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Langridge N. The skills, knowledge and attributes needed as a first-contact physiotherapist in musculoskeletal healthcare. Musculoskeletal Care 2019; 17:253-260. [PMID: 30993860 DOI: 10.1002/msc.1401] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/15/2019] [Accepted: 03/15/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The provision of musculoskeletal assessment and pathway management by physiotherapists in primary care is an expanding innovation within the UK National Health Service. This new model of care is challenging physiotherapists to work in new ways, and so an understanding of these roles is timely and wil contribute to the growing knowledge regarding these practitioners and their impact. METHODS This qualitative study aimed to improve the understanding of the clinical practice of first-contact clinicians in musculoskeletal healthcare. The study used a think-aloud method to explore eight clinicians' views via a stage 1 semi-structured interview process. This was followed by a stage 2 focus group involving physiotherapists and a general practitioner trainer. A thematic analysis then followed, which involved the researcher and a research colleague coding the data and subsequently developing themes. RESULTS The themes identified were: medical assessment and systems knowledge; speed of thought in an uncertain environment; breadth of knowledge; people and communication skills; common sense/simplify; and responsibility and experience. CONCLUSIONS The identified themes should help to underpin the competence, capability and training requirements for these new roles, and should be considered when developing new services utilizing first-contact primary care physiotherapy practice.
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Nolbris MJ, Gustafsson AL, Fondin C, Mellgren K, Nilsson S. Development of a web-based assessment tool that evaluates the meal situation when a child has a percutaneous endoscopic gastrostomy. BMC Pediatr 2019; 19:76. [PMID: 30857527 PMCID: PMC6410499 DOI: 10.1186/s12887-019-1447-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children with cancer often suffer side effects from their treatment, for example nausea and vomiting, which can lead to malnutrition. If a child cannot eat orally, a percutaneous endoscopic gastrostomy (PEG) can improve his or her well-being, psychosocial development and growth by enabling the supply of nourishment and facilitating the administration of necessary medicines. Few data exist on children's comfort when using a PEG. The aim of this study was firstly to develop three versions of a web-based assessment tool in which children, families, and healthcare professionals would be able to register their observations and assessments for evaluating the meal situation when a child has a PEG and secondly to validate the content of the tool. METHODS A qualitative design was chosen with purposive sampling of participants. Five children with cancer, five parents, five registered nurses and five paediatricians participated first in an interview and then in a member check of the web-based tool. The data were analysed with manifest qualitative content analysis. RESULTS The results highlighted four categories of issues which needed to be revised in the web-based tool: words which were difficult for the participants to understand, items which contained several questions, items which needed to be split into more items to be answerable and the layout of the questionnaire. The web-based tool was revised according to the categories, and then a member check evaluated and finally confirmed the revisions. CONCLUSIONS A web-based tool may be able to evaluate the meal situation when a child with cancer has a PEG. The tool may be able to detect early failures of the PEG, facilitating early action from the healthcare professionals in supporting the child and his or her parents in their care of the PEG. In the long run, this web-based tool may also be able to increase the quality of care of children living with a PEG.
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Affiliation(s)
- Margaretha Jenholt Nolbris
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden.,Department of Paediatric Cancer Centre, The Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Ann-Louise Gustafsson
- Department of Paediatric Cancer Centre, The Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Carina Fondin
- Department of Paediatric Cancer Centre, The Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Karin Mellgren
- Department of Paediatric Cancer Centre, The Queen Silvia Children's Hospital, Gothenburg, Sweden.,Department of Paediatrics, Institution for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden.
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Maguire T, Daffern M, Bowe SJ, McKenna B. Risk assessment and subsequent nursing interventions in a forensic mental health inpatient setting: Associations and impact on aggressive behaviour. J Clin Nurs 2018; 27:e971-e983. [DOI: 10.1111/jocn.14107] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Tessa Maguire
- Centre for Forensic Behavioural Science; Swinburne University of Technology; Melbourne Vic. Australia
- Victorian Institute of Forensic Mental Health, Forensicare; Melbourne Vic. Australia
| | - Michael Daffern
- Centre for Forensic Behavioural Science; Swinburne University of Technology; Melbourne Vic. Australia
- Victorian Institute of Forensic Mental Health, Forensicare; Melbourne Vic. Australia
| | - Steven J Bowe
- Faculty of Health, Biostatistics Unit; Deakin University; Melbourne Vic. Australia
| | - Brian McKenna
- Centre for Forensic Behavioural Science; Swinburne University of Technology; Melbourne Vic. Australia
- School of Clinical Sciences; Auckland University of Technology; Auckland New Zealand
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Souza JD, Almeida LYD, Luis MAV, Nievas AF, Veloso TMC, Barbosa SP, Giacon BCC, Assad FB. Mental health in the Family Health Strategy as perceived by health professionals. Rev Bras Enferm 2017; 70:935-941. [DOI: 10.1590/0034-7167-2016-0492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/03/2017] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to analyze the management of mental health needs in primary care as perceived by Family Health Strategy professionals. Method: this was a qualitative descriptive exploratory study developed within the coverage area of five family health teams. The data were collected using observation, group interviews, individual semi-structured interviews, and focus groups. Content analysis was conducted using text analysis software and interpretation was based on the corresponding analytical structures. Results: numerous and challenging mental health demands occur in this setting, for which the teams identified care resources; however, they also indicated difficulties, especially related to the operationalization and integration of such resources. Conclusion: there is a need for a care network sensitive to mental health demands that are better coordinated and more effectively managed.
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DaSilva M. A Model for Rounding With Patients in a Psychiatric Hospital. Perspect Psychiatr Care 2017; 53:313-320. [PMID: 27456319 DOI: 10.1111/ppc.12182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 06/30/2016] [Accepted: 07/03/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Hourly rounding is an organized practice where nurses perform regular checks on individual patients at fixed intervals in order to elicit any information that will improve the patient's care and well-being. Weaknesses in the existing literature on rounding include a lack of focus on the nurse-patient interaction, the absence of a guiding theoretical framework, and, lastly, marginal implementation of rounding within the psychiatric setting. PURPOSE The intent of this paper is to address these weaknesses by describing and proposing a rounding tool, based upon the acronym ICARE, to be used in the inpatient psychiatric setting. Roach's Theory on Caring will be the theoretical underpinnings for the basis of this rounding initiative. PRACTICE IMPLICATIONS It is the belief that the hourly rounding initiative will improve satisfaction and the overall quality of care for the psychiatric patient.
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Affiliation(s)
- Maryann DaSilva
- College of Nursing, University of Rhode Island, Kingston, Rhode Island, USA.,Butler Hospital, Providence, Rhode Island, USA
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Manohar H, Subramanian K, Kandasamy P, Penchilaiya V, Arun A. Diagnostic Masking and Overshadowing in Intellectual Disability-How Structured Evaluation Helps. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2016; 29:171-176. [PMID: 27901303 DOI: 10.1111/jcap.12160] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 10/24/2016] [Accepted: 10/28/2016] [Indexed: 11/28/2022]
Abstract
PROBLEM Comorbid psychiatric diagnoses tend to be underdiagnosed in patients with intellectual disability. Diagnosing anxiety disorders in such patients can pose challenges, in particular with regard to obsessive and compulsive disorder (OCD). METHODS We present the case of an adolescent diagnosed with intellectual disability with poor expressive language skills who presented with nonspecific mood and behavioral symptoms, not improving with routine clinical evaluations and treatment. A structured assessment was done to decipher the psychopathology. FINDINGS The structured evaluation was able to diagnose OCD, and the treatment response was accentuated, bringing about a significant reduction in patient and caregiver distress. Psychosocial interventions through nurses played a significant role. CONCLUSIONS The case highlights the need for a systematic assessment of patients with intellectual disability to arrive at reliable diagnoses and to plan appropriate treatment strategies.
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Affiliation(s)
- Harshini Manohar
- Harshini Manohar, MBBS, is a Junior Resident, Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Karthick Subramanian
- Karthick Subramanian, MD, is a Senior Resident, Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Preeti Kandasamy
- Preeti Kandasamy, DM (Child & Adolescent Psychiatry), is an Assistant Professor, Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Venkatalakshmi Penchilaiya
- Venkatalakshmi Penchilaiya, MBBS, is a Junior Resident, Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Anandbabu Arun
- Anandbabu Arun, MD, is a Senior Resident, Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Structure of the Social Support Network of Patients with Severe and Persistent Psychiatric Disorders in Follow-Ups to Primary Health Care. Arch Psychiatr Nurs 2016; 30:70-6. [PMID: 26804504 DOI: 10.1016/j.apnu.2015.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/29/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022]
Abstract
The objective of this study is to analyze the characteristics of social support networks of patients with psychiatric disorders at follow-up to primary care. This is a cross-sectional qualitative research study. Forty-five interviews were held with patients and their supporters. The results showed small and dense networks, with a strong emphasis on the bonds with formal supporters and a scant network of informal supporters. It is recommended to develop strategies to improve social support networks and use this as an outcome indicator related to social integration of these patients and to the quality of services involved with outpatient healthcare.
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Kanerva A, Lammintakanen J, Kivinen T. Nursing Staff's Perceptions of Patient Safety in Psychiatric Inpatient Care. Perspect Psychiatr Care 2016; 52:25-31. [PMID: 25623953 DOI: 10.1111/ppc.12098] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 10/02/2014] [Accepted: 12/08/2014] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study aims to explore nursing staff's perceptions of patient safety in psychiatric inpatient care. DESIGN AND METHODS Nurses were asked to describe their perceptions in semi-structured interviews, and their responses were analyzed by inductive content analysis. FINDINGS Nurses addressed two sets of factors: one related to the experiences of safety and the other related to the implementation of safe care. PRACTICE IMPLICATIONS The views of the nurses contribute to formalization of organizational policies and strategies. In particular, they highlight the importance of continual training for the staff and management, considering patients' views, and treating patients as collaborators in their care.
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Affiliation(s)
- Anne Kanerva
- Central Finland Health Care District, Jyväskylä, Finland
| | - Johanna Lammintakanen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Tuula Kivinen
- Central Finland Health Care District, Jyväskylä, Finland
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Hauge CH, Jacobs-Knight J, Jensen JL, Burgess KM, Puumala SE, Wilton G, Hanson JD. Establishing survey validity and reliability for American Indians through "think aloud" and test-retest methods. QUALITATIVE HEALTH RESEARCH 2015; 25:820-830. [PMID: 25888693 PMCID: PMC4425588 DOI: 10.1177/1049732315582010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The purpose of this study was to use a mixed-methods approach to determine the validity and reliability of measurements used within an alcohol-exposed pregnancy prevention program for American Indian women. To develop validity, content experts provided input into the survey measures, and a "think aloud" methodology was conducted with 23 American Indian women. After revising the measurements based on this input, a test-retest was conducted with 79 American Indian women who were randomized to complete either the original measurements or the new, modified measurements. The test-retest revealed that some of the questions performed better for the modified version, whereas others appeared to be more reliable for the original version. The mixed-methods approach was a useful methodology for gathering feedback on survey measurements from American Indian participants and in indicating specific survey questions that needed to be modified for this population.
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An interpretive study of nursing students' experiences of caring for suicidal persons. J Prof Nurs 2014; 30:426-35. [PMID: 25223291 DOI: 10.1016/j.profnurs.2014.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Indexed: 11/20/2022]
Abstract
Suicide is a worldwide public health problem. Although preparing nursing students to care for suicidal persons has been a standard part of nursing education for many years, nurses consistently report that they lack competencies in caring for this population of patients. The purpose of this phenomenological and hermeneutical study was to understand the experiences undergraduate nursing students had in regard to caring for suicidal persons. The aim of the study was to obtain insights into the basic preparation of students in the care of suicidal persons to inform pedagogical approaches pertaining to suicide and improve the nursing care for these individuals. Twelve senior nursing students were recruited for the study. Data were collected using in-depth, unstructured interviews. The study themes indicated that (a) when participants read about suicidal persons' mental status and behavior in patient, records they initially feared interacting with and caring for these individuals; (b) participants' abilities to gather information about suicide risk was influenced by how much patients talked with them about their suicidal tendencies; and (c) participants' capacity to provide safe and therapeutic suicide prevention interventions was impacted by judicious critical thinking skills. Teaching strategies that align with the themes are provided.
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Thompson C, Aitken L, Doran D, Dowding D. An agenda for clinical decision making and judgement in nursing research and education. Int J Nurs Stud 2013; 50:1720-6. [DOI: 10.1016/j.ijnurstu.2013.05.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 04/30/2013] [Accepted: 05/04/2013] [Indexed: 01/18/2023]
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Butler MP, Begley M, Parahoo K, Finn S. Getting psychosocial interventions into mental health nursing practice: a survey of skill use and perceived benefits to service users. J Adv Nurs 2013; 70:866-77. [PMID: 24020885 DOI: 10.1111/jan.12248] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Mary Pat Butler
- Department of Nursing and Midwifery; Health Sciences Building; University of Limerick; Ireland
| | - Mary Begley
- Limerick Mental Health Services, St Joseph's Hospital; HSE West; Limerick Ireland
| | - Kader Parahoo
- Institute of Nursing and Health Research; University of Ulster; Coleraine UK
| | - Sophia Finn
- HSE-North Cork Mental Health Service; Mental Health Resource Centre; Charleville, Co Cork Ireland
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Kenny A, Allenby A. Barriers to nurses providing psychosocial care in the Australian rural context. Nurs Health Sci 2012; 15:194-200. [DOI: 10.1111/nhs.12014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 10/08/2012] [Accepted: 10/16/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Amanda Kenny
- La Trobe Rural Health School; La Trobe University; Bendigo; Victoria; Australia
| | - Ann Allenby
- Mt Alexander Hospital; Castlemaine; Victoria; Australia
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MacNeela P, Scott PA, Treacy M, Hyde A, O'Mahony R. A risk to himself: attitudes toward psychiatric patients and choice of psychosocial strategies among nurses in medical-surgical units. Res Nurs Health 2012; 35:200-13. [PMID: 22334254 DOI: 10.1002/nur.21466] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2012] [Indexed: 11/07/2022]
Abstract
Psychiatric patients are liable to stereotyping by healthcare providers. We explored attitudes toward caring for psychiatric patients among 13 nurses working in general hospitals in Ireland. Participants thought aloud in response to a simulated patient case and described a critical incident of a patient for whom they had cared. Two attitudinal orientations were identified that correspond to stereotypical depictions of risk and vulnerability. The nurses described psychosocial care strategies that were pragmatic rather than authentically person-centered, with particular associations between risk-oriented attitudes and directive nursing care. Nurses had expectations likely to impede relationship building and collaborative care. Implications arising include the need for improved knowledge about psychiatric conditions and for access to professional development in targeted therapeutic communication skills.
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Affiliation(s)
- Pádraig MacNeela
- School of Psychology, National University of Ireland, Galway, Galway, Ireland
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Interpersonal community psychiatric treatment for non-psychotic chronic patients and nurses in outpatient mental health care: a controlled pilot study on feasibility and effects. Int J Nurs Stud 2011; 49:549-59. [PMID: 22130506 DOI: 10.1016/j.ijnurstu.2011.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 10/08/2011] [Accepted: 11/04/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the authors. It was evaluated with the aim to increase effective behaviours by both patients and community psychiatric nurses (CPNs). OBJECTIVE To assess the feasibility and effectiveness of an intervention program for use by CPNs in the care of 'difficult' patients with non-psychotic chronic disorders, in a controlled pilot study. DESIGN A mixed-methods quasi-experimental study using process and outcome measures across several dimensions. Measurements took place at 0, 3, and 6 months. SETTINGS Three community mental health centres in the centre of The Netherlands. PARTICIPANTS 14 CPNs and 36 long-term non-psychotic patients who were perceived as 'difficult' were selected. Patients were offered either ICPT (20) or care as usual (16). All patients and CPNs could be followed up at all measurements. METHODS Quantitative data included type and severity of psychiatric disorder, psychosocial functioning, needs for care, quality of life and social participation. Also, service use, satisfaction with care, and quality of the therapeutic alliance were measured. Qualitative interviews were conducted with all CPNs and patients in the experimental group. RESULTS ICPT was found feasible by both CPNs and patients. Both the experimental and control condition showed improvement on a number of outcomes. ICPT, however, resulted in significantly better results in some areas. Patients' social network size increased and their care utilization decreased. Also, the quality of the working alliance increased and perceived patient difficulty decreased, both as scored by professionals. CONCLUSIONS ICPT is one of very few intervention programs aimed at 'difficult' non-psychotic chronic patients. In this pilot study was found that it can be successfully carried out by CPNs, is generally experienced as acceptable and useful by patients and CPNs alike, and results in some significantly better effects on both process and outcome measures. In the main study, some alterations will be made to the instruction manual and training program. Also, the diagnostic interview may be briefer, and the characteristics and treatment integrity of CPNs will be included in measurements. Further controlled and randomized research is needed to test the effectiveness of the program in a larger group of patients.
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