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Abuzied Y, Al-Amer R, Saleh MYN, Somduth S, AlBashtawy M, Ali AM. Exploring the lived experience of Arab male patients on intermittent catheterization after spinal cord injury: A phenomenological study. Int J Nurs Pract 2024:e13268. [PMID: 38798100 DOI: 10.1111/ijn.13268] [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: 12/20/2023] [Revised: 04/19/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Intermittent catheterization (IC) has been identified as one of the critical techniques used by spinal cord injury (SCI) patients to cope with emptying the bladder, despite several problems impeding this procedure. AIM The study aimed accordingly to explore the lived experience of Arab male patients on IC after their SCI. DESIGN This study was carried out by using a descriptive qualitative approach with a phenomenological analysis of data. METHODS A qualitative study was carried out on 10 Arab male patients from the Rehabilitation Hospital at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia who were utilizing intermittent catheters following SCI. The interviews were analysed using Husserl's phenomenology and the Colaizzi method of data analysis. RESULTS Two major themes and six sub-themes were identified from exploring the patients experience. These themes are as follows: Theme 1: The Way to IC; with two sub-themes: (i) 'service provided and acceptance' and (ii) 'educational experience'; Theme 2: Lifestyle and self-adaptation; with four sub-themes: (i) 'Flexibility and freedom', (ii) 'Physical access to the community', (iii) 'Traveling' and (iv) 'Work and Social life balance'. CONCLUSION It is evident that using an intermittent catheter among patients with SCI influenced almost all aspects of the participant's life, including their social lives and body image appearance.
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Affiliation(s)
- Yacoub Abuzied
- Department of Nursing, Spinal Cord Injury, Rehabilitation Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Mohammad Y N Saleh
- Clinical Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
| | - Shreemathie Somduth
- Nursing Administration, Rehabilitation Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed AlBashtawy
- Nursing Community Health, Princess Salma Faculty of Nursing, Al Al-Bayt University, Al-Mafraq, Jordan
| | - Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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Pérez-Rugosa V, de Lorena-Quintal P, Domínguez-Valdés E, Rodríguez-Rodríguez A, Núñez-Castro I, Suárez-Fernández Y, Sarabia-Cobo C. Exploring older people's experiences of the interpersonal care relationship between nurses and patients during hospitalization in the pandemic period: A qualitative study. J Adv Nurs 2024. [PMID: 38225866 DOI: 10.1111/jan.16050] [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: 10/22/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/17/2024]
Abstract
AIM This article presents the findings of a qualitative study focusing on the experiences of people aged over 70 years in the interpersonal nurse-patient care relationship in hospital settings during and after the COVID-19 pandemic. The aim was to analyse different aspects of this relationship, including nurses' behaviour and caring attitudes, the person-centred model of care, patients' involvement in their own care and communication in the hospital context. DESIGN An exploratory qualitative study was conducted on the basis of an interpretative framework. METHODS Six focus groups were conducted. A total of 34 participants were purposively recruited from three nursing homes in Spain, Italy and Portugal. Specific inclusion criteria were used to select participants. RESULTS Five main categories were identified. Analysis revealed the importance of empathy and sensitivity in caring relationships, as well as the need for personalized and patient-centred care. The importance of effective communication and recognition of ageist behaviour by professionals was highlighted. In addition, independent of the pandemic, situational factors in the hospital environment were identified that influence the interpersonal care relationship. CONCLUSIONS The study highlights the need to promote a person-centred model of care that takes into account the specific preferences and needs of older people. This is achieved by identifying elements of the interpersonal nurse-patient relationship. In addition to highlighting the disparity of opinion regarding an active or passive role in self-care and decision making, the importance of addressing ageism and improving communication is emphasized. WHAT PROBLEM DID THE STUDY ADDRESS?: The importance of the patient-nurse relationship in hospital care has been highlighted in previous studies. Critical elements of the patient care experience have been identified as empathy and effective communication. Ageism in healthcare has been recognized as a potential barrier to patient-centred care. WHAT WERE THE KEY FINDINGS?: The main findings highlight the importance of empathy and personalized care, emphasize the importance of effective communication and address ageist behaviours in the nurse-patient relationship. WHERE AND WHO WILL THE RESEARCH IMPACT?: By highlighting the need for person-centred care and improved communication strategies, particularly in the context of caring for older patients during and after the COVID-19 pandemic, this research will have an impact on healthcare professionals, policy makers and carers. REPORTING METHOD The COREQ guideline was used. PATIENT OR PUBLIC CONTRIBUTION This study adopted a collaborative approach to ensure that patient perspectives were integrated into the research process. We organized regular focus groups. Patients were actively involved in shaping the research questions, refining the study design and interpreting the emerging findings. Their valuable input helped us to understand the nuances of their experience and to prioritize the aspects that were critical to their well-being. In addition, their insights guided the development of practical recommendations aimed at improving the interpersonal care relationship between nurses and patients in hospital settings, ensuring that their voices were heard and reflected in the proposed interventions. This patient-centred approach fostered a sense of empowerment among the participants. It reinforced the notion that their experiences and opinions are integral to shaping healthcare practice.
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Affiliation(s)
| | | | | | | | | | | | - Carmen Sarabia-Cobo
- Faculty of Nursing, University of Cantabria, Santander, Spain
- Nursing Research Group, IDIVAL. CIBERFRAIL, Santander, Spain
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Fuseini AG, Rawson H, Redley B, Ley L, Mohebbi M, Kerr D. Self-reported dignity and factors that influence dignity in hospitalised older adults: A cross-sectional survey. J Clin Nurs 2023; 32:7791-7801. [PMID: 37604797 DOI: 10.1111/jocn.16850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/09/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE This study examined levels of self-reported dignity and explored factors expected to influence dignity experienced by older adults during acute hospitalisation in Ghana. BACKGROUND Dignified care has been recognised as inseparable from quality nursing care and maintaining patients' dignity has been highlighted in professional codes of conduct for nurses. However, there is a lack of research on self-reported dignity and the factors that influence the dignity of older adults during acute hospitalisation in Africa. SETTING A large teaching hospital in the northern region of Ghana. PARTICIPANTS Hospitalised older adults. METHODS A cross-sectional survey was used to gather data from a convenience sample of 270 older inpatients, using the Hospitalized Older Adults' Dignity Scale. Data were analysed using descriptive statistics and stepwise ordinal logistic regression to investigate stratified dignity outcomes. The study was reported following the STROBE checklist. RESULTS More than half of the older adults surveyed reported low to moderate levels of dignity. Demographic characteristics such as age, marital status, religious status, occupation, level of education and type of hospital ward did not show any significant associations with dignity levels. However, there was a significant association found between dignity levels and sex and the number of hospitalisations. CONCLUSION Most older adults in a Ghanian hospital experienced loss of dignity during their acute hospitalisation. Male older adults reported higher dignity levels during acute hospitalisation than their female counterparts. Further, older adults who were admitted to hospital for the second time reported less dignity compared to those admitted three or more times. RELEVANCE TO CLINICAL PRACTICE The results emphasise the importance of healthcare professionals having the necessary knowledge and skills to provide gender-sensitive care, which ultimately promotes the dignity of all patients. Additionally, the results underscore the urgency of implementing measures that guarantee patients' dignity during all hospital admissions. PATIENT OR PUBLIC CONTRIBUTION Survey questionnaires were completed by hospitalised older adults at the study setting.
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Affiliation(s)
- Abdul-Ganiyu Fuseini
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Helen Rawson
- Monash Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Bernice Redley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Lenore Ley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Mohammadreza Mohebbi
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
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Fuseini AG, Mohebbi M, Redley B, Rawson H, Ley L, Kerr D. Development and psychometric validation of the hospitalized older adults' dignity scale for measuring dignity during acute hospitalization. J Adv Nurs 2023; 79:4058-4073. [PMID: 37226570 DOI: 10.1111/jan.15714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 02/06/2023] [Accepted: 05/05/2023] [Indexed: 05/26/2023]
Abstract
AIM To develop and validate a culturally appropriate patient-reported outcome measure for measuring dignity for older adults during acute hospitalization. DESIGN A three-phased exploratory sequential mixed-method design was used. METHODS Domains were identified and items were generated from findings of a recent qualitative study, two systematic reviews and grey literature. Content validity evaluation and pre-testing were undertaken using standard instrument development techniques. Two-hundred and seventy hospitalized older adults were surveyed to test construct and convergent validity, internal consistency reliability and test-retest reliability of the measure. Analysis was performed using Statistical Package for the Social Sciences, version 25. The STROBE checklist was used to document reporting of the study. RESULTS We established the 15-item Hospitalized Older Adults' Dignity Scale (HOADS) that has a 5-factor structure: shared decision-making (3 items); healthcare professional-patient communication (3 items); patient autonomy (4 items); patient privacy (2 items); respectful care (3 items). Excellent content validity, adequate construct and convergent validity, acceptable internal consistency reliability and good test-retest reliability were demonstrated. CONCLUSION We established the HOADS is a valid and reliable scale to measure dignity for older adults during acute hospitalization. Future studies using confirmatory factor analysis are needed to corroborate the dimensionality of the factor structure and external validity of the scale. Routine use of the scale may inform the development of strategies to improve dignity-related care in the future. IMPACT The development and validation of the HOADS will provide nurses and other healthcare professionals with a feasible and reliable scale for measuring older adults' dignity during acute hospitalization. The HOADS advances the conceptual understanding of dignity in hospitalized older adults by including additional constructs that have not been captured in previous dignity-related measures for older adults (i.e. shared decision-making and respectful care). The factor structure of the HOADS, therefore, includes five domains of dignity and offers a new opportunity for nurses and other healthcare professionals to better understand the nuances of dignity for older adults during acute hospitalization. For example, the HOADS enables nurses to identify differences in levels of dignity based on contextual factors and to use this information to guide the implementation of strategies that promote dignified care. PATIENT OR PUBLIC CONTRIBUTION Patients were involved in the generation of items for the scale. Their perspectives and the perspectives of experts were sought in determining the relevance of each item of the scale to patients' dignity.
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Affiliation(s)
- Abdul-Ganiyu Fuseini
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Burwood, Australia
| | | | - Bernice Redley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Burwood, Australia
| | - Helen Rawson
- Monash Nursing and Midwifery, Monash University, Clayton, Australia
| | - Lenore Ley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Burwood, Australia
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Burwood, Australia
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Laranjeira C. Dignity promotion in people with advanced chronic diseases: contributions for a value-based healthcare practice. Front Public Health 2023; 11:1156830. [PMID: 37575126 PMCID: PMC10415073 DOI: 10.3389/fpubh.2023.1156830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023] Open
Affiliation(s)
- Carlos Laranjeira
- Department of Nursing Science, School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
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Fuseini AG, Redley B, Rawson H, Ley L, Kerr D. Methodological quality of dignity-related patient reported outcome measures used in acute hospital settings: A systematic review using the COSMIN methodology. J Clin Nurs 2023. [PMID: 36604845 DOI: 10.1111/jocn.16598] [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: 08/03/2022] [Revised: 10/26/2022] [Accepted: 11/23/2022] [Indexed: 01/07/2023]
Abstract
AIMS AND OBJECTIVE The aim of this systematic review was to examine the methodological quality of dignity-related patient reported outcome measures (PROMs) used to measure patients' dignity during acute hospitalisation using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology for systematic review of PROMs. BACKGROUND Previous scoping review studies on the methodological quality of dignity-related PROMs lack specificity for dignity during acute hospital admission. They included PROMs that were developed to measure constructs of care other than patient dignity or designed to measure dignity in contexts outside of the acute hospital setting. STUDY DESIGN A systematic review based on COSMIN methodology. METHODS A systematic search was undertaken using five databases (CINAHL Complete, Medline Complete, EMBASE, PsycINFo and AgeLine) for articles published between 2000 and 2022. Relevant papers were identified using strict adherence to eligibility criteria, and studies that included development of dignity-related PROMs for use in acute hospital settings were selected. Two reviewers independently screened the identified papers, extracted data and examined the quality of studies. RESULTS Six papers met the inclusion criteria. Two PROMs, the 25-item Patient Dignity Inventory and the 34-item Inpatient Dignity Scale, met the COSMIN quality criteria because of their sufficient quality of evidence for content validity and reliable internal consistency. None of the PROMs met the quality criteria for assessment of measurement error, criterion validity, cross-cultural validity and responsiveness. CONCLUSION We recommend the Patient Dignity Inventory and the Inpatient Dignity Scale as the PROMs of choice for evaluating patients' dignity and/or dignified care during acute hospital admissions. These PROMs were developed using robust procedures with sufficient overall quality for content validity, internal consistency reliability and other measurement properties, and with moderate to high quality of evidence for these measurement properties. Researchers and clinicians who wish to use other dignity-related PROMs identified in this review should consider the methodological limitations of these PROMs, as highlighted in the present systematic review. RELEVANCE TO CLINICAL PRACTICE The review findings will guide healthcare professionals about their choice of patient reported outcome measures for evaluating patients' dignity or dignified care during acute hospitalisation.
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Affiliation(s)
- Abdul-Ganiyu Fuseini
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Bernice Redley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Helen Rawson
- Monash Nursing and Midwifery, Monash University, Victoria, Melbourne, Australia
| | - Lenore Ley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
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Fuseini A, Ley L, Rawson H, Redley B, Kerr D. A systematic review of patient-reported dignity and dignified care during acute hospital admission. J Adv Nurs 2022; 78:3540-3558. [PMID: 35841334 PMCID: PMC9795980 DOI: 10.1111/jan.15370] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/13/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
AIMS To synthesize quantitative evidence on levels of dignity during acute hospital admission and identify barriers and facilitators to patients' dignity or dignified care from the perspective of hospitalized patients. The secondary aim was to examine the relationship between dignity and demographic, clinical and psychological characteristics of patients. DESIGN A systematic review based on the protocol of the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline for reporting systematic reviews. DATA SOURCES Five electronic databases (PubMed, CINAHL, Embase, PsycINFO, AgeLine) were searched in February 2021, followed by backward-forward searching using Web of Science and Scopus databases. REVIEW METHODS Potentially eligible articles were scrutinized by two reviewers. Articles that met the eligibility criteria were appraised for quality using the Critical Appraisal Tool for Cross-Sectional Studies. Two reviewers extracted data for the review and resolved differences by consensus. RESULTS Out of 3052 potentially eligible studies, 25 met the inclusion criteria. Levels of dignity for hospitalized patients vary widely across geographic locations. Patients' dignity is upheld when healthcare professionals communicate effectively, maintain their privacy, and provide dignity therapy. Patients' perceptions of dignity were, in some studies, reported to be associated with demographic (e.g. age, marital status, gender, employment, educational status), clinical (e.g. hospitalization, functional impairment, physical symptoms) and psychological (e.g. depression, anxiety, demoralization, coping mechanisms) variables whilst other studies did not observe such associations. CONCLUSION Patients in acute care settings experience mild to a severe loss of dignity across different geographic locations. Patients' dignity is influenced by several demographic, clinical and psychological characteristics of patients. IMPACT The findings of the review support impetus for improvement in dignified care for hospitalized patients, addressing factors that facilitate or impede patients' dignity. Measures aimed at alleviating suffering, fostering functional independence and addressing patients' psychosocial needs can be used to promote dignity.
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Affiliation(s)
- Abdul‐Ganiyu Fuseini
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and MidwiferyDeakin University, Geelong Waterfront CampusGeelongVictoriaAustralia
| | - Lenore Ley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and MidwiferyDeakin University, Geelong Waterfront CampusGeelongVictoriaAustralia
| | - Helen Rawson
- Nursing and Midwifery, Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneVictoriaAustralia
| | - Bernice Redley
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and MidwiferyDeakin University, Geelong Waterfront CampusGeelongVictoriaAustralia
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and MidwiferyDeakin University, Geelong Waterfront CampusGeelongVictoriaAustralia
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