The impact of economic recession on health-care and the contribution by nurses to promote individuals' dignity

A survey of Greek women's satisfaction of postnatal care

Background

The research described in this paper is a cross-sectional study which surveys women who delivered their babies in a regional hospital in Greece to investigate their satisfaction with their postnatal care. This is the first published study which measures satisfaction of postnatal services in Greece. The aim of this study is to determine which factors most influence postnatal satisfaction, which areas are lacking and therefore identify specific areas which should be targeted to improve the performance of health services.

Methods

A cross sectional, quantitative study of 300 women who gave birth in a regional Greek hospital between January 2015 and July 2017 were surveyed 40 days after birth using a self-administered questionnaire. The questionnaire contained sociodemographic and clinical characteristic questions and a selection of questions from the WOMen's views of Birth Postnatal Satisfaction Questionnaire (WOMBPNSQ).

Results

This study found that the dimensions with the higher satisfaction scores were “Professional support” and “Continuity”. The lower satisfaction scores were for the dimensions “Woman's health”, “Contraceptive advice” and “Social support” indicating that these are areas for improvement. The three dimensions most correlated with general satisfaction were “Time with woman”, “Feeding baby” and “Professional support”.

Conclusions

This study highlights the important role of health professionals showing that they can enhance postnatal satisfaction by spending time with the women, giving guidance on the care of the newborn and baby feeding. Focusing on improving these areas is expected to enhance the quality of postnatal care.

Performance measurement for the strategic management of health-care estates

Purpose

The purpose of this study is to explore the role of performance measurement in current practices for strategic management of health-care estates.

Design/methodology/approach

The research adopts a constructivist grounded theory approach, combining different methodologies of a pan-European qualitative questionnaire, interviews with international health-care providers and a case study of National Health Services (NHS) Scotland. Here, documentation analysis, observations and in-depth interviews involving NHS stakeholders were undertaken.

Findings

The analysis shows evidence that measuring estate performance has limited value for individual NHS boards regarding strategic decisions related to long-term planning and investment. This was due to design issues and the prioritisation of clinical delivery, which contribute to the neglect of the estate as a consideration in long-term strategic planning. This misalignment results in a tool which is valuable for accountability but which is less helpful to NHS boards in shaping future decisions around the estate.

Practical implications

Responding to a gap in understanding of the application of performance measurement in the context of health-care estates, this research provides three recommendations to promote a more effective and relevant performance measurement system. These actively recognise the importance of the estate within strategic decision-making as helping to inform the long-term planning and management of the estate within the individual NHS boards.

Originality/value

This paper shows the current role of performance measurement for the strategic management of health-care estates and identifies issues related to its applicability and value.

Dignity in nursing care: What does it mean to nursing students?

BACKGROUND:

Despite growing interest in the potential of nursing education to enhance dignity in nursing care, relatively little is known about what dignity means to nursing students.

RESEARCH QUESTION:

What meaning does dignity in nursing care have for nursing students?

RESEARCH DESIGN:

Photo-elicitation was embedded within a Nominal Group Technique and responses were analysed by qualitative and quantitative content analysis.

PARTICIPANTS AND RESEARCH CONTEXT:

Participants were recruited from each year of a 3-year undergraduate preregistration adult nursing programme in Scotland. In total, 31 nursing students participated in the study.

ETHICAL CONSIDERATIONS:

The study was approved by the Ethics Committee of the School of Health, Nursing and Midwifery, University of the West of Scotland.

FINDINGS:

Participants articulated the meaning of dignity in nursing care in terms of the relationships and feelings involved. A total of 10 categories of meaning were identified.

DISCUSSION:

The significance of the nature of the nurse-patient interaction to preserving dignity in nursing care is highlighted.

CONCLUSION:

Understanding the meaning of dignity for nursing students may help prepare future nurses more able to preserve dignity in nursing care.

Difficulties of Portuguese Patients Following Acute Myocardial Infarction: Predictors of Readmissions and Unchanged Lifestyles

PURPOSE

Myocardial infarction can occur due to known risk factors and lifestyle choices. The difficulties that patients experience after discharge can lead to readmission and nonadherence to lifestyle change. The purpose of this study was to analyze the difficulties experienced by patients after hospitalization due to myocardial infarction and to identify the predictors of readmission and unchanged lifestyles.

METHODS

The study used a mixed-methods design across 106 patients who had experienced a first episode of acute myocardial infarction. The data were collected from two patient interviews and the patients' medical records. A logistic regression was used to predict unchanged lifestyle and readmission.

RESULTS

In the first interview, 74.5% of the patients reported receiving information prior to discharge. Six months after discharge, 80.2% mentioned that they had changed their lifestyles, but only 59.4% reported that their health had improved, and 75.5% continued to have concerns regarding their health. Patients described difficulties with regard to psychological problems, family dynamics, professional issues, problems with managing cardiovascular symptoms, and complications associated with hospital interventions. A follow-up assessment revealed that 12.3% of patients had been readmitted for cardiovascular disease.

CONCLUSIONS

The analysis revealed significant predictors of readmission amongst patients with hypertension and three-vessel disease. Specifically, the number of people in the household, per capita income, and a lack of information/education provided at discharge as well as problems related to mental health after discharge predicted unchanged lifestyle. An educational program might be advantageous to clarify doubts and involve patients in their own disease management.