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Dahlke S, Butler JI, Baskerville K, Fox MT, Chasteen AL, Hunter KF. Development and evaluation of an anti-ageism advisory group with older adults and gerontological experts: a qualitative descriptive study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:86. [PMID: 39123251 PMCID: PMC11312679 DOI: 10.1186/s40900-024-00621-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/07/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND In recent years, academics have increasingly acknowledged the importance of involving health service users and community stakeholders as active partners in health research. Yet, the involvement of older adults, the largest group of health service users, as research partners remains limited, possibly due to ageist attitudes that devalue older adults' contributions. During the three years of our Awakening Canadians to Ageism study, we convened an advisory group consisting of older adults and gerontological experts to discuss issues related to ageism, help interpret the study findings, and develop a range of knowledge mobilization strategies to dispel ageism. METHODS To understand the experiences of members of the advisory group and solicit recommendations for improving future groups, we conducted a qualitative descriptive study and interviewed 8 older adults and 6 gerontological experts. Data were content analyzed. RESULTS Four categories that were developed to explain participants' experiences and suggestions for future advisory groups included: organization and management, group experience, suggestions for future advisory groups and moving forward. A key finding was the value that the older adults and gerontological experts ascribed to conversations about the prevalence of ageism and their desire to continue these types of conversations in their personal groups and professional networks. Numerous helpful strategies for future advisory groups were identified, such as enhancing social diversity, both in terms of racial/ethnic/cultural representation and gender. Older adults wanted more "getting to know you time" in meetings and gerontological experts wanted more details about the research process and their role. CONCLUSIONS This study's partnership approach can guide researchers seeking to involve key health service users and community stakeholders in health research and help enact positive social change.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
| | - Jeffrey I Butler
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Kelly Baskerville
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Mary T Fox
- School of Nursing, York University, Centre for Aging Research & Education, York University, 3560 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Alison L Chasteen
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON, M5S 3G3, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, 5-293 Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
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Butler JI, Fox MT. 'Our Voices Aren't Being Heard': A qualitative descriptive study of nurses' perceptions of interprofessional collaboration in care supporting older people's functioning during a hospital stay. Scand J Caring Sci 2024; 38:398-408. [PMID: 38323707 DOI: 10.1111/scs.13243] [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: 11/24/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Older people admitted to hospital are highly susceptible to functional decline and related complications. Care supporting their functioning is complex and requires healthcare professionals working in concert, with nurses playing a central role. Yet, little is known about nurses' perceptions of interprofessional collaboration (IPC) in care supporting functioning in acutely admitted older people. To fill this knowledge gap, we elucidate the perspectives of nurses in Ontario, Canada, on IPC in care supporting older people's functioning during a hospital stay. METHODS We employed a qualitative methodology in conjunction with a qualitative descriptive design. Thirteen focus groups were held with a purposeful, criterion-based sample of 57 acute care nurses practising in a range of acute care settings (e.g. Emergency, General Medicine, General Surgery, Intensive Care, Coronary Care). Data were thematically analysed. RESULTS We identified two overarching themes: (1) IPC is improving, but nurses are excluded from decision-making and (2) nurse advocacy causes friction with other professionals. The first theme captures nurses' perception that IPC in older people's care is improving, but nurses are marginalised in interprofessional decision-making. As a result, nurses perceive that their knowledge is devalued, and their contributions to care supporting older people's functioning are undermined. The second theme underlines a tension between interprofessional team practices and patient- and family-centred care, while also demonstrating nurses' increasing willingness to act as patient and family advocates. CONCLUSIONS Findings can be used to enhance IPC in care supporting the functioning of acutely hospitalised older people. To improve IPC, clinical and administrative leaders should cultivate more egalitarian team relationships that encourage nurses to contribute to decision-making and advocate on behalf of older patients and their families.
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Affiliation(s)
- Jeffrey I Butler
- Faculty of Health, School of Nursing, York University, Toronto, Ontario, Canada
- York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Mary T Fox
- Faculty of Health, School of Nursing, York University, Toronto, Ontario, Canada
- York University Centre for Aging Research and Education, Toronto, Ontario, Canada
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Kokorelias KM, Singh H, Nelson MLA, Hitzig SL. "Why Do We Always Have to Focus on the Bad": A Strengths-Based Approach to Identify the Positive Aspects of Care From the Perspective of Older Adults Using a Secondary Qualitative Analysis. J Patient Exp 2023; 10:23743735231188841. [PMID: 37547702 PMCID: PMC10399251 DOI: 10.1177/23743735231188841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
Hospitalization is often viewed as a burdensome and stressful period for older adults and their family caregivers; however, little attention has been given to the positive aspects of the care continuum journey. The purpose of this article is to highlight the positive aspects of healthcare from the perspective of Canadian older adults with complex needs and their family caregivers. This study utilized a strengths-based theoretical perspective to conduct a secondary qualitative analysis of interviews with 12 older adults and seven family caregivers. Four themes relating to positive aspects of care were identified, including: (1) looking beyond illness, (2) emotional support from healthcare providers, (3) timely discharge, and (4) upholding independence. Focusing on the positive aspects can help determine areas of care practice that currently work well. These insights will be valuable for current and future initiatives seeking to restructure and optimize healthcare services for older adults.
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Affiliation(s)
- Kristina M Kokorelias
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Michelle LA Nelson
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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Hunter KF, Dahlke SA. Fast thinking: How unconscious bias and binary language contribute to rationing of care to older persons. Int J Older People Nurs 2023; 18:e12538. [PMID: 37013362 DOI: 10.1111/opn.12538] [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: 08/15/2022] [Revised: 02/08/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Binary or categorical thinking is a way of thinking in which the brain unconsciously sorts the masses of information it receives into categories. This helps us to quickly process information and keeps us safe through pattern recognition of possible threats. However, it can also be influenced by unconscious and conscious biases that inform our judgements of other people and situations. OBJECTIVES To examine nursing practice with older people through the lens of unconscious bias. METHODS In this critical analysis, using Kahneman's fast and slow thinking, we argue that nurses working with hospitalised older people often rely on thinking quickly in hectic work environments, which can contribute to unconscious and conscious bias, use of binary language to describe older persons and nursing tasks, and ultimately rationing of care. RESULTS Binary language describes older persons and their care simplistically as nursing tasks. A person is either heavy or light, continent or incontinent, confused or orientated. Although these descriptions are informed in part by nurses' experiences, they also reflect conscious and unconscious biases that nurses hold towards older patients or nursing tasks. We draw on explanations of fast (intuitive) and slow (analytical) to explain how nurses gravitate to thinking fast as a survival mechanism in environments where they are not supported or encouraged to think slow. CONCLUSIONS Nurses survival efforts in getting through the shift using fast thinking, which can be influenced by unconscious and conscious biases, can lead to use of shortcuts and the rationing of care. We believe that it is of paramount importance that nurses be encouraged and supported to think slowly and analytically in their clinical practice. IMPLICATIONS FOR PRACTICE Implications Nurses can engage in journaling and reflecting on their practice with older people to examine possible unconscious bias. Managers can support reflective thinking by supporting nurses through staffing models and encouraging conversations about person-centered care in unit practices.
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Affiliation(s)
- Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sherry Ann Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Abudu-Birresborn D, Brennenstuhl S, Puts M, McCleary L, Yakong V, Chu CH, Cranley L. Evaluating knowledge and attitudes scales for the care of older adults among nursing students in Ghana. BMC Nurs 2023; 22:47. [PMID: 36805691 PMCID: PMC9942360 DOI: 10.1186/s12912-023-01195-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Understanding nursing students' knowledge about and attitudes toward older adults' using context-specific survey instruments can help to identify and design effective learning and teaching materials to improve the care for persons 60 years and above. However, there are no validated instruments to examine nursing students' knowledge and attitudes toward the care for older adults in the African context. The study aimed to evaluate the items on the Knowledge about Older Patients Quiz and Kogan's Attitudes towards Old People Scale suitable for the African context. METHODS A cross-sectional study was conducted using second-and third-year nursing students from two public Nursing Training Institutions in Ghana. Using Sahin's rule of sample size estimate of at least 150 participants for unidimensional dichotomous scales, 170 nursing students were recruited to participate after an information session in their classrooms. Data were collected from December 2019-March 2020 using the Knowledge about Older Patients Quiz and Kogan's Attitudes Towards Old People Scale. Item response theory was employed to evaluate the Knowledge about Older Patients Quiz difficulty level and discrimination indices. Corrected item-to-total correlation analysis was conducted for Kogan's Attitudes towards Old People Scale. The internal consistency for both scales was examined. RESULTS Of the 170 participants, 169 returned completed surveys. The mean age of participants was 21 years (SD = 3.7), and (54%) were female. Of the 30-items of the Knowledge about Older Patients Quiz, seven items were very difficult for most students to choose the correct response, and one was easy, as most of the students chose the correct response. Although 22 items demonstrated appropriate difficulty level, discrimination indices were used to select the final 15- items that discriminated moderately between upper and lower 25% performing students. The Kuder-Richardson-20 reliability was. 0.30, which was low. Considering Kogan's Attitudes towards Old People scale, 10-items were removed following negative and low corrected item-to-total correlation and a high Alpha coefficient if items were deleted. The final 22-items had a Cronbach alpha coefficient of 0.65, which was moderately satisfactory. CONCLUSION Evaluation of the scales demonstrated essential content validity and moderate internal consistency for the context of our study. Further research should focus on ongoing context-specific refinement of the survey instruments to measure nursing students' knowledge about and attitudes toward caring for older adults in the African context.
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Affiliation(s)
- Diana Abudu-Birresborn
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON, M5T 1P8, Canada.
| | - Sarah Brennenstuhl
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
| | - Martine Puts
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
| | - Lynn McCleary
- grid.411793.90000 0004 1936 9318Department of Nursing, Brock University, 1812 Sir Isaac Brock Way, St. Catharine’s, ON L2S 3A1 Canada
| | - Vida Yakong
- grid.442305.40000 0004 0441 5393School of Nursing and Midwifery, University for Development Studies, Box 1350, Tamale, Ghana
| | - Charlene H. Chu
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
| | - Lisa Cranley
- grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON M5T 1P8 Canada
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The Effects of Education Based on the Nursing Process on Ostomy Self-Care Knowledge and Performance of Elderly Patients with Surgical Stoma. Nurs Res Pract 2023; 2023:2800796. [PMID: 36644020 PMCID: PMC9833921 DOI: 10.1155/2023/2800796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 01/05/2023] Open
Abstract
Background Patients with surgical stoma experience problems, which can lead to their impaired adaptation and self-efficacy. The nursing process provides a framework for planning and implementing nursing care. This study aimed to investigate the effect of education based on the nursing process on ostomy self-care knowledge and performance of elderly patients with intestinal stoma. Materials and Methods. In this quasi experimental study, 52 elderly patients with intestinal ostomy who were referred to Razi Hospital in Rasht and met the inclusion criteria were invited to participate in research. Sampling was done by a simple random method. The intervention group received an educational programme based on the nursing process, whereas the control group received traditional training. The research instruments included a questionnaire to assess the level of ostomy self-care knowledge and ostomy self-care performance. Data were analyzed by SPSS software version 21 using descriptive and inferential statistics at a significant level of p < 0.05. Results The mean scores of ostomy self-care knowledge and performance in both groups (intervention and control) were increased. However, the improvement in self-care knowledge and performance of the intervention group was significantly greater than that in the control group (p < 0.001). Conclusions The educational programme based on the nursing process compared to the routine patients training caused more improvement in ostomy self-care knowledge and performance of older adult patients with surgical stoma. Therefore, an educational programme based on the nursing process can be used as an educational model for these patients.
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Devkota R, Dahlke S, Fox MT, Davidson S, Hunter KF, Butler JI, Shrestha S, Chasteen AL, Moody E, Martin LS, Pietrosanu M. E-learning modules to enhance student nurses' perceptions of older people: a single group pre-post quasi-experimental study. Int J Nurs Educ Scholarsh 2023; 20:ijnes-2023-0059. [PMID: 38029314 DOI: 10.1515/ijnes-2023-0059] [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: 06/16/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES To examine whether e-learning activities on cognitive impairment (CI), continence and mobility (CM) and understanding and communication (UC) improve student nurses' knowledge and attitudes in the care of older adults. METHODS A quasi-experimental single group pre-post-test design was used. We included 299 undergraduate nursing students for the CI module, 304 for the CM module, and 313 for the UC module. We administered knowledge quizzes, Likert scales, and a feedback survey to measure student nurses' knowledge, ageist beliefs, and feedback on the modules respectively. RESULTS Participants demonstrated significantly more knowledge and reduced ageist attitudes following the e-learning activities. CONCLUSIONS Findings suggest that e-learning activities on cognitive impairment, continence and mobility, and understanding and communication improve knowledge and reduce ageist attitudes among nursing students.
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Affiliation(s)
- Rashmi Devkota
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Mary T Fox
- School of Nursing, York University Centre for Aging Research & Education, York University, Toronto, ON, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | | | - Jeffrey I Butler
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Shovana Shrestha
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Alison L Chasteen
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Lori Schindel Martin
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
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Sedri N, Zakeri MA, Zare Zardiny M, Tavan A. Evaluation of Nurses’ Knowledge and Attitudes towards Older Adults and Associated Factors. Open Nurs J 2022. [DOI: 10.2174/18744346-v16-e2206200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Due to the increased risk of developing chronic diseases among older adults, their demand for health care has increased. Preparing nurses to care for the older adults is one of the most difficult challenges in nursing education.
Objective:
This study investigated nurses’ knowledge and attitudes towards older adults and demographic and occupational features that affect them.
Methods:
This cross-sectional study was conducted on 412 participants from July to October 2020. Patients were selected using a random sampling method. Three questionnaires were used: a socio-demographic form, an Older Patient in Acute Care Survey, and a Knowledge about Older Patients-Quiz.
Results:
According to the Pearson correlation test, there is a statistically significant and positive correlation between knowledge and general opinion (P = 0.000), (r = 0.271) as well as between practice experiences and general opinion (P = 0.000), (r = 0.205) of nurses about older adult’s care. There was no statistically significant relationship between knowledge and practice experiences (P = 0.857), (r = -. 009).
Conclusion:
Having a better understanding of the needs of the older adults would improve the quality of care that nurses provide to them.
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Geelen SJG, van Dijk-Huisman HC, de Bie RA, Veenhof C, Engelbert R, van der Schaaf M, Lenssen AF. Barriers and enablers to physical activity in patients during hospital stay: a scoping review. Syst Rev 2021; 10:293. [PMID: 34736531 PMCID: PMC8569983 DOI: 10.1186/s13643-021-01843-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low levels of physical activity are common during the hospital stay and have been associated with negative health outcomes. Understanding barriers and enablers to physical activity during a hospital stay can improve the development and implementation of tailored interventions aimed at improving physical activity. Previous studies have identified many barriers and enablers, but a comprehensive overview is lacking. This study aimed to identify and categorize all published patient- and healthcare professional-reported barriers and enablers to physical activity during a hospital stay for acute care, using the Theoretical Domains Framework (TDF). METHODS We conducted a scoping review of Dutch and English articles using MEDLINE, CINAHL Plus, EMBASE, PsycINFO, and Cochrane Library (inception to September 2020), which included quantitative, qualitative, and mixed-methods studies reporting barriers and enablers to physical activity during a hospital stay for acute care, as perceived by patients or healthcare professionals. Two reviewers systematically extracted, coded, and categorized all barriers and enablers into TDF domains. RESULTS Fifty-six articles were included in this review (32 qualitative, 7 quantitative, and 17 mixed-methods). In total, 264 barriers and 228 enablers were reported by patients, and 415 barriers and 409 enablers by healthcare professionals. Patient-reported barriers were most frequently assigned to the TDF domains Environmental Context & Resources (ECR, n = 148), Social Influences (n = 32), and Beliefs about Consequences (n = 25), while most enablers were assigned to ECR (n = 67), Social Influences (n = 54), and Goals (n = 32). Barriers reported by healthcare professionals were most frequently assigned to ECR (n = 210), Memory, Attention and Decision Process (n = 45), and Social/Professional Role & Identity (n = 31), while most healthcare professional-reported enablers were assigned to the TDF domains ECR (n = 143), Social Influences (n = 76), and Behavioural Regulation (n = 54). CONCLUSIONS Our scoping review presents a comprehensive overview of all barriers and enablers to physical activity during a hospital stay and highlights the prominent role of the TDF domains ECR and Social Influences in hospitalized patients' physical activity behavior. This TDF-based overview provides a theoretical foundation to guide clinicians and researchers in future intervention development and implementation. SCOPING REVIEW REGISTRATION No protocol was registered for this review.
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Affiliation(s)
- Sven Jacobus Gertruda Geelen
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands.
| | - Hanneke Corine van Dijk-Huisman
- Department of Physical Therapy, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, 6229HX, The Netherlands.
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
| | - Robert Adriaan de Bie
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Cindy Veenhof
- Physical Therapy Research, Department of Rehabilitation, Physical Therapy Sciences & Sports, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Expertise Centre Healthy Urban Living, Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Raoul Engelbert
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Marike van der Schaaf
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Antoine François Lenssen
- Department of Physical Therapy, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, 6229HX, The Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
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Dahlke S, Hunter KF, Fox MT, Davidson S, Perry N, Watts LT, Martin LS, Butler JI, Raymond C, Chasteen AL, McCleary L, Boscart V, Moody E. Awakening Canadians to ageism: a study protocol. BMC Nurs 2021; 20:192. [PMID: 34627234 PMCID: PMC8502289 DOI: 10.1186/s12912-021-00713-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/24/2021] [Indexed: 12/02/2022] Open
Abstract
Background Making fun of growing older is considered socially acceptable, yet ageist humour reinforces negative stereotypes that growing old is linked with physical and mental deterioration, dependence, and less social value. Such stereotypes and discrimination affect the wellbeing of older people, the largest demographic of Canadians. While ageism extends throughout professions and social institutions, we expect nurses—the largest and most trusted group of healthcare professionals—to provide non-ageist care to older people. Unfortunately, nurses working with older people often embrace ageist beliefs and nursing education programs do not address sufficient anti-ageism content despite gerontological nursing standards and competencies. Methods To raise awareness of ageism in Canada, this quasi-experimental study will be supported by partnerships between older Canadians, advocacy organizations, and academic gerontological experts which will serve as an advisory group. The study, guided by social learning theory, will unfold in two parts. In Phase 1, we will use student nurses as a test case to determine if negative stereotypes and ageist perceptions can be addressed through three innovative e-learning activities. The activities employ gamification, videos, and simulations to: (1) provide accurate general information about older people, (2) model management of responsive behaviours in older people with cognitive impairment, and (3) dispel negative stereotypes about older people as dependent and incontinent. In Phase 2, the test case findings will be shared with the advisory group to develop a range of knowledge mobilization strategies to dispel ageism among healthcare professionals and the public. We will implement key short term strategies. Discussion Findings will generate knowledge on the effectiveness of the e-learning activities in improving student nurses’ perceptions about older people. The e-learning learning activities will help student nurses acquire much-needed gerontological knowledge and skills. The strength of this project is in its plan to engage a wide array of stakeholders who will mobilize the phase I findings and advocate for positive perspectives and accurate knowledge about aging—older Canadians, partner organizations (Canadian Gerontological Nurses Association, CanAge, AgeWell), and gerontological experts.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Mary T Fox
- School of Nursing, Faculty of Health, York University Centre for Aging Research and Education, HNES suite 343, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, 2800 University Way N.W., 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Nicole Perry
- National Programs, HelpAge Canada, 1300 Carling Avenue, Ottawa, ON, K1Z 7L2, Canada
| | - Laura Tamblyn Watts
- CanAge, Factor - Inwentash Faculty of Social Work, University of Toronto 246 Bloor St West, Toronto ON M5S 1V4, Toronto, ON, M5S 1V4, Canada
| | - Lori Schindel Martin
- Canadian Gerontological Nursing Association, PO Box 64009, Royal Bank Plaza, Toronto, ON, M5J 2T6, Canada
| | - Jeffrey I Butler
- School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University; Faculty of Nursing, University of Alberta, HNES suite B05, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Christy Raymond
- Faculty of Nursing, MacEwan University, 5-111C, Robbins Health Learning Centre, 10910-104 Ave NW, Edmonton, AB, T5J 4S2, Canada
| | - Alison L Chasteen
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON, M5S 3G3, Canada
| | - Lynn McCleary
- Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Veronique Boscart
- School of Health and Life Sciences, Conestoga College Institute of Technology and Advanced Learning, 299 Doon Valley Drive, Kitchener, ON, N2G 4M4, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Room N19 Forrest Bldg., Dalhousie University, University Avenue, PO Box 15000 5869, Halifax, NS, B3H 4R, Canada
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Nurse and Health Care Aide Knowledge of Urinary Continence Promotion and Management In Hospitalized Older People. J Wound Ostomy Continence Nurs 2021; 48:435-439. [PMID: 34495935 DOI: 10.1097/won.0000000000000794] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aims of this study were to determine if there was a change in medical unit nursing staffs' knowledge about lower urinary tract symptoms following an education presentation and whether the education session met their learning needs. DESIGN Single-group, before-after study. SUBJECTS AND SETTING The study sample comprised 21 licensed nurses and 16 health care aides from 3 medical units in a tertiary care hospital in western Canada. METHODS Participants completed pre- and post-true/false questionnaires developed for the project to assess lower urinary tract symptom knowledge, and a questionnaire to determine whether the education session met staff learning needs. RESULTS Knowledge was moderate on the pretest in both groups, with licensed nurses showing a significant improvement after the education intervention. Health care aides did not have a significant change in knowledge; they persisted in their belief that incontinence is a normal change of aging. CONCLUSIONS Health care aides need targeted education and enhanced care processes to shift their knowledge and thinking about continence.
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Dahlke S, Davidson S, Kalogirou MR, Swoboda NL, Hunter KF, Fox MT, Pollard C, Baumbusch J, Salyers V. Nursing faculty and students' perspectives of how students learn to work with older people. NURSE EDUCATION TODAY 2020; 93:104537. [PMID: 32717698 DOI: 10.1016/j.nedt.2020.104537] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 06/12/2020] [Accepted: 07/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Despite efforts to incorporate information about older people in pre-licensure nursing programs, there are inconsistent results from studies examining student nurses' perceptions towards the aging population. There is research suggesting that healthcare settings and nursing practice is perpetuating negative perspectives towards older people. OBJECTIVE To gain an understanding of how social contexts are influencing student nurses' experiences when learning to work with older people. DESIGN Descriptive case study guided by the theoretical framework of social learning theory. SETTING A university in Western Canada that offers a pre-licensure nursing program. PARTICIPANTS 28 student nurses and 13 faculty in the nursing program. METHODS Participant interviews and focus groups were conducted with nursing faculty and students. RESULTS Key findings from this study are that students' previous experiences with older people, through family or work experiences, and their first clinical experience in long- term care negatively influenced their perceptions about working with older people. Clinical nurses and faculty influenced students' perceptions about nursing practice with older people, sometimes in subtle ways, underscoring that students are learning from what they see and hear in practice. Students were ill-prepared for the complexity of the aging population, particularly those with cognitive impairment. CONCLUSIONS Learning activities that engage students in active learning, such as simulation, providing students with a positive lexicon of how to describe older patients, and more overt attention to the perspectives students and faculty bring to the learning environment need to be carefully explored. Meaningful learning experiences with older people in multiple contexts are needed to thoughtfully plan how to disrupt negative perceptions that might emerge through the nursing education program.
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Walsh B, Dahlke S, O'Rourke H, Hunter KF. Exploring acute care nurses' decision-making in psychotropic PRN use in hospitalised people with dementia. J Clin Nurs 2020; 31:2024-2035. [PMID: 32860272 DOI: 10.1111/jocn.15477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/30/2020] [Accepted: 08/19/2020] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To understand how acute care nurses make decisions about administering "as-needed" (PRN) psychotropic medications to hospitalised people with dementia (PWD). BACKGROUND Behavioural and psychological symptoms of dementia occur in approximately 75% of PWD admitted to acute care. Despite this, few studies provide insight into the use and prevalence of psychotropic use in acute care. DESIGN A qualitative descriptive design was used to explore acute care nurses' decision-making about PRN psychotropic medication administration to PWD. METHODS Semi-structured interviews were conducted with eight nurses from three acute care medical units in a large tertiary hospital in Western Canada. Conventional content analysis was used to develop three themes that reflect nurses' decision-making related to administering PRNs to hospitalised PWD. COREQ guidelines were followed. RESULTS Three themes of legitimising control, making the patient fit and future telling were developed. Legitimising control involved medicating undesirable behaviours to promote the nurses' perceptions of safety. Making the patient fit involved maintaining routine and order. Future telling involved pre-emptively medicating to prevent undesirable behaviours from escalating. Nurses provided little to no mention of assessing for physical causes contributing to behaviours. PRNs were seen as a reasonable alternative to physical restraints and were frequently used. Additionally, organisational and unit routines greatly influenced nurses' decision-making. CONCLUSIONS These findings provide an initial understanding of how nurses make decisions to administer PRN medications to hospitalised older people and may inform prescribing practices. There were novel findings about the lack of assessment prior to PRN administration, and the nurses' collective response in decision-making. More research is needed to better understand the complexities of nurses' decision-making, to assist in the development of interventions for nursing practice.
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Affiliation(s)
- Brittany Walsh
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Hannah O'Rourke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Fox MT, Butler JI, Sidani S, Durocher E, Nowrouzi-Kia B, Yamada J, Dahlke S, Skinner MW. Collaborating with healthcare providers to understand their perspectives on a hospital-to-home warning signs intervention for rural transitional care: protocol of a multimethod descriptive study. BMJ Open 2020; 10:e034698. [PMID: 32295775 PMCID: PMC7200029 DOI: 10.1136/bmjopen-2019-034698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION This study builds on our prior research, which identified that older rural patients and families (1) view preparation for detecting and responding to worsening health conditions as their most pressing unmet transitional care (TC) need and (2) perceive an evidence-based intervention, preparing them to detect and respond to warning signs of worsening health conditions, as highly likely to meet this need. Yet, what healthcare providers need to implement a warning signs intervention in rural TC is unclear. The objectives of this study are (1) to examine healthcare providers' perspectives on the acceptability of a warning signs intervention and (2) to identify barriers and facilitators to healthcare providers' provision of the intervention in rural communities. METHODS AND ANALYSIS This multimethod descriptive study uses a community-based, participatory research approach. We will examine healthcare providers' perspectives on a warning signs intervention. A purposive, criterion-based sample of healthcare providers stratified by professional designation (three strata: nurses, physicians and allied healthcare professionals) in two regions (Southwestern and Northeastern Ontario, Canada) will (1) rate the acceptability of the intervention and (2) participate in small (n=4-6 healthcare providers), semistructured telephone focus group discussions on barriers and facilitators to delivering the intervention in rural communities. Two to three focus groups per stratum will be held in each region for a total of 12-18 focus groups. Data will be analysed using conventional qualitative content analysis and descriptive statistics. ETHICS AND DISSEMINATION Ethics approval was obtained from the Office of Research Ethics at York University and the Health Sciences North Research Ethics Board. Findings will be communicated through plain language summary and policy briefs, press releases, manuscripts and conferences.
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Affiliation(s)
- Mary T Fox
- School of Nursing, York University, Toronto, Ontario, Canada
| | | | - Souraya Sidani
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Evelyne Durocher
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Behdin Nowrouzi-Kia
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Janet Yamada
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Mark W Skinner
- Trent School of the Environment, Trent University, Peterborough, Ontario, Canada
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Kusi-Appiah E, Dahlke S, Stahlke S, Hunter KF. Acute care nursing team members' perceptions of roles: Their own and each other's. J Nurs Manag 2019; 27:1784-1790. [PMID: 31532017 DOI: 10.1111/jonm.12877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/10/2019] [Accepted: 09/14/2019] [Indexed: 11/29/2022]
Abstract
AIM To examine registered nurses', licensed practical nurses' and health care aides' perceptions of their and each other's roles. BACKGROUND Nursing team members' perceptions about their own and each other's roles affect how they understand their contributions to patient care and their work relationships and social status within health care organisations. There is a paucity of literature on how nursing team members perceive their roles and those of their colleagues. DESIGN Secondary analysis of qualitative data using qualitative description. The parent study used grounded theory to examine nursing care for hospitalized older adults. METHOD Conventional content analysis of interview transcripts and field notes from the original study. RESULTS All nursing team members reported satisfaction from providing direct care. Registered nurses were uniquely responsible for leadership. Scope-of-practice changes contributed to role confusion and tension among team members. CONCLUSIONS More research is needed to better understand how to support nursing teams learning about one another. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers could facilitate clarification about nursing roles and support effective role deployment.
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Affiliation(s)
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sarah Stahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Dahlke S, Davidson S, Duarte Wisnesky U, Kalogirou MR, Salyers V, Pollard C, Fox MT, Hunter KF, Baumbusch J. Student Nurses’ Perceptions About Older People. Int J Nurs Educ Scholarsh 2019; 16:ijnes-2019-0051. [DOI: 10.1515/ijnes-2019-0051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/26/2019] [Indexed: 11/15/2022]
Abstract
Abstract
Educating nursing students about the ageing population is situated within negative societal, heath care and nursing perceptions. A cross-sectional design using Burbank’s perceptions towards older people scale was used to survey students in a pre-licensure nursing program in western Canada. Findings revealed that students’ perceptions about older people were lower in the third year of the nursing program and after four clinical experiences. We suggest that students’ first experiences in long-term care settings, in which they learn to provide basic care to older people, be balanced with experiences of older people in a variety of settings. Such experiences would allow students to develop the knowledge and skill needed to work with an ageing population with complex healthcare needs. More research is needed to better understand students’ experiences and perceptions about where in the program more learning strategies about how to best work with older people would be helpful.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing , University of Alberta , Edmonton , Alberta , Canada
| | - Sandra Davidson
- Faculty of Nursing , University of Calgary , Calgary , Alberta , Canada
| | | | - Maya R. Kalogirou
- Faculty of Nursing , University of Alberta , Edmonton , Alberta , Canada
| | | | | | - Mary T. Fox
- York University , Toronto , Ontario , Canada
| | - Kathleen F. Hunter
- Faculty of Nursing , University of Alberta , Edmonton , Alberta , Canada
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Abstract
Interprofessional collaboration is understood to improve efficiencies and quality of care but is associated with challenges such as professionals' differing routines, knowledge, and identities, as well as professional hierarchies and time constraints. Given these challenges, there is limited understanding of how professionals collaborate effectively in providing patient-centred care. This study, with a convergence triangulation mixed-methods study design, explored interprofessional staffs' perceptions of interprofessional collaboration and patient-centred care when working with hospitalized older adults. Thirty-six staff responded to a survey which included the Patient-Centred Care measure and the Modified Index of Interdisciplinary Collaboration; we also interviewed 14 nursing staff. Although all scores suggested a high value was placed on interprofessional collaboration, scores were low related to activities that facilitated team processes. We identified three themes from the data: knowing the patient/family, functional needs, and communication processes. Staff identified daily rounds with interprofessional teams as supportive of interprofessional collaboration and patient-centred-care.
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Hunter KF, Dahlke S, Negrin K, Kalogirou MR, Fox M, Antonio N, Buckborough N, Morgan A, Wagg A. The feasibility of implementing education on older person care to practice on medical units: Nurses' perceptions and the influence of practice context. Int J Older People Nurs 2019; 14:e12265. [PMID: 31441244 DOI: 10.1111/opn.12265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/03/2019] [Accepted: 07/16/2019] [Indexed: 11/26/2022]
Abstract
AIM As part of a larger primary study on evidence-informed practice with hospitalised older people, we aimed to (a) examine nursing staffs' perceptions of the interactive geriatric educational intervention and to explore how perceptions of their work context may influence their ability to enact the evidence-informed assessment and care approaches discussed during the educational sessions and (b) compare differences in perceptions of context between RNs, LPNs and HCAs. METHOD A survey-based evaluation that used both closed and open-ended questions was conducted as part of an interactive educational intervention on cognitive impairment and managing responsive behaviours. Data were gathered on participants' perceptions of the education intervention and organisational context. RESULTS Findings from this study suggest when education is tailored to nurses' articulated educational needs, it is well received; however, barriers to implementation exist. Assessment of the context by using a standardised survey tool to get the nursing staffs' perceptions of organisational context revealed strengths in leadership support and day-to-day interactions with other nurses and healthcare professionals, but potential barriers related to lack of facilitation to transfer new knowledge into practice existed. CONCLUSION Providing evidence-based education related to care of older patients and evaluating nursing staffs' perceptions of the education and their context has laid the groundwork for a long-term relationship with the managers and nursing staff on the participating medical units. Further investigation about how best to incorporate the facilitator role into the medical units to support evidence-based practices with older patients is warranted. IMPLICATIONS FOR PRACTICE: While nurses are receptive to new knowledge, the unpredictable workload of acute care creates challenges to implementing this new knowledge. Assessment of contextual factors that influence evidence-informed practice facilitates planning for implementation of new knowledge and support practice change.
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Affiliation(s)
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Kelly Negrin
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | | | - Mary Fox
- York University, Toronto, ON, Canada
| | | | | | - Angela Morgan
- University of Alberta Hospital, Edmonton, AB, Canada
| | - Adrian Wagg
- Division of Geriatric Medicine, University of Alberta, Edmonton, AB, Canada
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Venables H, Wells Y, Fetherstonhaugh D. Psychometric testing of the Older Patients in Acute Care Survey (OPACS) in Australian final year nursing students. Nurs Open 2019; 6:558-565. [PMID: 30918706 PMCID: PMC6419114 DOI: 10.1002/nop2.238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/16/2018] [Accepted: 12/10/2018] [Indexed: 11/09/2022] Open
Abstract
AIM To assess the internal reliability and validity (content and criterion) of the Older Patients in Acute Care Survey (OPACS) as a measure of nurses' knowledge, attitudes and practices regarding care of older hospitalized patients in Australia. DESIGN Cross-sectional survey. METHOD A convenience sample of final year nursing students at an Australian university in October 2014 completed the OPACS (N = 191). Internal reliability was assessed using Cronbach's alpha, content validity using exploratory factor analysis and criterion validity using correlations between the OPACS and Palmore's Facts on Aging Quiz and the Caring Efficacy Scale. RESULTS Despite good internal reliability on both OPACS subscales, exploratory factor analysis of the 36 items representing behaviours and the 50 items on knowledge and attitudes failed to load strongly on their corresponding factors. Analyses of criterion validity suggested the OPACS scales are measures of attitude.
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Affiliation(s)
- Helen Venables
- College of Science, Health and EngineeringLa Trobe UniversityMelbourneVic.Australia
| | - Yvonne Wells
- Lincoln Centre for Research on AgingLa Trobe UniversityMelbourneVic.Australia
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20
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Abudu-Birresborn D, McCleary L, Puts M, Yakong V, Cranley L. Preparing nurses and nursing students to care for older adults in lower and middle-income countries: A scoping review. Int J Nurs Stud 2019; 92:121-134. [PMID: 30807890 DOI: 10.1016/j.ijnurstu.2019.01.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 01/08/2019] [Accepted: 01/30/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this review was to examine the extent and nature of published literature on nurses' and nursing students' preparedness to care for older adults in lower and middle-income countries. METHOD A scoping review with 27 articles, guided by the Arksey and O'Malley (2005) framework was conducted. The following electronic databases were searched: MEDLINE, CINAHL, ERIC and SCOPUS. Grey literature using Google Scholar and ProQuest were also searched. Key search terms and subject headings such as "nursing students", "nurses", "stakeholders", "ministry of health", "readiness", "knowledge", "attitudes", "elder care", "seniors care" and "older adults" were used to identify relevant articles. Studies that reported on gerontological nursing, nursing students' and nurses' knowledge and attitudes towards older adults, and stakeholders/employers' views about nursing students' knowledge and attitudes towards older adults were included. RESULTS Nurses reported having moderate to insufficient knowledge in the care of older adults in the majority of the studies. Nursing students reported insufficient knowledge in the care of older adults. However, both nurses and nursing students reported positive attitudes towards the care of older adults but held misconceptions about caring for older adults. Nursing students also reported a low preference for working with older adults. DISCUSSION AND IMPLICATIONS The inadequate preparation of nurses and nursing students in the care of older adults means there are opportunities to enhance knowledge about health and nursing care in lower and middle-income countries and build on the positive attitudes towards older adults.
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Affiliation(s)
- Diana Abudu-Birresborn
- Faculty of Nursing, University of Toronto, 155 College Street Suite, Toronto, ON 130M5T 1P8, Canada.
| | - Lynn McCleary
- Department of Nursing, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada.
| | - Martine Puts
- Faculty of Nursing, University of Toronto, 155 College Street Suite, Toronto, ON 130M5T 1P8, Canada.
| | - Vida Yakong
- Department of Midwifery, University for Development Studies, Box 1350, Tamale, West Africa, Ghana.
| | - Lisa Cranley
- Faculty of Nursing, University of Toronto, 155 College Street Suite, Toronto, ON 130M5T 1P8, Canada.
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Dahlke SA, Hunter KF, Negrin K. Nursing practice with hospitalised older people: Safety and harm. Int J Older People Nurs 2019; 14:e12220. [PMID: 30628753 DOI: 10.1111/opn.12220] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/26/2018] [Accepted: 11/28/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nursing teams work with hospitalised older people in institutions, which prioritise a biomedical model of care. This model does not fit the needs of older people because it emphasises efficacy and a narrow definition of patient safety, but does not prioritise functional needs. Nursing care is provided around the clock within the context of fiscal restraints as well as negative societal and nursing perspectives about ageing and old people. Yet, nursing perceptions of managing safety and potential harms to older patients within these hospital institutions are not well understood. METHODS An integrative review was conducted to examine nursing perspectives of safety and harm related to hospitalised older people. RESULTS The majority of included papers focused on restraint use. Findings reveal that nurses are using restraints and limiting mobility as strategies to manage their key priority of keeping older patients safe, reflecting a narrow conceptualisation of safety. Policy, administrative support and individual nurse characteristics influence restraint use. Safety policies that nurses interpret as preventing falls can encourage the use of restraints and limiting mobility, both of which result in functional losses to older people. CONCLUSIONS This complex issue requires attention from clinical nurses, leaders, policy makers and researchers to shift the focus of care to preservation and restoration of function for older people in hospital as a safety priority. IMPLICATIONS FOR PRACTICE Clinical leaders and nursing teams should engage in developing processes of care that incorporate maintaining and restoring older people's function.
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Affiliation(s)
- Sherry Ann Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kelly Negrin
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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22
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Dahlke S, Hunter KF, Negrin K, Reshef Kalogirou M, Fox M, Wagg A. The educational needs of nursing staff when working with hospitalised older people. J Clin Nurs 2018; 28:221-234. [PMID: 30039614 DOI: 10.1111/jocn.14631] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/09/2018] [Accepted: 07/15/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine nursing staffs' geriatric knowledge, perceptions about interprofessional collaboration and patient-centred care, and perceived learning needs related to working with hospitalised older people. METHOD A triangulation mixed methods design was used. A survey was administered to nursing staff that contained the Knowledge About Older Patients Quiz, the patient-centered Care measure and the Modified Index of Interdisciplinary Collaboration measure. Interviews were conducted to understand nursing staffs' learning needs. Survey data were analysed using descriptive statistics. Interview data were analysed using content analysis. Survey and interview data were then compared and contrasted. RESULTS Twenty-two nursing staff (response rate 26%) completed surveys and 14 participated in interviews. The mean knowledge about older patients score was 22.95, indicating moderately high gerontological knowledge. The mean scores on the patient-centered Care measure and Modified Index of Interdisciplinary Collaboration were moderately high at 3.75 and 3.86, respectively. Themes developed from analysis of the interview data were as follows: complex vulnerable population, clinical care concerns and working as a team. In spite of scores on knowledge surveys, nursing staff identified learning needs related to managing the responsive behaviours of older patients with cognitive impairment, chemical and physical restraints, mobility and continence. CONCLUSIONS There was an incongruence between survey and interview data as nursing staff reported gaps in their knowledge despite moderately high scores on the Knowledge about Older People Quiz. Further research is needed to understand additional factors that influence nurses' educational needs.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kelly Negrin
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | - Mary Fox
- York University, Toronto, Ontario, Canada
| | - Adrian Wagg
- Division of Geriatric Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Dahlke S, Stahlke S, Coatsworth-Puspoky R. Influence of Teamwork on Health Care Workers' Perceptions About Care Delivery and Job Satisfaction. J Gerontol Nurs 2018; 44:37-44. [PMID: 29355879 DOI: 10.3928/00989134-20180111-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/13/2017] [Indexed: 12/28/2022]
Abstract
The aim of the current study was to examine the nature of teamwork in care facilities and its impact on the effectiveness of care delivery to older adults and job satisfaction among health care workers. A focused ethnography was conducted at two care facilities where older adults reside. Analysis of interviews with 22 participants revealed perceptions of teamwork and understandings about facilitators of and barriers to effective teamwork. Participants indicated that team relationships impacted care provided and job satisfaction. Participants also identified trust and reciprocity, communication, and sharing a common goal as critical factors in effective teamwork. In addition, participants identified the role of management as important in setting the tone for teamwork. Future research is needed to understand the complexity of supporting teamwork in residential settings given the challenges of culture, diversity, and individuals working multiple jobs. [Journal of Gerontological Nursing, 44(4), 37-44.].
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Colborne M, Dahlke S. Nurses' Perceptions and Management of Urinary Incontinence in Hospitalized Older Adults: An Integrative Review. J Gerontol Nurs 2017; 43:46-55. [DOI: 10.3928/00989134-20170515-02] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 04/20/2017] [Indexed: 11/20/2022]
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25
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Kentischer F, Kleinknecht-Dolf M, Spirig R, Frei IA, Huber E. Patient-related complexity of care: a challenge or overwhelming burden for nurses - a qualitative study. Scand J Caring Sci 2017; 32:204-212. [PMID: 28475265 DOI: 10.1111/scs.12449] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 01/23/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND Patient-related complexity of nursing care in acute care hospitals has increased in recent years, in part due to shorter hospital stays and the increase in multimorbid patients. However, little research has been conducted on how nurses experience complex nursing care situations. AIMS The aim of this study was to gain a better understanding of how nurses experience complex nursing care situations in Swiss acute care hospitals. METHODS This qualitative study utilised focus group interviews and thematic analysis. Focus groups facilitate different perspectives of the topic. Thematic analysis is suitable for the analysis of everyday stories. Participants were 24 Registered Nurses with experience in their field, from four Swiss hospitals. The evaluation was performed in six steps according to themes. Participation was voluntary. This study was part of a multicentre research project that had been approved by the responsible ethics committees. RESULTS Three main themes regarding the experience of complex nursing care situations were found: complexity as a challenge, complexity as an overwhelming burden and mediating factors. Mediating factors included time resources and teamwork and interprofessional collaboration as contextual conditions. Additionally, nurses' individual characteristics such as their professional experience and expertise, as well as their personal and professional values and beliefs were considered as mediating factors. These mediating factors may determine whether complex nursing care situations are experienced as challenging or overwhelming. LIMITATIONS The findings from this study are limited as only experienced nurses participated in the study. CONCLUSIONS Nurses are ambivalent with regard to how they experience complex nursing care situations. The contextual conditions and the nurses' personal characteristics play a key role in whether nurses perceive complex nursing care situations as positive challenges or overwhelming burdens. These findings are important for managers, as they can support nurses to master complex nursing care situations.
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Affiliation(s)
- Felix Kentischer
- Center for Surgery, Medical Center, University of Freiburg, Freiburg, Germany.,Institute of Nursing Science, University of Basel, Basel, Switzerland
| | - Michael Kleinknecht-Dolf
- Department of Nursing and Allied Health Care Professionals, University Hospital Zurich, Zurich, Switzerland
| | - Rebecca Spirig
- Institute of Nursing Science, University of Basel, Basel, Switzerland.,Department of Nursing and Allied Health Care Professionals, University Hospital Zurich, Zurich, Switzerland.,Department of Nursing Science, Faculty for Health, University Witten/Herdecke, Witten/Herdecke, Germany
| | - Irena Anna Frei
- Institute of Nursing Science, University of Basel, Basel, Switzerland.,Practice Development Unit, Department Nursing & Allied Health Professions, University Hospital Basel, Basel, Switzerland
| | - Evelyn Huber
- Department of Nursing and Allied Health Care Professionals, University Hospital Zurich, Zurich, Switzerland.,Department of Nursing Science, Faculty for Health, University Witten/Herdecke, Witten/Herdecke, Germany
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Dahlke S, Fox M. Navigating Relationships: Nursing Teamwork in the Care of Older Adults. Can J Nurs Res 2017; 47:97-112. [DOI: 10.1177/084456211504700406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Dahlke S, Hall WA, Baumbusch J. Constructing definitions of safety risks while nurses care for hospitalised older people: Secondary analysis of qualitative data. Int J Older People Nurs 2017; 12. [DOI: 10.1111/opn.12148] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/11/2017] [Indexed: 01/14/2023]
Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing; University of Alberta; Edmonton AB Canada
| | - Wendy A. Hall
- School of Nursing; University of British Columbia; Vancouver BC Canada
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Dahlke S, Stahlke Wall S. Does the emphasis on caring within nursing contribute to nurses' silence about practice issues? Nurs Philos 2016; 18. [PMID: 27699966 DOI: 10.1111/nup.12150] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Dahlke S, Baumbusch J. Nursing teams caring for hospitalised older adults. J Clin Nurs 2015; 24:3177-85. [DOI: 10.1111/jocn.12961] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2015] [Indexed: 01/20/2023]
Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing; University of Alberta; Edmonton AB Canada
| | - Jennifer Baumbusch
- School of Nursing; University of British Columbia; Vancouver BC Canada
- Canadian Institute of Health Research; Canadian Gerontological Nurses Association; University of British Columbia; Vancouver BC Canada
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Dahlke S, Hall W, Phinney A. Maximizing Theoretical Contributions of Participant Observation While Managing Challenges. QUALITATIVE HEALTH RESEARCH 2015; 25:1117-1122. [PMID: 25810466 DOI: 10.1177/1049732315578636] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Participant observation (PO) is an important method of data collection used in a variety of research methodologies. PO can inform theory development by providing understanding of participants' behaviors and the contexts that influence their behaviors. Because theory development is important in grounded theory studies, we emphasize theoretical contributions of PO while interrogating the challenges of using PO, in particular, attending to informed consent. We use the exemplar of a mid-range theory about nursing practice with hospitalized older adults to highlight contributions of PO to category development. While acknowledging theoretical contributions, we explore challenges entailed in observations where consenting participants interact with vulnerable patients and a changing cast of health care professionals in dynamic contexts. Reflexivity about interactions with vulnerable individuals, as well as other actions to avoid compromising voluntary consent, enhances contributions of PO.
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Affiliation(s)
| | - Wendy Hall
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Alison Phinney
- University of British Columbia, Vancouver, British Columbia, Canada
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