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Kabbadj K, Amekran Y, Damoun N, Taiek N, El Hangouche AJ. Sleep quality and shift work among Moroccan nurses: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:453. [PMID: 38464634 PMCID: PMC10920774 DOI: 10.4103/jehp.jehp_664_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/31/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND Sleep is vital for physical and mental health. The nursing profession is often associated with unique challenges when it comes to sleep quality. Nurses are often faced with irregular work schedules, including night shifts and rotations, high-stress levels, and significant job demands that can contribute to sleep problems and hinder their productivity at work. This study aimed to assess sleep quality in Moroccan nurses and to investigate the relationship between sleep quality and shift work. MATERIALS AND METHODS This was a cross-sectional study carried out between August 8, 2022 and September 30, 2022 among 260 nurses working day or night shifts in the province of Tétouan, northern Morocco. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality in day and night shift nurses. Data on sociodemographic characteristics and shift work were also collected. Descriptive and inferential statistical analyses were performed. Regression models were used to study the association between participant characteristics and sleep quality. RESULTS Among all participants, 60.4% had poor sleep quality. The results of the study revealed that there was no significant association between shift work and sleep quality among nurses in Morocco. CONCLUSION Given that the majority of nurses suffer from sleep disorders, an action plan to raise awareness and promote good sleep in this population should be implemented.
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Affiliation(s)
- Kaoutar Kabbadj
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Youssra Amekran
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Narjisse Damoun
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Nora Taiek
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Abdelkader Jalil El Hangouche
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
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Wahsheh MA, Hassan ZM. Association between mortality risk levels and AIFELL triage scores for suspected COVID-19 patients. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:454. [PMID: 38464647 PMCID: PMC10920775 DOI: 10.4103/jehp.jehp_604_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/31/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND It is crucial to examine and classify patients as soon as possible to save their lives when they display Coronavirus Disease of 2019 (COVID-19) symptoms. The Altered sense of smell/taste, Inflammation, Fever, Elevated Lactate dehydrogenase, and Lymphocytopenia (AIFELL) evaluation tool is quick, easy, and simple for medical professionals. OBJECTIVES Determine the relationship between the COVID-19 patient confirmation and the AIFELL score. Examine any relationships between the AIFELL score and the degree of mortality. MATERIALS AND METHODS A retrospective study was conducted on 970 hospitalized (18 years or older) with a COVID-19 diagnosis in 2021. Patients admitted to the intensive care unit (ICU) as critical cases and moderate cases. The Chi-square test was utilized. RESULTS The scores of the AIFELL tool ranged from 0 to 6 points; the AIFELL score for COVID-19 symptoms with a high score (4-6) made up 41.5% of the patients. More than half of the patients (58.7%) were men; the oldest age group ranged from 40 to 50 years. A very high risk of dying due to a positive COVID-19 virus exists in more than a fifth of patients (21.5%). The ICU (37.5%) received around a third of the patients. The findings showed significant associations between levels of mortality risk and gender and age. There were significant associations between AIFELL scores and mortality risk levels. AIFELL scores, mortality risk levels, and patient admissions to the critical care unit were strongly associated. CONCLUSION The AIFELL scores were excellent for predicting COVID-19 mortality risk levels and ICU admission.
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Affiliation(s)
- Moayad A. Wahsheh
- Department of Sport Rehabilitation, Faculty of Physical Education and Sport Sciences, The Hashemite University, Zarqa, Jordan
| | - Zeinab M. Hassan
- Department of Adult Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Parvaresh-Masoud M, Cheraghi MA, Imanipour M. Nurses' perception of emergency department overcrowding: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:449. [PMID: 38464660 PMCID: PMC10920764 DOI: 10.4103/jehp.jehp_1789_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/28/2023] [Indexed: 03/12/2024]
Abstract
INTRODUCTION One of the most important wards of the hospital is the emergency department (ED). Due to the increasing number of referrals, overcrowding has become a significant problem. It means an increase in patients' referrals and swarms at the ED, limiting their medical staff access. This study investigates the nurses' experiences and perceptions about the reasons for ED overcrowding. MATERIALS AND METHODS Twelve emergency nurses were purposefully selected to take part in this study. Data collection was through face-to-face semi-structured interviews until data saturation was finalized. Data analysis was conducted using Graneheim and Lundman's conventional content analysis. RESULTS Nurses' experiences with the reasons for ED overcrowding came into two main categories. The first was "increased referral to the emergency department," which had three subcategories: "increased referral due to health system reform plan," "increased referral due to corona pandemic," and "improper triage." The second was "increased patients' length of stay at the ED" with seven subcategories including "shortage of bed," "shortage of nursing staff," "lack of physical space," "turtle para-clinic," "on-call specialists' delay," "timely medical record documentation requirements," and "delaying in patients' transfer from the ED to the ward." CONCLUSION The results showed ED overcrowding is inevitable. Intentional or unintentional changes in the health system, such as implementing the health system reform plan or the corona pandemic, can also increase overcrowding. Findings showed ED overcrowding increased referrals and patients' length of stay. This study suggests the health system authorities pay more attention to this phenomenon and look for solutions.
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Affiliation(s)
- Mohammad Parvaresh-Masoud
- Department of Emergency Medicine, Paramedical Faculty, Qom University of Medical Sciences, Qom, Iran
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Cheraghi
- Department of Nursing Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoomeh Imanipour
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Saadatmehr SR, Vedadhir A, Sanagoo A, Jouybari L. Raising patients hope in despair: The culture of nursing care of burn pain: An ethnographic study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:451. [PMID: 38464633 PMCID: PMC10920761 DOI: 10.4103/jehp.jehp_1807_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/28/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND Although many studies have been carried out to address burn patients' pain and suffering, pain relief still remains an immense unsolved challenge with individual, social, and cultural aspects. MATERIAL AND METHODS This study was conducted aiming to investigate and explain nursing care in burn patients. This was a semifocused ethnographic research conducted in burns units in a referral teaching hospital (Mazandaran, Iran). The data were collected through descriptive, focused, and selective participant observations and ethnographic interviews with burns unit nurses selected via a purposeful sampling method. The collected data were analyzed on the basis of James Spradley's approach. RESULTS Three main categories and nine subcategories were obtained from data analysis that are as follows: 1) Bending over backward (tenacity, altruism, dedication, and conscience and constancy), 2) Prevention is worth a pound of cure (unique clinical methods, enhanced frustration tolerance through self-motivation and self-efficacy, raise patient's hope in despair), and 3) undisputed dominance of nursing art (reduced unsettling experiences, burnt and ripped body rehabilitation, patient stress management, and avoidance of false hope). CONCLUSIONS Although burn nurses are under huge physical and mental pressure, they enhance patients' pain tolerance through their art of nursing, which is a collection of empirical knowledge, huge work conscience, unique clinical skills, and various therapeutic communication techniques.
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Affiliation(s)
- Seyed Reza Saadatmehr
- Faculty of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abouali Vedadhir
- Department of Anthropology, Faculty of Social Sciences, University of Tehran, Tehran, Iran
| | - Akram Sanagoo
- Faculty of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | - Leila Jouybari
- Faculty of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
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Bahmaei J, Bahrami MA, Asadollahi A, Bastani P, Ravangard R. Older people's health promotion policies challenges: Making an avenue for policy responses in a developing country. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:428. [PMID: 38464659 PMCID: PMC10920687 DOI: 10.4103/jehp.jehp_1785_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/22/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND Older people's health policies suffer from many challenges in Iran. The issue is more highlighted considering the increasing rate of the older population in the country. This study aimed to explore the challenges of older people's health policies in Iran as well as make an avenue for policy responses. MATERIALS AND METHODS This study was a qualitative study that was conducted using conventional content analysis in 2020-2021 in Iran. The purposive and snowball sampling methods were used for semi-structured interviews with 30 selected participants. Data were analyzed through the content analysis approach using Granheim and Landman's five-step thematic method. RESULTS The results of analyzing the data were categorized into four main themes, 16 sub-themes, and 70 final codes. The main themes were executive, policymaking, intra- and inter-sectoral, and environmental challenges. CONCLUSIONS Older people are facing challenges in receiving appropriate and timely care. In order to achieve a wide national policy dialogue for covering all older people's health needs in policy agendas and better formulation and implementation of the policies, it is necessary for Iranian health policymakers to address executive challenges and apply effective strategies.
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Affiliation(s)
- Jamshid Bahmaei
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Behbahan Faculty of Medical Sciences, Behbahan, Iran
| | - Mohammad Amin Bahrami
- Health Human Recourses Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Science, Shiraz, Iran
| | - Abdolrahim Asadollahi
- Department of Gerontology, Faculty of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peivand Bastani
- College of Health and Human Sciences, Faculty of Health, Charles Darwin University, Alice Springs campus, NT, Australia
| | - Ramin Ravangard
- Health Human Recourses Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Science, Shiraz, Iran
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Bilgin A, Kovanci MS, Öcalan S. "Working in the emergency department is not a job; it's like a war" A narrative inquiry and interpretive phenomenology of the violence experienced by emergency nurses in Turkey. Int J Nurs Pract 2023:e13225. [PMID: 38112041 DOI: 10.1111/ijn.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/27/2023] [Accepted: 11/26/2023] [Indexed: 12/20/2023]
Abstract
AIMS This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them. METHODS This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi-structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used. RESULTS In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub-themes. CONCLUSIONS This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management.
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Affiliation(s)
- Aylin Bilgin
- Faculty of Health Sciences, Internal Medicine Nursing Department, Sakarya University of Applied Sciences, Sakarya, Turkey
| | - Mustafa Sabri Kovanci
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey
| | - Sinem Öcalan
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey
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Aminafshar A, Sartipi M, Pakzad A. The perceived self-efficacy of senior, middle, and operations managers of the incident command system dealing with emergencies and disasters during the COVID-19 pandemic. BMC Emerg Med 2023; 23:133. [PMID: 37946145 PMCID: PMC10636973 DOI: 10.1186/s12873-023-00904-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Natural disasters, health, terrorism, infectious diseases, and social unrest affect more than 200 million people worldwide each year. The present study is an attempt to evaluate the self-efficacy of senior, middle, and operational managers of the Incident Command System (ICS) of Zahedan University of Medical Sciences in Iran. METHODS The study examined the perceived self-efficacy of 103 senior, middle, and operational managers of the Incidence Command System (ICS) of Zahedan University of Medical Sciences in 2021. Sampling was done by census using a designed questionnaire based on Bandura's self-efficacy concepts. Based on Factor Analysis, 4 factors were extracted. The factors were labeled and analyzed. RESULTS The number of people who had passed the crisis management course was 57. Seventy-one participants reported their participation in crisis management. The score obtained by men in Factor 3 (F3) was significantly higher than women, but not in other factors. People with stable employment scored far higher in Factor 1 (F1) than those with unsustainable employment conditions. Those who had passed the Crisis Management courses had a higher average score, but only in the three factors 1, 2, and 4, this difference was significant. CONCLUSION Even training the temporary staff is an organizational investment that can return benefits to the system. This enhances their perceived self-efficacy and promotes their commitment to the organization. Therefore, empowering these managers should be a priority.
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Affiliation(s)
- Asiye Aminafshar
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Majid Sartipi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
- Department of Biostatistics and Epidemiology, School of Health, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Abdolrazzagh Pakzad
- Health Safety and Environmental Management (HSE), Zahedan University of Medical Sciences, Zahedan, Iran
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Kashani M, Bozorgzad P, Masror Roudsary D, Janani L, Asghari H, Asgari MR, Babamohamadi H. The relationship between moral courage and providing safe care in nurses: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:352. [PMID: 38144009 PMCID: PMC10743858 DOI: 10.4103/jehp.jehp_977_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/01/2022] [Indexed: 12/26/2023]
Abstract
BACKGROUND Moral courage is one of the moral virtues, which can have a great impact on the provision of safe care for patients. Providing safe care is one of the most significant and fundamental principles of healthcare. This study aimed to determine the relationship between moral courage and safe care among nurses and explain the factors predicting safe care. MATERIALS AND METHODS This is a cross-sectional study conducted on 172 nurses who worked in selected hospitals affiliated with the Iran University of Medical Sciences in 2019. For this purpose, self-report questionnaires on moral courage and safe nursing care were used. The collected data were analyzed in the Statistical Package for Social Sciences (SPSS) version 23.0 using descriptive (mean, standard deviation, percentage, and frequency) and inferential (Pearson's correlation coefficient and multiple linear regression) statistics. P values less than 0.05 were considered statistically significant. RESULTS Mean scores of nurses' moral courage and safe care were desirable (407.57 ± 53.97) and satisfactory (311.31 ± 39.48), respectively. There was a significant correlation between the scores of nursing safe care and moral courage (r = 0.69, P < 0.001). Moral courage, gender, and work experience explained 54% of the variance of nursing safe care. CONCLUSION The results showed that there is a positive and significant relationship between safety care and moral courage. It seems that increasing nurses' awareness of ethical principles leads to their courageous ethical behaviors, and safety and high-quality care should be one of the goals of all healthcare professionals. Also, the results of this study support the need to improve the knowledge and awareness of nurses and nurse managers regarding the importance of moral courage in providing safe nursing care and improving patient safety.
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Affiliation(s)
- Maryam Kashani
- Department of Medical-Surgical Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Parisa Bozorgzad
- Department of Medical-Surgical Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Daryadokht Masror Roudsary
- Department of Medical-Surgical Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Health, Iran University of Medical Science, Tehran, Iran
| | - Hosein Asghari
- Department of Medical-Surgical Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Mohammad Reza Asgari
- Department of Critical Care Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
| | - Hassan Babamohamadi
- Department of Medical-Surgical Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
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Amanpour S, Akbari Javar M, Sarhadinejad Z, Doustmohammadi M, Moghadari M, Sarhadynejad Z. A systematic review of medicinal plants and herbal products' effectiveness in oral health and dental cure with health promotion approach. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:306. [PMID: 38023092 PMCID: PMC10670971 DOI: 10.4103/jehp.jehp_1297_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/27/2022] [Indexed: 12/01/2023]
Abstract
Medicinal plants and herbal drugs are being used increasingly as part of primary health care in most parts of the world. As important adjunctive and alternative treatments for oral health care, herbal products' use may continue to increase and become more widespread. The objective of this study is to present a comprehensive systematic review of the current published literature on the effectiveness of medicinal plants and herbal products employed to improve oral health in adolescents with a health promotion approach. The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The keywords "herbal medicine," "herbal extract," "herbal supplements," "plant extract," "natural drug," "pulpitis," "dental caries," "oral viral diseases," and "abscess" were used in combination with the Boolean operators OR and AND. PubMed, Embase, Scopus, and Web of Science were searched. Quality assessment of the included studies was performed using the Cochrane Handbook for Systematic Reviews of Interventions. The search yielded 49 original research studies. A total of 22 studies had low or unclear risk bias. The geographical distribution of included studies was primarily concentrated on western countries. Overall, studies reported herbal product users' age, ranging from young adults aged 18 years to elderly people aged 75 years or older. Most studies reported multiple compounds, including herbal drugs and herbal extracts. Chamomile and Aloe vera were the most frequently reported herbal compounds. The most commonly described herbal products to treat oral diseases were gels, mouth rinses, and pastes. The studies included a range of people with oral diseases, including periodontal and gingival diseases, recurrent aphthous stomatitis, oral lichen planus, and oral candidiasis. Herbal product interventions were found to be effective and safe alternatives for oral health care. One of the most important goals of the World Health Organization (until 2015) is the oral health index, so it is important that dental services be followed up more seriously. Considering the problems in reaching this goal of the World Health Organization in our country, herbal products have the ability to improve clinical oral health outcomes in adolescents. Limited adverse side effects indicate the overall safety of these treatments for a wide range of oral diseases. Therefore, the use of medicinal plants as well as alternative medicine is one of the useful methods in achieving this important goal of public health.
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Affiliation(s)
- Sara Amanpour
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahsa Akbari Javar
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Zohreh Sarhadinejad
- Noncommunicable Disease Research Center, Bam University of Medical Sciences, Bam, Iran
| | - Mohammadmahdi Doustmohammadi
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Moghadari
- Department of Persian Medicine, Faculty of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Zarrin Sarhadynejad
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Traditional Pharmacy, Faculty of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran
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He H, Chen X, Tian L, Long Y, Li L, Yang N, Tang S. Perceived patient safety culture and its associated factors among clinical managers of tertiary hospitals: a cross-sectional survey. BMC Nurs 2023; 22:329. [PMID: 37749580 PMCID: PMC10518958 DOI: 10.1186/s12912-023-01494-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Patient safety is a global challenge influenced by perceived patient safety culture. However, limited knowledge exists regarding the patient safety culture perceived by hospital clinical managers and its associated factors. This study aims to investigate the perceptions of patient safety culture and associated factors among clinical managers of tertiary hospitals in China. METHODS A cross-sectional survey was conducted from June 19 to July 16, 2021, involving 539 clinical managers from four tertiary hospitals in Changsha City of Hunan Province. The Hospital Survey on Patient Safety Culture (HSOPSC) was utilized to assess perceived patient safety culture. Bivariate, multivariable linear regression, and logistic regression analyses were performed. RESULTS The mean score for the total HSOPSC was 72.5 ± 7.6, with dimensional scores ranging from 62.1 (14.9) to 86.6 (11.7). Three dimensions exhibited positive response rates (PRRs) < 50%, indicating areas that need to be improved: "nonpunitive response to errors" (40.5%), "staffing" (41.9%), and "frequency of events reported" (47.4%). Specialized hospitals (β = 1.744, P = 0.037), female gender (β = 2.496, P = 0.003), higher professional title (β = 1.413, P = 0.049), a higher education level (β = 1.316, P = 0.001), and shorter time delays per shift (β=-1.13, P < 0.001) were correlated with higher perceived patient safety culture. Education level, work department, "teamwork within a unit", "management support for patient safety", "communication openness", and "staffing" dimensions were associated with patient safety grades (all P < 0.05). Years worked in hospitals, occupation, education level, work department, hospital nature, professional title, "communication openness", and "handoffs & transitions" were associated with the number of adverse events reported (all P < 0.05). CONCLUSIONS Our study revealed a generally low level of patient safety culture perceived by clinical managers and identified priority areas requiring urgent improvement. The associated factors of patient safety culture provide important guidance for the development of targeted interventions in the future. Promoting patient safety by optimizing the patient safety culture perceived by clinical managers should be prioritized.
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Affiliation(s)
- Haiyan He
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xi Chen
- School of Nursing, Hong Kong Polytechnic University, Hongkong, China
| | - Lingyun Tian
- Department of Nursing, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yanfang Long
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Li Li
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
| | - Ning Yang
- Emergency Department, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Amiri H, Aminizadeh M, Rezapour M, Tavan A, Aminizadeh M. The impact of Covid 19 pandemic on life satisfaction and health of Iranian bank employees. Heliyon 2023; 9:e19088. [PMID: 37662794 PMCID: PMC10474419 DOI: 10.1016/j.heliyon.2023.e19088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/06/2023] [Accepted: 08/10/2023] [Indexed: 09/05/2023] Open
Abstract
Background COVID-19 pandemic has affected various aspects of human life. Bank employees who are more in contact with people are more likely to be infected during the pandemic situation. Moreover, mental, physical and social impacts of COVID-19 are more intense among these employees.Objective: this study aims to determine the effect of COVID-19 pandemic on bank employees' health and life satisfaction in Iran. Methods This cross-sectional study was conducted during the fifth wave of COVID-19 from July to October 2021. The population included all the employees of Tejarat Bank in 20 provinces of Iran, 350 of whom were selected using the multi-stage cluster sampling method. The data were collected by demographic questionnaire, 12-item short-form (SF-12) personal health assessment survey and satisfaction with life scale (SWLS). The objective of the study was examined by the structural equation modeling (SEM). Results The results showed the two default models of health function (CFI = 0.95) and life satisfaction (CFI = 0.99) had acceptable fit. Assessing the bank employees with COVID-19 revealed this disease had no direct impact on life satisfaction (β = -0.05, P = 0.28) and health function (β = 0.04, P = 0.48). However, it had a direct impact on physical function (β = -0.18, P = 0.001) and, consequently, an indirect impact on life satisfaction. Moreover, low mental function reduced life satisfaction. Conclusion COVID-19 infection had no direct impact on life satisfaction. However, it had an indirect and positive impact on it. Considering gender showed COVID-19 infection had a direct and positive impact on life satisfaction among women. The employees who recovered from COVID-19 infection reported higher life satisfaction after returning to work for various reasons than those who never got it.
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Affiliation(s)
- Hadis Amiri
- Department of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Maysam Rezapour
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Asghar Tavan
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Aminizadeh
- Department of Psychology, Azadshahr Branch, Islamic Azad University, Azadshahr, Iran
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López-Ros P, López-López R, Pina D, Puente-López E. User violence prevention and intervention measures to minimize and prevent aggression towards health care workers: A systematic review. Heliyon 2023; 9:e19495. [PMID: 37809629 PMCID: PMC10558594 DOI: 10.1016/j.heliyon.2023.e19495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023] Open
Abstract
Workplace violence in the health care setting is a social problem of great interest both at the health care level and in research in recent decades. The most common type of violence is the one coming from the user towards the professional. Although the bibliography includes multiple preventive actions focused on working with professionals, there are hardly any studies that explore and collect actions aimed at the user. The aim of this study is to analyze the results of the literature to provide an overview of the current evidence. Specifically, it aims to describe the various user-directed strategies or interventions aimed at reducing workplace violence experienced by professionals within the healthcare sector. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), methodology of publications published up to December 2022 in the main databases. Studies that met the previously established eligibility criteria were identified. A peer review of the risk of bias was performed and the data were extracted from a previously elaborated template. The search yielded 5231 articles of which 11 were finally included in the review. Of these, 3 had a quantitative design, 7 had a qualitative design and one had a combined design. Of these, 38 measures or actions aimed at the user were compiled, grouped into four blocks according to the attitudinal objective pursued: Improvement of communication and creation of links, involvement of the user in joint decisions with the staff, informing and training the user, and other independent proposals. This study makes it possible to explore actions aimed at users with the objective of reducing violence towards health professionals. It collects and makes available to the scientific community a set of measures aimed at making a change of attitude in the perpetrator themselves, with the involvement of the perpetrator in the health system. This set of collected measures provides researchers with a basis to be taken into account for the implementation of future prevention plans according to the new multicomponent prevention models and with the involvement of the perpetrator themselves.
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Affiliation(s)
- Paloma López-Ros
- Department of Behavioral Sciences and Health, University Miguel Hernández, Elche, Spain
| | - Reyes López-López
- Applied Psychology Service (SEPA), University of Murcia, Murcia, Spain
| | - David Pina
- Applied Psychology Service (SEPA), University of Murcia, Murcia, Spain
- Department of Socio-Sanitary Sciences, University of Murcia, Murcia, Spain
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Miri K, Sabbaghi M, Mazlum SR, Namazinia M. The trend of change in the role of pre-hospital emergency medical services in Iran's healthcare system: a situational analysis. BMC Emerg Med 2023; 23:99. [PMID: 37648986 PMCID: PMC10468862 DOI: 10.1186/s12873-023-00861-3] [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: 06/12/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Following the significant changes in healthcare systems over the last century, the role of pre-hospital emergency medical services (EMS) has been drawn against numerous challenges. In view of this, the present study aims to reflect on the trend of change in the role of pre-hospital EMS to meet new situations and needs, thereby providing a clear picture of this process. METHODS Respecting the intricate concept of development and the major changes in Iran's healthcare system, this study was fulfilled using situational analysis (SA), developed by Clarke (2018), in Iran within 2022-2023. For this purpose, the data were collected through semi-structured, in-depth individual interviews with four faculty members, two managers involved in EMS, and six highly skilled EMS personnel in various positions. Moreover, the relevant articles published from 1950 to 2023 were reviewed. The data analysis was then performed via SA in the form of open coding as well as simultaneous analysis through three types of maps, viz., situational, social worlds/arenas, and positional maps, along with constant comparative analysis. RESULTS Pre-hospital EMS in Iran has thus far had two turning points from 1970 to 2023, wherein academic components, need for equipment and resources, in conjunction with basic needs in the modern society, have been the main propellers. As well, the complexity of care for non-communicable diseases (NCDs), demand for managed care, and technological advancement has gradually resulted in further development in EMS. This trend describes the EMS situation in Iran from 1973 to 2023, as well as the EMS emergence stages, quantitative growth and infrastructure, and clinical education development in 2002-2023, indicating the lack of funding and inadequate scientific infrastructure in proportion to the population receiving such services. CONCLUSION Considering the trend of change in the approaches adopted by healthcare systems across the world, and given the breakthroughs in nursing and medicine, along the education of professionals during the last thirty years, the descriptions of duties and performance in EMS have moved from primary care and patient transfer to specialized services and outpatient care. In addition, the cultural context specific to Iran, the challenges of women working in EMS centers, the disconnection of service providers, namely, the Iranian Red Crescent Society (IRCS) Relief and Rescue Organization (R&RO), Iran's National Police Force (INPF), and Iran's National Medical Emergency Organization (INMEO), as well as lack of resources and equipment, and the geographical distribution of human resources (HRs) based on population dispersion, are thus among the significant issues facing pre-hospital EMS in this country.
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Affiliation(s)
- Kheizaran Miri
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mohammadreza Sabbaghi
- Department of Medical Emergency, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Seyyed Reza Mazlum
- Department of Medical - Surgical Nursing, School of Nursing and Midwifery, Mashhad University Medical of Medical Sciences, Mashhad, Iran
| | - Mohammad Namazinia
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
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Sabbaghi M, Miri K, Namazinia M. Effects of the COVID-19 pandemic on trauma-related emergency medical service in older people: a retrospective cohort study. BMC Emerg Med 2023; 23:98. [PMID: 37633933 PMCID: PMC10463572 DOI: 10.1186/s12873-023-00874-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/22/2023] [Indexed: 08/28/2023] Open
Abstract
INTRODUCTION The ever-increasing human life expectancy has currently resulted in a noticeable rise in the world's older population. Addressing the healthcare needs of the older people has become a significant concern for many countries. Moreover, the older people are particularly vulnerable to traumatic events. This study aimed to examine the impact of the COVID-19 pandemic on prehospital care provided by Emergency Medical Services (EMS) for trauma-related cases among the older people in Iran. METHODS This retrospective cohort study involved analyzing the medical records of 1,111 older people aged above 60 who experienced traumatic injuries and received pre-hospital emergency services from March 2018 to March 2022. In order to collect the data, the checklist made by the researcher was used and data analysis in SPSS16 was done using the Chi-square test and Fisher's exact test. RESULTS The age group of 60-74 received the highest number of services both before and after the COVID-19 pandemic. The older men experienced more traumatic events compared to women throughout the study period. The majority of the traumatic events occurred between 8 a.m. and 12 p.m. both before and after the COVID-19 pandemic. CONCLUSIONS The high prevalence rate of geriatric traumas can be primarily attributed to their physical problems and no control over movements caused by old age, as well as unsafe living conditions. To address these issues, it is suggested that facilities be provided to assist with mobility problems. Moreover, constructing suitable pedestrian bridges and regularly checking neighborhoods and surroundings to identify potential risk factors should be prioritized. Once these risk factors are identified, efforts can be made to adjust and eliminate them, thereby minimizing traumatic events and enhancing a safe and friendly environment for the older people.
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Affiliation(s)
- Mohammadreza Sabbaghi
- Department of Medical Emergency, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Kheizaran Miri
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Mohammad Namazinia
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
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Wei G, Lin F, Cao C, Hu H, Han Y. Non-linear dose-response relationship between body mass index and stroke risk in middle-aged and elderly Chinese men: a nationwide Longitudinal Cohort Study from CHARLS. Front Endocrinol (Lausanne) 2023; 14:1203896. [PMID: 37484946 PMCID: PMC10356587 DOI: 10.3389/fendo.2023.1203896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/07/2023] [Indexed: 07/25/2023] Open
Abstract
Objective Body mass index (BMI) and stroke risk have been linked, but these findings are still debated. This study investigated the relationship between BMI and stroke risk in a middle-aged and elderly Chinese population. Methods This study used four waves of CHARLS data (2011, 2013, 2015, and 2018), including 12,161 participants. The CHARLS sample was obtained by multi-stage probability sampling and all participants were assessed by one-to-one interviews using a standardized questionnaire. We used a Cox proportional-hazards regression model to examine the relationship between BMI and stroke risk. We used Cox proportional hazards regression with cubic spline functions and smooth curve fitting to identify the non-linear relationship between them. A series of sensitivity analyses were also conducted. Results The multivariate Cox proportional hazards regression model identified a positive association between BMI and stroke risk (HR=1.025, 95% CI: 1.010-1.040). We also found a non-linear relationship between BMI and stroke incidence, with an inflection point at 26.63 kg/m2 for BMI. Each 1 kg/m2 increase in BMI to the left of the inflection point was related to a 4.4% increase in stroke risk (HR=1.044, 95% CI: 1.019-1.069). We stratified individuals by gender to further investigate their association and found a particular non-linear relationship and saturation effect between BMI and stroke risk in men, with the inflection point at 25.94 kg/m2. Each 1 kg/m2 increase in BMI to the left of the inflection point was related to a 7.6% increase in stroke risk (HR=1.076, 95% CI 1.034-1.119). The association was linear in women, with each 1 kg/m2 increase in BMI associated with a 2.1% increase in stroke risk (HR=1.021, 95% CI 1.002, 1.040). Conclusion In men, there was a specific non-linear association and saturation effect of BMI with stroke (inflection point of 25.94 kg/m2), while in women, there was none. When males had a BMI below 25.94 kg/m2, the risk of stroke was significantly and positively associated with BMI. By controlling BMI below 25.94 kg/m2 in men, a further decrease in BMI may promote a significant reduction in stroke risk.
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Affiliation(s)
- Gang Wei
- Department of Emergency, Hechi People’s Hospital, Hechi, Guangxi Zhuang Autonomous Region, China
| | - Feng Lin
- Department of Emergency, Hechi People’s Hospital, Hechi, Guangxi Zhuang Autonomous Region, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
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Hui T, Zakeri MA, Soltanmoradi Y, Rahimi N, Hossini Rafsanjanipoor SM, Nouroozi M, Dehghan M. Nurses' clinical competency and its correlates: before and during the COVID-19 outbreak. BMC Nurs 2023; 22:156. [PMID: 37149652 PMCID: PMC10163958 DOI: 10.1186/s12912-023-01330-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/05/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Clinical competency is the ability to integrate knowledge, skills, attitudes and values into a clinical situation and it is very important in nursing education, clinical settings, nursing management, and crises. This study aimed to investigate nurses' professional competence and its correlates before and during the COVID-19 pandemic. METHODS We conducted this cross-sectional study before and during the COVID-19 outbreak and recruited all nurses working in hospitals affiliated to Rafsanjan University of Medical Sciences, southern Iran, so we included 260 and 246 nurses in the study before and during the COVID-19 epidemic, respectively. Competency Inventory for Registered Nurses (CIRN) was used to collect data. After inputting the data into SPSS24, we analysed them using descriptive statistics, chi-square and multivariate logistic tests. A significant level of 0.05 was considered. RESULTS The mean clinical competency scores of nurses were 156.97 ± 31.40 and 161.97 ± 31.36 before and during the COVID-19 epidemic, respectively. The total clinical competency score before the COVID-19 epidemic was not significantly different from that during the COVID-19 epidemic. Interpersonal relationships (p = 0.03) and desire for research/critical thinking (p = 0.01) were significantly lower before the COVID-19 outbreak than during the COVID-19 outbreak. Only shift type had an association with clinical competency before the COVID-19 outbreak, while work experience had an association with clinical competency during the COVID-19 epidemic. CONCLUSION The clinical competency among nurses was moderate before and during the COVID-19 epidemic. Paying attention to the clinical competence of nurses can improve the care conditions of patients, and nursing managers should improve the clinical competence of nurses in different situations and crises. Therefore, we suggest further studies identifying factors improving the professional competency among nurses.
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Affiliation(s)
- Tian Hui
- Affiliated Hospital of Jiangnan University, Wuxi, 214122, China
| | - Mohammad Ali Zakeri
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Yaser Soltanmoradi
- Faculty Member, School of Paramedicine, Department of Operating Room Technology, Rafsanjan University Medical of Sciences, Rafsanjan, Iran
| | - Neda Rahimi
- Department of Surgical Nursing, Nursing and Midwifery School, Rafsanjan University of Medical, Rafsanjan, Iran
| | | | - Majid Nouroozi
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mahlagha Dehghan
- Nursing Research Centre, Kerman University of Medical Sciences, Kerman, Iran.
- Department of Critical Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Haft-Bagh Highway, Kerman, Iran.
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Vali M, Paydar S, Seif M, Sabetian G, Abujaber A, Ghaem H. Prediction prolonged mechanical ventilation in trauma patients of the intensive care unit according to initial medical factors: a machine learning approach. Sci Rep 2023; 13:5925. [PMID: 37045979 PMCID: PMC10097728 DOI: 10.1038/s41598-023-33159-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 04/07/2023] [Indexed: 04/14/2023] Open
Abstract
The goal of this study was to develop a predictive machine learning model to predict the risk of prolonged mechanical ventilation (PMV) in patients admitted to the intensive care unit (ICU), with a focus on laboratory and Arterial Blood Gas (ABG) data. This retrospective cohort study included ICU patients admitted to Rajaei Hospital in Shiraz between 2016 and March 20, 2022. All adult patients requiring mechanical ventilation and seeking ICU admission had their data analyzed. Six models were created in this study using five machine learning models (PMV more than 3, 5, 7, 10, 14, and 23 days). Patients' demographic characteristics, Apache II, laboratory information, ABG, and comorbidity were predictors. This study used Logistic regression (LR), artificial neural networks (ANN), support vector machines (SVM), random forest (RF), and C.5 decision tree (C.5 DT) to predict PMV. The study enrolled 1138 eligible patients, excluding brain-dead patients and those without mechanical ventilation or a tracheostomy. The model PMV > 14 days showed the best performance (Accuracy: 83.63-98.54). The essential ABG variables in our two optimal models (artificial neural network and decision tree) in the PMV > 14 models include FiO2, paCO2, and paO2. This study provides evidence that machine learning methods outperform traditional methods and offer a perspective for achieving a consensus definition of PMV. It also introduces ABG and laboratory information as the two most important variables for predicting PMV. Therefore, there is significant value in deploying such models in clinical practice and making them accessible to clinicians to support their decision-making.
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Affiliation(s)
- Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Paydar
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Non-Communicable Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnar Sabetian
- Anesthesiology and Critical Care Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Haleh Ghaem
- Non-Communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Hosseinabadi-Farahani M, Arsalani N, Hosseini M, Mohammadi E, Fallahi-Khoshknab M. Nurses' experiences of discrimination in health care: A qualitative study in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:100. [PMID: 37288420 PMCID: PMC10243445 DOI: 10.4103/jehp.jehp_648_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 07/02/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Justice in health is one of the main concerns of health organizations, and discrimination in health care is one of the negative outcomes to achieving this goal. Hence, a full understanding of the phenomenon of discrimination in health care and adopting strategies to eliminate it is necessary. The present study was conducted to explore and describe the experiences of nurses of discrimination in health care. MATERIALS AND METHODS The present qualitative content analysis study was conducted between 2019 and 2020. Data were collected through semi-structured interviews with 18 participants (two physicians, three nursing supervisors, two head nurses, four clinical nurses, two nursing assistants, and three hospitalized patients) in one public and one private hospital in the city of Tehran. The participants were selected by purposive sampling, which continued until saturation of data. Data obtained were analyzed using the Graneheim and Lundman method. RESULTS Four main categories and 14 subcategories were extracted from data analysis: 1) habitual discrimination (everyday discrimination in health centers, ignoring patient rights, low levels of trust in medical staff); 2) interpersonal relationships (expectations of associates, respect for colleagues and friends, the possibility of the occurrence of similar situations, reciprocating people's favors); 3) shortage of health-care resources (shortage of medical equipment, heavy workload, infrastructure of medical centers, lack of access to physicians); and 4) favoritism (ethnicity, favoritism as a common method, and favoritism as the ultimate solution to treatment problems). CONCLUSION The present study revealed certain dimensions of discrimination in health care that remain hidden in many quantitative studies. It appears that health system managers will be able to move toward eliminating discrimination in health care. Thus, designing effective models to reduce discrimination in health care based on the underlying concepts of this study is recommended.
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Affiliation(s)
| | - Narges Arsalani
- Iranian Research Center on Aging, Tarbiat Modares University, Tehran, Iran
| | - Mohammadali Hosseini
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Eesa Mohammadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Najafi Ghezeljeh T, Rezaei M, Keyvanloo Shahrestanaki S, Sheikh Milani A. Exploring family caregiver challenges in caring for patients with COVID-19 in intensive care units. Front Public Health 2023; 11:1057396. [PMID: 36969646 PMCID: PMC10034162 DOI: 10.3389/fpubh.2023.1057396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/20/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundFamilies of individuals hospitalized in an intensive care unit (ICU) with severe illnesses, such as COVID-19, are experiencing a range of physical and emotional stressors. Identifying the challenges faced by family members and providing support to loved ones battling life-threatening diseases can lead to improved treatment and care for the said family members in a healthcare setting.AimThe current study was conducted to explore and understand the experiences of family caregivers caring for their loved ones battling COVID-19 in an ICU.MethodsThis descriptive qualitative study was conducted from January 2021 to February 2022, based on the experiences of 12 family caregivers of patients with COVID-19 hospitalized in the ICU. Data collection was conducted through purposeful sampling using semi-structured interviews. MAXQDA10 software was used for data management, and conventional content analysis was used for qualitative data analysis.ResultsThe present study conducted interviews with caregivers to understand their experiences while caring for a loved one in an ICU. Three main themes emerged from the analysis of these interviews: hardship of care trajectory, pre-loss mourning, and contributing factors in resolving family health crises. The first theme, the hardship of care trajectories, encompasses categories such as immersion in the unknown, lack of care facilities, negligence in care, neglect of families by healthcare providers, self-ignorance, and perceived stigma. The second these was pre-loss mourning that included some categories such as emotional and psychological turmoil, witnessing the exhaustion of loved ones, separation suffering, the fearing of loss, anticipatory grief, blame related to the disease causative agents, and perceived helplessness and despair. The third theme was contributing factors in resolving family health crises that included categories of the critical role of family caregivers in health engagement, the role of healthcare professionals in health engagement, and the role of interpersonal factors in health engagement. A total of 80 subcategories were also obtained based on the experiences of the family caregivers.ConclusionThis study's findings indicate that families can play an important role in resolving their loved ones' health problems in life-threatening situations such as the COVID-19 pandemic. Moreover, healthcare providers must recognize and prioritize family-based care and trust the families' ability to effectively manage health crises. Healthcare providers should also be attentive to the needs of both the patient and their family members.
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Affiliation(s)
- Tahereh Najafi Ghezeljeh
- Nursing and Midwifery Care Research Center, Cardiovascular Nursing Research Center, Rajaie Cardiovascular Medical and Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Rezaei
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
- *Correspondence: Masoud Rezaei
| | | | - Arezoo Sheikh Milani
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Li H, Sun M, Jiang J, Shi B, Wang B, Wang L, Wu W, Wang W. Gestational trophoblastic neoplasia with primary lung cancer and mesenchymal tumor of sigmoid colon: a case report and literature review. BMC Womens Health 2023; 23:76. [PMID: 36803691 PMCID: PMC9940668 DOI: 10.1186/s12905-023-02204-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/01/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Gestational trophoblastic neoplasia (GTN) is rare, and it is even rarer for GTN to merge with primary malignant tumors in other organs. Herein is described a rare clinical case of GTN combined with primary lung cancer and mesenchymal tumor of the sigmoid colon, followed with literature review. CASE PRESENTATION The patient was hospitalized due to diagnosis of GTN with primary lung cancer. Firstly, two cycles of chemotherapy including 5-fluorouracil (5-FU) and actinomycin-D(Act-D) was given. Laparoscopic total hysterectomy and right salpingo-oophorectomy was performed during the third chemotherapy. During the operation, a 3*2 cm nodule was removed which was protruded from the serous surface of the sigmoid colon, and the nodule was confirmed mesenchymal tumor pathologically, in accord with gastrointestinal stromal tumor. During the treatment of GTN, Icotinib tablets were taken orally to control the progression of lung cancer. After 2 cycles of consolidation chemotherapy of GTN, she received thoracoscopic lower lobe of right lung lobectomy and the mediastinum lymph nodes removal. She undertook gastroscopy and colonoscopy and the tubular adenoma of the descending colon was removed. At present, the regular follow-up is taken and she remains free of tumors. CONCLUSIONS GTN combined with primary malignant tumors in other organs are extremely rare in clinical practice. When imaging examination reveals a mass in other organs, clinicians should be aware of the possibility of a second primary tumor. It will increase the difficulty of GTN staging and treatment. We emphasis the importance of the collaboration of multidisciplinary teams. Clinicians should choose a reasonable treatment plan according to the priorities of different tumors.
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Affiliation(s)
- HongYe Li
- grid.452702.60000 0004 1804 3009Department of Obstetics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei China
| | - Meng Sun
- grid.452702.60000 0004 1804 3009Department of Obstetics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei China
| | - Jing Jiang
- Department of Obstetics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Bin Shi
- grid.452702.60000 0004 1804 3009Department of Obstetics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei China
| | - BaoHua Wang
- grid.452702.60000 0004 1804 3009Department of Thoracic Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei China
| | - Lei Wang
- grid.452702.60000 0004 1804 3009Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei China
| | - WenXin Wu
- grid.452702.60000 0004 1804 3009Department of Pathology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei China
| | - WenYan Wang
- grid.452702.60000 0004 1804 3009Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei China
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Rashidi F, Mirghafourvand M. Pelvic floor disorder and relevant factors in Iranian women of reproductive age: a cross-sectional study. BMC Womens Health 2023; 23:71. [PMID: 36797735 PMCID: PMC9933298 DOI: 10.1186/s12905-023-02226-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND With high severity and prevalence, pelvic floor disorder is a health issue that women face worldwide. Different demographic-obstetric factors are involved in the emergence of this dysfunction that can have many adverse effects on a woman's quality of life. Hence, this study aimed to determine the prevalence of pelvic floor disorder and its related socio-demographic and obstetric factors among Iranian women of reproductive age. METHODS The statistical population of this cross-sectional study included 400 woman of reproductive age (15-49 years) covered by the health centers of Tabriz, Iran in 2022. The cluster sampling method was employed to select the participants. The data collection tools were a socio-demographic and obstetric characteristics questionnaire and the PDFI-20 (Pelvic Floor Distress Inventory-20). The chi-squared test was conducted to determine the association between socio-demographic and obstetric characteristics and prevalence of pelvic floor disorder in a bivariate analysis, whereas the multivariate logistic regression test was used in a multivariate analysis. RESULTS The general prevalence of pelvic floor disorder was 76%. The prevalence rates of pelvic organ prolapse distress 6 (POPDI-6), colorectal-anal distress 8 (CRAD-8), and urinary distress (UDI-6) were 54.3%, 61.8%, and 49.3%, respectively. The results of the multivariate logistic regression test indicated that constipation (odds ratio = 5.62; 95% CI 1.97 to 16.03; P = 0.001) increased the risk of pelvic floor disorder. CONCLUSIONS According to the findings, the prevalence of pelvic floor disorder is high among Iranian women of reproductive age. This condition is correlated with constipation. Therefore, screening is recommended through valid tools in addition to offering preventive measures such as preventing and curing constipation to reduce the risk of pelvic floor disorder.
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Affiliation(s)
- Fatemeh Rashidi
- grid.412888.f0000 0001 2174 8913Students’ Research Committee, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- grid.412888.f0000 0001 2174 8913Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati Street, P.O. Box: 51745-347, Tabriz, 513897977 Iran
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Hampel K, Hajduova Z. Human Resource Management as an Area of Changes in a Healthcare Institution. Risk Manag Healthc Policy 2023; 16:31-41. [PMID: 36636035 PMCID: PMC9831525 DOI: 10.2147/rmhp.s388185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023] Open
Abstract
Purpose The underlying objective of the paper was to investigate the areas that require changes in human resource management in healthcare institutions. The practical objective of the study was to formulate recommendations targeted at the management staff of a healthcare institution, which allow to increase the adaptability and development capacity of medical personnel with the use of appropriate instruments and methods of human resource management. Patients and Methods The quantitative research was conducted among 652 patients using the services of primary health care clinics located in the Silesian province in Poland, in 2019. The share of women in the research sample was 61%, and men - 39%. 11% of the respondents were students, 27% - people of retirement age, and 62% were economically active. An anonymous survey questionnaire was used. Calculations were performed using Statistica software. Mann-Whitney U-test and correlation analysis using Gamma (Γ) coefficients were used. Results The results of the empirical research showed that the respondents positively assessed most of the examined elements (over 70% of positive opinions). Negative opinions did not exceed the error threshold and amounted up to 5%. The presented results allowed to conclude that the expectations and preferences of patients should be constantly monitored, have an impact on the management of medical personnel and imply introducing changes in the weakest areas. Conclusion The conducted research made it possible to identify the needs and expectations of patients and to develop possible solutions to improve human resource management in healthcare entities. In order to improve the operating conditions of the clinic, managers should constantly monitor patient satisfaction and, if necessary, introduce changes to raise service standards. This will allow early detection of shortcomings and the introduction of necessary changes in the clinic.
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Affiliation(s)
- Katarzyna Hampel
- Faculty of Law and Economics, Jan Dlugosz University in Czestochowa, Częstochowa, Poland
| | - Zuzana Hajduova
- Department of Business Finance, Faculty of Business Management, University of Economics in Bratislava, Bratislava, Slovakia,Correspondence: Zuzana Hajduova, University of Economics in Bratislava, Department of Business Finance, Dolnozemská cesta 1, Bratislava, 852 35, Slovakia, Tel + 421 911 404 473, Email
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23
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Song W, Huang D, Yu J. How does centralized isolation treatment strategy affect the medical staff's mental health during the COVID-19 pandemic? Front Public Health 2023; 10:1055564. [PMID: 36684938 PMCID: PMC9846266 DOI: 10.3389/fpubh.2022.1055564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
Background During the coronavirus 2019 (COVID-19) pandemic, the Chinese Government adopted a centralized isolation treatment (CIT) strategy for patients, which has greatly improved the efficiency of the pandemic response. However, compared to those in local hospitals, anti-COVID-19 medical staff in mobile cabin hospitals, where the CIT strategy was adopted, suffered more mental health problems. This study aimed to explore how the CIT strategy affected the medical staff's mental health by comparing anti-COVID-19 medical staff who worked in mobile cabin hospitals to those in fever clinics of local hospitals. Methods Following the standard scale development procedure, this study first developed a scale measuring the mental health of anti-COVID-19 medical staff. Using SPSS 23.0 and Amos 23.0 software, the exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability analysis method were conducted to support the scale development. In the main investigation, a survey method using the developed scale was used, and 839 anti-COVID-19 medical staff from five hospitals in northern China were recruited as participants by snowball-sampling method. The first survey was conducted in February 2020, when the first round of COVID-19 was at a serious time. In April 2020, after the first round of COVID-19 in China was initially contained, and medical staff who worked in mobile cabin hospitals returned to local hospitals, a follow-up survey was conducted on these participants. Using SPSS 23.0 software, a series of 2 × 2 mixed-design ANOVA was conducted, in which working conditions (mobile cabin hospital vs. local hospital) served as a between-subject factor, time points (during vs. after the first round of COVID-19) served as a within-subject variable, and the indicators of the medical staff's mental health served as dependent variables respectively. Results The reliability and validity of the developed scale were desirable. The mental health problems of anti-COVID-19 medical staff were mainly manifested as anxiety, powerlessness, fear of infection, and somatization. Compared to those who worked in local hospitals, anti-COVID-19 medical staff who worked in mobile cabin hospitals where the CIT strategy was adopted suffered more powerlessness, fear of infection, and somatization. After returning to local hospitals, symptoms of fear of infection and powerlessness of medical staff who used to work in mobile cabin hospitals decreased significantly. However, their anxiety symptoms were not relieved, and their somatization symptoms even increased. Conclusion This study implied that the mental health of anti-COVID-19 medical staff in mobile cabin hospitals adopting CIT was worse than in local hospitals. Moreover, with the first outbreak in remission, the mental health recovery of medical staff in CIT hospitals was slower than in local hospitals. Relevant practitioners should pay more attention to the mental health condition of anti-COVID-19 medical staff who work in CIT hospitals. The psychological assistance service for them should continue even after they return to the local hospitals.
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Affiliation(s)
- Wei Song
- Yatai School of Business Management, Jilin University of Finance and Economics, Changchun, China
| | - Dongmei Huang
- Department of Psychology, School of Philosophy and Sociology, Jilin University, Changchun, China
| | - Jiejing Yu
- Department of Psychology, School of Philosophy and Sociology, Jilin University, Changchun, China
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24
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Zhang X, Dai J, Li W, Yang Y. High-risk population and factors of stroke has changed among middle-aged and elderly Chinese-Evidence from 1989 to 2015. Front Public Health 2023; 11:1090298. [PMID: 36935676 PMCID: PMC10022731 DOI: 10.3389/fpubh.2023.1090298] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Background Stroke is an acute cerebrovascular disease with high mortality and disability. This study aimed to investigate the trend of stroke prevalence from 1989 to 2015 in China, explore the transition of high-risk population and high-risk factors, and provide some evidence to develop more targeted stroke intervention strategies. Material and methods We derived the baseline data from China Health and Nutrition Survey (CHNS). Participants responded to face-to-face interviews and examinations containing demographic information, behavioral health information, disease history, and physical examination. We applied chi-square test, shapley value decomposition model, and decision tree model to evaluate the changes of high-risk population and high-risk factors of stroke. Results Across 42,419 middle-aged and elderly residents, the prevalence of stroke was decreasing from 1989 to 2015. Hypertension was the leading risk factor of stroke, while its contribution rate was weakened with the increasing of medicine taking rate. As the second risk factor of stroke, the contribution of age decreased either. Meanwhile, the contribution rate of historical health factors, lifestyle factors, and regional factors, such as body mass index, diabetes, and living area to the impact of stroke was increasing. In addition, the first high-risk population of stroke changed from hypertension patients aged 75 years and above to without spouse residents living in stroke belt such as Beijing and Liaoning. The second risk population of stroke transformed from male hypertensive patients under 75 years old into male hypertensive patients living in urban. The third high-risk group turned from the elderly aged 75 and above into the female patients with hypertension and diabetes. Conclusions This study demonstrated that the high-risk population and high-risk factors of stroke changed in China and revealed the direction and internal mechanism of transition of stroke. Targeted stroke intervention strategies should be renewed. Health education for the high-risk population of stroke should be carried out, healthy living habits need be advocated, and the use of antihypertensive drugs for the hypertensive patients should be standardized.
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Affiliation(s)
- Xue Zhang
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, China
| | - Jing Dai
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, China
- *Correspondence: Jing Dai
| | - Wei Li
- Department of Party Committee, The First People's Hospital of Yunnan Province, Kunming, China
- Wei Li
| | - Yunjuan Yang
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
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25
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Liu R, Zheng X, Wang Z, Zhou M, Weng J, Li YM, Chen X. COVID-19 symptoms and compliance: The mediating role of fundamental social motives. Front Psychol 2023; 14:1093875. [PMID: 37020914 PMCID: PMC10067610 DOI: 10.3389/fpsyg.2023.1093875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/28/2023] [Indexed: 04/07/2023] Open
Abstract
Background Understanding the compliance of infected individuals and the psychological process underlying compliance during pandemics is important for preventing and controlling the spread of pathogens. Our study investigated whether fundamental social motives mediate the relationship between having infectious disease and compliance. Methods An online survey was conducted in March 2020, during the severe phase of the COVID-19 outbreak in China to collect data from 15,758 participants. The survey comprised self-report questionnaires with items pertaining to current symptoms (COVID-19 symptoms, other symptoms or no symptoms), the Fundamental Social Motive Inventory, and measures of compliance. Correlation analysis, linear regression analysis, and structural equation model were used for data analysis. Results The participants with COVID-19 symptoms had lower levels of compliance than those without symptoms, and their lower compliance was caused by a decrease in disease avoidance (indirect effect = -0.058, 95% CI = [-0.061, -0.056]) and familial motives (indirect effect = -0.113, 95% CI = [-0.116, -0.062]). Whereas exclusion concern (indirect effect = 0.014, 95% CI = [0.011, 0.017]) suppressed the effects of COVID-19 symptoms on compliance, the effect disappeared in the multiple mediation model, while those of disease avoidance and familial motives remained. Conclusion Our findings emphasize the critical role of disease avoidance and familial motives in promoting compliance with public health norms during pandemics and suggest that enhancing these motives may serve as an effective intervention strategy to mitigate noncompliance among potentially infected individuals.
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Affiliation(s)
- Ruoting Liu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xueying Zheng
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital, Hefei, Anhui Province, China
- Department of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Ziyu Wang
- Department of Linguistics and Cognitive Science, College of Arts and Sciences, University of Delaware, Newark, DE, United States
| | - Mingjie Zhou
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital, Hefei, Anhui Province, China
- Department of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Yan-mei Li
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- *Correspondence: Yan-mei Li,
| | - Xuefeng Chen
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Xuefeng Chen,
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Dahiya N, Rani R, Nath UK. A sequential exploratory study to develop and validate neutropenic nursing care bundle for neutropenic patients admitted in a tertiary care hospital, Uttarakhand. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:267. [PMID: 36325211 PMCID: PMC9621356 DOI: 10.4103/jehp.jehp_241_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 06/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Patients diagnosed with cancer and who undergo cancer treatment are at potential risk of bone marrow suppression leading to prolonged hospitalization, delay in treatment, and chemotherapy dose reductions, which ultimately results in significant morbidity and mortality. This sequential exploratory study using a mixed-method approach was aimed to develop and validate a neutropenic nursing care (NNC) bundle for neutropenic patients admitted in a tertiary care hospital, Uttarakhand. MATERIAL AND METHODS This sequential exploratory study design with an instrument developmental model was used to develop the NNC bundle. It consisted of two phases: Qualitative phase and quantitative phase. In the qualitative phase, focused group discussion with eight oncology nurses was performed to derive themes related to neutropenic nursing care using conventional content analysis. An extensive literature review was also performed on these themes to explore the current pieces of evidence for item pool generation. In the quantitative phase, a preliminary draft bundle was developed, and two Delphi rounds (I and II) were carried out among the five experts for the content validation of the NNC bundle and a final bundle was developed. RESULTS Major domains identified for the bundle were hand hygiene, care of central and peripheral lines, routine oral care, antiseptic bath, peri-anal care, diet, and environmental hygiene. The content validity index (CVI) of the bundle was found to be >80% for all the items with I-CVI >0.8 and S-CVI = 0.99 after conducting two rounds of Delphi. CONCLUSION The present study has provided a set of valid written neutropenic nursing interventions to prevent complications in neutropenic patients. The NNC bundle should be subjected to other levels of evaluation that measure the bundle's practicability and suitability for the intended field.
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Affiliation(s)
- Nitesh Dahiya
- Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Bathinda, Punjab, India
| | - Ruchika Rani
- Department of Oncology Nursing, College of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Uttam K. Nath
- Department of Medical Oncology Haematology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Alshyyab MA, FitzGerald G, Albsoul RA, Ting J, Kinnear FB, Borkoles E. Strategies and interventions for improving safety culture in Australian Emergency Departments: A modified Delphi study. Int J Health Plann Manage 2021; 36:2392-2410. [PMID: 34476834 DOI: 10.1002/hpm.3314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 06/15/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient safety and safety culture are critical for quality healthcare delivery in general and in Emergency Departments (EDs) in particular. The aim of this study is to identify strategies that may contribute to the improvement and maintenance of patient safety culture and which are considered most feasible in the ED environment. METHODS A two-step modified Delphi method with 11 experts' panel was performed to establish consensus. A list of potential expert participants with a background in patient safety culture in EDs was compiled through the professional networks of the supervisory team. Snowball sampling was used to identify additional possible participants. The expert panel included key leaders in the emergency medicine community in Queensland, Australia: patient safety experts and researchers, patient safety directors, and healthcare providers in an Australian ED The study ran from September 2018 to December 2018. The tool used in Round 1 in this study was developed through triangulating the outcomes of a review of literature, results from a survey of ED staff and findings from semi-structured interviews with key stakeholders in ED. The results from Round 1 informed the development of the Round 2 tool. The responses from the Delphi Round 1 tool were analysed as both qualitative data and quantitative data. The responses from the Delphi Round 2 tool were treated as quantitative data and analysed with the SPSS software. Consensus was calculated based on more than 80% agreement in collapsed categories 1 and 2 (or 4 and 5) of the five-point Likert scale. RESULTS Only six strategies out of 17 (35%) achieved consensus for both importance and feasibility. These strategies may therefore be considered the most important and feasible key strategies for improving safety culture in EDs. Seven strategies (41.1%) achieved consensus for importance, but not for feasibility and four strategies (23.55%) did not achieve consensus for either importance or feasibility. CONCLUSIONS This study offers practical solutions for safety culture improvement in the ED context. Six key strategies were seen as both important and feasible and these grouped into three main themes; leadership through agenda setting, operational management approaches to reinforce the agenda and commitment, and systems and structures to reinforce the agenda and monitor progress.
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Affiliation(s)
- Muhammad Ahmed Alshyyab
- Department of Public Health, School of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Gerard FitzGerald
- Department of Public Health and Social Work, School of Health, Brisbane, Queensland, Australia
| | - Rania Ali Albsoul
- Department of Family and Community Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Joseph Ting
- Department of Public Health and Social Work, School of Health, Brisbane, Queensland, Australia.,Department of Emergency Medicine, Mater Health Services, Brisbane, Queensland, Australia
| | - Frances B Kinnear
- Emergency Department, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Erika Borkoles
- Department of Public Health, School of Medicine, Public Health, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
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