1
|
Pilleron B, Douillet D, Furon Y, Haubertin C, Parot-Schinkel E, Vielle B, Roy PM, Poiroux L. Nurses' moral judgements during emergency department triage - A prospective mixed multicenter study. Int Emerg Nurs 2024; 75:101479. [PMID: 38936277 DOI: 10.1016/j.ienj.2024.101479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/27/2024] [Accepted: 06/08/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION In EDs, triage ensures that patients whose condition requires immediate care are prioritized while reducing overcrowding. Previous studies have described the manifestation of caregivers' moral judgements of patients in EDs. The equal treatment of patients in clinical practice presents a major issue. Studying the impact of prejudice on clinical practice in the ED setting provides an opportunity to rethink clinical tools, organizations and future training needs. Our study sought to describe the moral judgements expressed by triage nurses during admission interviews in emergency departments and to assess their impact on patient management. METHODS An exploratory sequential mixed-method study was performed. The study was conducted between January 1, 2018, and February 18, 2018, in the EDs of three French hospitals. Five hundred and three patients and 79 triage nurses participated in the study. Audio recordings, observations and written handover reports made by nurses during admission triage interviews were analyzed with a view to discerning whether moral judgements were expressed in them. We studied the impact of moral judgements on patient management in the emergency department. RESULTS Abstract Moral judgements were made in 70% of the triage situations studied (n=351/503). They could be classified in seven categories. Patients were more likely to be subjected to moral judgements if they were over 75 years old, visibly disabled or if they had visible signs of alcohol intoxication. Being subjected to moral judgement was associated with differential treatment, including assignment of a triage score that differed from the theoretical triage score. CONCLUSION More than two thirds of patients admitted to EDs were triaged using moral criteria. Patients who were morally judged at the admission interview were more likely to be treated differently.
Collapse
Affiliation(s)
| | - Delphine Douillet
- Emergency Department, Angers University Hospital, Angers, France; MITOVASC, Equipe CarMe, INSERM 1083, CNRS 6015, SFR ICAT, UNIV Angers, Angers, France; F-CRIN INNOVTE, Saint-Etienne, France
| | - Yoakim Furon
- Research Department, Angers University Hospital, Angers, France
| | - Carole Haubertin
- Emergency Department, Angers University Hospital, Angers, France
| | - Elsa Parot-Schinkel
- Biostatistics and Methodology Department, Angers University Hospital, Angers, France
| | - Bruno Vielle
- Research Department, Angers University Hospital, Angers, France
| | - Pierre-Marie Roy
- Emergency Department, Angers University Hospital, Angers, France; MITOVASC, Equipe CarMe, INSERM 1083, CNRS 6015, SFR ICAT, UNIV Angers, Angers, France; F-CRIN INNOVTE, Saint-Etienne, France; Research Department, Angers University Hospital, Angers, France
| | - Laurent Poiroux
- Research Department, Angers University Hospital, Angers, France; Biostatistics and Methodology Department, Angers University Hospital, Angers, France; Équipe d'épidémiologie en santé au travail et ergonomie (ESTER) - Irset UMR_S 1085, University of Angers, France
| |
Collapse
|
2
|
van Heteren F, Raaphorst NJ, Bussemaker JM. Health promotion roles shaped by professional identity: an ethnographic study in the Netherlands. Health Promot Int 2024; 39:daad195. [PMID: 38217454 PMCID: PMC10787352 DOI: 10.1093/heapro/daad195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024] Open
Abstract
How frontline care professionals interpret and fulfill their health promotion roles is of great importance for the health of the vulnerable clients they work with. While the literature on health promotion is limited to describing the roles of healthcare professionals, this study examines the health promotion roles held by various frontline professionals when working with clients with combined psychosocial problems and how this is associated with professional identity. Based on ethnographic data from Dutch frontline professionals in social welfare, general healthcare and mental healthcare, this article shows how various frontline professionals promote health by reframing and customizing health problems and that this is associated with how they identify as pragmatic or holistic professionals.
Collapse
Affiliation(s)
- F van Heteren
- Department of Public Health and Primary Care/Health Campus, Leiden University Medical Centre, Turfmarkt 99, 2511 DP The Hague, The Netherlands
- Faculty of Governance and Global Affairs, Institute of Public Administration, Leiden University, 2511 DP The Hague, The Netherlands
| | - N J Raaphorst
- Faculty of Governance and Global Affairs, Institute of Public Administration, Leiden University, 2511 DP The Hague, The Netherlands
| | - J M Bussemaker
- Department of Public Health and Primary Care/Health Campus, Leiden University Medical Centre, Turfmarkt 99, 2511 DP The Hague, The Netherlands
- Faculty of Governance and Global Affairs, Institute of Public Administration, Leiden University, 2511 DP The Hague, The Netherlands
| |
Collapse
|
3
|
Otter CEM, Keers JC, Reker C, Smit J, Schoonhoven L, de Man-van Ginkel JM. How nurses support self-management of hospitalized patients through verbal communication: a qualitative study. BMC Nurs 2022; 21:329. [PMID: 36443771 PMCID: PMC9703649 DOI: 10.1186/s12912-022-01099-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/10/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Patients' self-management of the implications of their disease(s) is becoming increasingly important. Research shows that hospitalization disrupts established self-management routines. Nurses can play an important role in supporting patients' self-management. The aim of this study is to describe how nurses support the self-management of hospitalized patients through verbal communication during routine nursing care. METHODS A qualitative descriptive study, using overt, non-participant observations was conducted on three wards of a general teaching hospital in the Netherlands. A total of 215 hours of nursing work during 49 shifts was observed. Data was analyzed using thematic analysis based on the six phases of Braun and Clarke. RESULTS Our observations showed that nurses discuss patients' self-management mainly in short conversations during the care provision. Nurses ask patients about their self-management at home and stimulate patients to express their opinions and to be involved in the care process. Three themes reflect how nurses support self-management: 'Discussing patient's self-management', 'Enhancing patient's involvement in care' and 'Focusing on patient's perspective'. CONCLUSION Hospital nurses have methods to support hospitalized patients' self-management but it does not seem to be an integral part of daily practice. Given current developments in healthcare, it is reasonable to argue that self-management should be given greater emphasis within the hospital setting, requiring a collaborative approach with patients and other healthcare professionals across the care continuum.
Collapse
Affiliation(s)
- Caroline E. M. Otter
- grid.416468.90000 0004 0631 9063Martini Hospital, Van Swietenlaan 1, Groningen, 9728 NT The Netherlands
| | - Joost C. Keers
- grid.416468.90000 0004 0631 9063Martini Hospital, Van Swietenlaan 1, Groningen, 9728 NT The Netherlands
| | - Celeste Reker
- grid.416468.90000 0004 0631 9063Martini Hospital, Van Swietenlaan 1, Groningen, 9728 NT The Netherlands
| | - Jakobus Smit
- grid.438049.20000 0001 0824 9343University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht, 3584 CS The Netherlands
| | - Lisette Schoonhoven
- grid.7692.a0000000090126352Julius Centre for Health Sciences and Primary Care, Nursing Science, University Medical Centre Utrecht, University Utrecht, HP Str. 6.131, Heidelberglaan 100, Utrecht, 3584 CX The Netherlands ,grid.5491.90000 0004 1936 9297School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, University Road, Southampton, S017 1BJ UK
| | - Janneke M. de Man-van Ginkel
- grid.7692.a0000000090126352Julius Centre for Health Sciences and Primary Care, Nursing Science, University Medical Centre Utrecht, University Utrecht, HP Str. 6.131, Heidelberglaan 100, Utrecht, 3584 CX The Netherlands ,grid.10419.3d0000000089452978Academic Nursing, Department of Gerontology and Geriatrics, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA The Netherlands
| |
Collapse
|
4
|
Iriarte-Roteta A, Lopez-Dicastillo O, Mujika A, Ruiz-Zaldibar C, Hernantes N, Bermejo-Martins E, Pumar-Méndez MJ. Nurses' role in health promotion and prevention: A critical interpretive synthesis. J Clin Nurs 2020; 29:3937-3949. [PMID: 32757432 DOI: 10.1111/jocn.15441] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Role confusion is hampering the development of nurses' capacity for health promotion and prevention. Addressing this requires discussion to reach agreement among nurses, managers, co-workers, professional associations, academics and organisations about the nursing activities in this field. Forming a sound basis for this discussion is essential. AIMS AND OBJECTIVES To provide a description of the state of nursing health promotion and prevention practice expressed in terms of activities classifiable under the Ottawa Charter and to reveal the misalignments between this portrayal and the ideal one proposed by the Ottawa Charter. METHODS A critical interpretive synthesis was conducted between December 2018 and May 2019. The PubMed, CINAHL, Scopus, PsychINFO, Web of Science and Dialnet databases were searched. Sixty-two papers were identified. The relevant data were extracted using a pro-forma, and the reviewers performed an integrative synthesis. The ENTREQ reporting guidelines were used for this review. RESULTS Thirty synthetic constructs were developed into the following synthesising arguments: (a) addressing individuals' lifestyles versus developing their personal skills; (b) focusing on environmental hazards versus creating supportive environments; (c) action on families versus strengthening communities; (d) promoting community partnerships versus strengthening community action; and (e) influencing policies versus building healthy public policy. CONCLUSIONS There are notable misalignments between nurses' current practice in health promotion and prevention and the Ottawa Charter's actions and strategies. This may be explained by the nurses' lack of understanding of health promotion and prevention and political will, research methodological flaws, the predominance of a biomedical perspective within organisations and the lack of organisational prioritisation for health promotion and prevention.
Collapse
Affiliation(s)
| | - Olga Lopez-Dicastillo
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, University of Navarra, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Navarra, Spain
| | - Agurtzane Mujika
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, University of Navarra, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Navarra, Spain
| | | | - Naia Hernantes
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, University of Navarra, Navarra, Spain
| | - Elena Bermejo-Martins
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, University of Navarra, Navarra, Spain
| | - María J Pumar-Méndez
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, University of Navarra, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Navarra, Spain
| |
Collapse
|
5
|
Williams I, Baird M, Schneider M. Experiences of radiographers working alone in remote locations: A Far North Queensland non-participant observational study. Radiography (Lond) 2020; 26:e284-e289. [PMID: 32386826 DOI: 10.1016/j.radi.2020.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Radiographers employed in remote locations such as Far North Queensland (FNQ) can face unique sets of challenges as they often perform radiographic and sonographic diagnostic imaging without onsite radiologists' services. Additionally, the majority of patients presenting to these sites are Indigenous for whom English may be their third language. This non-participant observational study observed two FNQ radiographers' interactions with patients and interprofessional staff, and the radiographers' ability to fit into the Indigenous community during routine radiographic and sonographic examinations which to date have received little attention. METHODS Non-participant observations and semi-structured interviews with radiographers were held at two FNQ hospitals. Consecutive radiographer-patient interactions were observed and recorded on checklists. Interviews were audio recorded and transcribed for thematic analysis. RESULTS Across both remote sites, 24 patients were observed as they underwent diagnostic imaging examinations, with the majority being Aboriginal or Torres Strait Islanders (n = 17/24 (70.8%). In total, eleven general radiography and sixteen ultrasound examinations were observed. Semi-structured interviews highlighted complex issues such as the need for radiographer communication in local dialect, ongoing interprofessional collaborations, overcoming the lack of radiologists' onsite support by providing radiographic reports directly to referring doctors and midwives, and isolation with regard to professional development opportunities. CONCLUSIONS Radiographers working in remote hospitals need to be culturally competent, navigate local indigenous languages and possess excellent interprofessional skills as well as thorough knowledge of imaging pathology to convey findings to referring doctors and allied health professionals. These findings have implications for the entry to practice curriculum. IMPLICATIONS FOR PRACTICE This study provides evidence that culturally competent radiographers are capable of undertaking reporting roles to facilitate patient management in the absence of timely radiologists' reports at remote sites.
Collapse
Affiliation(s)
- I Williams
- Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Road, Clayton, VIC, 3800, Australia.
| | - M Baird
- Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Road, Clayton, VIC, 3800, Australia.
| | - M Schneider
- Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Road, Clayton, VIC, 3800, Australia.
| |
Collapse
|
6
|
Bossy D, Knutsen IR, Rogers A, Foss C. Moving between ideologies in self-management support-A qualitative study. Health Expect 2018; 22:83-92. [PMID: 30289189 PMCID: PMC6351411 DOI: 10.1111/hex.12833] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 11/30/2022] Open
Abstract
Background Reforms in current health policy explicitly endorse health promotion through group‐based self‐management support for people with long‐term conditions. Health promotion and traditional medicine are based on different logics. Accordingly, health professionals in health‐promoting settings demand the adoption of new practices and ways of thinking. Objectives The objective of our study was to investigate how health professionals perceive the health‐promoting group‐based self‐management support that is politically initiated for people with long‐term conditions. Design This study had a qualitative research design that included focus group interviews and was guided by a social constructivist paradigm in which group‐based self‐management was viewed as a social construction. Different logics at play were analysed through the theoretical lens of institutional logic. Discussions among participants show frames of references seen as logics. Setting and participants We recruited health professionals from group‐based health‐promoting measures for people with type 2 diabetes in Norway. Two focus groups comprising four and six participants each were invited to discuss the practices and value of health promotion through group‐based self‐management support. Results The analysis resulted in three themes of discussion among participants that contained reflections of logics in movement. Health professionals’ discussions moved between different logics based on the importance of expert‐based knowledge on compliance and on individual lifestyle choices. Discussion and conclusion The study indicates that health promotion through self‐management support is still a field “in the making” and that professionals strive to establish new logics and practices that are not considered difficult to manage or do not contain incompatible understandings.
Collapse
Affiliation(s)
- Dagmara Bossy
- Norwegian National Advisory Unit on Learning and Mastery in Health, Universitetssykehus HF, Aker Sykehus, Oslo, Norway.,Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Ruud Knutsen
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Kjeller, Norway
| | - Anne Rogers
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Hampshire, UK
| | - Christina Foss
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
7
|
Nursing students’ perceptions of preparation to engage in patient education. Nurse Educ Pract 2018; 28:1-6. [DOI: 10.1016/j.nepr.2017.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 09/13/2016] [Accepted: 09/08/2017] [Indexed: 11/20/2022]
|
8
|
Skilbeck JK, Arthur A, Seymour J. Making sense of frailty: An ethnographic study of the experience of older people living with complex health problems. Int J Older People Nurs 2017; 13. [PMID: 28990309 PMCID: PMC6175446 DOI: 10.1111/opn.12172] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 08/23/2017] [Indexed: 11/28/2022]
Abstract
Aim To explore how older people with complex health problems experience frailty in their daily lives. Background A better understanding of the personal experience of frailty in the context of fluctuating ill‐health has the potential to contribute to the development of personalised approaches to care planning and delivery. Design An ethnographic study of older people, living at home, receiving support from a community matron service in a large city in the North of England. Methods Up to six care encounters with each of ten older people, and their community matron, were observed at monthly intervals, over a period of time ranging from 4 to 11 months. Semi‐structured interviews were conducted with the older participants in their own homes. Fieldwork took place over a 4‐year period. Data analysis was undertaken using the constant comparative method. Findings The experience of frailty was understood through the construction of four themes: Fluctuating ill‐health and the disruption of daily living; Changes to the management of daily living; Frailty as fear, anxiety and uncertainty; Making sense of changes to health and daily living. Conclusions Older people work hard to shape and maintain daily routines in the context of complicated and enduring transitions in health and illness. However, they experience episodic moments of frailty, often articulated as uncertainty, where daily living becomes precarious and their resilience is threatened. Developing an understanding of the personal experiences of frail older people in the context of transition has the potential to inform nursing practice in person‐centred care . Implications for practice Nurses need to support frail older people to maintain independence and continuity of personhood in the context of daily routines.
Collapse
|
9
|
Karimi Moonaghi H, Emami Zeydi A, Mirhaghi A. Patient education among nurses: bringing evidence into clinical applicability in Iran. INVESTIGACION Y EDUCACION EN ENFERMERIA 2016; 34:137-151. [PMID: 28569983 DOI: 10.17533/udea.iee.v34n1a16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 12/04/2015] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of this study was to present a comprehensive review of the literatures describing barriers and facilitators of patient education (PE) perceived by Iranian nurses in order to explain clinical applicability of patient education. METHODS Review of the literature was undertaken using the international databases including PubMed/Medline, Scopus, ScienceDirect, as well as Google Scholar. Also, Persian electronic databases such as Magiran, SID and IranMedex were searched. Electronic databases were searched up from conception to September 2014 using search terms: "patient education", " patients education", "patient teaching", "patient training", "nurse", " nurses", " nursing", " and "Iran". Only studies were included that were related to barriers and facilitators of PE among Iranian nurses. RESULTS Twenty-seven studies were included. The main influential barriers were categorized into three major areas: 1) Nurse-related factors: nursing shortage 2) Administration-related factors: unsupportive organizational culture, and 3) Patient-related factors: low compliance. The most perceived facilitators were recognized as "increasing, selecting and training special nurses for providing PE" and "providing PE courses for nurses and appropriate facilities for PE". CONCLUSION Iranian nurses encounter barriers in PE, and the most frequently encountered barriers were related to administration factors. These findings have implications for administrators and managers in health settings. In order to promote PE among nurses, administrators should create a supportive environment and use effective strategies to smooth the progress of PE by nurses in their practice in order to ensure optimal outcomes for patients.
Collapse
Affiliation(s)
| | | | - Amir Mirhaghi
- Mashhad University of Medical Sciences, Mashhad, Iran,
| |
Collapse
|
10
|
Pueyo-Garrigues M, San Martín Loyola Á, Caparrós Leal MC, Jiménez Muñoz C. [Health education in transplant patients and their families in an intensive care unit]. ENFERMERIA INTENSIVA 2016; 27:31-9. [PMID: 26810953 DOI: 10.1016/j.enfi.2015.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/25/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
Abstract
Health Education (HE) is extremely important in transplant patients and their families in order to promote suitable self-care in this new stage of life. Intensive Care Units offer various opportunities by nurses in order to improve their Health Education. This process could start in this unit where the interaction between nurse and family is constant. The HE of transplant patient includes three dimensions: Knowledge: information about self-care in order to have a healthy way of life, and getting some information on how to reduce anxiety in patients and their families; Skills: as regards the abilities to properly apply the Health Education, where the families are really important; and finally Attitudes: ambivalent attitudes that are experienced by transplant patients. The objective is to describe the level of development of HE for critical transplant patients and their families from Intensive Care Units. A non-systematic literature review was performed in Pubmed and CINHAL data bases. In conclusion, it is emphasised that the skill of the HE nurse in an Intensive Care Units is important to promote lifestyles appropriate to the cognitive, affective, and psychomotor needs of transplant patients. Its implementation entails positive effects on clinical outcomes of the patient, decreased morbidity and mortality, costs, and health resources.
Collapse
Affiliation(s)
- M Pueyo-Garrigues
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España.
| | - Á San Martín Loyola
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España
| | - M C Caparrós Leal
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España
| | - C Jiménez Muñoz
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España
| |
Collapse
|
11
|
Tobiano G, Bucknall T, Marshall A, Guinane J, Chaboyer W. Patients’ perceptions of participation in nursing care on medical wards. Scand J Caring Sci 2015; 30:260-70. [DOI: 10.1111/scs.12237] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/17/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Georgia Tobiano
- Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Gold Coast Qld Australia
| | - Tracey Bucknall
- Centre for Quality and Patient Safety; School of Nursing and Midwifery; Deakin University; Melbourne Vic Australia
- Alfred Health; Melbourne Vic Australia
| | - Andrea Marshall
- Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Gold Coast Qld Australia
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients; Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Gold Coast Qld Australia
| | - Jessica Guinane
- School of Nursing and Midwifery; Deakin University; Melbourne Vic Australia
| | - Wendy Chaboyer
- Gold Coast University Hospital; Gold Coast Qld Australia
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients; Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Gold Coast Qld Australia
| |
Collapse
|
12
|
Tobiano G, Marshall A, Bucknall T, Chaboyer W. Patient participation in nursing care on medical wards: An integrative review. Int J Nurs Stud 2015; 52:1107-20. [PMID: 25769475 DOI: 10.1016/j.ijnurstu.2015.02.010] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 12/19/2014] [Accepted: 02/12/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patient participation is a way for patients to engage in their nursing care. In view of the possible link between patient participation and safety, there is a need for an updated review to assess patient participation in nursing care. OBJECTIVES To investigate patients' and nurses' perceptions of and behaviours towards patient participation in nursing care in the context of hospital medical wards. DESIGN Integrative review. DATA SOURCES Three search strategies were employed in August 2013; a computerised database search of Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Medline and PsychINFO; reference lists were hand-searched; and forward citation searching was executed. REVIEW METHODS After reviewing the studies, extracting study data and completing summary tables the methodological quality was assessed using the Mixed-Methods Assessment Tool by two reviewers. Reviewers met then to discuss discrepancies as well as the overall strengths and limitations of the studies. Discrepancies were overcome through consensus or a third reviewer adjudicated the issue. Within and across study analysis and synthesis of the findings sections was undertaken using thematic synthesis. RESULTS Eight studies met inclusion criteria. Four themes were identified - enacting participation, challenges to participation, promoting participation and types of participation. Most studies included were conducted in Europe. The majority of studies used qualitative methodologies, with all studies sampling patients; nurses were included in three studies. Data were largely collected using self-reported perceptions; two studies included observational data. Methodological issues included a lack of reflexivity, un-validated data collection tools, sampling issues and low response rates. CONCLUSIONS On medical wards, patients and nurses desire, perceive or enact patient participation passively. Challenging factors for patient participation include patients' willingness, nurses' approach and confusion around expectations and roles. Information-sharing was identified as an activity that promotes patient participation, suggesting nurses encourage active communication with patients in practice. Involving patients in assessment and care planning may also enhance patient participation. For education, enhancing nurses' understanding of the attributes of patient participation, as well as patient-centred care approaches may be beneficial for medical ward nurses. From here, researchers need to examine ways to overcome the barriers to patient participation; further nurse participants and observational data is required on medical wards.
Collapse
Affiliation(s)
- Georgia Tobiano
- Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland, Australia.
| | - Andrea Marshall
- Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland, Australia; The Gold Coast University Hospital, Queensland, Australia
| | - Tracey Bucknall
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Alfred Health, Victoria, Australia
| | - Wendy Chaboyer
- Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland, Australia; National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| |
Collapse
|
13
|
Chiou ST, Chiang JH, Huang N, Chien LY. Health behaviors and participation in health promotion activities among hospital staff: which occupational group performs better? BMC Health Serv Res 2014; 14:474. [PMID: 25335875 PMCID: PMC4282514 DOI: 10.1186/1472-6963-14-474] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 09/29/2014] [Indexed: 11/20/2022] Open
Abstract
Background Staff health behaviors affect not only their own health but also their provision of health promotion services to their patients. Although different occupational groups work in hospitals, few studies have compared health behaviors among them. The objectives of this study were to examine health behaviors, including physical activity, eating 5 portions of fruits and vegetables per day (5 a day), and stress adaptation, and participation in hospital-based health promotion activities by occupational groups in hospitals. Methods This cross-sectional survey was conducted among full-time employees in 100 hospitals across Taiwan. This analysis included 4202 physicians, 31639 nurses, 2315 pharmacists, 8161 other health professionals, and 13079 administrative personnel. Results Administrative personnel attended more health promotion lectures and clubs/groups than other health professionals, pharmacists and physicians, and those workers participated more than nurses. Participation in health promotion activities provided by hospitals was associated with better practice of health behaviors. After adjustment for socio-demographics and participation in health promotion activities, physicians, pharmacists, and other health professionals reported more 5 a day than administrative staff. Other health professionals reported more physical activity than administrative staff, and they reported more than physicians. Nurses reported the lowest level of physical activity, 5 a day, and stress adaptation of all occupational groups. Conclusions Nurses had worse health behaviors and less participation in health promotion activities than other groups. Workplace health promotion program for health professionals is needed, with special emphasis on nurses. Hospital-based health promotion programs could take the differences of occupational groups into consideration to tailor programs to the needs of different occupational groups.
Collapse
Affiliation(s)
| | | | | | - Li-Yin Chien
- Institute of Clinical and Community Health Nursing, National Yang-Ming University, 155 Li-Nong Street, Section 2, Bei-Tou, Taipei 11221, Taiwan.
| |
Collapse
|
14
|
Bergh AL, Friberg F, Persson E, Dahlborg-Lyckhage E. Perpetuating 'New Public Management' at the expense of nurses' patient education: a discourse analysis. Nurs Inq 2014; 22:190-201. [PMID: 25327764 DOI: 10.1111/nin.12085] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2014] [Indexed: 11/28/2022]
Abstract
This study aimed to explore the conditions for nurses' daily patient education work by focusing on managers' way of speaking about the patient education provided by nurses in hospital care. An explorative, qualitative design with a social constructionist perspective was used. Data were collected from three focus group interviews and analysed by means of critical discourse analysis. Discursive practice can be explained by the ideology of hegemony. Due to a heavy workload and lack of time, managers could 'see' neither their role as a supporter of the patient education provided by nurses, nor their role in the development of nurses' pedagogical competence. They used organisational, financial, medical and legal reasons for explaining their failure to support nurses' provision of patient education. The organisational discourse was an umbrella term for 'things' such as cost-effectiveness, which were prioritised over patient education. There is a need to remove managerial barriers to the professional development of nurses' patient education. Managers should be responsible for ensuring and overseeing that nurses have the prerequisites necessary for providing patient education as well as for enabling continuous reflective dialogue and opportunities for learning in practice.
Collapse
|
15
|
Owusu-Addo E. Midwives' perceptions and experiences of health promotion practice in Ghana. Glob Health Promot 2014; 22:4-14. [PMID: 25085477 DOI: 10.1177/1757975914543574] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 05/06/2014] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This research explores midwives' perceptions and experiences of health promotion practice in Ghana. METHODS A qualitative descriptive exploratory design was used in order to gain better insight into midwives' perceptions and experiences of health promotion practice. A total of 21 midwives took part in the study. Data were collected by individual in-depth semi-structured interviews. Thematic analysis was used to analyse the transcript. RESULTS Five dominant themes emerged from the interview transcripts, namely: health promotion as education, health promotion activities, the value of health promotion, client participation, and midwives' barriers to promoting health. Although midwives underscored the importance of health promotion to their work, their reports indicated that, in practice, midwives mostly delivered health education and behaviour change communication rather than health promotion. The midwives expressed the view that by way of their close association with women, they were in a better position to influence women's health. Health promotion activities engaged by the midwives included weight management, healthy eating, infection prevention, personal hygiene, counselling on family planning, and screening for hazardous and harmful substance use such as alcohol and smoking. All the midwives mentioned that clients participated in their health promotion activities. Factors that were identified by the midwives to enhance client participation were trust, attitude of the midwife, building rapport, creating enabling environment, listening and paying attention to clients and using simple language. The barriers to health promotion identified by the midwives included time, stress, culture, lack of training and inadequate health educational materials. DISCUSSION Midwives in this study had limited knowledge about health promotion, yet could play a significant role in influencing health; thus there is a need for on-going in-service training for midwives to focus on health promotion.
Collapse
Affiliation(s)
- Ebenezer Owusu-Addo
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| |
Collapse
|
16
|
Dombrowski JJ, Snelling AM, Kalicki M. Health Promotion Overview: Evidence-Based Strategies for Occupational Health Nursing Practice. Workplace Health Saf 2014. [DOI: 10.3928/21650799-20140708-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
17
|
Dombrowski JJ, Snelling AM, Kalicki M. Health Promotion Overview. Workplace Health Saf 2014; 62:342-9; quiz 350. [DOI: 10.1177/216507991406200805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/01/2014] [Indexed: 11/15/2022]
Abstract
Health promotion practice has evolved over the past four decades in response to the rising rates of chronic disease. The focus of health promotion is attaining wellness by managing modifiable risk factors, such as smoking, diet, or physical activity. Occupational health nurses are often asked to conduct worksite health promotion programs for individuals or groups, yet may be unfamiliar with evidence-based strategies. Occupational health nurses should lead interprofessional groups in designing and implementing worksite health promotion programs. This article introduces occupational health nurses to health promotion concepts and discusses evidence-based theories and planning models that can be easily introduced into practice.
Collapse
|
18
|
Malin Malmgren R, Eva Törnvall R, Inger Jansson R. Patients with hip fracture: Experiences of participation in care. Int J Orthop Trauma Nurs 2014. [DOI: 10.1016/j.ijotn.2013.08.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
19
|
Bergh AL, Johansson I, Persson E, Karlsson J, Friberg F. Nurses’ Patient Education Questionnaire – development and validation process. J Res Nurs 2014. [DOI: 10.1177/1744987114531583] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Conditions for nurses’ daily patient education work are unclear and require clarification. The aim was to develop and validate the Nurses’ Patient Education Questionnaire, a questionnaire that assesses nurses’ perceptions of appropriate conditions for patient education work: what nurses say they actually do and what they think about what they do. The questionnaire was developed from a literature review, resulting in the development of five domains. This was followed by ‘cognitive interviewing’ with 14 nurses and dialogue with 5 pedagogical experts. The five domains were identified as significant for assessing nurses’ beliefs and knowledge; education environment; health care organisation; interdisciplinary cooperation and collegial teamwork; and patient education activities. A content validity index was used for agreement of relevance and consensus of items by nurses ( n = 10). The total number of items in the final questionnaire is 60, consisting of demographic items, what nurses report they do and perceptions about patient education in daily work. The questionnaire can be used by managers and nurses to identify possibilities and barriers to patient education in different care contexts.
Collapse
Affiliation(s)
- Anne-Louise Bergh
- Doctoral Student, School of Health Sciences, University of Borås, Sweden
- Professor, Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway; Associate Professor, Institute of Health Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Inger Johansson
- Professor, Department of Nursing, University College Gjøvik, Norway; Associate Professor, Department of Nursing, University of Karlstad, Sweden
- Professor, Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway; Associate Professor, Institute of Health Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Eva Persson
- Associate Professor, Faculty of Medicine, Department of Health Sciences, Lund University, Sweden; School of Health Sciences, University of Borås, Sweden
- Professor, Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway; Associate Professor, Institute of Health Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Jan Karlsson
- Associate Professor, Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden; Centre for Health Care Sciences, Örebro University Hospital, Sweden
- Professor, Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway; Associate Professor, Institute of Health Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Febe Friberg
- Professor, Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway; Associate Professor, Institute of Health Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden
| |
Collapse
|
20
|
Changes in health promotion practice in hospitals across England: the National Health Promotion in Hospital Audit 2009 and 2011. J Public Health (Oxf) 2013; 36:651-7. [DOI: 10.1093/pubmed/fdt120] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
21
|
Shoqirat N. ‘Let other people do it…’: the role of emergency department nurses in health promotion. J Clin Nurs 2013; 23:232-42. [DOI: 10.1111/jocn.12383] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2013] [Indexed: 11/29/2022]
|
22
|
McElligott JT, Summer AP. Health Care Utilization Patterns for Young Children in Rural Counties of the I-95 Corridor of South Carolina. J Rural Health 2012; 29:198-204. [DOI: 10.1111/j.1748-0361.2012.00434.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
23
|
Bergh AL, Karlsson J, Persson E, Friberg F. Registered nurses' perceptions of conditions for patient education - focusing on organisational, environmental and professional cooperation aspects. J Nurs Manag 2012; 20:758-70. [DOI: 10.1111/j.1365-2834.2012.01460.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2012] [Indexed: 11/28/2022]
|
24
|
Kemppainen V, Tossavainen K, Turunen H. Nurses' roles in health promotion practice: an integrative review. Health Promot Int 2012; 28:490-501. [DOI: 10.1093/heapro/das034] [Citation(s) in RCA: 162] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
|
25
|
Walthew P, Scott H. Conceptions of health promotion held by pre-registration student nurses in four schools of nursing in New Zealand. NURSE EDUCATION TODAY 2012; 32:229-234. [PMID: 21640447 DOI: 10.1016/j.nedt.2011.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 04/20/2011] [Accepted: 04/30/2011] [Indexed: 05/30/2023]
Abstract
A research project conducted in four nursing schools in New Zealand presents an account of student nurses' conceptions of health promotion. Focus groups of six to ten pre-registration nursing students were conducted in each of the schools of nursing. The findings indicated that the student nurses had difficulty clearly articulating the concept of health education and health promotion. The student nurses focused on individuals. The main strategy they used was the giving of information. This strategy was in keeping with a traditional approach to health promotion. However a number of students did include empowering interpersonal strategies in their health promotion activities. Many of the students demonstrated an awareness of the impact of economic determinants on health but did not have the support or opportunity to address these. None of the students included addressing the political determinants of health in their discussion of the health promoting role of the nurse.
Collapse
Affiliation(s)
- Pat Walthew
- Department of Nursing and Health Studies, Manukau Institute of Technology, 5 View Road, Papakura, Auckland 2110, New Zealand
| | | |
Collapse
|
26
|
FRIBERG FEBE, GRANUM VIGDIS, BERGH ANNELOUISE. Nurses’ patient-education work: conditional factors - an integrative review. J Nurs Manag 2012; 20:170-86. [DOI: 10.1111/j.1365-2834.2011.01367.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Healy D, Sharry PM. Promoting self awareness in undergraduate nursing students in relation to their health status and personal behaviours. Nurse Educ Pract 2011; 11:228-33. [DOI: 10.1016/j.nepr.2010.10.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Revised: 10/01/2010] [Accepted: 10/16/2010] [Indexed: 11/27/2022]
|
28
|
Abstract
There is a growing recognition of the need for health promotion interventions in all health care today. In spite of this, health promotion interventions among patients with mental illnesses have been scarce in research, practice, and policies. There is also an ambiguous interpretation of the definition of health promotion in the literature. The emphasis in this paper is thus to (1) discuss why we should pay attention to the interpretations of the concept of health promotion and (2) present a possible model for what nurses do when they intend to promote health in mental health care. This paper was presented at the Nordic Conference of Mental Health Nursing in Helsinki, Finland in 2010.
Collapse
Affiliation(s)
- Petra Svedberg
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
| |
Collapse
|
29
|
Whitehead D. Health promotion in nursing: a Derridean discourse analysis. Health Promot Int 2010; 26:117-27. [DOI: 10.1093/heapro/daq073] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
30
|
Choi WHH, Hui GKH, Lee ACK, Chui MML. Student nurses' experiences and challenges in providing health education in Hong Kong. NURSE EDUCATION TODAY 2010; 30:355-359. [PMID: 19819050 DOI: 10.1016/j.nedt.2009.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Revised: 07/30/2009] [Accepted: 09/05/2009] [Indexed: 05/28/2023]
Abstract
Despite a call for increased emphasis on health education within the Hong Kong acute healthcare setting, in reality nurses conduct only minimal health education and do not model good educational practice for students. At the baccalaureate level, nursing education programmes aim to provide students with practical experience of best practice and international standards of care. This study describes the experiences of nursing students in providing health education to in-patients at an obstetric unit in Hong Kong. A qualitative research study using a phenomenological approach was conducted at a major public hospital. Data were collected using participant observation, debriefing notes, students' reflective journals and semi-structured interviews. Four themes emerged from the data: (a) effective knowledge building, (b) being a professional nurse, (c) refining learned skills, and (d) greater cultural awareness. The student experiences were further influenced by the patients' responses, the expectations of both patients and nurses concerning the health educator's role, and the role of the clinical teacher. Study findings highlight the experience of the students in conducting health education, something which has not been adequately examined previously, and demonstrates the benefits of independent clinical learning.
Collapse
Affiliation(s)
- W H Hui Choi
- Department of Nursing Studies, The University of Hong Kong, Hong Kong.
| | | | | | | |
Collapse
|
31
|
Svedberg P, Hansson L, Svensson B. The attitudes of patients and staff towards aspects of health promotion interventions in mental health services in Sweden. Health Promot Int 2009; 24:269-76. [DOI: 10.1093/heapro/dap019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
32
|
Reconciling the differences between health promotion in nursing and ‘general’ health promotion. Int J Nurs Stud 2009; 46:865-74. [DOI: 10.1016/j.ijnurstu.2008.12.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 11/26/2008] [Accepted: 12/28/2008] [Indexed: 11/30/2022]
|
33
|
Nilsson K, Campbell AM, Andersson EP. Night nursing - staff's working experiences. BMC Nurs 2008; 7:13. [PMID: 18976475 PMCID: PMC2606673 DOI: 10.1186/1472-6955-7-13] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Accepted: 10/31/2008] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although the duties and working conditions of registered, and enrolled nurses have previously been described from different perspectives, they have not been examined from the night nursing aspect. The aim of the study was to describe the night nursing staff's working experiences. METHODS The design of the study is qualitative and descriptive. Interviews were conducted with 10 registered and 10 enrolled nurses working as night staff at a Swedish University Hospital. The interview guide was thematic and concerned the content of their tasks, as well as the working conditions that constitute night nursing. In addition, the interviews were transcribed verbatim and analyzed using content analysis. RESULTS The night duties have to be performed under difficult conditions that include working silently in dimmed lighting, and making decisions when fatigue threatens. According to the night staff, its main goals are to provide the patients with rest and simultaneously ensure qualified care. Furthermore, the night nursing staff must prepare the ward for the daytime activities. CONCLUSION The most important point is the team work, which developed between the registered and enrolled nurses and how necessary this team work is when working at night. In order for nurses working at night to be fully appreciated, the communication between day and night staff in health care organizations needs to be developed. Furthermore, it is important to give the night staff opportunities to use its whole field of competence.
Collapse
Affiliation(s)
- Kerstin Nilsson
- University of Gothenburg, the Sahlgrenska Academy, Institute of Health and Care Sciences, Göteborg, Sweden
- University of Skövde, School of Life Science, Skövde, Sweden
| | | | - Ewa Pilhammar Andersson
- University of Gothenburg, the Sahlgrenska Academy, Institute of Health and Care Sciences, Göteborg, Sweden
| |
Collapse
|
34
|
Svedberg P, Arvidsson B, Svensson B, Hansson L. Psychometric characteristics of a self-report questionnaire (HPIQ) focusing on health promotion interventions in mental health services. Int J Ment Health Nurs 2008; 17:171-9. [PMID: 18460078 DOI: 10.1111/j.1447-0349.2008.00527.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The aim of this study was to develop and investigate psychometric properties of the Health Promotion Intervention Questionnaire, a newly developed instrument intended to measure patients' subjective experiences of health promotion interventions in the mental health services. Health promotion practice has often been contested; therefore, it is important to produce convincing evidence that health promotion initiated by the health-care services actually works. A cross-sectional study was performed in order to investigate health promotion interventions among mental health service outpatients. A sample of 135 patients was used to test the psychometric properties of a new questionnaire designed to measure subjective experiences of health promotion interventions carried out by the mental health services. The factor structure of the questionnaire was tested by means of principal component factor analysis with varimax rotation. Reliability was measured in terms of internal consistency of the factors and test-retest reliability in a subsample of patients. The final scale contained 19 items derived from four factors: alliance, empowerment, educational support, and practical support. In terms of internal consistency, reliability was found to be good, both for the overall scale and the subscales. Test-retest reliability was moderate or higher in 13 out of 19 items and poor in only one item. This questionnaire, developed to evaluate patients' experiences of health promotion interventions in mental health services, may be used as an alternative in further empirical studies. With additional testing, the questionnaire could facilitate the work of defining and evaluating health promotion interventions conducted by the mental health services.
Collapse
Affiliation(s)
- Petra Svedberg
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
| | | | | | | |
Collapse
|
35
|
Whitehead D. An international Delphi study examining health promotion and health education in nursing practice, education and policy. J Clin Nurs 2008; 17:891-900. [PMID: 18321288 DOI: 10.1111/j.1365-2702.2007.02079.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To arrive at an expert consensus in relation to health promotion and health education constructs as they apply to nursing practice, education and policy. BACKGROUND Nursing has often been maligned and criticized, both inside and outside of the profession, for its ability to understand and conduct effective health promotion and health education-related activities. In the absence of an expert-based consensus, nurses may find it difficult to progress beyond the current situation. In the absence of any previously published nursing-related consensus research, this study seeks to fill that knowledge-gap. DESIGN A two-round Delphi technique via email correspondence. METHODS A first-round qualitative questionnaire used open-ended questions for defining health promotion and health education. This was both in general terms and as participants believed these concepts related to the clinical, theoretical (academic/educational) and the policy (political) setting in nursing. Line-by-line qualitative content and thematic analysis of the first-round data generated 13 specific categories. These categories contained 134 statement items. The second-round questionnaire comprised the identified 134 statements. Using a five-point Likert scale (ranging from 1 = strongly disagree to 5 = strongly agree) participants scored and rated their level of agreement/disagreement against the listed items. Data from the second-round was descriptively analysed according to distribution and central tendency measures. RESULTS An expert consensus was reached on 65 of the original 134 statements. While some minor contradiction was demonstrated, strong consensus emerged around the issues of defining health promotion and health education and the emergence of a wider health promotion and health education role for nursing. No consensus was reached on only one of the 13 identified topic categories - that of 'nurses working with other disciplines and agencies in a health education and health promotion role.' CONCLUSIONS This study provides a hitherto previously absent expert consensus on the current position of health promotion and health education, in nursing and predictions for their future course. Its findings represent an important step for nurses as they seek to become increasingly active and influential within wider health promotion and health education arenas. Relevance to clinical practice. Delphi studies do not necessarily offer indisputable fact. This study, however, with its strong consensus on the majority of original statements is a good indicator as to how nursing experts currently view health promotion and health education constructs. Expert consensus offers a useful form of measure against current and future clinical practice and helps to build a firm foundation for change. Nurses, then, are advised here to refer to the findings presented, that they remain contextually and conceptually clear, as they embark on current and future health promotion-related activities.
Collapse
Affiliation(s)
- Dean Whitehead
- College of Humanities and Social Sciences, School of Health Sciences, Massey University, Palmerston North, New Zealand.
| |
Collapse
|
36
|
Whitehead D, Wang Y, Wang J, Zhang J, Sun Z, Xie C. Health promotion and health education practice: nurses’ perceptions. J Adv Nurs 2008; 61:181-7. [DOI: 10.1111/j.1365-2648.2007.04479.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|