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Berdaweel IA, Monroe TB, Alowaisi AA, Mahoney JC, Liang IC, Berns KA, Gao D, McLendon JM, Anderson EJ. Iron scavenging and suppression of collagen cross-linking underlie antifibrotic effects of carnosine in the heart with obesity. Front Pharmacol 2024; 14:1275388. [PMID: 38348353 PMCID: PMC10859874 DOI: 10.3389/fphar.2023.1275388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/13/2023] [Indexed: 02/15/2024] Open
Abstract
Oral consumption of histidyl dipeptides such as l-carnosine has been suggested to promote cardiometabolic health, although therapeutic mechanisms remain incompletely understood. We recently reported that oral consumption of a carnosine analog suppressed markers of fibrosis in liver of obese mice, but whether antifibrotic effects of carnosine extend to the heart is not known, nor are the mechanisms by which carnosine is acting. Here, we investigated whether oral carnosine was able to mitigate the adverse cardiac remodeling associated with diet induced obesity in a mouse model of enhanced lipid peroxidation (i.e., glutathione peroxidase 4 deficient mice, GPx4+/-), a model which mimics many of the pathophysiological aspects of metabolic syndrome and T2 diabetes in humans. Wild-type (WT) and GPx4+/-male mice were randomly fed a standard (CNTL) or high fat high sucrose diet (HFHS) for 16 weeks. Seven weeks after starting the diet, a subset of the HFHS mice received carnosine (80 mM) in their drinking water for duration of the study. Carnosine treatment led to a moderate improvement in glycemic control in WT and GPx4+/-mice on HFHS diet, although insulin sensitivity was not significantly affected. Interestingly, while our transcriptomic analysis revealed that carnosine therapy had only modest impact on global gene expression in the heart, carnosine substantially upregulated cardiac GPx4 expression in both WT and GPx4+/-mice on HFHS diet. Carnosine also significantly reduced protein carbonyls and iron levels in myocardial tissue from both genotypes on HFHS diet. Importantly, we observed a robust antifibrotic effect of carnosine therapy in hearts from mice on HFHS diet, which further in vitro experiments suggest is due to carnosine's ability to suppress collagen-cross-linking. Collectively, this study reveals antifibrotic potential of carnosine in the heart with obesity and illustrates key mechanisms by which it may be acting.
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Affiliation(s)
- Islam A. Berdaweel
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, United States
- Department of Clinical Pharmacy, College of Pharmacy, Yarmouk University, Irbid, Jordan
| | - T. Blake Monroe
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, United States
| | - Amany A. Alowaisi
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, United States
- Department of Clinical Pharmacy, College of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Jolonda C. Mahoney
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, United States
| | - I-Chau Liang
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, United States
| | - Kaitlyn A. Berns
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, United States
| | - Dylan Gao
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, United States
| | - Jared M. McLendon
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
- Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Ethan J. Anderson
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA, United States
- Abboud Cardiovascular Research Center, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
- Fraternal Order of Eagles Diabetes Research Center, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
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Jang SY, Kim HS, Jeong SH, Kim YM. [Factors Affecting Radiation Protective Behaviors in Perioperative Nurses Applying the Theory of Planned Behavior: Path Analysis]. J Korean Acad Nurs 2023; 53:222-235. [PMID: 37164349 DOI: 10.4040/jkan.22099] [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: 08/25/2022] [Revised: 02/27/2023] [Accepted: 03/30/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE The aim of this study was to identify the factors explaining protective behaviors against radiation exposure in perioperative nurses based on the theory of planned behavior. METHODS This was a cross-sectional study. A total of 229 perioperative nurses participated between October 3 and October 20, 2021. Data were analyzed using SPSS/WIN 23.0 and AMOS 23.0 software. The three exogenous variables (attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control) and two endogenous variables (radiation protective intention and radiation protective behaviors) were surveyed. RESULTS The hypothetical model fit the data (χ²/df = 1.18, SRMR = .02, TLI = .98, CFI = .99, RMSEA = .03). Radiation protective intention (β = .24, p = .001) and attitude toward radiation protective behaviors (β = .32, p = .002) had direct effects on radiation protective behaviors. Subjective norm (β = .43, p = .002) and perceived behavior control (β = .24, p = .003) had direct effects on radiation protective intention, which explained 38.0% of the variance. Subjective norm (β = .10, p = .001) and perceived behavior control (β = .06, p = .002) had indirect effects via radiation protective intention on radiation protective behaviors. Attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control were the significant factors explaining 49.0% of the variance in radiation protective behaviors. CONCLUSION This study shows that the theory of planned behavior can be used to effectively predict radiation protective behaviors in perioperative nurses. Radiation safety guidelines or education programs to enhance perioperative nurses' protective behaviors should focus on radiation protective intention, attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control.
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Affiliation(s)
- Se Young Jang
- Department of Nursing, Jeonbuk National University Hospital, Jeonju, Korea
| | - Hee Sun Kim
- College of Nursing·Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea.
| | - Seok Hee Jeong
- College of Nursing·Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea
| | - Young Man Kim
- College of Nursing·Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea
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Implementing an Evidence-Based Feeding Protocol: Impact on Nurses' Knowledge, Perceptions, and Feeding Culture in the NICU. Adv Neonatal Care 2022; 22:493-502. [PMID: 34596085 DOI: 10.1097/anc.0000000000000923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Evidence-based feeding practices are often variable among neonatal providers due to lack of knowledge and neonatal intensive care unit (NICU) feeding culture norms. PURPOSE To evaluate changes in NICU nurses' knowledge, perceptions, feeding practices and culture following education about, and implementation of, an evidence-based Infant-Driven Feeding (IDF) protocol. METHODS A pre-/postprospective comparative design was used to survey 120 registered nurses employed in a level 3 NICU about feeding practices, knowledge, and culture prior to IDF education and 1 to 2 months after IDF implementation. RESULTS The preeducation survey yielded 59 respondents; of these, 30 responded to the same survey after IDF implementation. Postimplementation responses were significant for fewer nurses making decisions to begin oral feedings ( P = .035), greater use of gestational age to increase frequency of oral feeding attempts ( P = .03), less reliance on weight loss to decrease oral feeding attempts ( P = .018), an increase in use of combination interventions to prepare infants for oral feeding ( P = .001), and greater willingness to allow a rest period or stop the feeding if an infant falls asleep after completing 70% of the feeding ( P = .03). IMPLICATIONS FOR PRACTICE AND RESEARCH Trends in several survey categories following the education program and implementation of IDF support the use of evidence-based practices (EBPs) such as IDF. Future research focused on nurses' perceptions of how education influences integration of specific EBPs into practice is needed. Evaluating EBP mentorship combined with education about EBPs can provide insights on how best to integrate EBPs into practice.
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Theuns-Boumans L, Mathijssen J, Rots-de Vries C, van de Goor I. Survey of intention among public health nurses in providing solution-focused parenting support. Public Health Nurs 2021; 39:643-651. [PMID: 34897767 PMCID: PMC9300147 DOI: 10.1111/phn.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 12/03/2022]
Abstract
Objective Parenting support has shifted from a problem‐focused to a strengths‐based solution‐focused approach. This study surveyed public health nurses to explain their intention to provide solution‐focused parenting support in their practice. Design The design of this study was cross‐sectional. Sample The initial sample included 781 public health nurses who were employed with various youth healthcare organizations in the Netherlands. Measurements Based on the Theory of Planned Behavior, a questionnaire was developed and administered to measure (a) behavioral, normative, and control beliefs, (b) attitudes, subjective norm, and perceived behavioral control, and (c) intention. The data were subjected to structural equation modeling. Results A total of 449 (57.5%) public health nurses completed questionnaires. Associations as indicated by the Theory of Planned Behavior were confirmed with the exception of that between perceived behavioral control and intention. Statistically significant paths and correlations were added. The final model accounted for 53% of the variance in the intention to perform solution‐focused parenting support. Conclusions In this study, public health nurses strongly intended to provide solution‐focused parenting support, thus indicating their acceptance of the approach. Their intention was predominantly associated with subjective norm.
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Affiliation(s)
- Liesbeth Theuns-Boumans
- Department Tranzo, Academic Collaborative Centre Youth, Tilburg University, Tilburg, The Netherlands.,Avans University of Applied Sciences, Bachelor of Nursing, Breda, The Netherlands
| | - Jolanda Mathijssen
- Department Tranzo, Academic Collaborative Centre Youth, Tilburg University, Tilburg, The Netherlands
| | - Carin Rots-de Vries
- Department Tranzo, Tilburg University, Academic Collaborative Centre Public Health, Tilburg, The Netherlands
| | - Ien van de Goor
- Department Tranzo, Tilburg University, Academic Collaborative Centre Public Health, Tilburg, The Netherlands
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A pre-experimental pilot study exploring EBP Beliefs and EBP Implementation among post-graduate student nurses in Saudi Arabia. Nurse Educ Pract 2021; 57:103215. [PMID: 34700260 DOI: 10.1016/j.nepr.2021.103215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 09/07/2021] [Accepted: 09/20/2021] [Indexed: 11/21/2022]
Abstract
AIM This study aimed to measure the impact of a dedicated EBP module on the knowledge, skills and capability for EBP of students undertaking the inaugural MSc in Nursing: Advanced Practice programme in the KSA. BACKGROUND Evidence-based practice (EBP) yields multiple benefits for all key stakeholders of healthcare. Key to this are healthcare professionals armed with necessary EBP knowledge and skills. Nurses, the largest professional group in healthcare, can be instrumental in effecting sustained EBP implementation. In the Kingdom of Saudi Arabia (KSA) achieving this is hindered by a chronic shortage of nurses and a heavy reliance on expatriate nurses who are often a transient workforce, resulting in a high turnover. The Government of Saudi Arabia 2030 Vision aspires to address the indigenous nurse shortage and the quality of healthcare. In 2017 the inaugural MSc in Nursing: Advanced Practice programme was established in the KSA to prepare Saudi nurses for emerging advanced practice roles. A dedicated EBP module was a core component of the programme. METHODS A pre-experimental pilot study conducted over 18-months collected data from the same participants at three different points. Two validated EBP questionnaires measuring EBP Beliefs and EBP Implementation were administered to post-graduate students undertaking the MSc in Nursing: Advanced Practice programme in one Higher Education Institution in the KSA. Descriptive, inferential and correlational statistics were employed to analyse the demographic data, group mean scores and distribution on the EBP scales, as well the correlation between EBP Beliefs and EBP Implementation. FINDINGS Findings demonstrated that the educational intervention did improve participants' EBP beliefs and implementation. Participants reported positive beliefs about EBP at all 3 data collection points (M = 57.4 SD = 7.0; M = 62.54 SD = 7.21; M = 55.31 SD = 15.81, respectively). EBP implementation was low prior to undertaking the module but improved thereafter as illustrated across the 3 data collection points (M = 15.14 SD = 11.9; M = 27.64 SD = 14.35; M = 25.9 SD = 20.43). On both measures, higher scores indicate higher EBP beliefs and implementation. CONCLUSION This study established the EBP Beliefs and EBP Implementation of a sample of postgraduate nursing students in the KSA. Findings revealed a substantial improvement in both EBP Beliefs and EBP Implementation following the EBP module. Findings support the use of a dedicated module to prepare nurses to use EBP and to practice at an advanced level while simultaneously preparing them for leadership roles in healthcare in KSA. In so doing, this will help to advance the healthcare goals of the KSA 2030 vision.
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Archambault P, Turcotte S, Smith PY, Said Abasse K, Paquet C, Côté A, Gomez D, Khechine H, Gagnon MP, Tremblay M, Elazhary N, Légaré F. Intention to Use Wiki-Based Knowledge Tools: Survey of Quebec Emergency Health Professionals. JMIR Med Inform 2021; 9:e24649. [PMID: 34142977 PMCID: PMC8277401 DOI: 10.2196/24649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/16/2021] [Accepted: 05/07/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Clinical decision support systems are information technologies that assist clinicians in making better decisions. Their adoption has been limited because their content is difficult to adapt to local contexts and slow to adapt to emerging evidence. Collaborative writing applications such as wikis have the potential to increase access to existing and emerging evidence-based knowledge at the point of care, standardize emergency clinical decision making, and quickly adapt this knowledge to local contexts. However, little is known about the factors influencing health professionals' use of wiki-based knowledge tools. OBJECTIVE This study aims to measure emergency physicians' (EPs) and other acute care health professionals' (ACHPs) intentions to use wiki-based knowledge tools in trauma care and identify determinants of this intention that can be used in future theory-based interventions for promoting the use of wiki-based knowledge tools in trauma care. METHODS In total, 266 EPs and 907 ACHPs (nurses, respiratory therapists, and pharmacists) from 12 Quebec trauma centers were asked to answer a survey based on the theory of planned behavior (TPB). The TPB constructs were measured using a 7-point Likert scale. Descriptive statistics and Pearson correlations between the TPB constructs and intention were calculated. Multiple linear regression analysis was conducted to identify the salient beliefs. RESULTS Among the eligible participants, 57.1% (152/266) of EPs and 31.9% (290/907) of ACHPs completed the questionnaire. For EPs, we found that attitude, perceived behavioral control (PBC), and subjective norm (SN) were significant determinants of the intention to use wiki-based knowledge tools and explained 62% of its variance. None of the sociodemographic variables were related to EPs' intentions to use wiki-based knowledge tools. The regression model identified two normative beliefs ("approval by physicians" and "approval by patients") and two behavioral beliefs ("refreshes my memory" and "reduces errors"). For ACHPs, attitude, PBC, SN, and two sociodemographic variables (profession and the previous personal use of a wiki) were significantly related to the intention to use wiki-based knowledge tools and explained 60% of the variance in behavioral intention. The final regression model for ACHPs included two normative beliefs ("approval by the hospital trauma team" and "people less comfortable with information technology"), one control belief ("time constraints"), and one behavioral belief ("access to evidence"). CONCLUSIONS The intentions of EPs and ACHPs to use wiki-based knowledge tools to promote best practices in trauma care can be predicted in part by attitude, SN, and PBC. We also identified salient beliefs that future theory-based interventions should promote for the use of wiki-based knowledge tools in trauma care. These interventions will address the barriers to using wiki-based knowledge tools, find ways to ensure the quality of their content, foster contributions, and support the exploration of wiki-based knowledge tools as potential effective knowledge translation tools in trauma care.
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Affiliation(s)
- Patrick Archambault
- Département de médecine d'urgence, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, QC, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada
- VITAM - Centre de recherche en santé durable, Université Laval, Québec, QC, Canada
| | - Stéphane Turcotte
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, QC, Canada
| | - Pascal Y Smith
- Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, QC, Canada
| | - Kassim Said Abasse
- Département de management, Faculté des sciences de l'administration, Université Laval, Québec, QC, Canada
| | - Catherine Paquet
- Département de marketing, Faculté des sciences de l'administration, Université Laval, Québec, QC, Canada
| | - André Côté
- Département de management, Faculté des sciences de l'administration, Université Laval, Québec, QC, Canada
| | - Dario Gomez
- Département de systèmes d'information organisationnels, Faculté des sciences de l'administration, Université Laval, Québec, QC, Canada
| | - Hager Khechine
- Département de systèmes d'information organisationnels, Faculté des sciences de l'administration, Université Laval, Québec, QC, Canada
| | - Marie-Pierre Gagnon
- VITAM - Centre de recherche en santé durable, Université Laval, Québec, QC, Canada
- Faculté des sciences infirmières, Université Laval, Québec, QC, Canada
| | - Melissa Tremblay
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Nicolas Elazhary
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada
- VITAM - Centre de recherche en santé durable, Université Laval, Québec, QC, Canada
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Fontaine G, Cossette S, Gagnon MP, Dubé V, Côté J. Effectiveness of a Theory- and Web-Based Adaptive Implementation Intervention on Nurses' and Nursing Students' Intentions to Provide Brief Counseling: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e18894. [PMID: 32734932 PMCID: PMC7473472 DOI: 10.2196/18894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Brief counseling can motivate patients to initiate health behavior change. However, increasing the provision of brief counseling by nurses is difficult due to contextual and practitioner-level factors impeding nurses' motivation and intentions to provide brief counseling (eg, unfavorable attitude toward brief counseling, lack of perceived control linked to barriers). Theory-based implementation interventions could address these practitioner-level factors and support evidence-based practice in the context of brief counseling. Web-based, adaptive e-learning (electronic learning) programs are a novel type of implementation intervention that could address the limitations of current brief counseling training programs, such as accessibility and personalization. OBJECTIVE This paper presents a study protocol for evaluating the effectiveness of the E_MOTIVA implementation intervention-a theory- and web-based adaptive e-learning program-to increase nurses' and nursing students' intentions to provide brief counseling for smoking, an unbalanced diet, and medication nonadherence. METHODS A two-group, single-blind, randomized controlled trial will be conducted with nurses and nursing students enrolled in a Bachelor of Science in Nursing program in Quebec, Canada. Participants in the experimental group will be allocated to the E_MOTIVA intervention-a theory- and web-based adaptive e-learning program-while participants in the active control group will be allocated to the E_MOTIVB intervention, a knowledge- and web-based standardized e-learning program. The E_MOTIVA intervention was designed to influence the constructs of the Theory of Planned Behavior (eg, attitude, subjective norms, and perceived behavioral control) in the context of brief counseling. The Cognitive Load Index and User Engagement Scale will be used to assess participants' cognitive load and engagement related to e-learning. Participants will complete the Brief Counseling Nursing Practices Questionnaire-Abridged Version at baseline and follow-up. All study measures will be completed online. RESULTS The study is ongoing. The results of the study will provide answers to the primary hypothesis (H1) that experimental group participants will demonstrate a greater change in the score of intentions to provide brief counseling between baseline (-T1) and follow-up (T4). Secondary hypotheses include greater improvements in scores of attitude (H2), subjective norms (H3), perceived control (H4), behavioral beliefs (H5), normative beliefs (H6), and control beliefs (H7) regarding brief counseling in the experimental group between baseline and follow-up. We also anticipate lower intrinsic and extrinsic cognitive loads (H8, H9), higher germane cognitive load (H10), and higher engagement (H11, H12) in the experimental group. CONCLUSIONS This study will be among the first in evaluating a novel type of implementation intervention, a theory- and web-based adaptive e-learning program, in nurses and nursing students. This type of intervention has the potential to support evidence-based practice through accessible, personalized training in wide-ranging domains in nursing. TRIAL REGISTRATION ISRCTN Registry ISRCTN32603572; http://www.isrctn.com/ISRCTN32603572. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/18894.
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Affiliation(s)
- Guillaume Fontaine
- Research Center, Montreal Heart Institute, Montréal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | - Sylvie Cossette
- Research Center, Montreal Heart Institute, Montréal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Gagnon
- Faculty of Nursing, Université Laval, Québec, QC, Canada
- Research Center, CHU de Québec, Québec, QC, Canada
| | - Véronique Dubé
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
- Research Center, University of Montreal Hospital Center, Montréal, QC, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
- Research Center, University of Montreal Hospital Center, Montréal, QC, Canada
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Assessment of healthcare workers' behavior in implementing a newborn screening program for congenital hypothyroidism in Perak, Malaysia. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-08-2019-0198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThe aim of this study is to assess healthcare workers' behavior on the congenital hypothyroidism screening program implementation based on a framework protocol and its associated factors.Design/methodology/approachA cross-sectional study was conducted using the multistage random sampling method in recruiting health clinic workers and purposive sampling techniques for hospital workers. The demographics, providers' characteristic, occupational profile, attitude, perceived behavior control (PBC), knowledge, behavioral intention and adherence to protocol were gathered using validated and reliable self-administered questionnaires.FindingsPartial intention to adhere to protocol was 25.7%. Weak attitude (adjusted odds ratio [AOR]: 5.48, 95% confidence interval [CI]: 3.32–9.06), low PBC score (AOR: 0.91, 95% CI: 0.86–0.95) and low knowledge score (AOR: 0.85, 95% CI: 0.75–0.96) were associated with partial intention to adhere to protocol. In the self-rated adherence assessment, 92.6% of participants from health clinics, 79.1% from pediatric and 61.1% from pathology were found not adhering to protocol. There was a significant association between intention and adherence to protocol.Research limitations/implicationsDocumentations and observations in assessing program implementation were limited to perform in the present study. Using self-rated instruments and focusing on healthcare workers alone did not provide a comprehensive assessment.Practical implicationsAvailability of a training module at site and regular refreshing course training should be made available to harness knowledge, attitude and behavioral perception in implementing the program activities.Originality/valueIntegrating the Logical Framework Approach in assessing program implementation and application of the Theory of Planned Behavior and Attitude, Subjective Norms, Self-Efficacy Model in this study were beneficial.
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Adekpedjou R, Haesebaert J, Stacey D, Brière N, Freitas A, Rivest LP, Légaré F. Variations in factors associated with healthcare providers' intention to engage in interprofessional shared decision making in home care: results of two cross-sectional surveys. BMC Health Serv Res 2020; 20:203. [PMID: 32164669 PMCID: PMC7069220 DOI: 10.1186/s12913-020-5064-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 02/28/2020] [Indexed: 12/14/2022] Open
Abstract
Background DOLCE (Improving Decision making On Location of Care with the frail Elderly and their caregivers) was a post-intervention clustered randomised trial (cRT) to assess the effect of training home care teams on interprofessional shared decision-making (IP-SDM). Alongside the cRT, we sought to monitor healthcare providers’ level of behavioural intention to engage in an IP-SDM approach and to identify factors associated with this intention. Methods We conducted two cross-sectional surveys in the province of Quebec, Canada, one each at cRT entry and exit. Healthcare providers (e.g. nurses, occupational therapists and social workers) in the 16 participating intervention and control sites self-completed an identical paper-based questionnaire at entry and exit. Informed by the Integrated model for explaining healthcare professionals’ clinical behaviour by Godin et al. (2008), we assessed their behavioural intention to engage in IP-SDM to support older adults and caregivers of older adults with cognitive impairment to make health-related housing decisions. We also assessed psychosocial variables underlying their behavioural intention and collected sociodemographic data. We used descriptive statistics and linear mixed models to account for clustering. Results Between 2014 and 2016, 271 healthcare providers participated at study entry and 171 at exit. At entry, median intention level was 6 in a range of 1 (low) to 7 (high) (Interquartile range (IQR): 5–6.5) and factors associated with intention were social influence (β = 0.27, P < 0.0001), beliefs about one’s capabilities (β = 0.43, P < 0.0001), moral norm (β = 0.31, P < 0.0001) and beliefs about consequences (β = 0.21, P < 0.0001). At exit, median intention level was 5.5 (IQR: 4.5–6.5). Factors associated with intention were the same but did not include moral norm. However, at exit new factors were kept in the model: working in rehabilitation (β = − 0.39, P = 0.018) and working as a technician (β = − 0.41, P = 0.069) (compared to as a social worker). Conclusion Intention levels were high but decreased from entry to exit. Factors associated with intention also changed from study entry to study exit. These findings may be explained by the major restructuring of the health and social care system that took place during the 2 years of the study, leading to rapid staff turnover and organisational disturbance in home care teams. Future research should give more attention to contextual factors and design implementation interventions to withstand the disruption of system- and organisational-level disturbances. Trial registration Clinicaltrials.gov (NCT02244359). Registered on September 19th, 2014.
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Affiliation(s)
- Rhéda Adekpedjou
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Quebec, Canada
| | - Julie Haesebaert
- Université de Lyon, Université Claude Bernard Lyon 1, Université Saint-Étienne, HESPER EA 7425, F-69008 Lyon, F-42023, Saint-Etienne, France
| | - Dawn Stacey
- Ottawa Hospital Research Institute and Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Nathalie Brière
- Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec, Canada
| | - Adriana Freitas
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Quebec, Canada
| | - Louis-Paul Rivest
- Department of Mathematics and Statistics, Université Laval, Quebec, Canada
| | - France Légaré
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Quebec, Canada. .,Canada Research Chair in Shared Decision Making and Knowledge Translation, 2525, chemin de la Canardière, Quebec, G1J 0A4, Canada.
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Abstract
Four decades ago, perioperative nursing transitioned from a task-oriented and problem-focused specialty to a patient-centered discipline. This transition involved the incorporation of research and implementation of evidence-based practice to improve patient care. This article discusses the theory of planned behavior (TPB) and its possible application in the perioperative practice area. There is a lack of published literature on the direct use of the TPB to describe and explain perioperative practice behaviors. Perioperative leaders and educators can use this theory to help them understand their staff members' behaviors (eg, lack of adherence to policies for patient care activities [eg, surgical counting]). Using the model may help leaders and educators determine the intentions behind staff members' behaviors and identify participants' attitudes, subjective beliefs, and perceived control over their behaviors. This information should help leaders and educators implement effective strategies to improve patient safety and clinical outcomes.
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Bastani P, Alipoori S, Imani-Nasab MH, Jamalabadi S, Kavosi Z. Evidence-based decision making among healthcare managers: Evidence from a developing Country. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1632002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Peivand Bastani
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayeh Alipoori
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad-Hasan Imani-Nasab
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Sara Jamalabadi
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kavosi
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
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Knowledge, Attitudes, Social Desirability, and Organizational Characteristics in Youth Mental Health Services. J Behav Health Serv Res 2018; 43:630-647. [PMID: 26645291 DOI: 10.1007/s11414-015-9491-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This project investigated the extent to which knowledge of evidence-based practices (EBPs) and organizational characteristics predicted attitudes toward EBPs, while controlling for social desirability and organization membership. Participants were 167 public sector youth practitioners. Hierarchical multiple regression analyses were conducted to determine which factors significantly predicted EBP attitudes. Findings suggested that social desirability, organization membership, and various organizational characteristics predicted EBP attitudes. Results are discussed as they relate to the importance of including social desirability in future research and identifying different factors that influence EBP attitudes across various organizations.
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Lawn S, Zhi X, Morello A. An integrative review of e-learning in the delivery of self-management support training for health professionals. BMC MEDICAL EDUCATION 2017; 17:183. [PMID: 29017521 PMCID: PMC5634849 DOI: 10.1186/s12909-017-1022-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 09/29/2017] [Indexed: 05/07/2023]
Abstract
BACKGROUND E-learning involves delivery of education through Information and Communication Technology (ITC) using a wide variety of instructional designs, including synchronous and asynchronous formats. It can be as effective as face-to-face training for many aspects of health professional training. There are, however, particular practices and skills needed in providing patient self-management support, such as partnering with patients in goal-setting, which may challenge conventional practice norms. E-learning for the delivery of self-management support (SMS) continuing education to existing health professionals is a relatively new and growing area with limited studies identifying features associated with best acquisition of skills in self-management support. METHODS An integrative literature review examined what is known about e-learning for self-management support. This review included both qualitative and quantitative studies that focused on e-learning provided to existing health professionals for their continuing professional development. Papers were limited to those published in English between 2006 and 2016. Content analysis was used to organize and focus and describe the findings. RESULTS The search returned 1505 articles, with most subsequently excluded based on their title or abstract. Fifty-two full text articles were obtained and checked, with 42 excluded because they did not meet the full criteria. Ten peer-reviewed articles were included in this review. Seven main themes emerged from the content analysis: participants and professions; time; package content; guiding theoretical framework; outcome measures; learning features or formats; and learning barriers. These themes revealed substantial heterogeneity in instructional design and other elements of e-learning applied to SMS, indicating that there is still much to understand about how best to deliver e-learning for SMS skills development. CONCLUSIONS Few e-learning approaches meet the need for high levels of interactivity, reflection, practice and application to practice for health professionals learning to deliver effective SMS. Findings suggest that the context of SMS for patients with chronic condition matters to how health professional training is delivered, to ensure partnership and person-centred care. Further creative approaches and their rigorous evaluation are needed to deliver completely online learning in this space. Blended learning that combines e-learning and face-to-face methods is suggested to support SMS skills development for health professionals.
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Affiliation(s)
- Sharon Lawn
- Flinders Human Behaviour & Health Research Unit, Department of Psychiatry, Flinders University, PO Box 2100, Adelaide, South Australia 5001 Australia
| | - Xiaojuan Zhi
- Flinders Human Behaviour & Health Research Unit, Department of Psychiatry, Flinders University, PO Box 2100, Adelaide, South Australia 5001 Australia
| | - Andrea Morello
- Flinders Human Behaviour & Health Research Unit, Department of Psychiatry, Flinders University, PO Box 2100, Adelaide, South Australia 5001 Australia
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Kang KA, Kim SJ, Kaneko N. Factors influencing behavioral intention to undergo Papanicolaou testing in early adulthood: Comparison of Japanese and Korean women. Nurs Health Sci 2017; 19:475-484. [PMID: 28833987 DOI: 10.1111/nhs.12370] [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: 03/01/2017] [Revised: 05/28/2017] [Accepted: 06/07/2017] [Indexed: 11/29/2022]
Abstract
In this study, we identified the factors influencing behavioral intention to undergo Papanicolaou testing among Japanese and Korean women in early adulthood. Their behavioral intentions were compared in this cross-sectional descriptive study. In total, 887 women (Japanese = 498, Korean = 389) aged 20-39 years participated in this study. Using a self-report questionnaire, knowledge, attitudes, subjective norm, perceived behavioral control, and behavioral intention were surveyed. There were significant differences between Japanese and Korean women's scores on all main variables. For Japanese women, all the variables moderately correlated with behavioral intention. In comparison, for Korean women, all independent variables, except for knowledge, moderately correlated with behavioral intention. Through a multiple regression analysis, age, undergoing Papanicolaou testing, attitudes, subjective norm, and perceived behavioral control were identified as significant predictors of behavioral intention among Japanese women. Among Korean women, job status, undergoing a Papanicolaou test, attitudes, subjective norm, and perceived behavioral control were demonstrated as significant predictors of behavioral intention. Health professionals should consider these factors to encourage Papanicolaou testing in women in early adulthood.
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Affiliation(s)
- Kyung-Ah Kang
- Department of Nursing, Sahmyook University, Seoul, South Korea
| | - Shin-Jeong Kim
- Department of Nursing, Hallym University, Chuncheon, South Korea
| | - Noriyo Kaneko
- School of Nursing, Nagoya City University, Nagoya, Japan
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Van Kessel G, Hillier S, English C. Physiotherapists' attitudes toward circuit class therapy and 7 day per week therapy is influenced by normative beliefs, past experience, and perceived control: A qualitative study. Physiother Theory Pract 2017; 33:850-858. [PMID: 28786711 DOI: 10.1080/09593985.2017.1357152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Attitudes are recognized as influencing research implementation. However, little is known about the process by which physiotherapists' attitudes and beliefs shape their use of 7-day per week therapy and circuit class therapy research findings. Understanding beliefs may assist in addressing barriers to research uptake. METHODS Fifteen physiotherapists from six rehabilitation centers who ranged in seniority, experience, and education levels consented to be interviewed. The transcribed interviews were analyzed using a qualitative content analysis drawing on the Theory of Planned Behavior. FINDINGS Participants felt that they had autonomy in adopting new approaches when the evidence was supported by social norms. Participants believed that 7-day per week therapy delivers a seamless service that increases physiotherapy time, which helps maintain patient improvement, but needs to accommodate patient choice and expectations. Circuit class therapy was viewed positively as it provides more physiotherapy time, increases patient social interaction, and motivation. However, this was qualified by a belief that patients would not receive individualized, quality of movement focused therapy, particularly for patients with limited capacities. CONCLUSION Implementation of a new approach depends on the past experience, coherence with individual beliefs regarding important elements of therapy content, and opportunities to control barriers to implementation.
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Affiliation(s)
- Gisela Van Kessel
- a School of Health Sciences , University of South Australia , Adelaide , Australia
| | - Susan Hillier
- a School of Health Sciences , University of South Australia , Adelaide , Australia
| | - Coralie English
- b School of Health Sciences, Faculty of Health and Medicine , University of Newcastle , Callaghan , Australia
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Guo R, Berkshire SD, Fulton LV, Hermanson PM. Predicting intention to use evidence-based management among U.S. healthcare administrators: Application of the theory of planned behavior and structural equation modeling. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2017. [DOI: 10.1080/20479700.2017.1336856] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ruiling Guo
- Health Care Administration Program, Kasiska School of Health Professions, Idaho State University, Pocatello, ID, USA
| | - Steven D. Berkshire
- Doctor of Health Administration Program, College of Health Professions, Central Michigan University, Mount Pleasant, MI, USA
| | - Lawrence V. Fulton
- Department of Health Organization Management, Rawls College of Business, Texas Tech University, Lubbock, TX, USA
| | - Patrick M. Hermanson
- Health Care Administration Program, Kasiska School of Health Professions, Idaho State University, Pocatello, ID, USA
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Angelis AD, Pancani L, Steca P, Colaceci S, Giusti A, Tibaldi L, Alvaro R, Ausili D, Vellone E. Testing an explanatory model of nurses' intention to report adverse drug reactions in hospital settings. J Nurs Manag 2017; 25:307-317. [PMID: 28127821 DOI: 10.1111/jonm.12467] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 12/01/2022]
Abstract
AIM To test an explanatory model of nurses' intention to report adverse drug reactions in hospital settings, based on the theory of planned behaviour. BACKGROUND Under-reporting of adverse drug reactions is an important problem among nurses. METHODS A cross-sectional design was used. Data were collected with the adverse drug reporting nurses' questionnaire. Confirmatory factor analysis was performed to test the factor validity of the adverse drug reporting nurses' questionnaire, and structural equation modelling was used to test the explanatory model. RESULTS The convenience sample comprised 500 Italian hospital nurses (mean age = 43.52). Confirmatory factor analysis supported the factor validity of the adverse drug reporting nurses' questionnaire. The structural equation modelling showed a good fit with the data. Nurses' intention to report adverse drug reactions was significantly predicted by attitudes, subjective norms and perceived behavioural control (R² = 0.16). CONCLUSIONS The theory of planned behaviour effectively explained the mechanisms behind nurses' intention to report adverse drug reactions, showing how several factors come into play. IMPLICATIONS FOR NURSING MANAGEMENT In a scenario of organisational empowerment towards adverse drug reaction reporting, the major predictors of the intention to report are support for the decision to report adverse drug reactions from other health care practitioners, perceptions about the value of adverse drug reaction reporting and nurses' favourable self-assessment of their adverse drug reaction reporting skills.
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Affiliation(s)
- Alessia De Angelis
- Department of Nursing, Local Health Authority Roma 4, Civitavecchia, Rome, Italy
| | - Luca Pancani
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Sofia Colaceci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Angela Giusti
- National Center of Epidemiology, Surveillance and Health Promotion National Institute of Health, Rome, Italy
| | - Laura Tibaldi
- Department of Nursing, Local Health Authority Roma 4, Civitavecchia, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Park H, Jang KS. [Structural Model of Evidence-Based Practice Implementation among Clinical Nurses]. J Korean Acad Nurs 2016; 46:697-709. [PMID: 27857013 DOI: 10.4040/jkan.2016.46.5.697] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 07/04/2016] [Accepted: 07/04/2016] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was conducted to develop and test a structural model of evidence-based practice (EBP) implementation among clinical nurses. The model was based on Melnyk and Fineout-Overholt's Advancing Research and Clinical Practice through Close Collaboration model and Rogers' Diffusion of Innovations theory. METHODS Participants were 410 nurses recruited from ten different tertiary hospitals in Korea. A structured self-report questionnaire was used to assess EBP knowledge/skills, EBP beliefs, EBP attitudes, organizational culture & readiness for EBP, dimensions of a learning organization and organizational innovativeness. Collected data were analyzed using SPSS/WINdows 20.0 and AMOS 20.0 program. RESULTS The modified research model provided a reasonable fit to the data. Clinical nurses' EBP knowledge/skills, EBP beliefs, and the organizational culture & readiness for EBP had statistically significant positive effects on the implementation of EBP. The impact of EBP attitudes was not significant. The dimensions of the learning organization and organizational innovativeness showed statistically significant negative effects on EBP implementation. These variables explained 32.8% of the variance of EBP implementation among clinical nurses. CONCLUSION The findings suggest that not only individual nurses' knowledge/skills of and beliefs about EBP but organizational EBP culture should be strengthened to promote clinical nurses' EBP implementation.
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Affiliation(s)
| | - Keum Seong Jang
- College of Nursing, Chonnam National University·Chonnam Research Institute of Nursing Science, Gwangju, Korea.
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Lee CF, Chiang IC, Hwang FM, Chi LK, Lin HM. Using the Theory of Planned Behavior to predict pregnant women's intention to engage in regular exercise. Midwifery 2016; 42:80-86. [DOI: 10.1016/j.midw.2016.09.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/17/2016] [Accepted: 09/22/2016] [Indexed: 11/16/2022]
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Martin JR, Beegle NL, Zhu Y, Hanisch EM. Subcutaneous Administration of Bortezomib: A Pilot Survey of Oncology Nurses. J Adv Pract Oncol 2015; 6:308-18. [PMID: 26705492 PMCID: PMC4677804 DOI: 10.6004/jadpro.2015.6.4.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Subcutaneous (SC) administration of the proteasome inhibitor bortezomib was approved in the United States and European Union in 2012. There is limited guidance regarding how to administer SC bortezomib and a general lack of clear direction on optimal techniques for administering SC chemotherapy injections. Nurses may be utilizing different techniques, and inconsistent techniques may result in injection-site reactions, causing patient discomfort and treatment cessatioin. This observational survey of oncology nurses in community oncology clinics aimed to identify techniques being used and explore nurses’ opinions about SC bortezomib administration. A 44-question electronic survey was developed, based on the current literature regarding appropriate techniques for administering SC injections. A total of 43 nurses from 17 clinics in 12 states responded. The majority (74%) had been practicing oncology nursing for at more than 5 years. Respondents predominantly used and preferred the abdomen for injections (88%); 81% used a skin lift to ensure injection into adipose tissue. There was no relationship between the angle of insertion and the needle length; 51% used an air-bubble technique. Nurses took 3–5 (49%), 5–10 (35%), 10–30 (9%), or > 30 (7%) seconds to administer each mL of SC bortezomib injection. All nurses completely/somewhat agreed that practice guidelines would be important for standardizing SC bortezomib administration. Advanced practice registered nurses (APRNs) shared the responsibility for ordering SC bortezomib, according to 53% of respondents. These findings could help APRNs improve the quality of patient care, may help minimize adverse events and maximize effective therapy, and could help inform the development of practice guidelines.
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Affiliation(s)
| | - Nancy L Beegle
- Cancer Clinics of Excellence, Greenwood Village, Colorado
| | - Yanyan Zhu
- Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, Massachusetts
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Welch J. Building a foundation for brief motivational interviewing: communication to promote health literacy and behavior change. J Contin Educ Nurs 2015; 45:566-72. [PMID: 25401341 DOI: 10.3928/00220124-20141120-03] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/12/2014] [Indexed: 11/20/2022]
Abstract
The use of collaborative communication styles such as motivational interviewing promotes patient engagement, health literacy, self-management, and improved outcomes for individuals with chronic illness. Brief motivational interviewing is an adaptation developed for use with medical populations in time-limited encounters. Inpatient nurses caring for individuals with chronic diagnoses may lack knowledge regarding brief motivational interviewing. This evidence-based quality improvement project used an online approach to introduce continuing education regarding brief motivational interviewing within the constraints of the inpatient setting. Nurses on four units in a community hospital completed a web-based learning module in preparation for context-based skills training. A significant increase in knowledge scores, combined with strong positive attitudes prior to and following the module, indicated a reliable foundation for skills training within the practice setting. Nurses' enhanced ability to recognize the practice of motivational interviewing in scenarios following online education supported the potential value of a hybrid approach to education.
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Knowles S, Lam LT, McInnes E, Elliott D, Hardy J, Middleton S. Knowledge, attitudes, beliefs and behaviour intentions for three bowel management practices in intensive care: effects of a targeted protocol implementation for nursing and medical staff. BMC Nurs 2015; 14:6. [PMID: 25663819 PMCID: PMC4320841 DOI: 10.1186/s12912-015-0056-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 01/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bowel management protocols have the potential to minimize complications for critically ill patients. Targeted implementation can increase the uptake of protocols by clinicians into practice. The theory of planned behaviour offers a framework in which to investigate clinicians' intention to perform the behaviour of interest. This study aimed to evaluate the effect of implementing a bowel management protocol on intensive care nursing and medical staffs' knowledge, attitude, subjective norms, perceived behavioural control, behaviour intentions, role perceptions and past behaviours in relation to three bowel management practices. METHODS A descriptive before and after survey using a self-administered questionnaire sent to nursing and medical staff working within three intensive care units before and after implementation of our bowel management protocol (pre: May - June 2008; post: Feb - May 2009). RESULTS Participants had significantly higher knowledge scores post-implementation of our protocol (pre mean score 17.6; post mean score 19.3; p = 0.004). Post-implementation there was a significant increase in: self-reported past behaviour (pre mean score 5.38; post mean score 7.11; p = 0.002) and subjective norms scores (pre mean score 3.62; post mean score 4.18; p = 0.016) for bowel assessment; and behaviour intention (pre mean score 5.22; post mean score 5.65; p = 0.048) for administration of enema. CONCLUSION This evaluation, informed by the theory of planned behaviour, has provided useful insights into factors that influence clinician intentions to perform evidence-based bowel management practices in intensive care. Addressing factors such as knowledge, attitudes and beliefs can assist in targeting implementation strategies to positively affect clinician behaviour change. Despite an increase in clinicians' knowledge scores, our implementation strategy did not, however, significantly change clinician behaviour intentions for all three bowel management practices. Further research is required to explore the influence of opinion leaders and organizational culture on clinicians' behaviour intentions related to bowel management for intensive care patients.
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Affiliation(s)
- Serena Knowles
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Australia, and Clinical Nurse Specialist, Intensive Care Service, St. Vincent's Hospital, Sydney, Australia
| | - Lawrence T Lam
- Department of Health and Physical Education, The Hong Kong Institute of Education, Hong Kong, Hong Kong
| | - Elizabeth McInnes
- Nursing Research Institute, St Vincent's Health Australia (Syd) and Australian Catholic University, Sydney, NSW Australia
| | - Doug Elliott
- Faculty of Health, University of Technology, Sydney, Australia
| | - Jennifer Hardy
- Sydney Nursing School, University of Sydney, Sydney, Australia
| | - Sandy Middleton
- Nursing Research Institute, St Vincent's Health Australia (Syd) and Australian Catholic University, Executive Suite, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW Australia
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Friesen-Storms JH, Bours GJ, van der Weijden T, Beurskens AJ. Shared decision making in chronic care in the context of evidence based practice in nursing. Int J Nurs Stud 2015; 52:393-402. [DOI: 10.1016/j.ijnurstu.2014.06.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 06/15/2014] [Accepted: 06/27/2014] [Indexed: 10/25/2022]
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Walsh A. The effect of social interaction on mental health nurse student learning. Nurse Educ Pract 2015; 15:7-12. [DOI: 10.1016/j.nepr.2014.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 07/01/2014] [Accepted: 11/09/2014] [Indexed: 10/24/2022]
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Lavoie M, Godin G, Vézina-Im LA, Blondeau D, Martineau I, Roy L. Psychosocial determinants of nurses’ intention to practise euthanasia in palliative care. Nurs Ethics 2014; 23:48-60. [DOI: 10.1177/0969733014557117] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Most studies on euthanasia fail to explain the intentions of health professionals when faced with performing euthanasia and are atheoretical. Research objective: The purpose of this study was to identify the psychosocial determinants of nurses’ intention to practise euthanasia in palliative care if it were legalised. Research design: A cross-sectional study using a validated anonymous questionnaire based on an extended version of the Theory of Planned Behaviour. Participants and research context: A random sample of 445 nurses from the province of Quebec, Canada, was selected for participation in the study. Ethical considerations: The study was reviewed and approved by the Ethics Committee of the Centre hospitalier universitaire de Québec. Findings: The response rate was 44.2% and the mean score for intention was 4.61 ± 1.90 (range: 1–7). The determinants of intention were the subjective (odds ratio = 3.08; 95% confidence interval: 1.50–6.35) and moral (odds ratio = 2.95; 95% confidence interval: 1.58–5.49) norms. Specific beliefs which could discriminate nurses according to their level of intention were identified. Discussion: Overall, nurses have a slightly positive intention to practise euthanasia. Their family approval seems particularly important and also the approval of their medical colleagues. Nurses’ moral norm was related to beneficence, an ethical principle. Conclusion: To our knowledge, this is the first study to identify nurses’ motivations to practise euthanasia in palliative care using a validated psychosocial theory. It also has the distinction of identifying the ethical principles underlying nurses’ moral norm and intention.
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Affiliation(s)
- Mireille Lavoie
- Laval University, Canada; Research Centre of the University Hospital of Québec, Canada
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Cassista J, Payne-Gagnon J, Martel B, Gagnon MP. Applying Theory to Understand and Modify Nurse Intention to Adhere to Recommendations regarding the Use of Filter Needles: An Intervention Mapping Approach. Nurs Res Pract 2014; 2014:356153. [PMID: 25120927 PMCID: PMC4121269 DOI: 10.1155/2014/356153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 05/26/2014] [Accepted: 06/22/2014] [Indexed: 11/26/2022] Open
Abstract
The manipulation of glass ampoules involves risk of particle contamination of parenteral medication, and the use of filter needles has often been recommended in order to reduce the number of particles in these solutions. This study aims to develop a theory-based intervention to increase nurse intention to use filter needles according to clinical guideline recommendations produced by a large university medical centre in Quebec (Canada). Using the Intervention Mapping framework, we first identified the psychosocial determinants of nurse intention to use filter needles according to these recommendations. Second, we developed and implemented an intervention targeting nurses from five care units in order to increase their intention to adhere to recommendations on the use of filter needles. We also assessed nurse satisfaction with the intervention. In total, 270 nurses received the intervention and 169 completed the posttest questionnaire. The two determinants of intention, that is, attitude and perceived behavioral control, were significantly higher after the intervention, but only perceived behavioral control remained a predictor of intention. In general, nurses were highly satisfied with the intervention. This study provides support for the use of Intervention Mapping to develop, implement, and evaluate theory-based interventions in order to improve healthcare professional adherence to clinical recommendations.
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Affiliation(s)
- Julianne Cassista
- CHU de Québec, 2705 boulevard Laurier, Quebec City, QC, Canada G1V 2L9
| | - Julie Payne-Gagnon
- Population Health and Optimal Health Practices, CHU de Québec Research Centre, 10 rue de l'Espinay, Quebec City, QC, Canada G1L 3L5
| | - Brigitte Martel
- Nursing Directorate, CHU de Québec, 11 Côte du Palais, Quebec City, QC, Canada G1R 2J6
| | - Marie-Pierre Gagnon
- Population Health and Optimal Health Practices, CHU de Québec Research Centre, 10 rue de l'Espinay, Quebec City, QC, Canada G1L 3L5
- Faculty of Nursing, Université Laval, 2325 rue de l'Université, Quebec City, QC, Canada G1V 0A6
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Krifa F, Gagnon J, Nouira A. Description des facteurs facilitants et contraignants l'utilisation des résultats de la recherche : le point de vue d'infirmiers tunisiens. Rech Soins Infirm 2014. [DOI: 10.3917/rsi.116.0040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Parahoo K. Research and Theory. Nurs Res 2014. [DOI: 10.1007/978-1-137-28127-2_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lievens I, Vlerick P. Transformational leadership and safety performance among nurses: the mediating role of knowledge-related job characteristics. J Adv Nurs 2013; 70:651-61. [PMID: 23981245 DOI: 10.1111/jan.12229] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2013] [Indexed: 11/26/2022]
Abstract
AIMS To report the impact of transformational leadership on two dimensions of nurses' safety performance (i.e. safety compliance and safety participation) and to study the mediating role of knowledge-related job characteristics in this relationship. BACKGROUND Safety performance refers to the behaviours that employees exhibit to adhere to safety guidelines and to promote health and safety at their workplace. Nurses' safety performance is a major challenge for healthcare settings, urging the need to identify the key determinants and psychological mechanisms that influence it. DESIGN A cross-sectional survey study. METHODS The study was carried out in September 2010 in a large Belgian hospital. We used self-administered questionnaires; 152 nurses participated. The hypotheses were tested using hierarchical regression analyses. RESULTS/FINDINGS In line with our first hypothesis, the results show that transformational leadership exerted a significant positive impact on both dimensions of nurses' safety performance. This positive relation was mediated by knowledge-related job characteristics, supporting our second hypothesis. CONCLUSION Head nurses' transformational leadership can enhance nurses' compliance with and participation in safety. Furthermore, transformational head nurses are able to influence the perception that their nurses have about the kind and amount of knowledge in their job, which can also lead to increases in both dimensions of nurses' safety performance. This study therefore demonstrates the key impact that transformational head nurses have, both directly and indirectly, on the safety performance of their nurses.
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Affiliation(s)
- Ilse Lievens
- Department of Personnel Management, Work and Organizational Psychology, Ghent University, Belgium
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Social Robots, Brain Machine Interfaces and Neuro/Cognitive Enhancers: Three Emerging Science and Technology Products through the Lens of Technology Acceptance Theories, Models and Frameworks. TECHNOLOGIES 2013. [DOI: 10.3390/technologies1010003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Psychosocial factors of dietitians' intentions to adopt shared decision making behaviours: a cross-sectional survey. PLoS One 2013; 8:e64523. [PMID: 23700484 PMCID: PMC3659101 DOI: 10.1371/journal.pone.0064523] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 04/16/2013] [Indexed: 11/19/2022] Open
Abstract
Objectives While shared decision making (SDM) promotes health-related decisions that are informed, value-based and adhered to, few studies report on theory-based approaches to SDM adoption by healthcare professionals. We aimed to identify the factors influencing dietitians' intentions to adopt two SDM behaviours: 1) present dietary treatment options to patients and 2) help patients clarify their values and preferences. Methods We conducted a cross-sectional postal survey based on the Theory of Planned Behaviour among 428 randomly selected dietitians working in clinical practice across the Province of Quebec, Canada. We performed descriptive analyses and multiple regression analyses to determine the variables that explained the variance in intention to perform the behaviours. Results A total of 203 dietitians completed the questionnaire. Their ages were from 23 to 66 and they had been practising dietetics for 15.4±11.1 years (mean ± SD). On a scale from 1 to 7 (from strongly disagree to strongly agree), dietitians' intentions to present dietary treatment options and to clarify their patients' values and preferences were 5.00±1.14 and 5.68±0.74, respectively. Perceived behavioural control (β = 0.56, ρ<0.0001), subjective norm (β = 0.16, ρ<0.05), and moral norm (β = 0.22, ρ<0.0001), were the factors significantly predicting the intention to present dietary treatment options, while perceived behavioural control (β = 0.60, ρ<0.0001), attitude (β = 0.20, ρ<0.05), and professional norm (β = 0.22, ρ<0.001), significantly predicted the intention to help patients' clarify their values and preferences. Conclusion Our results showed that dietitians intend to adopt the two SDM behaviours studied. Factors influencing intention were different for each behaviour, except for perceived behavioural control which was common to both behaviours. Thus, perceived behavioural control could be a key factor in interventions aiming to encourage implementation of SDM by dietitians.
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