The roles of community health nurses for older adults during the COVID-19 pandemic in Northeastern Thailand: A qualitative study

Nursing interventions in a newly established community health nursing system: A cross sectional survey

Background

Community health nursing was introduced in Austria in 2022. Information about nurses' activities, their alignment with established public health frameworks, and their relationship to existing care services is crucial for understanding the role's implementation and potential impact.

Objective

This study examines the activities of the first cohort of Austrian Community Health Nurses, focusing on their alignment with the Public Health Intervention Wheel and the Nursing Intervention Classification. An important aspect comes from the question, whether these new services complement or substitute existing direct care services. In this process, we also address heterogeneity across urbanization levels.

Design

Cross-sectional survey.

Settings

An online survey (April to June 2023) among Community Health Nurses captured their perception of activity frequencies based on the Public Health Intervention Wheel and Nursing Intervention Classification.

Participants

130 nurses (59 %, N = 220) answered >6 (out of 33) questions, 98 nurses (45 %, N = 220) provided all required information.

Methods

The analysis used descriptive statistics, statistical tests, and hierarchical cluster analysis, employing Excel®, Stata® and R.

Results

Austrian Community Health Nurses implement many principles of the Public Health Intervention Wheel, with a focus on counselling, consultation, and health teaching. Direct care interventions (according the Nursing Intervention Classification) are rarely performed. Findings indicate that community health nurses complement rather than substitute existing direct care and home nursing services. However, unlike international practices, activities are primarily at the individual level, with limited engagement at community and systems levels.

Conclusions

Community health nursing in Austria demonstrates a public health focus and therefore complements existing care services. However, it focuses primarily at the individual level, which differs from international norms where activities span individual, community, and systems levels.

Tweetable abstract

First Austrian Community Health Nurses implement public health intervention principles mainly on individual level.

Community Nursing: A Time and Motion Study of Community Nurses' Work and Workload

AIM

To explore activities performed by community nurses in community health centre clinics and during home visits.

DESIGN

Cross-sectional, observational using time and motion technique. Data collected during lockdown in 2020.

METHODS

Community nurses' work in clinics and during home visits were observed and recorded. The purposefully designed data collection tool covered six categories (Administration, Communication, Direct care, Documentation, Indirect care and Other) and 35 activities relative to community nurses' work.

RESULTS

Eight hundred and ten complete timings were obtained. Community nurses' time was most often (86.5%) spent on Direct care, Communication, Documentation and Other activities. Patient education occurred more often in the home.

CONCLUSIONS

The type, frequency and time taken to complete community nursing activities provides insight into the community nurse role. Addressing inefficient practices such as documentation and travel could serve to improve workload.

REPORTING METHOD

Adheres to EQUATOR guideline STROBE for cross-sectional studies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Roles and experiences of nurses in primary health care during the COVID-19 pandemic: a scoping review

BACKGROUND

Nurses form the frontline of the healthcare system's response to both epidemics and pandemics, and this was especially the case during the novel coronavirus disease (COVID-19) pandemic. Although the influence of COVID-19 on nursing roles has attracted interest, there is no integrated knowledge of nurses' roles and experiences in primary health care settings during the COVID-19 pandemic. Thus, this study identifies the roles and experiences of nurses in primary health care during the COVID-19 pandemic.

METHODS

A scoping review study design and the Joanna Briggs Institute methodology were used. The study searched five electronic databases (PubMed, CINAHL, EMBASE, Scopus, and PsychINFO) and included studies published in English from March 2020 to June 2023 that focused on the roles and experiences of nurses (participants) during COVID-19 (concept) in primary health care settings (context).

RESULTS

Fourteen articles were selected for review, involving a total of 1,487 nurses as study participants. The various roles undertaken by nurses in primary health care settings were categorized as comprehensive care providers, supporters and empowerers, coordinators and collaborators, information navigators, and change agents. Challenges and strategies are multilevel intrapersonal, interpersonal, organizational, community, and societal issues, but are not mutually exclusive.

CONCLUSIONS

The pandemic-induced challenges revealed primary health care nurses' vital and indispensable roles and resilience. They also fostered a heightened awareness of technological influence on the progression of primary health care in the current milieu. Policymakers and healthcare organizations need to integrate primary health care nurses' expanding and emerging roles within the scope of practice, ensuring their effective implementation without excessive regulatory constraints. This study emphasizes the importance of developing multilevel interventions to address the support needs of primary health care nurses through a system-based approach. Building a strong infrastructure to support nurses' self-care, offering continuing professional development opportunities, and securing official government recognition will be essential for enhancing the resilience of primary healthcare nurses in preparation for future, potentially devastating pandemics.

Compassionate care of nurses for the elderly admitted to the COVID-19 wards in teaching hospitals of southern Iran

BACKGROUND

Compassionate care is the main indicator of the quality regarding nursing care. The importance of this care in the recovery process for the elderly hospitalized for COVID-19 has been under-researched in studies. Therefore, this study aimed to determine the compassionate care level of nurses to the elderly hospitalized in the COVID-19 wards of teaching hospitals in the south of Iran.

METHODS

This descriptive-analytical study was conducted on 212 nurses working in the COVID-19 wards of teaching hospitals in the south of Iran, who were selected through census in a cross-sectional study. The data were collected using the Tehranineshat et al. nurses' compassionate care questionnaire and then the data were analyzed using descriptive and analytical statistics along with SPSS software version 22.

RESULTS

The mean score of nurses' compassionate care was 130.18 ± 9.42, which was at a high level. The highest and lowest scores were related to professional performance (43.17 ± 2.799) and empathic communication dimension (27.76 ± 2.970). No significant relationship was found between variables such as gender, marital status, education, work experience, and job position with the compassionate care score (P > 0.05).

CONCLUSION

Nurses providing care for hospitalized elderly are recommended to consider all aspects of compassionate care, especially empathic communication, in their educational planning.

Experiences of poverty amongst low-income older adults living in a high-income country: A qualitative study

AIM

To understand the experience of low-income older adults living in poverty in a high-income country.

DESIGN

A qualitative study based on Gadamer's hermeneutic phenomenology.

METHODS

A convenience sample of twenty-seven low-income older adults were interviewed in-depth between September 2021 and January 2022. Fleming's method for conducting phenomenological qualitative studies was followed and ATLAS.ti software was used for data analysis.

RESULTS

Three main themes were extracted from the analysis: (i) 'living in the shadow of poverty', (ii) 'unprotected by the 'social shield' of the welfare state' (iii) 'the struggle to attain good health'.

CONCLUSION

Living in poverty affects all spheres of life. Older adults living in poverty feel excluded from social support policies and laws. This has a negative impact on the older adults' mental health and can lead to social isolation.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Nursing interventions to promote health amongst older adults living in poverty should include an assessment of the patient's social determinants and a focus on increasing social participation. Older people living in poverty experience difficulties accessing formal social support so nurses should implement patient navigation interventions that aim to help them overcome the complexities of the system. Nursing interventions to improve mental health amongst older adults living in poverty are much needed.

IMPACT

Living in poverty increases older adults' vulnerability. Older adults living in poverty suffer from mental health issues as they live under constant pressure to meet their basic needs and lack formal social support. These findings are important for nurses, who play a pivotal role in the design, implementation and evaluation of policies and interventions that promote health equity.

REPORTING METHOD

The study has been conducted following the COREQ guidelines.

PATIENT OR PUBLIC CONTRIBUTION

There has been no public or patient involvement in the design or development of the study.

Lessons from China's Experience: Legal Analysis of Health Risks and Medical Obstacles of Personnel in COVID-19 Control Areas

Purpose

Individuals in controlled areas often face restrictions on their personal freedom, and if they are unable to receive medical treatment when needed, it can significantly increase their health risks. However, current epidemic prevention and control policies do not provide clear guidelines on how to ensure individuals in controlled areas to seek medical attention when faced with health problems. By implementing specific measures that local governments must take in order to protect the health of those in controlled areas, the risks to their health can be greatly reduced.

Patients and Methods

Our research utilizes a comparative approach to analyze the measures adopted by various regions for safeguarding the health of individuals in control areas, and the diverse outcomes they produce. We conduct empirical analysis and present examples of severe health risks that individuals in control areas face due to inadequate health protection measures. Furthermore, we conduct a critical evaluation of China's legal management of control areas, identifying both its principles and shortcomings.

Results

The lack of unified legal regulations has led some local governments to make some shortcomings in making decisions on epidemic prevention and control. Specifically, some governments have neglected to provide adequate medical protection for individuals in controlled areas, limited the authority of specific implementers of prevention policies, and failed to establish fair punishment mechanisms. These shortcomings have a direct impact on the health of those in controlled areas and can even lead to tragic outcomes.

Conclusion

Effective management of individuals in control areas during public health emergencies is crucial in reducing health risks. To achieve this, China needs to establish unified regulations and requirements, particularly with regards to medical protection, for individuals in control areas. Such measures can be achieved through the improvement of legislation, which can significantly reduce health risks faced by individuals in control areas during public health emergencies.