial interventions in clinical practice. TRIAL REGISTRATION PROSPERO CRD42020189698; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=189698.
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Affiliation(s)
- Yingzi Zhang
- Magnet Program and Nursing Research Department, UT Southwestern Medical Center, Dallas, TX, United States
| | - Marie Flannery
- School of Nursing, University of Rochester Medical Center, Rochester, NY, United States
| | - Zhihong Zhang
- School of Nursing, University of Rochester Medical Center, Rochester, NY, United States
| | | | - Melanie Bobry
- School of Nursing, University of Rochester Medical Center, Rochester, NY, United States
| | - Natalie Leblanc
- School of Nursing, University of Rochester Medical Center, Rochester, NY, United States
| | - Darcey Rodriguez
- Edward G Miner Library, University of Rochester Medical Center, Rochester, NY, United States
| | - Chen Zhang
- School of Nursing, University of Rochester Medical Center, Rochester, NY, United States
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Jaffe N, Jones MC, Angelone DJ. Development, feasibility, and acceptability of SPoRT: a dating violence and sexual risk prevention intervention for college student-athletes. Pilot Feasibility Stud 2023; 9:183. [PMID: 37936248 PMCID: PMC10629049 DOI: 10.1186/s40814-023-01413-z] [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: 03/16/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Student-athletes are one subgroup of college students in the USA at risk for dating violence and sexual risk behaviors. Despite this, research on student-athletes' dating behaviors is limited; existing research pertains primarily to the National Collegiate Athletic Association (NCAA) Division I athletes and focuses on male student-athletes as perpetrators of dating and sexual violence. While some existing programs aim to reduce dating violence and promote healthy relationships, these programs are education based, and not tailored to the specific strengths and challenges of student-athletes. We therefore designed Supporting Prevention in Relationships for Teams (SPoRT), a novel, four-session prevention intervention for Division III student-athletes of all genders to reduce dating violence and sexual risk behavior by targeting knowledge and skills identified in pilot research, incorporating psychoeducation with techniques from cognitive-behavioral therapy, mindfulness, bystander intervention, and normative feedback. METHODS This study represents stage 1 of the National Institutes of Health (NIH) Stage Model for Behavioral Intervention Development, evaluating the feasibility and acceptability of SPoRT. We describe the development, content, and proposed delivery methods for SPoRT and evaluated the feasibility and acceptability of the program using a mixed-methods approach. Thirty college student-athletes (12 men, 18 women) completed questionnaires and participated in focus groups to provide feedback on the program's length, timing, group size and dynamics, content, and suggestions for making the SPoRT prevention intervention more feasible and acceptable. RESULTS Our recruitment procedures were successful, and participants rated the program as feasible in terms of delivery methods and logistics. Participants liked that SPoRT was developed based on pilot data collected from student-athletes, brief, and skills based and tailored to athletic team needs. SPoRT was perceived as appropriate and relevant to student-athlete needs in terms of dating violence and sexual risk prevention knowledge and skills. Most participants (63%) rated the program as "excellent" and said they would recommend it to others. CONCLUSIONS We found SPoRT to be both feasible and acceptable in terms of content and delivery. Suggested modifications will be incorporated into the SPoRT healthy relationships prevention intervention to be tested in an NIH Stage 1 efficacy trial.
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Affiliation(s)
- Nicole Jaffe
- The Center for Psychology, 12499 Brantley Commons Ct #101, Fort Myers, FL, 33907, USA
| | - Meredith C Jones
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA.
| | - D J Angelone
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA
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Lim ELP, Ong RHS, Thor J, Allgurin M, Gäre BA, Thumboo J. An Evaluation of the Relationship between Training of Health Practitioners in a Person-Centred Care Model and their Person-Centred Attitudes. Int J Integr Care 2023; 23:11. [PMID: 38020415 PMCID: PMC10668878 DOI: 10.5334/ijic.7564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The Esther Network (EN) person-centred care (PCC) advocacy training aims to promote person-centred attitudes among health practitioners in Singapore. This study aimed to assess the relationship between the training and practitioners' PCC attributes over a 3-month period, and to explore power sharing by examining the PCC dimensions of "caring about the service user as a whole person" and the "sharing of power, control and information". Methods A repeated-measure study design utilising the Patient-Practitioner Orientation Scale (PPOS), was administered to 437 training participants at three time points - before training (T1), immediately after (T2) and three months after training (T3). A five-statement questionnaire captured knowledge of person-centred care at T1 and T2. An Overall score, Caring and Sharing sub-scores were derived from the PPOS. Scores were ranked and divided into three groups (high, medium and low). Ordinal Generalised Estimating Equation (GEE) model analysed changes in PPOS scores over time. Results A single, short-term training appeared to result in measurable improvements in person-centredness of health practitioners, with slight attenuation at T3. There was greater tendency to "care" than to "share power" with service users across all three time points, but the degree of improvement was larger for sharing after training. The change in overall person-centred scores varied by sex and profession (females score higher than males, allied health showed a smaller attenuation at T3). Conclusion Training as a specific intervention, appeared to have potential to increase health practitioners' person-centredness but the aspect of equalising power was harder to achieve within a hierarchical structure and clinician-centric culture. An ongoing network to build relationships, and a supportive system to facilitate individual and organisational reflexivity can reinforce learning.
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Affiliation(s)
- Esther Li Ping Lim
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Allied Health Division, Singapore General Hospital, Singapore
- Centre for Person-centred Care, Singapore Health Services, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore
| | | | - Johan Thor
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Monika Allgurin
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Boel Andersson Gäre
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
- Futurum, Region Jönköping County, Jönköping, Sweden
| | - Julian Thumboo
- SingHealth Office of Regional Health, Singapore Health Services, Singapore
- SingHealth Centre for Population Health Research and Implementation, Singapore Health Services, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
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Siegel N, Lee C, Oddo B, Robinson A, Xia L, Grimes J, Wisco JJ. A novel scale for the evaluation of physician drawn medical illustrations. J Vis Commun Med 2023; 46:116-121. [PMID: 37431723 DOI: 10.1080/17453054.2023.2228849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/14/2023] [Indexed: 07/12/2023]
Abstract
Effective communication is a crucial component of patient-centered care and individuals with low health literacy face significant challenges in managing their health, leading to longer hospital stays and worse outcomes. Visual aids, such as medical illustrations and pictograms, can enhance patient understanding and memory retention; however, there is a lack in the medical field of tools for evaluating and improving a physician's ability to draw clinical illustrations for their patient. This article explores an aesthetic scale created in collaboration between Boston University Medical School and the Boston University Fine-Arts department. The scale scores basic design elements that could reasonably be improved in a clinical setting. A pilot study demonstrated interrater reliability between trained artists scoring images of varying concepts and visual quality with a Cronbach's alpha of 0.95. This scale has potential use in medical visual education and clinical evaluation.
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Affiliation(s)
- Noah Siegel
- Department of Anatomy, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Cassandra Lee
- Department of Anatomy, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Brandon Oddo
- Department of Anatomy, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Anthony Robinson
- Department of Anatomy, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Lucy Xia
- School of Visual Arts, Boston University College of Fine Arts, Boston, MA, USA
| | - Jill Grimes
- School of Visual Arts, Boston University College of Fine Arts, Boston, MA, USA
| | - Jonathan J Wisco
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
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Gwon SH, Lee HJ, Brian Ahn H. Transcranial Direct Current Stimulation in Nicotine Use: Nursing Implications for Patient Outcomes. J Addict Nurs 2023; 34:E74-E78. [PMID: 37669347 DOI: 10.1097/jan.0000000000000542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
ABSTRACT Tobacco use is a leading cause of cancer, cardiovascular and respiratory disease, and preventable death in the United States. The brains of individuals with nicotine dependence are characterized by damaged mesolimbic pathways in the medial portion of the limbic and frontal lobes, creating positive reinforcing mechanisms. Transcranial direct current stimulation (tDCS) targets this neuroadaptation to improve smokers' nicotine-related outcomes, such as craving and smoking behavior, by depolarizing or hyperpolarizing the neurons of the brain. Recent literature reported promising outcomes in smokers after tDCS treatment interventions. tDCS has great potential for clinical nursing research for tobacco control given its multiple methodological advantages and few disadvantages. Nurse researchers can consider individualized and home-based tDCS interventions for community-based tobacco control research and may need to consider objective outcome measures (e.g., cotinine in urine) and addiction-related cognitive variables (e.g., self-regulation). Users of electronic nicotine delivery systems also need to be considered as participants in tDCS interventions. Additional considerations for nursing research are discussed.
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Clasby B, Hughes N, Clasby E, Catroppa C. School-based interventions for children and adolescents following traumatic brain injury: A systematic review. NeuroRehabilitation 2023:NRE220218. [PMID: 37212076 DOI: 10.3233/nre-220218] [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: 05/23/2023]
Abstract
BACKGROUND Childhood traumatic brain injury (TBI) can result in impairments in learning, cognition, and behaviour; all of which can adversely influence educational outcomes. Schools can play a crucial role in rehabilitation, therefore it is important that evidence-based supports are available in these settings. OBJECTIVE The aim of this systematic review was to evaluate the effectiveness of school-based supports and interventions available following childhood TBI. METHODS A comprehensive search strategy involved eight research databases, grey literature, and backward reference searching. RESULTS The search identified 19 studies, reporting on sixteen distinct interventions, which used a variety of person-centred and systemic approaches, and typically contained multiple components, including: psychoeducation, behavioural scripts, and attention training. While offering some indication for future directions in intervention, the evidence base for individual interventions was typically limited, and does not take account of cost or issues in sustainability. CONCLUSION While there appears to be great potential to support students who may otherwise not gain access to services, there is insufficient evidence to guide widespread policy or practice change without further research. Greater collaboration between researchers, clinical practitioners, and educators is necessary to ensure that all interventions developed are robustly evaluated and disseminated.
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Affiliation(s)
- Betony Clasby
- University of Sheffield, Sheffield, UK
- University of Otago, Dunedin, New Zealand
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Nathan Hughes
- University of Sheffield, Sheffield, UK
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
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Trainum K, Tunis R, Xie B, Hauser E. Robots in Assisted Living Facilities: Scoping Review. JMIR Aging 2023; 6:e42652. [PMID: 36877560 PMCID: PMC10028516 DOI: 10.2196/42652] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Various technological interventions have been proposed and studied to address the growing demand for care of residents in assisted living facilities, in which a preexisting shortage of professional caregivers has been exacerbated by the COVID-19 pandemic. Care robots are one such intervention with the potential to improve both the care of older adults and the work life of their professional caregivers. However, concerns about efficacy, ethics, and best practices in the applications of robotic technologies in care settings remain. OBJECTIVE This scoping review aimed to examine the literature on robots used in assisted living facilities and identify gaps in the literature to guide future research. METHODS On February 12, 2022, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) protocol, we searched PubMed, CINAHL Plus with Full Text, PsycINFO, IEEE Xplore digital library, and ACM Digital Library using predetermined search terms. Publications were included if they were written in English and focused on the use of robotics in assisted living facilities. Publications were excluded if they did not provide peer-reviewed empirical data, focused on user needs, or developed an instrument to study human-robot interaction. The study findings were then summarized, coded, and analyzed using the Patterns, Advances, Gaps, Evidence for practice, and Research recommendations framework. RESULTS The final sample included 73 publications from 69 unique studies on the use of robots in assisted living facilities. The findings of studies on older adults were mixed, with some studies suggesting positive impacts of robots, some expressing concerns about robots and barriers to their use, and others being inconclusive. Although many therapeutic benefits of care robots have been identified, methodological limitations have weakened the internal and external validity of the findings of these studies. Few studies (18/69, 26%) considered the context of care: most studies (48/69, 70%) collected data only on recipients of care, 15 studies collected data on staff, and 3 studies collected data on relatives or visitors. Theory-driven, longitudinal, and large sample size study designs were rare. Across the authors' disciplines, a lack of consistency in methodological quality and reporting makes it difficult to synthesize and assess research on care robotics. CONCLUSIONS The findings of this study call for more systematic research on the feasibility and efficacy of robots in assisted living facilities. In particular, there is a dearth of research on how robots may change geriatric care and the work environment within assisted living facilities. To maximize the benefits and minimize the consequences for older adults and caregivers, future research will require interdisciplinary collaboration among health sciences, computer science, and engineering as well as agreement on methodological standards.
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Affiliation(s)
- Katie Trainum
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
| | - Rachel Tunis
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | - Bo Xie
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | - Elliott Hauser
- School of Information, The University of Texas at Austin, Austin, TX, United States
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Katja L, Terhi L, Minna S, Jouko K, Riitta S. Nurse competence provides more individuality in the care of older hospitalized people. Nurs Open 2022; 10:3191-3200. [PMID: 36572665 PMCID: PMC10077381 DOI: 10.1002/nop2.1569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 07/20/2022] [Accepted: 12/10/2022] [Indexed: 12/28/2022] Open
Abstract
AIM The aim of the study was to assess Registered Nurses' perceptions of general nurse competence, patient-centred care competence, and individuality in the care of older patients and to explore their associations. DESIGN A descriptive correlative survey. METHODS Data were collected using questionnaires at one Finnish university hospital during winter 2016-2017 amongst Registered Nurses (n = 223) and analyzedd statistically using descriptive and inferential statistics (ANOVA, Pearson's correlations coefficients) and path analysis. RESULTS Registered Nurses assessed their general competence, patient-centred care competenc,e and individuality in the care of older patients at a good level. The Path model confirmed general nurse competence was a predictor of patient-centred care competence, which in turn was a predictor of individuality in the nursing care of older patients. The novelty lies in empirical confirmation of the association between nurse competence and individuality in the care. Increasing competence may enhance individuality in the care of older people and enable interventions to support care outcomes.
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Affiliation(s)
- Lahtinen Katja
- Department of Nursing Science, University of Turku, Turku, Finland.,Department of Social and Health Care, City of Helsinki, Helsinki, Finland
| | - Lemetti Terhi
- Department of Nursing Science, University of Turku, Turku, Finland.,Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Stolt Minna
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Katajisto Jouko
- Statistics Unit, Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Suhonen Riitta
- Department of Nursing Science, University of Turku, Turku, Finland.,Welfare Services Division, Turku University Hospital and City of Turku, Turku, Finland
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Risk Factors for Tube Feeding at Discharge in Infants Undergoing Neonatal Surgery for Congenital Heart Disease: A Systematic Review. Pediatr Cardiol 2022; 44:769-794. [PMID: 36404346 DOI: 10.1007/s00246-022-03049-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022]
Abstract
Approximately 30-50% of infants undergoing neonatal surgery for congenital heart disease (CHD) cannot meet oral feeding goals by discharge and require feeding tube support at home. Feeding tubes are associated with increased readmission rates and consequent hospital, payer, and family costs, and are a burden for family caregivers. Identification of modifiable risk factors for oral feeding problems could support targeted care for at-risk infants. Therefore, the aim of this systematic review is to determine risk factors for tube feeding at discharge in infants undergoing neonatal surgery for CHD. Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a search was conducted using MEDLINE, CINAHL, and Cochrane Database of Systematic Reviews. Studies published before 2010 were excluded. The search resulted in 607 records, of which 18 were included. Studies were primarily retrospective cohort designs and results were often inconsistent. Study quality was assessed using the Joanna Briggs Critical Appraisal Tools. As a group, the studies exhibited substantial risk for bias. Based on the findings, infants who struggle with feeding preoperatively, experience increased nil per os duration and/or low oral feeding volume postoperatively, experience increased duration of mechanical ventilation, or have vocal cord dysfunction may be at risk for tube feeding at hospital discharge. Factors warranting further examination include cardiac physiology (e.g., aortic arch obstruction) and the relationship between neurodevelopment and oral feeding. Clinicians should use caution in assuming risk for an individual and prioritize early implementation of interventions that facilitate oral feeding development.
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Kim EY, Chang SO. A Meta-Synthesis Study of Person-Centered Care Experience from the Perspective of Nursing Home Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148576. [PMID: 35886426 PMCID: PMC9317621 DOI: 10.3390/ijerph19148576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/06/2022] [Accepted: 07/13/2022] [Indexed: 11/20/2022]
Abstract
Purpose: To systematically review and synthesize the evidence for the experience of person-centered care from the perspective of nursing home residents to understand their views in depth. Methods: The seven steps of Nobit and Hare’s meta-ethnography, a well-known meta-synthesis method, were applied. We used four databases for the literature search (PubMed, Web of Science, EMBASE, and CINAHL). Results: A total of seven studies were included for review. As a result of synthesizing the results, three themes (“promotion of mutual understanding through communication”, “care that acknowledges the independence of residents” and “finding the optimized state”) and six sub-themes were derived. Conclusions: This study has provided an in-depth understanding of person-centered care and will contribute to increasing its practical application.
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Affiliation(s)
- Eun-Young Kim
- College of Nursing, Korea University, Seoul 02841, Korea;
| | - Sung-Ok Chang
- College of Nursing, and BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul 02841, Korea
- Correspondence: ; Tel.: +82-2-3290-4918
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The Effect of Individual Nursing on Anxiety and Depression in Patients with Temporomandibular Disorders. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:7748696. [PMID: 35935326 PMCID: PMC9296338 DOI: 10.1155/2022/7748696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/12/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022]
Abstract
Objective This study aimed to explore the effects of individualized nursing in patients with temporomandibular disorders (TMD). Methods From June 2019 to April 2021, 80 patients with TMD were admitted to the First Affiliated Hospital of Wenzhou Medical University. Among them, 40 patients (control group, CG) received routine nursing and 40 patients (experimental group, EG) received individualized nursing. Functional exercise compliance, pain score, maximum mouth opening, nursing satisfaction questionnaire, self-rating anxiety scale, and self-rating depression scale were investigated. Results From June 2019 to April 2021, 81 patients with TMD were admitted to the First Affiliated Hospital of Wenzhou Medical University. Among them, 40 patients (control group) received routine care and 41 patients (experimental group) received individual care. There were no significant differences in mouth opening and pain score between the two groups before surgery (P > 0.05), but there were significant differences in mouth opening and pain score between the two groups 3 weeks after surgery. Patients' anxiety and depression were assessed by the SAS and SDS scores. Before nursing, the control group and experimental group (P < 0.05) had no significant difference. After nursing, the score of both groups decreased (P < 0.05). However, the score was lower in the experimental group, compared to the control group (P < 0.01). Conclusion In summary, individualized nursing can improve patients' physical condition and reduce negative emotions and complications. In light of this, the study needs further verification by a large sample randomized controlled trial.
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Kim KS, Lor M. Art Making as a Health Intervention: Concept Analysis and Implications for Nursing Interventions. ANS Adv Nurs Sci 2022; 45:155-169. [PMID: 35020607 PMCID: PMC9064896 DOI: 10.1097/ans.0000000000000412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Art making has been adopted across multiple disciplines as a health intervention. However, our understanding of art making as a health intervention and how it differs from art therapy is still limited. Therefore, we conducted a concept analysis to better understand art making as a health intervention guided by Walker and Avant's approach. We examined 85 studies in which we found 4 defining attributes, 4 antecedents, and physical, cognitive, emotional, and psychological consequences. We suggest several nursing research and practical implications for nurse researchers and clinicians to aid in designing and implementing art making health interventions.
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Affiliation(s)
- Kyung Soo Kim
- University of Iowa College of Nursing, Iowa City (Dr Kim); and University of Wisconsin-Madison School of Nursing, Madison (Dr Lor)
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14
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Cho H, Sagherian K, Scott LD, Steege LM. Occupational fatigue, individualized nursing care, and quality of nursing care among hospital nurses. J Nurs Scholarsh 2022; 54:648-657. [PMID: 35166443 DOI: 10.1111/jnu.12768] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/21/2021] [Accepted: 01/17/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE This study aimed to evaluate the relationships among nurse fatigue, individualized nursing care, and nurse-reported quality of care. DESIGN The study used a cross-sectional design. Data from 858 registered nurses providing bedside care in hospitals were collected between March and April 2021 in the United States. METHODS Participants completed a self-administered online survey, including the Occupational Fatigue Exhaustion Recovery scale, the Individualized Care Scale-Nurse version, and a single item assessing nursing care quality. Relationships among the study variables were examined using multiple linear and logistic regression models. FINDINGS Nurses' higher levels of acute fatigue were significantly associated with decreased perceptions of individualized nursing activities provided to patients on their last shifts, specifically related to personal life condition and decision-making control. Nurses' higher levels of chronic fatigue were significantly associated with decreased perception of individualized nursing activities provided to patients on their last shifts related to clinical condition, personal life condition, and decision-making control. Nurses with higher levels of acute or chronic fatigue, and who perceived their nursing care activities as less individualized were less likely to assess their quality of care as excellent. CONCLUSION These findings suggest that addressing hospital nurses' acute and chronic fatigue may contribute to promoting the delivery of individualized nursing care and in improving patients' quality of care. CLINICAL RELEVANCE Healthcare institutions are encouraged to regularly monitor and manage nurse fatigue to improve the delivery of individualized and quality nursing care to their patients.
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Affiliation(s)
- Hyeonmi Cho
- Beta Eta at-Large Chapter, Research Associate, School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Knar Sagherian
- Assistant Professor, College of Nursing, The University of Tennessee Knoxville, Knoxville, Tennessee, USA
| | - Linda D Scott
- Dean and Professor, School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Linsey M Steege
- Associate Dean for Research and Associate Professor, School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Mohr W, Rädke A, Afi A, Edvardsson D, Mühlichen F, Platen M, Roes M, Michalowsky B, Hoffmann W. Key Intervention Categories to Provide Person-Centered Dementia Care: A Systematic Review of Person-Centered Interventions. J Alzheimers Dis 2021; 84:343-366. [PMID: 34542075 PMCID: PMC8609709 DOI: 10.3233/jad-210647] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Person-centered care (PCC) is an important concept in many countries’ national guidelines and dementia plans. Key intervention categories, i.e., a taxonomy of person-centered (PC)-interventions, to provide person-centered dementia care, are difficult to identify from literature. Objective: This systematic review aimed to identify and categorize published PC-interventions into key intervention categories to guide the provision of person-centered dementia care. Methods: Conduct of this systematic review followed Cochrane guidelines. A search of the dimensions ‘Dementia’, ‘Person-Centered Care’, and ‘Intervention’ combined was performed in PubMed, EMBASE, and Web of Science. Study selection was based on 2-stage screening against eligibility criteria, limited to controlled study designs. Information about interventions and outcomes was extracted into an “Effects Table”. The identified PC-interventions were categorized in intervention categories to provide person-centered dementia care. Results: Searches identified 1,806 records. 19 studies were included. These covered a range of psychosocial interventions, oftentimes multi-component interventions, which followed heterogeneous approaches. Studies were conducted in long-term care/hospital settings. Nine key intervention categories were identified: social contact, physical activities, cognitive training, sensory enhancement, daily living assistance, life history oriented emotional support, training and support for professional caregivers, environmental adjustments, and care organization. Conclusion: Our findings provide a current overview of published PC-interventions in dementia, which followed heterogeneous approaches under the PCC-concept. The heterogeneity made it challenging to identify a well-defined concept of PCC and common key intervention categories. An effectiveness-evaluation of “PC” - including “relationship-centered”-interventions may be valuable, to assess whether an explicit focus on relationships around PCC-interventions yields an added benefit. PROSPERO-ID: CRD42021225084.
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Affiliation(s)
- Wiebke Mohr
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Anika Rädke
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Adel Afi
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - David Edvardsson
- Department of Nursing, Umeaa University, Umeaa, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Franka Mühlichen
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Moritz Platen
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Martina Roes
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Witten, Witten, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
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Jin Y, Peng Y. The Development of a Situation-Specific Nurse-Led Culturally Tailored Self-Management Theory for Chinese Patients With Heart Failure. J Transcult Nurs 2021; 33:6-15. [PMID: 34109881 DOI: 10.1177/10436596211023973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Self-management is essential for treating heart failure (HF). Culture influences the ability to cope, negotiate, and adopt self-management behaviors. However, current HF self-management interventions for Chinese patients do not take culture into consideration. The aim of this article is to describe the development of a situation-specific nurse-led culturally tailored self-management theory for Chinese patients with HF. METHODOLOGY An integrative approach was used as theory development strategy for the situation-specific theory. RESULTS Based on theoretical and empirical evidence, and theorists' experiences from research and practice, a nurse-led culturally tailored self-management theory for Chinese patients with HF was developed. DISCUSSION Researchers addressing health phenomena often have difficulty defining, conceptualizing, and operationalizing culture. The situation-specific theory developed in this study has the potential to increase specificity (i.e., logical adequacy and usefulness) of existing theories while informing the application to nursing practice. Further critique and testing of the situation-specific theory is warranted.
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Affiliation(s)
- Yuanyuan Jin
- University of Wisconsin-Madison, School of Nursing, Madison, WI, USA
| | - Youqing Peng
- Tongji University Affiliated Shanghai East Hospital, Shanghai, China
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17
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Kim KS, Kwekkeboom KL, Roberts T, Ward E. Biopsychosocial characteristics associated with engagement in art making among older adults. Geriatr Nurs 2021; 42:727-733. [PMID: 33839591 PMCID: PMC9891234 DOI: 10.1016/j.gerinurse.2021.03.011] [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: 12/01/2020] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 02/03/2023]
Abstract
In order to design patient-centered art making interventions for health and well-being, investigators need to understand the population of interest regarding their relationship to engagement in art making activities. This study, therefore, aimed to examine older adults' characteristics that were associated with engagement in art making activities, and to provide practical examples of how to use the identified characteristics. We conducted correlation analyses to evaluate such associations, using cross-sectional survey data from the 2014 Health and Retirement Study (n=731). Female sex, higher education, personality traits, positive attitude toward the arts, and a larger social network size were positively associated with engagement in art making activities (p<.05). Males and those with lower education could be targeted, while the type of art making activity could be tailored based on personality traits for patient-centered art making interventions. Future studies can use this information to empirically study art making interventions for older adults.
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Affiliation(s)
- Kyung Soo Kim
- University of Iowa College of Nursing, 50 Newton Rd, Iowa City, IA 52246, United States
| | - Kristine L Kwekkeboom
- University of Wisconsin School of Nursing, 701 Highland Ave, Madison, WI 53705, United States
| | - Tonya Roberts
- University of Wisconsin School of Nursing, 701 Highland Ave, Madison, WI 53705, United States
| | - Earlise Ward
- University of Wisconsin School of Nursing, 701 Highland Ave, Madison, WI 53705, United States
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18
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Cheung DST, Yeung WF, Chau PH, Lam TC, Yang M, Lai K, Ip CY, Lao L, Lin CC. Patient-centred, self-administered acupressure for Chinese advanced cancer patients experiencing fatigue and co-occurring symptoms: A pilot randomised controlled trial. Eur J Cancer Care (Engl) 2020; 31:e13314. [PMID: 32896014 DOI: 10.1111/ecc.13314] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 06/18/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the feasibility and potential effects of patient-centred self-administered acupressure for alleviating fatigue and co-occurring symptoms among Chinese advanced cancer patients receiving treatment. METHODS Thirty advanced cancer patients who screened positive for moderate/severe fatigue with symptoms of insomnia and/or pain were recruited from a hospital in Hong Kong. They were randomly assigned (1:1) to receive a 4-week patient-centred self-administered acupressure intervention or health education. Fatigue (primary outcome) and secondary outcomes (sleep quality, pain, fatigue-sleep disturbance-pain symptom cluster severity, anxiety, depression and quality of life) were measured by questionnaires and actigraphy. RESULTS Twenty-four participants (80%) completed the study. Adherence to self-administered acupressure practice was satisfactory, with all retained participants attending all sessions and 90.9% practising acupressure daily. All completers rated the class as very enjoyable or quite enjoyable. Fatigue, pain, symptom cluster severity, anxiety, depression and quality of life appeared to improve from baseline to post-intervention in the intervention group. Among these outcomes, only the between-group difference in anxiety post-intervention was significant. The group × time interaction effect was nonsignificant for all outcomes. CONCLUSIONS Patient-centred self-administered acupressure appears to be feasible and acceptable among advanced cancer patients. A fully powered trial is warranted to confirm the intervention effect.
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Affiliation(s)
- Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tai Chung Lam
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Mingxiao Yang
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kithelia Lai
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
| | - Chun Yat Ip
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Virginia University of Integrative Medicine, Virginia, United States
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong, China.,School of Nursing, College of Nursing, Taipei Medical University, Taiwan
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19
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Moga DC, Beech BF, Abner EL, Schmitt FA, El Khouli RH, Martinez AI, Eckmann L, Huffmyer M, George R, Jicha GA. INtervention for Cognitive Reserve Enhancement in delaying the onset of Alzheimer's Symptomatic Expression (INCREASE), a randomized controlled trial: rationale, study design, and protocol. Trials 2019; 20:806. [PMID: 31888732 PMCID: PMC6937673 DOI: 10.1186/s13063-019-3993-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 12/11/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The course of Alzheimer's disease (AD) includes a 10-20-year preclinical period with progressive accumulation of amyloid β (Aβ) plaques and neurofibrillary tangles in the absence of symptomatic cognitive or functional decline. The duration of this preclinical stage in part depends on the rate of pathologic progression, which is offset by compensatory mechanisms, referred to as cognitive reserve (CR). Comorbid medical conditions, psychosocial stressors, and inappropriate medication use may lower CR, hastening the onset of symptomatic AD. Here, we describe a randomized controlled trial (RCT) designed to test the efficacy of a medication therapy management (MTM) intervention to reduce inappropriate medication use, bolster cognitive reserve, and ultimately delay symptomatic AD. METHODS/DESIGN Our study aims to enroll 90 non-demented community-dwelling adults ≥ 65 years of age. Participants will undergo positron emission tomography (PET) scans, measuring Aβ levels using standardized uptake value ratios (SUVr). Participants will be randomly assigned to MTM intervention or control, stratified by Aβ levels, and followed for 12 months via in-person and telephone visits. Outcomes of interest include: (1) medication appropriateness (measured with the Medication Appropriateness Index (MAI)); (2) scores from Trail Making Test B (TMTB), Montreal Cognitive Assessment (MoCA), and California Verbal Learning Test (CVLT); (3) perceived health status (measured with the SF-36). We will also evaluate pre- to post-intervention change in: (1) use of inappropriate medications as measured by MAI; 2) CR Change Score (CRCS), defined as the difference in scopolamine-challenged vs unchallenged cognitive scores at baseline and follow-up. Baseline Aβ SUVr will be used to examine the relative impact of preclinical AD (pAD) pathology on CRCS, as well as the interplay of amyloid burden with inappropriate medication use. DISCUSSION This manuscript describes the protocol of INCREASE ("INtervention for Cognitive Reserve Enhancement in delaying the onset of Alzheimer's Symptomatic Expression"): a randomized controlled trial that investigates the impact of deprescribing inappropriate medications and optimizing medication regimens on potentially delaying the onset of symptomatic AD and AD-related dementias. TRIAL REGISTRATION ClinicalTrials.gov, NCT02849639. Registered on 29 July 2016.
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Affiliation(s)
- Daniela C Moga
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA.
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA.
- Sanders-Brown Center on Aging, Lexington, KY, USA.
| | | | - Erin L Abner
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA
- Sanders-Brown Center on Aging, Lexington, KY, USA
| | - Frederick A Schmitt
- Sanders-Brown Center on Aging, Lexington, KY, USA
- Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Riham H El Khouli
- Department of Radiology, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Ashley I Martinez
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA
| | - Lynne Eckmann
- PRO2RX LLC Pharmacy Consulting Services, Lexington, KY, USA
| | - Mark Huffmyer
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA
- PRO2RX LLC Pharmacy Consulting Services, Lexington, KY, USA
| | - Rosmy George
- Sanders-Brown Center on Aging, Lexington, KY, USA
| | - Gregory A Jicha
- Sanders-Brown Center on Aging, Lexington, KY, USA
- Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, USA
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20
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Rasing SPA, Stikkelbroek YAJ, Bodden DHM. Is Digital Treatment the Holy Grail? Literature Review on Computerized and Blended Treatment for Depressive Disorders in Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E153. [PMID: 31878249 PMCID: PMC6982181 DOI: 10.3390/ijerph17010153] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022]
Abstract
Computerized and blended treatments seem to be an attractive treatment for adolescents as an alternative to face-to-face treatment, but mental health professionals seem hesitant to use these treatment modalities. This review provides an overview of factors contributing to and withholding from using computerized or blended treatment in routine care. Three databases were searched with terms related to (1) adolescents, (2) depression, (3) computerized or blended, and (4) treatment. Of the 33 articles identified, 10 focused on unguided computerized treatments, six on guided, two on blended, two compared unguided, blended- and face-to-face treatment to no treatment, and eight studies on games. Further, two articles that were focused on an online monitoring tool and three on intervention characteristics or preferred modes of help-seeking. Evidence for effectiveness, adherence, drop-out, and forming therapeutic relations were suspected to be barriers, but are no reason to reject computerized or blended treatment. Improvement in mental health literacy and the possibility to tailor the intervention are facilitators. However, adolescents' intention to seek help, acceptability of computerized treatment, symptom severity, time spent by therapist, and other facilities are identified as barriers and they need to be taken into account when using computerized or blended interventions. Nevertheless, computerized and blended are promising treatments for depressed youth.
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Affiliation(s)
- Sanne P. A. Rasing
- Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands; (Y.A.J.S.); (D.H.M.B.)
- Child and Adolescent Psychiatry, GGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
| | - Yvonne A. J. Stikkelbroek
- Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands; (Y.A.J.S.); (D.H.M.B.)
- Child and Adolescent Psychiatry, GGZ Oost Brabant, P.O. Box 3, 5427 ZG Boekel, The Netherlands
| | - Denise H. M. Bodden
- Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands; (Y.A.J.S.); (D.H.M.B.)
- Developmental Psychopathology, Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
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21
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Tongpeth J, Du H, Barry T, Clark RA. Effectiveness of an Avatar application for teaching heart attack recognition and response: A pragmatic randomized control trial. J Adv Nurs 2019; 76:297-311. [DOI: 10.1111/jan.14210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/22/2019] [Accepted: 08/30/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Jintana Tongpeth
- Prachomklao College of Nursing Praboromrajchanok Institute Ministry of Public Health Muang Phetchaburi Thailand
| | - Huiyun Du
- College of Nursing & Health Sciences Flinders University Adelaide SA Australia
| | - Tracey Barry
- College of Nursing & Health Sciences Flinders University Adelaide SA Australia
| | - Robyn A. Clark
- College of Nursing & Health Sciences Flinders University Adelaide SA Australia
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Langberg EM, Dyhr L, Davidsen AS. Development of the concept of patient-centredness - A systematic review. PATIENT EDUCATION AND COUNSELING 2019; 102:1228-1236. [PMID: 30846206 DOI: 10.1016/j.pec.2019.02.023] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Patient-centredness is often linked to high-quality patient care, but the concept is not well-defined. This study aims to provide an overview of how patient-centredness has been defined in the literature since Mead and Bower's review in 2000, and to provide an updated definition of the concept. METHOD & DESIGN We performed a systematic literature search in PubMed to identify original articles with a sufficient definition of patient-centredness. We analysed extracted data defining patient-centredness. RESULTS Eighty articles were included. The dimensions "biopsychosocial", "patient-as-person", "sharing power and responsibility" and "therapeutic alliance" corresponded to four of five dimensions described by Mead and Bower. "Coordinated care" was a new dimension. CONCLUSION The identified dimensions are encompassed by three elements: the patient, the doctor-patient relationship and the framework of care i.e. the health care system. The additional focus on coordinated care could reflect increasing complexity of the health care system. PRACTICE IMPLICATIONS Narrowing down the understanding of patient-centredness to these three focus areas, viz. 1) understanding of the patients' experience of the illness in their life situation, 2) the professional's relationship with the patient, and 3) coordination of care in the system, could make the operationalisation and implementation of a patient-centred approach more manageable.
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Affiliation(s)
- Emil Mørup Langberg
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
| | - Lise Dyhr
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
| | - Annette Sofie Davidsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
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23
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Danaci E, Koç Z. The association of job satisfaction and burnout with individualized care perceptions in nurses. Nurs Ethics 2019; 27:301-315. [DOI: 10.1177/0969733019836151] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Individualized care is closely related to the fulfillment of nurses’ ethical responsibilities regarding the provision of healthcare as well as having a strong foundation in the philosophy of nursing. Objective: This study aimed to determine the association of job satisfaction and burnout with individualized care perceptions in nurses working at a university hospital located in the Central Black Sea region of northern Turkey. Research design: A cross-sectional correlational survey design. Participants and research context: The study was conducted between 15 February 2017 and 15 August 2017 with 419 nurses working at a public university hospital located in Samsun. Data were collected using an information form, the Individualized Care Scale-Nurse Version, the Minnesota Job Satisfaction Scale, and the Maslach Burnout Inventory. The Mann–Whitney U test, Kruskal–Wallis test and Spearman Correlation were used. Ethical considerations: Ethical approval for the study was obtained from the Ondokuz Mayıs University Clinical Studies Board of Ethics. Oral informed consent was taken from the participants. Findings: There was a significant positive relationship between the total Individualized Care Scale-A Nurse Version score and the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale (r = 0.121, p < 0.05). The total Individualized Care Scale-A Nurse Version score increased as the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale increased. There was a significant negative relationship between the total Individualized Care Scale-B Nurse Version score and the Desensitization (r = –0.143, p < 0.01) and Personal Achievement subscale scores of the Maslach Burnout Inventory (r = –0.182, p < 0.01). The Desensitization and Personal Achievement subscale scores of the Maslach Burnout Inventory increased as the total Individualized Care Scale-B Nurse Version score decreased. Discussion: Factors associated with the individualized care perceptions of nurses, such as job satisfaction and burnout levels and factors related to personal life and worklife should be taken into consideration. Also in order to increase job satisfaction and motivation in nurses, personal preferences regarding the service they want to work at should be taken into account. Conclusion: Nurses with lower burnout and higher job satisfaction were found to have higher individualized care perceptions and to support the individuality of patients in care applications. It is important to consider work-related factors associated with individualized care perceptions, job satisfaction, and burnout in nurses.
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Bounds DT, Edinburgh LD, Fogg LF, Saeywc EM. A nurse practitioner-led intervention for runaway adolescents who have been sexually assaulted or sexually exploited: Effects on trauma symptoms, suicidality, and self-injury. CHILD ABUSE & NEGLECT 2019; 90:99-107. [PMID: 30772751 DOI: 10.1016/j.chiabu.2019.01.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Adolescent victims of sexual assault and exploitation suffer significant mental health distress including PTSD, self-harm, suicidal ideation, and attempts. OBJECTIVE This longitudinal observational study investigated the Runaway Intervention Program's influence on trauma responses at 3, 6, and 12 months for adolescents who have run away at least once and have been sexually assaulted or exploited. PARTICIPANTS Runaways (n = 362) received nurse practitioner (NP) home and community visits, intensive case management, and optional empowerment groups. SETTING An urban Midwestern city's hospital-based Children's Advocacy Center. METHODS Trauma responses were measured by the UCLA PTSD-RI index, past 30 days emotional distress scale, and self-harm, suicidal ideation, and suicide attempt questions. Repeated Measures ANOVA assessed trauma response changes over time. Growth curve analyses using intervention doses determined which aspects of the intervention predicted change. RESULTS From program entry to 3 and 6 months, mean values decreased significantly for emotional distress (-0.67, -.91) self-harm (-.30, -.55), suicidal ideation (-.45, -.57), suicide attempts (-.58, -.61), and trauma symptoms (-11.8, -16.2, all p < .001) all maintained at 12 months. In growth curve models, NP visits independently predicted declines in emotional distress (-.038), self-injury (-.020), suicidal ideation (-.025) and attempts (-.032), while empowerment groups predicted trauma symptoms (-.525) and all others except suicide attempts. CONCLUSIONS The program, especially NP community visits and empowerment group elements, decreased trauma responses in runaway youth with a history of sexual assault. Given high rates of PTSD and emotional distress among runaways, the Runaway Intervention Program offers promise for improving mental health outcomes.
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Affiliation(s)
- Dawn T Bounds
- Rush University Medical Center, College of Nursing, 600 S. Paulina St., AAC Suite 1080, Chicago, IL 60612, United States
| | - Laurel D Edinburgh
- Midwest Children's Resource Center, Children's Hospital of Minnesota, 347 N. Smith Ave., St. Paul, MN 55102, United States.
| | - Louis F Fogg
- Rush University Medical Center, College of Nursing, 600 S. Paulina St., AAC Suite 1080, Chicago, IL 60612, United States
| | - Elizabeth M Saeywc
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, BC V6T 2B5, Canada
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Celano CM, Gianangelo T, Millstein RA, Chung WJ, Wexler DJ, Park ER, Huffman JC. A positive psychology-motivational interviewing intervention for patients with type 2 diabetes: Proof-of-concept trial. Int J Psychiatry Med 2019; 54:97-114. [PMID: 30114958 PMCID: PMC6370502 DOI: 10.1177/0091217418791448] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Eighteen million Americans with type 2 diabetes (T2D) do not follow recommended guidelines for physical activity. Motivational interviewing (MI) has had modest effects on activity and related behaviors in T2D. Positive psychological attributes (e.g., optimism) are associated with superior medical outcomes in T2D, and positive psychology (PP) interventions promote such attributes. There had been no study in T2D of a combined PP-MI intervention to promote well-being and health behavior adherence. We developed a novel, telephone-delivered, 16-week PP-MI intervention and explored its feasibility and impact in T2D patients in a single-arm, proof-of-concept trial. METHOD Participants completed PP-based exercises and MI-based physical activity goal-setting activities and reviewed these activities weekly with a study trainer for 16 weeks. Feasibility and acceptability were assessed via exercise completion rates and post-exercise ratings of ease/utility (0-10 scales). Impact was explored by examining changes in physical activity (via accelerometers and self-report), other health behaviors, psychological measures, and medical outcomes (e.g., hemoglobin A1c (A1C)) from baseline to 16 weeks, using paired t tests. RESULTS Twelve participants enrolled, and 10 provided follow-up data. Seventy-eight percent of PP-MI activities were completed, and participants rated the PP-MI content and sessions as easy (mean = 8.2/10, standard deviation (SD) = 1.9) and useful (mean = 9.1/10, SD = 1.5). PP-MI was associated with improved adherence to health behaviors and overall self-care, variable effects on accelerometer-measured activity and psychological outcomes, and modest beneficial effects on body mass index and A1C. CONCLUSION Further testing of this intervention is warranted in a larger, controlled trial to assess its effects on important health outcomes.
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Affiliation(s)
- Christopher M. Celano
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Taylor Gianangelo
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Rachel A. Millstein
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Wei-Jean Chung
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Deborah J. Wexler
- Harvard Medical School, Boston, MA,MGH Diabetes Center, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Elyse R. Park
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Jeff C. Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
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Carlson M, Vigen CL, Rubayi S, Blanche EI, Blanchard J, Atkins M, Bates-Jensen B, Garber SL, Pyatak EA, Diaz J, Florindez LI, Hay JW, Mallinson T, Unger JB, Azen SP, Scott M, Cogan A, Clark F. Lifestyle intervention for adults with spinal cord injury: Results of the USC-RLANRC Pressure Ulcer Prevention Study. J Spinal Cord Med 2019; 42:2-19. [PMID: 28414254 PMCID: PMC6340272 DOI: 10.1080/10790268.2017.1313931] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CONTEXT/OBJECTIVE Medically serious pressure injuries (MSPrIs), a common complication of spinal cord injury (SCI), have devastating consequences on health and well-being and are extremely expensive to treat. We aimed to test the efficacy of a lifestyle-based intervention designed to reduce incidence of MSPrIs in adults with SCI. DESIGN A randomized controlled trial (RCT), and a separate study wing involving a nonrandomized standard care control group. SETTING Rancho Los Amigos National Rehabilitation Center, a large facility serving ethnically diverse, low income residents of Los Angeles County. PARTICIPANTS Adults with SCI, with history of one or more MSPrIs over the past 5 years: N=166 for RCT component, N=66 in nonrandomized control group. INTERVENTIONS The Pressure Ulcer Prevention Program, a 12-month lifestyle-based treatment administered by healthcare professionals, largely via in-home visits and phone contacts. OUTCOME MEASURES Blinded assessments of annualized MSPrI incidence rates at 12 and 24 months, based on: skin checks, quarterly phone interviews with participants, and review of medical charts and billing records. Secondary outcomes included number of surgeries and various quality-of-life measures. RESULTS Annualized MSPrI rates did not differ significantly between study groups. At 12 months, rates were .56 for intervention recipients, .48 for randomized controls, and .65 for nonrandomized controls. At follow-up, rates were .44 and .39 respectively for randomized intervention and control participants. CONCLUSIONS Evidence for intervention efficacy was inconclusive. The intractable nature of MSPrI threat in high-risk SCI populations, and lack of statistical power, may have contributed to this inability to detect an effect. TRIAL REGISTRATION ClinicalTrials.gov NCT01999816.
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Affiliation(s)
- Mike Carlson
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Cheryl L.P. Vigen
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA,Correspondence to: Cheryl L.P. Vigen, Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St. CHP 133, Los Angeles, CA 90089–9003, USA.
| | - Salah Rubayi
- Rancho Los Amigos National Rehabilitation Center, Downey, California, USA
| | - Erna Imperatore Blanche
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Jeanine Blanchard
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Michal Atkins
- Rancho Los Amigos National Rehabilitation Center, Downey, California, USA
| | - Barbara Bates-Jensen
- School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | - Susan L Garber
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Elizabeth A Pyatak
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Jesus Diaz
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Lucia I Florindez
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Joel W Hay
- Leonard Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, USA
| | - Trudy Mallinson
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Jennifer B Unger
- Institute for Health Promotion & Disease Prevention Research, University of Southern California, Los Angeles, California, USA
| | - Stanley Paul Azen
- Division of Biostatistics, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Michael Scott
- Rancho Los Amigos National Rehabilitation Center, Downey, California, USA
| | - Alison Cogan
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Florence Clark
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
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Lee H, Chalmers NI, Brow A, Boynes S, Monopoli M, Doherty M, Croom O, Engineer L. Person-centered care model in dentistry. BMC Oral Health 2018; 18:198. [PMID: 30497465 PMCID: PMC6267887 DOI: 10.1186/s12903-018-0661-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To achieve optimal health and oral health, the system of care must place a person and their social well-being at the center of decision making and understand factors spent outside the clinical settings, including individual behavior, context and lifestyle. MAIN TEXT Person-centered care offers a unique and compelling opportunity for dentistry, and its practitioners, to improve quality of care and overall health outcomes. For decades, the dominant treatment modalities within dentistry primarily focused on a surgical, treatment-oriented approach as opposed to health promotion and improvement. However, new business and care models are disrupting the dental care system, and transforming it into one that is focused on disease management and prevention-oriented primary care that considers overall health and well-being. We proposed a person-centered care model to improve oral health as an integral part of overall health. The model identified three key players who act as change agents with their respective roles and responsibilities: Person, provider, and health care system designer. CONCLUSIONS While previous person-centered models in dentistry focused on the role of providers within the clinical setting, this work emphasizes the role of the care designer in creating an environment where both person and provider are able to communicate effectively and achieve improved health outcomes.
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Affiliation(s)
- Hyewon Lee
- DentaQuest Institute, 10320 Little Patuxent Pkwy., Suite 200, Columbia, MD 21044 USA
- AcademyHealth, 1666 K Street NW, Suite 1100, Washington, DC, 20006 USA
| | - Natalia I. Chalmers
- DentaQuest Institute, 10320 Little Patuxent Pkwy., Suite 200, Columbia, MD 21044 USA
- Present address: U.S. Food and Drug Administration, Silver Spring, USA
| | - Avery Brow
- DentaQuest Institute, 10320 Little Patuxent Pkwy., Suite 200, Columbia, MD 21044 USA
| | - Sean Boynes
- DentaQuest Institute, 2400 Computer Dr, Westborough, MA 01581 USA
| | | | - Mark Doherty
- Safety Net Solutions, DentaQuest Institute, 2400 Computer Dr, Westborough, MA 01581 USA
| | - Olivia Croom
- DentaQuest Foundation, 465 Medford St, Boston, MA 02129 USA
| | - Lilly Engineer
- Department of Anesthesia and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205 USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 600 N. Wolfe St, Baltimore, MD 21205 USA
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Norris AE, Matsuda Y, Altares Sarik D, Pettigrew J. Implementation Quality: Implications for Intervention and Translational Science. J Nurs Scholarsh 2018; 51:205-213. [PMID: 30466163 DOI: 10.1111/jnu.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Implementation quality (IQ), a critical concept for translational science, measures the discrepancy between an intervention's intended design and its implementation. Quantifying the impact of IQ on intervention outcomes informs efforts to improve intervention translatability. The purpose of this article is to define and describe IQ and its dimensions (content adherence, quality of delivery, and engagement) with a focus on individualized interventions being delivered in research and practice settings. APPROACH We apply IQ concepts from intervention science in two contexts: (a) an intervention currently being investigated in an efficacy trial, and (b) a practice situation involving the application of evidence-based practice guidelines during clinic visits. IQ measurement approaches are presented using a study protocol, progress notes, interdisciplinary meeting notes, or clinical guidelines, depending upon whether the intervention is delivered during a research study or a clinical encounter. CONCLUSIONS The investigators describe the necessary infrastructure and support for capturing IQ data and the subsequent complexities and challenges of collecting, measuring, and analyzing these data. Understanding IQ is critical to advancing translational science. Such understanding informs application of appropriate IQ measures, and promotes effective translation of evidence-based interventions into practice. Policy changes are needed to promote IQ assessment to ensure high-quality clinical encounters during which interventions are effectively delivered. CLINICAL RELEVANCE In both research and practice settings, the conceptualization and measurement of IQ will improve patient outcomes by advancing translational science and integrating evidence-based interventions into nursing practice.
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Affiliation(s)
- Anne E Norris
- Professor, School of Nursing and Health Studies, University of Miami, Coral Gables, FL,, USA
| | - Yui Matsuda
- Beta Tau, Assistant Professor, School of Nursing and Health Studies, University of Miami, Coral Gables, FL,, USA
| | | | - Jonathan Pettigrew
- Assistant Professor, Hugh Downs School of Human Communication, Arizona State University, Tempe, AZ,, USA
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Fisher M, Pryor J, Capell J, Alexander T, Simmonds F. The psychometric properties of a modified client-centred rehabilitation questionnaire in an Australian population. Disabil Rehabil 2018; 42:122-129. [DOI: 10.1080/09638288.2018.1494214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Murray Fisher
- Sydney Nursing School, University of Sydney, Sydney, Australia
- Royal Rehab, Sydney, Australia
| | - Julie Pryor
- Sydney Nursing School, University of Sydney, Sydney, Australia
- Royal Rehab, Sydney, Australia
| | - Jacquelin Capell
- Australasian Rehabilitation Outcomes Centre (AROC), Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Tara Alexander
- Australasian Rehabilitation Outcomes Centre (AROC), Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Frances Simmonds
- Australasian Rehabilitation Outcomes Centre (AROC), Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
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Jones BA, Bouman WP, Haycraft E, Arcelus J. The Gender Congruence and Life Satisfaction Scale (GCLS): Development and validation of a scale to measure outcomes from transgender health services. INT J TRANSGENDERISM 2018; 20:63-80. [PMID: 32999594 PMCID: PMC6831013 DOI: 10.1080/15532739.2018.1453425] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: It is vital that the treatment offered at transgender health services can be evaluated to ensure a high quality of care. However, the tools currently used to evaluate treatment at transgender health services are limited by mainly focusing on mental health or because they have been developed for binary transgender people only. This study therefore aimed to develop and validate a tool that addresses these limitations. The Gender Congruence and Life Satisfaction Scale (GCLS) was developed through reviewing the literature, conducting interviews with transgender people, and holding discussions with experts working in transgender healthcare. An initial pool of items was developed and feedback on these was obtained. The tool was then validated. Method: For the validation of the tool, a total of 789 participants (451 transgender [171 transgender females, 147 transgender males, 133 people identifying as non-binary], and 338 cisgender [254 females, 84 males]) were recruited from the United Kingdom to test the factor structure and validity of the GCLS. Results: Exploratory factor analysis retained 38 items which formed seven subscales (psychological functioning; genitalia; social gender role recognition; physical and emotional intimacy; chest; other secondary sex characteristics; and life satisfaction). These seven subscales were found to have good internal consistency and convergent validity. The GCLS was also found to be capable of discriminating between groups (e.g., people who have and have not undergone gender affirming medical interventions). Transgender and cisgender subscale norms are provided for the GCLS. Conclusion: The GCLS is a suitable tool to use with the transgender population to measure health-related outcomes for both clinical and research purposes.
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Affiliation(s)
- Bethany A. Jones
- Nottingham Centre for Transgender Health, Nottingham, United Kingdom
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | | | - Emma Haycraft
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Jon Arcelus
- Nottingham Centre for Transgender Health, Nottingham, United Kingdom
- Division of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, United Kingdom
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Abstract
PROBLEM Nurses are uniquely positioned to implement behavior change interventions. Yet, nursing interventions have traditionally resulted from nurses problem-solving rather than allowing the patient to self-generate possible solutions for attaining specific health outcomes. PURPOSE The purpose of this review is to clarify the meaning of possible solutions in behavior change interventions. METHODS Walker and Avant's method on concept analysis serves as the framework for examination of the possible solutions. CONCLUSION Possible solutions can be defined as continuous strategies initiated by patients and families to overcome existing health problems. IMPLICATIONS FOR NURSING PRACTICE As nurses engage in behavior change interventions, supporting patients and families in problem-solving will optimize health outcomes and transform clinical practice.
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Affiliation(s)
- Diane E Mahoney
- Family Nurse Practitioner, Women's Health Care Nurse Practitioner, University of Missouri-Kansas City, School of Nursing and Health Studies, Kansas City, Missouri, PhD Student
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32
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Hanga K, DiNitto DM, Wilken JP, Leppik L. A person-centered approach in initial rehabilitation needs assessment: Experiences of persons with disabilities. ALTER-EUROPEAN JOURNAL OF DISABILITY RESEARCH 2017. [DOI: 10.1016/j.alter.2017.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Johnson HM, LaMantia JN, Brown CM, Warner RC, Zeller LM, Haggart RC, Stonewall K, Lauver DR. My Hypertension Education and Reaching Target (MyHEART): Development and Dissemination of a Patient-Centered Website for Young Adults with Hypertension. JMIR Cardio 2017; 1. [PMID: 29664482 PMCID: PMC5898439 DOI: 10.2196/cardio.8025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Young adults (18 to 39 years old) with hypertension have the lowest rates of blood pressure control (defined as blood pressure less than 140/90 mmHg) compared to other adult age groups. Approximately 1 in 15 young adults have high blood pressure, increasing their risk of future heart attack, stroke, congestive heart failure, and/or chronic kidney disease. Many young adults reported having few resources to address their needs for health education on managing cardiovascular risk. Objective The goal of our study was to develop and disseminate a website with evidence-based, clinical information and health behavior resources tailored to young adults with hypertension. Methods In collaboration with young adults, health systems, and community stakeholders, the My Hypertension Education and Reaching Target (MyHEART) website was created. A toolkit was also developed for clinicians and healthcare systems to disseminate the website within their organizations. The dissemination plan was guided by the Dissemination Planning Tool of the Agency for Healthcare Research and Quality (AHRQ). Results Google Analytics data were acquired for January 1, 2017 to June 29, 2017. The MyHEART website received 1090 visits with 2130 page views; 18.99% (207/1090) were returning visitors. The majority (55.96%, 610/1090) approached the website through organic searches, 34.95% (381/1090) accessed the MyHEART website directly, and 5.96% (65/1090) approached through referrals from other sites. There was a spike in site visits around times of increased efforts to disseminate the website. Conclusions The successfully implemented MyHEART website and toolkit reflect collaborative input from community and healthcare stakeholders to provide evidence-based, portable hypertension education to a hard-to-reach population. The MyHEART website and toolkit can support healthcare providers' education and counseling with young adults and organizations' hypertension population health goals.
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Affiliation(s)
- Heather M Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.,Health Innovation Program, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Jamie N LaMantia
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.,Health Innovation Program, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Colleen M Brown
- Health Innovation Program, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.,Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Ryan C Warner
- Health Innovation Program, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.,Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, WI, United States
| | - Laura M Zeller
- Health Innovation Program, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.,Department of Preventive Cardiology, University of Wisconsin Hospitals and Clinics, Madison, WI, United States
| | - Ryan C Haggart
- Health Innovation Program, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Keven Stonewall
- Health Innovation Program, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Diane R Lauver
- School of Nursing, University of Wisconsin, Madison, WI, United States
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Mosher CE, Ott MA, Hanna N, Jalal SI, Champion VL. Development of a Symptom Management Intervention: Qualitative Feedback From Advanced Lung Cancer Patients and Their Family Caregivers. Cancer Nurs 2017; 40:66-75. [PMID: 26925990 PMCID: PMC5001932 DOI: 10.1097/ncc.0000000000000350] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little is known about cancer patient and family caregiver preferences for the content and format of nonpharmacologic interventions. Revising interventions based on patient and caregiver feedback before implementation may improve intervention feasibility and acceptability, especially in the context of advanced-stage cancer. OBJECTIVES The aim of the study was to obtain feedback from patients with advanced-stage, symptomatic lung cancer and their family caregivers on the content and format of a nonpharmacologic symptom management intervention under development. The intervention blended evidence-based cognitive-behavioral and emotion-focused strategies to reduce physical and psychological symptoms. METHODS Semistructured qualitative interviews were conducted with 21 patients with advanced-stage, symptomatic lung cancer and caregivers. Participants reviewed handouts regarding intervention components and provided feedback. RESULTS Patients and caregivers desired intervention components that addressed the patient's high symptom burden such as education regarding treatment adverse effects and the provision of various coping tools. Offering interventions with a brief or flexible length and delivering them via telephone were other suggestions for enhancing intervention acceptability. Participants also preferred an equal focus on patient and caregiver concerns and a more positive intervention framework. CONCLUSIONS Intervention preferences of patients with advanced-stage lung cancer and caregivers underscore the severity of the disease and treatment process and the need to adapt interventions to patients with high symptom burden. These preferences may be incorporated into future intervention trials to improve participant recruitment and retention. IMPLICATIONS FOR PRACTICE Nurses can modify interventions to meet the needs of patients with advanced-stage, symptomatic lung cancer and caregivers. For example, flexibility regarding intervention content and length may accommodate those with significant symptoms.
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Affiliation(s)
- Catherine E Mosher
- Author Affiliations: Department of Psychology, Indiana University-Purdue University Indianapolis (Dr Mosher); and Departments of Pediatrics (Dr Ott) and Medicine (Drs Hanna and Jalal), School of Medicine, and School of Nursing (Dr Champion), Indiana University, Indianapolis
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Bhattacharya A, Vilardaga R, Kientz JA, Munson SA. Lessons from Practice: Designing Tools to Facilitate Individualized Support for Quitting Smoking. ACM TRANSACTIONS ON COMPUTER-HUMAN INTERACTION : A PUBLICATION OF THE ASSOCIATION FOR COMPUTING MACHINERY 2017; 2017:3057-3070. [PMID: 29123362 PMCID: PMC5675113 DOI: 10.1145/3025453.3025725] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Many health care providers, with a variety of trainings, counsel clients on quitting smoking on a day-to-day basis. In their clinical practice, they draw from and adapt guidelines and research-based strategies to fit individual client situations and challenges. Designers of technologies to support quitting smoking can learn from these real world practices to create tools that better adapt to individual differences. We present findings from interviews with 28 providers with diverse experiences in smoking cessation counselling. Through analysis of their individualization strategies, challenges, and perceptions of technology, we find that providers: (1) individualize context appropriate coping strategies by involving clients in brainstorming, (2) emphasize the need to support nicotine withdrawal in clients, (3) mitigate social triggers and mediate social support for clients, and (4) need to navigate dependencies with other providers for managing medications and comorbid health conditions of clients. With this empirical understanding, we extend the discussion on the design of technology to support quitting smoking, highlight current barriers to individualization, and suggest future opportunities to address these barriers.
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Affiliation(s)
- Arpita Bhattacharya
- Human Centered Design and Engineering, DUB Group, University of Washington, Seattle, USA
| | - Roger Vilardaga
- Psychiatry and Behavioral Sciences, Duke University, Durham, USA
| | - Julie A Kientz
- Human Centered Design and Engineering, DUB Group, University of Washington, Seattle, USA
| | - Sean A Munson
- Human Centered Design and Engineering, DUB Group, University of Washington, Seattle, USA
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Development and Assessment of the Feasibility of a Nurse-Led Care Program for Cancer Patients in a Chemotherapy Day Center: Results of the Pilot Study. Cancer Nurs 2016; 38:E1-12. [PMID: 25254408 DOI: 10.1097/ncc.0000000000000192] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The increasing number of cancer patients and inadequate communication in clinics are posing challenges to cancer patients receiving outpatient-based chemotherapy and healthcare providers. A nurse-led care program was proposed as one way of dealing with at least some of these challenges. OBJECTIVE The objectives of the pilot study were to assess the feasibility of the subject recruitment, care, and data collection procedures and to explore the acceptability of this program. METHODS A pilot study with a 1-group pretest-posttest design was conducted. Five cancer patients receiving chemotherapy in a chemotherapy day center participated. Each patient had a nurse consultation before chemotherapy and received 2 telephone calls after the first and second cycles of chemotherapy. Four questionnaires were adopted to evaluate the subjects' quality of life, self-efficacy, symptom experiences, and satisfaction with care. Questionnaires were completed before the chemotherapy and after the second cycle. The subjects were also interviewed to understand their comments on the service. RESULTS The recruitment, care, and data collection procedures were completed smoothly. Slight changes were observed in quality of life and self-efficacy. All 5 subjects were highly satisfied with the care. CONCLUSIONS The nurse-led care program is feasible and acceptable. IMPLICATIONS FOR PRACTICE The effect of the nurse-led care program will be evaluated in a single-center, open, randomized controlled trial. If the encouraging results can be confirmed, it may be an effective approach to improving the quality of ambulatory chemotherapy care. It would also shed light on the development of nurse-led care in other areas.
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Parsons JGM, Plant SE, Slark J, Tyson SF. How active are patients in setting goals during rehabilitation after stroke? A qualitative study of clinician perceptions. Disabil Rehabil 2016; 40:309-316. [DOI: 10.1080/09638288.2016.1253115] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- John G. M. Parsons
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- The Institute of Healthy Ageing, Waikato District Health Board, Hamilton, New Zealand
| | - Sarah E. Plant
- Stroke & Vascular Research Centre, School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, United Kingdom
| | - Julia Slark
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- The Institute of Healthy Ageing, Waikato District Health Board, Hamilton, New Zealand
| | - Sarah F. Tyson
- Stroke & Vascular Research Centre, School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, United Kingdom
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Albarracín D, Wilson K, Durantini MR, Sunderrajan A, Livingood W. A meta-intervention to increase completion of an HIV-prevention intervention: Results from a randomized controlled trial in the state of Florida. J Consult Clin Psychol 2016; 84:1052-1065. [PMID: 27786499 DOI: 10.1037/ccp0000139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE A randomized control trial with 722 eligible clients from a health department in the State of Florida was conducted to identify a simple, effective meta-intervention to increase completion of an HIV-prevention counseling program. METHOD The overall design involved 2 factors representing an empowering and instrumental message, as well as an additional factor indicating presence or absence of expectations about the counseling. Completion of the 3-session counseling was determined by recording attendance. RESULTS A logistic regression analysis with the 3 factors of empowering message, instrumental message, and presence of mediator measures, as well as all interactions, revealed significant interactions between instrumental and empowering messages and between instrumental messages and presence of mediator measures. Results indicated that (a) the instrumental message alone produced most completion than any other message, and (b) when mediators were not measured, including the instrumental message led to greater completion. CONCLUSIONS The overall gains in completion as a result of the instrumental message were 16%, implying success in the intended facilitation of counseling completion. The measures of mediators did not detect any experimental effects, probably because the effects were happening without much conscious awareness. (PsycINFO Database Record
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Affiliation(s)
- Dolores Albarracín
- Department of Psychology and Marketing, University of Illinois at Urbana Champaign
| | | | - Marta R Durantini
- Department of Psychology, University of Illinois at Urbana Champaign
| | | | - William Livingood
- Department of Office of the Dean, College of Medicine, University of Florida, Jacksonville
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Chen CX, Kwekkeboom KL, Ward SE. Beliefs About Dysmenorrhea and Their Relationship to Self-Management. Res Nurs Health 2016; 39:263-76. [PMID: 27177093 PMCID: PMC7509811 DOI: 10.1002/nur.21726] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Dysmenorrhea is highly prevalent and is the leading cause of work and school absences among women of reproductive age. However, self-management of dysmenorrhea is not well understood in the US, and little evidence is available on factors that influence dysmenorrhea self-management. Guided by the Common Sense Model, we examined women's representations of dysmenorrhea (beliefs about causes, symptoms, consequences, timeline, controllability, coherence, and emotional responses), described their dysmenorrhea self-management behaviors, and investigated the relationship between representations and self-management behaviors. We conducted a cross-sectional, web-based survey of 762 adult women who had dysmenorrhea symptoms in the last six months. Participants had varied beliefs about the causes of their dysmenorrhea symptoms, which were perceived as a normal part of life. Dysmenorrhea symptoms were reported as moderately severe, with consequences that moderately affected daily life. Women believed they understood their symptoms moderately well and perceived them as moderately controllable but them to continue through menopause. Most women did not seek professional care but rather used a variety of pharmacologic and complementary health approaches. Care-seeking and use of self-management strategies were associated with common sense beliefs about dysmenorrhea cause, consequences, timeline, and controllability. The findings may inform development and testing of self-management interventions that address dysmenorrhea representations and facilitate evidence-based management. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Chen X Chen
- Postdoctoral Fellow, Indiana University School of Nursing, 600 Barnhill Drive, NU 414, Indianapolis, IN 46202
| | | | - Sandra E Ward
- Professor Emerita, School of Nursing, University of Wisconsin-Madison, Madison, WI
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Suhonen R, Charalambous A, Berg A, Katajisto J, Lemonidou C, Patiraki E, Sjövall K, Stolt M, Radwin L. Hospitalised cancer patients’ perceptions of individualised nursing care in four European countries. Eur J Cancer Care (Engl) 2016; 27. [DOI: 10.1111/ecc.12525] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2016] [Indexed: 12/17/2022]
Affiliation(s)
- R. Suhonen
- Department of Nursing Science; University of Turku; Turku Finland
- Turku University Hospital; Turku Finland
- City of Turku; Welfare Division; Turku Finland
| | - A. Charalambous
- Department of Nursing Studies; Cyprus University of Technology; Limassol Cyprus
- University of Turku; Turku Finland
| | - A. Berg
- Kristianstad University; Kristianstad Sweden
- University West; Trollhättan Sweden
| | - J. Katajisto
- Department of Mathematics and Statistics; University of Turku; Turku Finland
| | - C. Lemonidou
- Faculty of Nursing; National and Kapodistrian University of Athens; Athens Greece
| | - E. Patiraki
- Faculty of Nursing; National and Kapodistrian University of Athens; Athens Greece
| | - K. Sjövall
- Department of Health Sciences and Skåne University Hospital; Lund University; Lund Sweden
| | - M. Stolt
- Department of Nursing Science; University of Turku; Turku Finland
| | - L.E. Radwin
- Center for Healthcare Organization & Implementation Research (CHOIR); Veteran Administration Boston Healthcare System; Boston MA USA
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DuBois CM, Millstein RA, Celano CM, Wexler DJ, Huffman JC. Feasibility and Acceptability of a Positive Psychological Intervention for Patients With Type 2 Diabetes. Prim Care Companion CNS Disord 2016; 18:15m01902. [PMID: 27733954 PMCID: PMC5035810 DOI: 10.4088/pcc.15m01902] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 02/03/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Positive psychological attributes (eg, optimism) have been associated with a healthier lifestyle and superior medical outcomes in patients with type 2 diabetes; however, there has been minimal study of behavioral interventions that target positive psychological constructs in this population. Accordingly, we developed a novel, telephone-based, 12-week positive psychology intervention and assessed its feasibility and short-term impact in adults with type 2 diabetes and suboptimal health behavior adherence. METHOD This was a pilot and feasibility study in adult inpatients and outpatients at an urban academic medical center recruited between December 2013 and December 2014. Adult patients with (1) type 2 diabetes (meeting American Diabetes Association criteria, eg, glycated hemoglobin A1c [HbA1c] > 6.5% or fasting glucose > 126 mg/dL) and (2) suboptimal adherence (score < 15/18 on the Medical Outcomes Study Specific Adherence Scale items for medication, diet, and exercise) were eligible. Participants received a positive psychology manual, completed exercises (eg, writing a gratitude letter, performing acts of kindness), and reviewed these activities by phone with a study trainer over the 12-week study period. Feasibility and acceptability were assessed via exercise completion rates and postexercise ratings of ease/utility on 0-10 Likert scales. Longer-term efficacy was explored by examining changes in psychological states and health behaviors from baseline to 12 weeks using random-effects regression models and estimates of effect size. RESULTS A total of 15 participants enrolled; 12 participants provided complete baseline and follow-up data and were included in the analyses. Over 90% of these participants completed at least 2 exercises, and 75% completed a majority of the exercises. Participants rated the exercises as helpful (mean = 7.8/10) and easy to complete (mean = 7.1/10), and they reported improvements in optimism, gratitude, depression, anxiety, physical function, self-care, and health behaviors (Cohen d = 0.28-1.00). CONCLUSION A positive psychology intervention for suboptimally adherent patients with type 2 diabetes was feasible, acceptable, and associated with broad pre-post psychological and health behavior improvement in a small initial study. Further testing of this promising intervention is warranted. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02736084.
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Affiliation(s)
| | - Rachel A. Millstein
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Christopher M. Celano
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Deborah J. Wexler
- Harvard Medical School, Boston, Massachusetts
- MGH Diabetes Center, Department of Medicine, Massachusetts General Hospital, Boston
| | - Jeff C. Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
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Coulombe S, Radziszewski S, Meunier S, Provencher H, Hudon C, Roberge P, Provencher MD, Houle J. Profiles of Recovery from Mood and Anxiety Disorders: A Person-Centered Exploration of People's Engagement in Self-Management. Front Psychol 2016; 7:584. [PMID: 27199819 PMCID: PMC4844930 DOI: 10.3389/fpsyg.2016.00584] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/08/2016] [Indexed: 12/21/2022] Open
Abstract
Context: A shift toward person-centered care has been occurring in services provided to people with mood and anxiety disorders. Recovery is recognized as encompassing personal aspects in addition to clinical ones. Guidelines now recommend supporting people's engagement in self-management as a complementary recovery avenue. Yet the literature lacks evidence on how individualized combinations of self-management strategies used by people relate to their clinical and personal recovery indicators. Objectives: The aims of this study were to identify profiles underlying mental health recovery, describe the characteristics of participants corresponding to each profile, and examine the associations of profiles with criterion variables. Method: 149 people recovering from anxiety, depressive, or bipolar disorders completed questionnaires on self-management, clinical recovery (symptom severity), personal recovery (positive mental health), and criterion variables (personal goal appraisal, social participation, self-care abilities, coping). Results: Latent profile analysis (LPA) revealed three profiles. The Floundering profile included participants who rarely used self-management strategies and had moderately severe symptoms and the lowest positive mental health. The Flourishing profile was characterized by frequent use of self-empowerment strategies, the least severe symptoms, and the highest positive mental health. Participants in the Struggling profile engaged actively in several self-management strategies focused on symptom reduction and healthy lifestyle. They concomitantly reported high symptom severity and moderately high positive mental health. The study revealed that Floundering was associated with higher probabilities of being a man, being single, and having a low income. People in the Flourishing profile had the most favorable scores on criterion variables, supporting the profiles' construct validity. Discussion: The mixed portrait of Struggling participants on recovery indicators suggests the relationship between health engagement and recovery is more intricate than anticipated. Practitioners should strive for a holistic understanding of their clients' self-management strategies and recovery indicators to provide support personalized to their profile. While people presenting risk factors would benefit from person-centered support, societal efforts are needed in the long term to reduce global health inequalities. The integration of constructs from diverse fields (patient-centered care, chronic illness, positive psychology) and the use of person-oriented analysis yielded new insights into people's engagement in their health and well-being.
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Affiliation(s)
- Simon Coulombe
- Department of Psychology, Université du Québec à Montréal, Montréal QC, Canada
| | | | - Sophie Meunier
- Department of Psychology, Université du Québec à Montréal, Montréal QC, Canada
| | | | - Catherine Hudon
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke Sherbrooke, QC, Canada
| | - Pasquale Roberge
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke Sherbrooke, QC, Canada
| | | | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, MontréalQC, Canada; Research Centre, Institut universitaire en santé mentale de Montréal, MontréalQC, Canada
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Backonja U, Robledo CA, Wallace ME, Flores KF, Kiely M. Reproductive Health Knowledge among African American Women Enrolled in a Clinic-Based Randomized Controlled Trial to Reduce Psychosocial and Behavioral Risk: Project DC-HOPE. Womens Health Issues 2016; 26:442-51. [PMID: 27094910 DOI: 10.1016/j.whi.2016.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 02/19/2016] [Accepted: 03/08/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Washington, DC, has among the highest rates of sexually transmitted infections and unintended pregnancy in the United States. Increasing women's reproductive health knowledge may help to address these reproductive health issues. This analysis assessed whether high-risk pregnant African American women in Washington, DC, who participated in an intervention to reduce behavioral and psychosocial risks had greater reproductive health knowledge than women receiving usual care. METHODS Project DC-HOPE was a randomized, controlled trial that included pregnant African American women in Washington, DC, recruited during prenatal care (PNC). Women in the intervention group were provided reproductive health education and received tailored counseling sessions to address their psychosocial and behavioral risk(s) (cigarette smoking, environmental tobacco smoke exposure, depression, and intimate partner violence). Women in the control group received usual PNC. Participants completed a 10-item reproductive knowledge assessment at baseline (n = 1,044) and postpartum (n = 830). Differences in total reproductive health knowledge scores at baseline and postpartum between groups were examined via χ(2) tests. Differences in postpartum mean total score by group were assessed via multiple linear regression. RESULTS Women in both groups and at both time points scored approximately 50% on the knowledge assessments. At postpartum, women in the intervention group had higher total scores compared with women receiving usual care (mean 5.40 [SD 1.60] vs. 5.03 [SD 1.53] out of 10, respectively; p < .001). CONCLUSIONS Although intervention participants increased reproductive health knowledge, overall scores remained low. Development of interventions designed to impart accurate, individually tailored information to women may promote reproductive health knowledge among high-risk pregnant African American women residing in Washington, DC.
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Affiliation(s)
- Uba Backonja
- Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland.
| | - Candace A Robledo
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland
| | - Maeve E Wallace
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland
| | - Katrina F Flores
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland
| | - Michele Kiely
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland
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Outcomes mapping study for childhood vaccination communication: too few concepts were measured in too many ways. J Clin Epidemiol 2016; 72:33-44. [DOI: 10.1016/j.jclinepi.2015.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/23/2015] [Accepted: 10/02/2015] [Indexed: 11/22/2022]
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A proposed model of person-, family-, and culture-centered nursing care. Nurs Outlook 2016; 64:352-366. [PMID: 27061841 DOI: 10.1016/j.outlook.2016.02.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 01/06/2016] [Accepted: 02/28/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND For decades person-, patient-, family-centered, and culturally competent care models have been evolving and conceptualized in the literature as separate. To our knowledge, there has not been a systematic approach to comparing all four of these conceptual models of care. PURPOSE To explicate and compare four conceptual care models: person-, patient-, family-centered, and culturally competent care. METHODS A comparative concept analysis informed by Rogers' evolutionary concept analysis was used to compare 32 nursing research on person-, patient-, family-centered care, and culturally-competent care published between 2009 and 2013. RESULTS Collective results of analyses of 32 nursing research articles found 12 attributes: collaborative relationship, effective communication, respectful care, holistic perspective, individualized care, inter-professional coordination, self-awareness, empowerment, family as unit of care, interpersonal relationships, cultural knowledge, and cultural skills. Antecedents included: lack of empirical evidence, poor patient outcomes, implementation problems, knowledge deficits, patient/parent emotional distress, poor patient-provider relationships, and health disparities. Consequences included: improved health-related outcomes, increased satisfaction, enhanced patient/family-provider relationships, reduced hospitalization, improved quality of life, improved quality of parent-child relationships, increased trust, enrollment in research, insights about biases, and appreciation for cultural differences. Social justice, advocated by scholars and national organizations, was absent from all studies. CONCLUSIONS Findings informed the proposed blended conceptual care framework that embraces the attributes of each care model and includes social justice.
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Köberich S, Feuchtinger J, Farin E. Factors influencing hospitalized patients' perception of individualized nursing care: a cross-sectional study. BMC Nurs 2016; 15:14. [PMID: 26937220 PMCID: PMC4774135 DOI: 10.1186/s12912-016-0137-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 02/24/2016] [Indexed: 11/30/2022] Open
Abstract
Background Individualized care is a cornerstone of patient-centered nursing care. To foster individualized care, influencing factors should be known. The aim of this study was to identify the individual and organizational factors influencing hospitalized patients’ perception of individualized care. Methods A cross-sectional study was conducted of 606 patients from 20 wards from five hospitals across Germany. Individualized care and potential influencing factors were assessed via structured questionnaires. To identify influencing factors, we applied a hierarchical linear model with two levels. Results Self-rated health, length of ward stay, educational level and shared decision-making process about nursing care were perceived to influence individualized care. A higher rating of health and longer ward stay correlated with improved perceptions of individualized nursing care. In addition, an educational level of nine or fewer years and a perceived shared decision-making process about nursing care positively influenced the perception of nursing care as being tailored to individual needs. Conclusions Several factors influence patients’ perception of individualized care. However, only the decision-making process can be actively influenced by nurses. Therefore, nurses should be encouraged to promote shared decision-making regarding patients’ nursing care. Trial number DRKS00005174 (Date of registration: 2013/08/01).
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Affiliation(s)
- Stefan Köberich
- Institute for Quality Management and Social Medicine, Medical Center - University of Freiburg, Engelbergerstr. 21, 79106 Freiburg, Germany ; Pflegedirektion, Heart Center - University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Johanna Feuchtinger
- Quality and Development in Nursing Care, Medical Center - University of Freiburg, Breisacher Str. 62, Freiburg, Germany
| | - Erik Farin
- Institute for Quality Management and Social Medicine, Medical Center - University of Freiburg, Engelbergerstr. 21, 79106 Freiburg, Germany
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Kain ZN, Fortier MA, Chorney JM, Mayes L. Web-based tailored intervention for preparation of parents and children for outpatient surgery (WebTIPS): development. Anesth Analg 2015; 120:905-14. [PMID: 25790212 DOI: 10.1213/ane.0000000000000610] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND As a result of cost-containment efforts, preparation programs for outpatient surgery are currently not available to the majority of children and parents. The recent dramatic growth in the Internet presents a unique opportunity to transform how children and their parents are prepared for surgery. In this article, we describe the development of a Web-based Tailored Intervention for Preparation of parents and children undergoing Surgery (WebTIPS). DEVELOPMENT OF PROGRAM A multidisciplinary taskforce agreed that a Web-based tailored intervention consisting of intake, matrix, and output modules was the preferred approach. Next, the content of the various intake variables, the matrix logic, and the output content was developed. The output product has a parent component and a child component and is described in http://surgerywebtips.com/about.php. The child component makes use of preparation strategies such as information provision, modeling, play, and coping skills training. The parent component of WebTIPS includes strategies such as information provision, coping skills training, and relaxation and distraction techniques. A reputable animation and Web design company developed a secured Web-based product based on the above description. CONCLUSIONS In this article, we describe the development of a Web-based tailored preoperative preparation program that can be accessed by children and parents multiple times before and after surgery. A follow-up article in this issue of Anesthesia & Analgesia describes formative evaluation and preliminary efficacy testing of this Web-based tailored preoperative preparation program.
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Affiliation(s)
- Zeev N Kain
- From the *Department of Anesthesiology and Perioperative Care, University of California, Irvine, Orange, California; †UCI Center on Stress & Health, University of California, Irvine, Orange, California; ‡Child Study Center, Yale University, New Haven, Connecticut; §Departments of Anesthesiology, Pain Management and Perioperative Medicine, and Psychology, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia; and ∥Departments of Pediatrics and Psychology, Yale University, New Haven, Connecticut
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Fortier MA, Bunzli E, Walthall J, Olshansky E, Saadat H, Santistevan R, Mayes L, Kain ZN. Web-based tailored intervention for preparation of parents and children for outpatient surgery (WebTIPS): formative evaluation and randomized controlled trial. Anesth Analg 2015; 120:915-22. [PMID: 25790213 DOI: 10.1213/ane.0000000000000632] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The purpose of this 2-phase project was to conduct a formative evaluation and to test the preliminary efficacy of a newly developed Web-based Tailored Intervention for Preparation of parents and children undergoing Surgery (WebTIPS). METHODS Phase 1 enrolled 13 children 2 to 7 years of age undergoing outpatient elective surgery and their parents for formative evaluation of WebTIPS. Parent participation focus groups are common in qualitative research and are a method of asking research participants about their perceptions and attitudes regarding a product or concept. In phase 2, children 2 to 7 years of age in 2 medical centers were assigned randomly to receive the WebTIPS program (n = 38) compared with children receiving the standard of care (n = 44). The primary outcome of phase II was child and parent preoperative anxiety. RESULTS In phase 2, parents reported WebTIPS to be both helpful (P < 0.001) and easy to use (P < 0.001). In phase 2, children in the WebTIPS group (36.2 ± 14.1) were less anxious than children in the standard of care group (46.0 ± 19.0) at entrance to the operating room (P = 0.02; Cohen d = 0.59) and introduction of the anesthesia mask (43.5 ± 21.7 vs 57.0 ± 21.2, respectively, P = 0.01; Cohen d = 0.63). Parents in the WebTIPS group (32.1 ± 7.4) also experienced less anxiety compared with parents in the control group (36.8 ± 7.1) in the preoperative holding area (P = 0.004; Cohen d = 0.65). CONCLUSIONS WebTIPS was well received by parents and children and led to reductions in preoperative anxiety.
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Affiliation(s)
- Michelle A Fortier
- From the *Department of Anesthesiology and Perioperative Care, University of California, Irvine School of Medicine, Irvine, California; †UCI Center on Stress & Health, Irvine, California; ‡Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut; §School of Nursing Science, University of California, Irvine, Irvine, California; ∥Child Life Department, Children's Hospital of Orange County, Orange, California; ¶Child Study Center, Yale University, New Haven, Connecticut
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Jakimowicz S, Perry L. A concept analysis of patient-centred nursing in the intensive care unit. J Adv Nurs 2015; 71:1499-517. [PMID: 25720454 DOI: 10.1111/jan.12644] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 11/28/2022]
Abstract
AIM To report an analysis of the concept of patient-centred nursing in the context of intensive care. BACKGROUND Clarification of patient-centred nursing in the intensive care unit is important because consensus definition of this concept is lacking. The severely compromised physiological state of these people and the sequelae of this differentiate patient-centred nursing in intensive care from that occurring in other hospital settings. While the broad concept has been analysed, it has not been examined in the context of intensive care. DESIGN Concept analysis. DATA SOURCES CINAHL, PsycINFO, Medline and PubMed databases (2000-2014) were searched. Peer-reviewed papers were identified and reference lists of relevant articles searched. METHODS Walker and Avant's eight-stage approach was used. RESULTS Patient-centred nursing in the intensive care unit incorporates antecedents of a physiologically compromised patient requiring biomedical intervention, a professional and competent nurse and organizational support. The concept's defining attributes entail maintenance of patient identity by a compassionate and professional nurse exercising biomedical expertise. Consequences include patient satisfaction, positive patient experience, nurse job satisfaction and better nurse workforce retention. CONCLUSION Patient-centred nursing in intensive care is differentiated from other healthcare areas by the particular characteristics of critically ill patients, the critical care environment and the challenging bio-psycho-social demands made on intensive care nurses. Effective patient-centred nursing in this environment promotes beneficial outcomes for patients, nurses and healthcare service. Decision-makers and policymakers should support critical care nurses in this challenging role, to maintain delivery of patient-centred nursing and grow an effective nursing workforce.
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Affiliation(s)
- Samantha Jakimowicz
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Lin Perry
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia
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Vanderboom CE, Thackeray NL, Rhudy LM. Key factors in patient-centered care coordination in ambulatory care: Nurse care coordinators' perspectives. Appl Nurs Res 2015; 28:18-24. [DOI: 10.1016/j.apnr.2014.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 03/04/2014] [Accepted: 03/08/2014] [Indexed: 10/25/2022]
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