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Milionis C, Ilias I, Venaki E, Koukkou E. Communicating with transgender people within health care settings: clinical perspectives. JOURNAL OF COMMUNICATION IN HEALTHCARE 2024:1-8. [PMID: 39248709 DOI: 10.1080/17538068.2024.2400436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
Transgender persons need to regularly interact with health services and practitioners for both gender-transition purposes and routine care. Communication between clinicians and patients is a key element of health care. However, barriers to communication with transgender people in the health care context are usual. They typically include a lack of willingness among health staff to care for trans patients, an adherence to cisnormativity and misgendering by clinicians, and the existence of a displeasing climate during the interaction. Miscommunication generates a series of adverse consequences, including the avoidance of health care by patients and the social marginalization of transgender people. The implementation of novel health policies and organizational restructuring are important steps to create a safe environment for the trans population within health systems. Modification of administrative procedures as well as training and advice for health practitioners are also necessary to facilitate communication with trans people and improve health outcomes among this underprivileged population. The establishment of a society with equal rights among its members and a life without discriminations is the ultimate goal.
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Affiliation(s)
- Charalampos Milionis
- Department of Endocrinology, Diabetes, and Metabolism, General Hospital "Elena Venizelou", Athens, Greece
| | - Ioannis Ilias
- Department of Endocrinology, Diabetes, and Metabolism, General Hospital "Elena Venizelou", Athens, Greece
| | - Evaggelia Venaki
- Department of Endocrinology, Diabetes, and Metabolism, General Hospital "Elena Venizelou", Athens, Greece
| | - Eftychia Koukkou
- Department of Endocrinology, Diabetes, and Metabolism, General Hospital "Elena Venizelou", Athens, Greece
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Giesen J, Timmerman I, Bakker-Jacobs A, Berings M, Huisman-de Waal G, Van Vught A, Vermeulen H. What can nurses learn from patient's needs and wishes when developing an evidence-based quality improvement learning culture? A qualitative study. Scand J Caring Sci 2024; 38:680-691. [PMID: 38525853 DOI: 10.1111/scs.13252] [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: 10/31/2023] [Revised: 02/02/2024] [Accepted: 02/24/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Patient participation is fundamental in nursing care and has yielded benefits for patient outcomes. However, despite their compassionate care approach, nurses do not always incorporate patients' needs and wish into evidence-based practice, quality improvement or learning activities. Therefore, a shift to continuous quality improvement based on evidence-based practice is necessary to enhance the quality of care. The patient's opinion is an essential part of this process. To establish a more sustainable learning culture for evidence-based quality improvement, it is crucial that nurses learn alongside their patients. However, to promote this, nurses require a deeper understanding of patients' care preferences. OBJECTIVE To explore patients' needs and wishes towards being involved in care processes that nurses can use in developing an evidence-based quality improvement learning culture. METHODS A qualitative study was conducted in two hospital departments and one community care team. In total, 18 patients were purposefully selected for individual semi-structured interviews with an average of 15 min. A framework analysis based on the fundamental of care framework was utilised to analyse the data deductively. In addition, inductive codes were added to patients' experiences beyond the framework. For reporting this study, the SRQR guideline was used. RESULTS Participants needed a compassionate nurse who established and sustained a trusting relationship. They wanted nurses to be present and actively involved during the care delivery. Shared decision-making improved when nurses offered fair, clear and tailored information. Mistrust or a disrupted nurse-patient relationship was found to be time-consuming and challenging to restore. CONCLUSIONS Results confirmed the importance of a durable nurse-patient relationship and showed the consequences of nurses' communication on shared decision-making. Insights into patients' care preferences are essential to stimulate the development of an evidence-based quality improvement learning culture within nursing teams and for successful implementation processes.
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Affiliation(s)
- Jeltje Giesen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ilse Timmerman
- Psychiatry Department, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Annick Bakker-Jacobs
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjolein Berings
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
- Surgical Department, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anneke Van Vught
- Department on Health and Vitality, HAN University of Applied Sciences, School of Allied Health, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
- Department on Health and Vitality, HAN University of Applied Sciences, School of Allied Health, Nijmegen, The Netherlands
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MacKay LJ, Chang U, Kreiter E, Nickel E, Kamke J, Bahia R, Shantz S, Meyerhoff H. Exploration of trust between pediatric nurses and children with a medical diagnosis and their caregivers on inpatient care units: A scoping review. J Pediatr Nurs 2024:S0882-5963(24)00212-4. [PMID: 39085007 DOI: 10.1016/j.pedn.2024.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 05/26/2024] [Accepted: 05/26/2024] [Indexed: 08/02/2024]
Abstract
PROBLEM Trust is central to the development of nurse-patient relationships. Pediatric nurses encounter difficulties developing trust with children and their caregivers. The purpose of this scoping review was to identify, examine, and summarize available evidence on the concept of trust among nurses and children/caregivers when admitted to hospital inpatient care units. ELIGIBILITY CRITERIA Using the Joanna Briggs Institute (JBI) methodology for conducing and reporting scoping reviews, CINAHL, MEDLINE, PsycINFO, Cochrane DSR, Cochrane Central, and JBI EBP were searched for qualitative, quantitative, mixed methods, and review studies with no time limits published in English. Included studies presented findings on the experiences of developing trust between pediatric nurses and children under 18 years of age and their caregivers within inpatient care units. RESULTS A total of 12,269 titles and abstracts were reviewed independently by two reviewers. 366 full-text articles were retrieved, a final of 81 studies were included in the review. CONCLUSIONS Trust was bi-directional between nurses and children/caregivers, developed over time during multiple interactions, and foundational to the development of relationships. Distinct facilitators and barriers to the development of trust between nurses and children/caregivers were identified. The development of trust was rewarding and enriching for both nurses and children/caregivers and was the fundamental to the provision of safe and high-quality nursing care. IMPLICATIONS Findings provide nurses with direction and strategies on how to develop and maintain trust with children/caregivers on inpatient care units. The development of training programs and interventions geared at equipping nurses with the skills to develop trust with children/caregivers is needed.
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Affiliation(s)
- Lyndsay Jerusha MacKay
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
| | - Una Chang
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
| | - Elizabeth Kreiter
- Norma Marion Alloway Library, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
| | - Emma Nickel
- Alberta Children's Hospital, 28 Oki Drive, Calgary, Alberta T3B 6A8, Canada.
| | - Janice Kamke
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
| | - Rubinder Bahia
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
| | - Sarah Shantz
- Alberta Children's Hospital, 28 Oki Drive, Calgary, Alberta T3B 6A8, Canada.
| | - Heather Meyerhoff
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, British Columbia V2Y 1Y1, Canada.
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Alexander KE, Rolfe M, Gabbett MT. Assessing genomics confidence and learning needs in Australian nurses and midwives: an educational program evaluation. Front Genet 2024; 15:1419302. [PMID: 39081808 PMCID: PMC11286479 DOI: 10.3389/fgene.2024.1419302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/24/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction: The mainstreaming of genomics across healthcare specialties necessitates that all nurses and midwives have a high literacy in genomics. Methods: We aimed to design, develop, implement and evaluate a genomics education workshop for nurses and midwives using action research principles. Results: Registered nurses and midwives completed an online survey regarding genomics confidence and learning needs (n = 274). The results of this survey were used to develop the genomics education workshop. The workshop was run three times (n = 105) with evaluation data being collected both before and after each workshop. Significant improvements in confidence across all learning domains was found following the workshops (p < 0.001). A desire for more education across all learning domains except for genetics knowledge was also identified (p < 0.001). Discussion: Genomics education workshops were found to increase the confidence of nurses and midwives across a range of specialties. Nurses and midwives also expressed a desire for further education in genomics.
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Affiliation(s)
- Kim E. Alexander
- Centre for Healthcare Transformation, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Melanie Rolfe
- Centre for Healthcare Transformation, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Michael T. Gabbett
- Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
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Diez de Los Rios de la Serna C, Lluch-Canut MT, Fernández-Ortega MP. Hereditary Cancer Syndrome Carriers: Feeling Left in the Corner. Semin Oncol Nurs 2024; 40:151624. [PMID: 38575458 DOI: 10.1016/j.soncn.2024.151624] [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: 12/14/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES There is limited evidence on health promotion interventions in people with hereditary cancer syndromes or on their main sources of support and information. This study aimed to understand these patients' experiences and needs, including their information needs, their views on prevention and mental health, and the support they want from nurses. METHODS This qualitative study included 22 people (8 previvors and 14 survivors) with hereditary breast and ovarian syndrome or Lynch syndrome from 10 European countries. Participants underwent individual semi-structured interviews, which were recorded and transcribed for reflexive thematic analysis. The patient and public involvement panel provided input on study design and thematic analysis. RESULTS Patient experiences were similar regardless of the country and access to testing and screening. Participants reported receiving little information on the importance of health behaviors for cancer risk and expressed their wish to be followed by cancer professionals. They felt compelled to seek support and information from the internet and patient groups. The main themes identified were: (unmet) informational and support needs, seeing life in a different way, and limitations of health care providers. CONCLUSIONS People with hereditary cancer syndromes need professionals to be involved in their long-term management and to provide reliable information. As genomics are increasingly integrated in oncology, the need for professionals to support these populations will increase. IMPLICATIONS FOR NURSING PRACTICE Nurses are crucial for promoting self-management and advocating for patient decision-making; however, they need skills and knowledge to do so. There is a need for nurses to get more involved in understanding hereditary cancer syndromes and an opportunity to take the lead in the care of these people.
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Affiliation(s)
| | - Maria Teresa Lluch-Canut
- PhD Programme, Faculty of Nursing, Bellvitge Campus, University of Barcelona (UB), Barcelona, Spain
| | - Maria Paz Fernández-Ortega
- PhD Programme, Faculty of Nursing, Bellvitge Campus, University of Barcelona (UB), Barcelona, Spain; Institut Català d'Oncologia (ICO) Barcelona, Barcelona, Spain
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Goff A, Lujan-Bear S, Titus H, Englander H. Integrating Hospital-Based Harm Reduction Care-Harnessing the Nursing Model. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:307-313. [PMID: 38258867 DOI: 10.1177/29767342231219577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Hospitals are risk environments for people who use drugs, and most hospitals are unprepared to deliver substance use disorder (SUD) care, including harm reduction (HR) interventions. HR philosophy clashes with traditional hospital hierarchy and norms, and staff may resist HR interventions due to stigma, fear of enabling substance use, legal and safety concerns. Nurses are central to hospital culture and care and could promote and deliver HR care. Our US hospital has an inter-professional addiction consult service (ACS) that includes medical providers, social workers, and peers. We developed and launched a hospital-based registered nurse-(RN) led HR intervention, including distributing safe-use supplies (eg, syringes). We describe model development and early experience, using an Exploration, Preparation, Implementation, and Sustainment framework. ACS experiences and community HR interventions informed our exploration phase. In the preparation phase we secured funding from Medicaid payers for a 2-year pilot, including full-time RN salary and HR supplies. We elicited buy-in from hospital executive leaders, partly by partnering with nurse champions who described unmet patient care and staff education needs. We consulted hospital lawyers and developed an institution-wide media campaign targeting staff, including in-person booths distributing naloxone and materials promoting international overdose awareness day (eg, "#EndOverdose" buttons). We collaborated with local and national experts to develop the intervention, which includes RN bedside HR education and staff trainings. The Implementation was from September 2022 to March 2023. We trained 459 staff (over 15 trainings) and conducted 209 patient encounters. Generally, patients and staff embraced the HR RN role, including previously controversial safe-use supply distribution. Sustainment efforts include engaging stakeholders in continuous improvement and evaluation efforts. A nurse-led hospital-based HR intervention can expand patient services, support staff, and bridge HR and medical models.
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Affiliation(s)
- Amelia Goff
- Section of Addiction Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Susannah Lujan-Bear
- Section of Addiction Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Hope Titus
- Section of Addiction Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Honora Englander
- Section of Addiction Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, USA
- Division of Hospital Medicine, Department of Medicine, Section of Addiction Medicine, Oregon Health and Science University, Portland, OR, USA
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Been-Dahmen JMJ, van der Stege H, Oldenmenger WH, Braat C, van der Lans MCM, Scheper M, van Staa A, Ista E. What factors contribute to cancer survivors' self-management skills? A cross-sectional observational study. Eur J Oncol Nurs 2024; 69:102539. [PMID: 38460391 DOI: 10.1016/j.ejon.2024.102539] [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: 09/26/2023] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE Many cancer survivors, facing the consequences of their disease and its treatment, have medical and supportive aftercare needs. However, limited knowledge exists regarding the relationship between support needs and survivors' self-management skills. The study aim is to explore factors contributing to cancer survivors' self-management skills. METHODS A cross-sectional study was conducted among cancer survivors (n = 277) of two outpatient oncology clinics at a university hospital in the Netherlands. Patients with head and neck cancer (n = 55) who had received radiotherapy and cisplatin or cetuximab were included, as well as patients who had undergone hematopoietic stem cell transplantation (n = 222). The primary outcome was self-management skills, assessed using the Partners in Health Scale (PIH), which comprises two subscales: knowledge and coping (PIH-KC), and recognition and management of symptoms, and adherence to treatment (PIH-MSA). Secondary outcomes were quality of life (EORTC QLQ-C30), self-efficacy (SECD6), patient-centered care (CAPHS), and social support (HEIQ). Machine learning-based Random Forest models were employed to construct associative models. Feature Importance (FI) was used to express the contribution to the model. RESULTS High emotional quality of life (FI = 33.1%), increased self-efficacy (FI = 22.2%), and greater social support (FI = 18.2%) were identified as key factors contributing to cancer survivors' self-management knowledge (PIH-KC). Furthermore, greater support from professionals (FI = 36.1%) and higher self-efficacy (FI = 18.2%) were found to benefit participants' recognition and management, and therapy adherence (PIH-MSA). CONCLUSIONS A patient-centered relationship between nurses and cancer survivors is essential for therapy adherence and the management of aftercare needs. Training to provide this holistic self-management support is required.
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Affiliation(s)
- Janet M J Been-Dahmen
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands.
| | - Heleen van der Stege
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands.
| | - Wendy H Oldenmenger
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, Rotterdam, the Netherlands.
| | - Cora Braat
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Radiotherapy, Rotterdam, the Netherlands.
| | - Mariska C M van der Lans
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Hematology, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | - Mark Scheper
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands; Macquarie University, Faculty of Medicine and Science, Allied Health Professions, Sydney, Australia.
| | - AnneLoes van Staa
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands.
| | - Erwin Ista
- Erasmus MC, University Medical Center Rotterdam, Department of Internal Medicine - Section Nursing Science, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
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Malik E, Shankar S. Empowering nurses: exploring self-managed organizations in Indian healthcare. BMC Nurs 2023; 22:477. [PMID: 38102581 PMCID: PMC10722781 DOI: 10.1186/s12912-023-01647-5] [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: 11/02/2023] [Accepted: 12/10/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Given India's high patient load on the existing healthcare setup, as well as political, social, and organizational challenges, the nursing sector is facing various problems, therefore leading to substandard nursing experiences leading to poor patient care at the parallel healthcare setups, specifically homecare. This paper presents self-managed organizations (SMOs) characterized by a horizontal management structure as an effective alternative to existing hierarchical management structures overladen with bureaucracy. Therefore, we are exploring the strategies at self-managed homecare organizations that can make nursing a better and more productive experience. METHOD This study utilized Constructivist Grounded Theory (CGT), employing semi-structured interviews to explore nursing dynamics in horizontal organizational structures. It delved into crucial aspects like finances, organizational structure, value systems, information flow, and conflict resolution within SMOs. The methodology involved theoretical sampling, prioritizing expert self-management knowledge over mere representativeness. Seven nurses, twelve management members, and fifteen patients from self-managed homecare organizations contributed to the examination of nursing experiences. Constant comparative analysis of data led to the identification of the Qualitative Success Enablers (QSEs), revealing three themes: Insightfulness, Enhancing Nursing Experience through Job Enrichment, and Autonomy-Enabled Intrapreneurship. RESULTS The findings indicate that the horizontal management structure represented by the studied organization in India has shown considerable success in times laden with uncertainties during the COVID-19 pandemic, especially during the delta wave, which revealed the frailty of existing healthcare infrastructure. The organization successfully maintained a better nursing experience and gained patient and employee satisfaction, as revealed by in-depth semi-structured interviews and constant comparative analysis. CONCLUSION In a world of unique challenges, we stand on the brink of significant transformations. SMOs are vital in India's homecare sector for enhancing nursing experiences and overall organizational performance. Fostering a trust-based environment within SMOs is integral to delivering effective services. The autonomy to design nursing jobs, insightfulness, and innovativeness in the nursing job through suitable training activities, various job enrichment methods, and finding meaningfulness in a job through softer aspects of caregiving result in an enhanced nursing experience at SMOs. This groundbreaking approach can be extended to other homecare organizations in India, relieving the strain on the existing healthcare system.
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Affiliation(s)
- Elham Malik
- Department of Humanistic Studies, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India.
| | - Shail Shankar
- Department of Humanistic Studies, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, India
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Elwood WN. Trust as a dyadic mechanism of action: a call to explore patient-provider relationships in the twenty-first century. JOURNAL OF COMMUNICATION IN HEALTHCARE 2023; 16:370-374. [PMID: 37846861 PMCID: PMC10842970 DOI: 10.1080/17538068.2023.2267830] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Background: There is general agreement that trust between patients and providers influences patient knowledge, behaviors, and adherence to provider-recommendations--with subsequent impacts on patient health-related outcomes and provider practices. There is less academic agreement on the processes by which trust is formulated and changed over time and how trust with ongoing healthcare providers can influence health-related outcomes over time.Methods: This opinion draws on social constructionism and symbolic interactionism to posit the possibility that trust can emanate through the communication process, during which a patient and provider transmit and attend to words, images, and paralanguage to convey their states of being and to induce responses, usually acknowledgement, suasion, or physical behaviors, from one another.Results: Theoretical bases for this construct are provided as are qualitative, quantitative, and mixed measurement approaches for multiple healthcare settings.Conclusions: A mechanistic approach to understand how trust is established through patient-provider communication and how trust informs patient health-related outcomes can contribute over time to improve communication in healthcare encounters.
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Affiliation(s)
- William N Elwood
- Office of Behavioral and Social Sciences Research (OBSSR), Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health (NIH), Bethesda, MD, USA
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Nyende A, Ellis-Hill C, Mantzoukas S. A Sense of Control and Wellbeing in Older People Living with Frailty: A Scoping Review. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:1043-1072. [PMID: 37139581 DOI: 10.1080/01634372.2023.2206438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
A sense of control is important for supporting older people living with frailty to develop adaptive functioning to optimize wellbeing. This scoping review examined the literature on the sense of control and wellbeing in older people living with frailty within their everyday life and care service use. Nine databases were searched using the timeframe 2000 to 2021 to identify key ideas regarding control and wellbeing in older people with frailty. The review highlighted three major themes: a) Control as conveyed in bodily expressions and daily activities, b) Sense of control and influence of place of residence, and c) Control within health and social care relationships. Maintaining a sense of control is not only an internal feeling but is impacted by physical and social environments. Greater focus is needed on the nature of relationships between older people living with frailty and those who work alongside them, which support control and wellbeing.
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Affiliation(s)
- Adam Nyende
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Caroline Ellis-Hill
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
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Čáp J, Miertová M, Bóriková I, Žiaková K, Tomagová M, Gurková E. Trust in healthcare professionals of people with chronic cardiovascular disease. Nurs Ethics 2023:9697330231209285. [PMID: 37889675 DOI: 10.1177/09697330231209285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
BACKGROUND Trust is an essential phenomenon of relationship between patients and healthcare professionals and can be described as an accepted vulnerability to the power of another person over something that one cares about in virtue of goodwill toward the trustor. This characterization of interpersonal trust appears to be adequate for patients suffering from chronic illness. Trust is especially important in the context of chronic cardiovascular diseases as one of the main global health problems. RESEARCH AIM The purpose of the qualitative study was to gain a deeper understanding of how people with chronic cardiovascular disease experience and make sense of trust in healthcare professionals. RESEARCH DESIGN Eleven semi-structured interviews with participants analysed using interpretative phenomenological analysis to explore in detail their lived experience of trust as a relational phenomenon. PARTICIPANTS AND RESEARCH CONTEXT Participants with chronic cardiovascular disease were purposively recruited from inpatients on the cardiology ward of the university hospital located in central Slovakia. ETHICAL CONSIDERATIONS The study was approved by the faculty ethics committee. Participants gave their written informed consent. FINDINGS FOUR INTERRELATED GROUP EXPERIENTIAL THEMES Sense of co-existence; Belief in competence; Will to help; Ontological security with eight subthemes were identified. The findings describe the participants' experience with trust in healthcare professionals as a phenomenon of close co-existence, which is rooted in the participants' vulnerability and dependence on the goodwill and competence of health professionals to help with the consequence of (re)establishing a sense of ontological security in the situation of chronic illness. CONCLUSION Findings will contribute to an in-depth understanding of trust as an existential dimension of human co-existence and an ethical requirement of healthcare practice, inspire patient empowerment interventions, support adherence to treatment, and person-centred care.
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Affiliation(s)
- Juraj Čáp
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Michaela Miertová
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Ivana Bóriková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Martina Tomagová
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Elena Gurková
- Department of Nursing, Faculty of Health Care, University of Prešov, Slovakia
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Groves PS, Bunch JL, Kuehnle F. Increasing a patient's sense of security in the hospital: A theory of trust and nursing action. Nurs Inq 2023; 30:e12569. [PMID: 37282711 DOI: 10.1111/nin.12569] [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: 11/15/2022] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 06/08/2023]
Abstract
Having a decreased sense of security leads to unnecessary suffering and distress for patients. Establishing trust is critical for nurses to promote a patient's sense of security, consistent with trauma-informed care. Research regarding nursing action, trust, and sense of security is wide-ranging but fragmented. We used theory synthesis to organize the disparate existing knowledge into a testable middle-range theory encompassing these concepts in hospitals. The resulting model illustrates how individuals are admitted to the hospital with some predisposition to trust or mistrust the healthcare system and/or personnel. Patients encounter circumstances increasing their emotional and/or physical vulnerability to harm, leading to experiences of fear and anxiety. Without intervention, fear and anxiety lead to a decreased sense of security, increased distress, and suffering. Nurse action can ameliorate these effects by increasing a hospitalized person's sense of security or by promoting the development of interpersonal trust, also leading to an increased sense of security. Increased sense of security results in diminished anxiety and fear, and increased hopefulness, confidence, calm, sense of value, and sense of control. The consequences of a decreased sense of security are harmful to patients and nurses should know that they can intervene in ways that both increase interpersonal trust and sense of security.
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Affiliation(s)
| | - Jacinda L Bunch
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Francis Kuehnle
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
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13
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Uhm JY. Development and validation of the school healthcare partnership scale for school nurses. J Pediatr Nurs 2023; 72:53-62. [PMID: 37079930 DOI: 10.1016/j.pedn.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/28/2023] [Accepted: 03/31/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE This study was conducted to develop the School Healthcare Partnership Scale for School Nurses (SHCPS-S) for children with type 1 diabetes and to validate its psychometric properties. METHODS This was a methodological study. A total 342 school nurses in South Korea participated in the study; 171 were randomly assigned to each group for exploratory factor analysis and confirmatory factor analysis. Data was collected from December 2021 to February 2022 via online survey. The Family Nursing Practice Scale was used to evaluate criterion validity, and the school nurse's professionalism scale and empathy were used to verify concurrent validity. Content validity review, response tests, and factor analysis were conducted. RESULTS A 50-items pool was created based on a hybrid concept analysis. Forty items were selected following the content validity review, using content validity index. A 20-item scale with four factors (trusting relationships, balanced responsibility, providing tailored care, and transparent and open communication) was chosen following exploratory factor analysis. Confirmatory factor analysis for the four factors showed an adequate model fit. The correlation coefficient with the family nursing practice and school nurse's professionalism scale were 0.642, 0.630, and 0.376. The Cronbach's α was 0.919, and the correlation coefficient was 0.768 in test-retest. CONCLUSIONS The SHCPS-S is a valid and reliable scale to measure school nurses' perceived collaborative relationships with parents for children with type 1 diabetes. PRACTICAL IMPLICATIONS This scale can be used as a tool in interventional studies to enhance school healthcare partnerships.
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Affiliation(s)
- Ju-Yeon Uhm
- Associate Professor, Department of Nursing, Pukyong National University, Busan, Republic of Korea.
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14
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Rantala A, Sterner A, Frank C, Heinrich E, Holmberg B. Older patients' perceptions of the Swedish ambulance service: A qualitative exploratory study. Australas Emerg Care 2023; 26:249-253. [PMID: 36764911 DOI: 10.1016/j.auec.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND As worldwide life expectancy increases, the Swedish Ambulance Service is likely to be affected by the demographic shift towards a larger proportion of older persons. An older population tends to increase the demand for ambulances, indicating a need to illuminate older patients' perspective. Thus, the aim of this study was to explore older patients' perceptions of the Swedish Ambulance Service. METHODS This interview study employed a descriptive qualitative design with a phenomenographic approach in accordance with Dahlgren and Fallsberg. RESULTS Three main descriptive categories emerged to describe the underlying conceptions in the interviews; A double-edged encounter, Trust is created by perceived competence, and Safety through accessibility in vulnerable situations. CONCLUSION Older patients described trust in ambulance clinicians as a prerequisite for feeling safe enough to share their feelings and allow a bodily examination. However, they also criticized the care provided because they questioned the need for certain actions.
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Affiliation(s)
- Andreas Rantala
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden; Department of Ambulance Service, Region Skåne, Helsingborg, Sweden; Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
| | - Anders Sterner
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden; Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Catharina Frank
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden; Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Elsa Heinrich
- Department of Ambulance Service, Region Skåne, Malmö, Sweden
| | - Bodil Holmberg
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden; Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
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15
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Kleman C, Ross R. Predictors of patient self-advocacy among patients with chronic heart failure. Appl Nurs Res 2023; 72:151694. [PMID: 37423677 DOI: 10.1016/j.apnr.2023.151694] [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: 09/22/2020] [Revised: 06/01/2022] [Accepted: 06/14/2023] [Indexed: 07/11/2023]
Abstract
The purpose of this study was to examine predictors of self-advocacy among patients with chronic heart failure (HF) as they were unknown. A convenience sample of 80 participants recruited from one Midwestern HF clinic completed surveys related to relationship-based predictors of patient self-advocacy including trust in nurses and social support. Self-advocacy is operationalized using the three dimensions of HF knowledge, assertiveness, and intentional non-adherence. Hierarchical multiple regression was used showing that trust in nurses predicted HF knowledge (ΔR2 = 0.070, F = 5.91, p < .05), social support predicted advocacy assertiveness (ΔR2 = 0.068, F = 5.67, p < .05), and ethnicity predicted overall self-advocacy (ΔR2 = 0.059, F = 4.89, p < .05). These findings suggest that support from family and friends can give the patient the needed encouragement to advocate for what they need. A trusting relationship with nurses impacts patient education so that patients not only understand their illness and its trajectory but also use that understanding to speak up for themselves. African American patients, who are less likely to self-advocate than their White counterparts, could benefit from nurses recognizing the impact of implicit bias so that these patients do not feel silenced in their care.
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Affiliation(s)
- Carolyn Kleman
- School of Nursing, University of North Carolina Wilmington, 601 S College Rd, Wilmington, NC 28403, United States of America.
| | - Ratchneewan Ross
- School of Nursing, University of Louisville, 555 South Floyd Street, Louisville, KY 40202, United States of America.
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16
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Çoşkun Palaz S, Kayacan S. The relationship between the level of trust in nurses and nursing care quality perceptions of patients treated for Covid-19. Scand J Caring Sci 2023; 37:364-372. [PMID: 35942605 PMCID: PMC9538283 DOI: 10.1111/scs.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/22/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND During the pandemic process, nursing care has gained more importance. So, it is critical to evaluate the level of trust in nurses and the perception of care in terms of the patient, in order to improve the care service provided, to achieve the desired successful patient results, to ensure patient satisfaction in nursing care and to create a healthy society in the long term. AIM This study aimed to examine the relationship between the level of trust in nurses, care perceptions of patients receiving care with the diagnosis of Covid-19, and the level of trust in nurses and care quality perceptions of patients. METHODS This descriptive, cross-sectional, correlational study was conducted in the Covid-19 unit of a state hospital in the Western Black Sea Region of Turkey between May and October 2021. The sample size was calculated as 227 using the sample calculation formula whose population is unknown in the literature. 'Personal Information Form', 'Trust in Nurses Scale' and 'Patient Perception of Hospital Experience with Nursing (PPHEN)' was used to collect data. Ethical approval was obtained from the clinical research ethics committee, RESULTS: The total mean score of the patients' trust in nurses scale was 27.67 ± 3.29 (min: 15, max: 30); the mean score of the patients' Perception of Nursing Care scale was determined as 69.52 ± 12.51 (min:15, max:75). It has been determined that the level of trust in nurses and the perception of nursing care of patients receiving Covid-19 treatment are high. A positive, significant and weak relationship (r = 0.348, p < 0.01) was found between the patients' level of trust in nurses and their perceptions of nursing care. CONCLUSION During the pandemic process, trust in the patient-nurse relationship increases the patient's perception of nursing care and positively affects the quality of care.
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Affiliation(s)
- Simge Çoşkun Palaz
- Fundamentals of Nursing Department, Faculty of Health SciencesBolu Abant Izzet Baysal UniversityBoluTurkey
| | - Semra Kayacan
- Intensive Care UnitZonguldak Karadeniz Ereğli State HospitalZonguldakTurkey
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Petry H, Pelzelmayer K, Ernst J, Thuerlimann E, Naef R. Nurse-patient interaction during the Covid-19 pandemic: Creating and maintaining an interactive space for care. J Adv Nurs 2023; 79:281-296. [PMID: 36344480 DOI: 10.1111/jan.15486] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 09/03/2022] [Accepted: 10/12/2022] [Indexed: 11/09/2022]
Abstract
AIMS To explore nurse-patient interactions during the Covid-19 pandemic from both nurses' and patients' perspectives. DESIGN Qualitative study using constructive grounded theory. METHODS A total of 34 patients and 49 nurses from acute and home care settings participated in individual or focus group interviews between December 2020 and May 2021. Data were analysed by a team of researchers using coding, memo-writing, theoretical sampling and constant comparison and integration. RESULTS We identified the creation and maintenance of an interactive space as the main social process. This interactive space was shaped by the care context and the course of the pandemic. For nurses, four factors were key, namely protecting oneself and others, navigating communication barriers, adapting nursing actions to the evolving situation, and providing emotional care work. Patients experienced attentive caring relationships with nurses and felt that, for the most part, their individual needs had been met despite the pandemic challenges. CONCLUSION Nurses and patients created an interactive space in which they were able to provide and receive the necessary care. Maintaining the interactive space was often challenging, and required an intentional effort by nurses, particularly in acute care settings. The findings illustrate that nurses ensured the provision of necessary care even during a public health crisis, thereby enabling patient access to good quality care. IMPACT Nurse-patient relationships are important for effective, person-centred care delivery. Despite the pandemic challenges, nurses managed to uphold their caring imperative and ensure quality care. Findings provide further insights on the importance of nurse-patient interaction in maintaining quality care. They inform models of nursing care delivery and strategies to support quality care during public health crises.
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Affiliation(s)
- Heidi Petry
- Center of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | | | - Jutta Ernst
- Center of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Eva Thuerlimann
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Rahel Naef
- Center of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland.,Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
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18
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Groves PS, Bunch JL, Hanrahan KM, Sabadosa KA, Sharp B, Williams JK. Patient Voices in Hospital Safety during the COVID-19 Pandemic. Clin Nurs Res 2023; 32:105-114. [PMID: 36250248 PMCID: PMC9577816 DOI: 10.1177/10547738221129711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Hospitalized patients and their families may be reluctant to express safety concerns. We aimed to describe safety and quality concerns experienced by hospitalized patients and families and factors and outcomes surrounding decisions about voicing concerns, including those related to the COVID-19 pandemic. We conducted semi-structured interviews with 19 discharged inpatients or family members in a qualitative descriptive design. Some participants reported concern about staff competency or knowledge, communication and coordination, potential treatment errors, or care environment. Factors influencing feeling safe included healthcare team member characteristics, communication and coordination, and safe care expectations. Reasoning for voicing concerns often included personal characteristics. Reasons for not voicing concerns included feeling no action was needed or the concern was low priority. Outcomes for voicing a concern were categorized as resolved, disregarded, and unknown. These findings support the vital importance of open safety communication and trustworthy response to patients and family members who voice concerns.
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Affiliation(s)
| | | | - Kirsten M. Hanrahan
- University of Iowa, IA, USA
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Brittaney Sharp
- University of Iowa, IA, USA
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Lee A, Tham J. Opt-in Vs. Opt-out of Organ Donation in Scotland: Bioethical analysis. New Bioeth 2022; 28:341-349. [PMID: 35802413 DOI: 10.1080/20502877.2022.2095714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This paper looks at the ethics of opt-in vs. opt-out of organ donation as Scotland has transitioned its systems to promote greater organ availability. We first analyse studies that compare the donation rates in other regions due to such a system switch and find that organ increase is inconclusive and modest at best. This is due to a lack of explicit opt-out choices resulting in greater resistance and family override unless there are infrastructures and greater awareness to support such change. The paper then looks at the difference between informed consent of the opt-in vs. presumed consent in the opt-out approaches. Patient autonomy and dignity are better reflected with informed consent. Eighteen months have passed since the new organ donation policy has come into effect, this paper recommends more research into organ donors' psychological motivations to help governments and the healthcare profession obtain more organs for transplantation.
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Affiliation(s)
| | - Joseph Tham
- Bioethics, Regina Apostolorum Pontifical University, Italy
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20
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The Impact of Music Therapists’ Perspectives on Quality of Life in Building Relationships with Older Adults with Chronic Illness. Behav Sci (Basel) 2022; 12:bs12110439. [DOI: 10.3390/bs12110439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Abstract
Older adults with chronic illnesses have diminished qualities of life (QoL) due to physical and mental decline. To promote their QoL, music therapists create meaningful shared music experiences and positive therapeutic relationships to address their psychosocial needs. However, within this relationship-building process, healthcare professionals, staff, and even caregivers appear to project their own perceptions and expectations of what positive QoL of older adults should be. This misapprehension may challenge therapists to meet older adults’ actual QoL needs adequately. To date, no studies have explored music therapists’ perspectives on QoL in building relationships with older adults experiencing chronic illness. Eleven music therapists participated in online, semi-structured phenomenological interviews that were thematically analyzed. Three themes emerged: participants gained an increased awareness of unconscious biases, a deepened understanding of older adults’ QoL, and a purposeful alignment with older adults’ QoL. These highlighted the significance of therapists’ consistent self-reflection within the relationship-building process. Identifying their shared commonalities with older adults guided therapists to engage with clients more salutogenically and empathically. Additionally, recognizing their own biases being projected onto older adults empowered therapists to be more intentional to reconcile their perceptual discrepancies while prioritizing older adults’ authentic voices and capable selves.
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21
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Tang X, Lu J, Chen Z, Liu C, Jiang X, Ning M. Influencing Factors of Patients' Trust in Nurses During the COVID-19 Pandemic: A Mixed-Methods Study. Disaster Med Public Health Prep 2022; 17:e302. [PMID: 36325834 PMCID: PMC9947035 DOI: 10.1017/dmp.2022.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study aimed to investigate the nurse-patient trust among in-patients in the context of the coronavirus disease (COVID-19) epidemic; it further analyzed the related influencing factors, which will provide a theoretical basis for developing corresponding measures. METHODS This study employed a mixed-method design and analyzed 149 patients at the Hongqi Hospital, affiliated with Mudanjiang Medical University, from December 2020 to February 2021. Quantitative analysis was carried out using the "Nurse Patient Trust Scale," and qualitative analysis was performed using a semi-structured interview with in-patients. RESULTS The average score on the scale was 46.65 ± 2.83, and the scores of the 2 dimensions were: 23.24 ± 1.51 for ability and peace of mind, and 23.32 ± 1.53 for attitude and care. According to the interview data, the factors included 3 aspects: a comfortable hospital environment and humane management measures; the nurse's own competence; and effective communication with patients. CONCLUSION During the COVID-19 epidemic, there are still many factors affecting patients' trust in nurses that can be addressed by taking different measures. All these factors must be considered by the relevant managers and clinical nursing staff to maintain a better nurse-patient trust relationship.
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Affiliation(s)
- Xiaolan Tang
- College of Nursing, Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Junhua Lu
- College of Nursing, Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Zhihui Chen
- Department of Emergency, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Chao Liu
- Department of General Surgery, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Xue Jiang
- Department of General Surgery, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Mei Ning
- Department of General Surgery, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
- Corresponding author: Mei Ning,
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22
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Galletta M, Piazza MF, Meloni SL, Chessa E, Piras I, Arnetz JE, D’Aloja E. Patient Involvement in Shared Decision-Making: Do Patients Rate Physicians and Nurses Differently? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14229. [PMID: 36361109 PMCID: PMC9656720 DOI: 10.3390/ijerph192114229] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/23/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Shared decision-making implies that patients and healthcare professionals make decisions together about clinical exams, available treatments, choice of options, and the benefit or downside of every choice. Patients involved in the shared decision-making process are more compliant with treatments and have a reduced risk of complications related to the pathology. In Italy, patient involvement in caring processes is still barely investigated. AIM To investigate patients' perceptions about shared decision-making with physicians and nurses, respectively, and to examine the relationship between shared decision-making and patient satisfaction and perceived quality of care/treatment. METHODS The study was performed between March and June 2019 in two wards of one Italian hospital. A questionnaire was administered to inpatients at the time of admission and again at discharge, including demographic information and measurement scales regarding patient involvement in shared decision-making, patient satisfaction, and perceived quality of treatment/care. RESULTS A total of 151 out of 301 patients completed questionnaires at both admission and discharge. Patients' scores for shared decision-making (information, patient needs, treatment planning) were significantly different for physicians and nurses. At both admission and discharge, patients rated shared decision-making significantly higher for physicians compared to nurses, while there were no differences in their satisfaction ratings. Patient ratings of physicians did not change from admission (information: mean (M) = 3.50, standard deviation (SD) = 0.81; patient need: M = 3.05, SD = 1.05; treatment planning: M = 2.75, SD = 1.23) to discharge (information: M = 3.50, SD = 0.79; patient need: M = 3.17, SD = 1.02; treatment planning: M = 2.66, SD = 1.23) (p = 0.924, p = 0.098, p = 0.293, respectively), but patients' ratings of nurses' behavior increased significantly from admission (information: M = 2.44, SD = 1.23; patient need: M = 2.27, SD = 1.17; treatment planning: M = 2.12, SD = 1.19) to discharge (information: M = 2.62, SD = 1.22; patient need: M = 2.53, SD = 1.24; treatment planning: M = 2.35, SD = 1.21) (p = 0.019, p = 0.001, p = 0.003, respectively). Attention to patients' needs was the key determinant of both satisfaction with nurses (OR = 3.65, 95% CI = 1.31-10.14, p = 0.013) and perceived quality of care (OR = 3.97, 95% CI = 1.49-10.55, p = 0.006). Providing appropriate information about disease progress and treatments was a key determinant of both satisfaction with physicians (OR = 19.75, 95% CI = 7.29-53.55, p < 0.001) and perceived quality of treatment (OR = 8.03, 95% CI = 3.25-19.81, p < 0.001). DISCUSSION Nurses should be sensitized to involving patients in the decision-making process, especially upon hospital admission. Specific training about effective communication techniques can be implemented to manage relationships with patients in different caring situations. Practical implications and future directions are discussed.
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Affiliation(s)
- Maura Galletta
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
| | | | - Stefania Luisa Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
| | - Elsa Chessa
- Intensive Care Unit, Binaghi Hospital, ASL Cagliari, 09100 Cagliari, Italy
| | - Ilenia Piras
- Emergency Department, SS. Trinità Hospital, ASL Cagliari, 09100 Cagliari, Italy
| | - Judith E. Arnetz
- Department of Family Medicine, Michigan State University, Grand Rapids, MI 48824, USA
| | - Ernesto D’Aloja
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
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Pérez-Toribio A, Moreno-Poyato AR, Roldán-Merino JF, Nash M. Spanish mental health nurses' experiences of mechanical restraint: A qualitative descriptive study. J Psychiatr Ment Health Nurs 2022; 29:688-697. [PMID: 35856924 DOI: 10.1111/jpm.12860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/02/2022] [Accepted: 07/12/2022] [Indexed: 10/17/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Mechanical restraint is a common practice in mental healthcare settings in Spain, despite controversy. Mechanical restraint is perceived as a negative experience for nurses and service users. Mechanical restraint damages the nurse-patient therapeutic relationship, which is essential in providing quality care and promoting recovery. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The negative experiences of service users and mental health nurses arising from use of mechanical restraint affects both parties involved and results in trauma. Using mechanical restraint can provoke a moral injury in mental health nurses which can negatively impact on the establishment of trust within the therapeutic nurse-patient relationship. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses must be aware of the negative effects that mechanical restraint use has on both their practice and their day-to-day lives. Post-mechanical restraint debriefing is required to repair the damage to the trust aspect of the nurse-patient relationship. Involving service users in co-producing a debriefing framework may be a way to rebuild trust through constructive dialogue. ABSTRACT INTRODUCTION: Mechanical restraint is an intervention that causes harm to service users and nurses, yet continues to be used in many countries, including Spain. However, there is a lack of research exploring Spanish mental health nurses' experiences of using mechanical restraint. AIM To describe the experiences of mental health nurses who have used mechanical restraint in practice. METHODS A qualitative descriptive methodology was used and a purposive sample of 10 Spanish mental health nurses were interviewed about their experiences of using mechanical restraint. Thematic analysis was then employed to analyse interview data. RESULTS Participants' experiences of using mechanical restraint were mostly negative. Three main themes arose from the analysis of interview transcripts, (i) symmetrical trauma, (ii) moral injury and (iii) broken trust. DISCUSSION The use of restrictive practices, which can be perceived as counter-therapeutic, exposes nurses to risks such as moral injury and service users to broken trust in the therapeutic nurse patient relationship. Avoiding empathy in order to use mechanical restraint is counterproductive, in the understanding that empathy is key to reducing this intervention. IMPLICATIONS FOR PRACTICE Reducing or eliminating use of mechanical restraints should be a policy and practice priority due to the symmetrical harms it causes both nurses and service users. The trust aspect of the therapeutic nurse-patient relationship is a significant casualty when mechanical restraint is used, therefore involving service users in co-production of post-mechanical restraint debriefing can be an avenue for restoring this trust through dialogue.
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Affiliation(s)
- Alonso Pérez-Toribio
- Unitat de Salut Mental de l'Hospitalet, Servei d'Atenció Primària Delta de Llobregat/Direcció d'Atenció Primària Costa de Ponent, Institut Català de la Salut, Barcelona, Spain
| | - Antonio R Moreno-Poyato
- Departament of Public Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, Barcelona, Spain
| | - Juan F Roldán-Merino
- Campus Docent Sant Joan de Déu Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Michael Nash
- School of Nursing & Midwifery, Trinity College Dublin, Dublin 2, Ireland
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24
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Garrigues L, Soulé I, Vermeesch AL. Nursing Students and the Human Body: Application of an Ethics Pilot Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11603. [PMID: 36141876 PMCID: PMC9517040 DOI: 10.3390/ijerph191811603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
This manuscript offers findings from a pilot project which prepares nursing students for embodied professional practice through the lens of ethics. Four undergraduate nursing students were mentored by two nursing faculty in the Dundon-Berchtold Institute Faculty Fellowship Program in the Application of Ethics through an exploration on the ethics of embodiment using an arts pedagogy across one academic year. Inspired by the intersection of nature and health, this project explores the impact of an arts-integrated pedagogy on the human body. The findings from this project provide a natural first step for nursing students to consider multiple interpretations of the human body and to facilitate the students' development of an embodied ethical practice that is perceptive, empathic, and attuned to themselves as natural beings as well as diverse individuals and populations. The findings from this pilot project presents a pivotal opportunity to guide future nursing curricular development toward holistic, nature-inspired, and mindful-based interventions in order to increase resilience, decrease risk factors of compassion fatigue and burnout, and support nursing students to develop strength-based skills to use in their professional nursing practice.
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Affiliation(s)
- Layla Garrigues
- School of Nursing and Health Innovations, The University of Portland, 5000 N, Willamette Blvd., Portland, OR 97203, USA
| | - Isabelle Soulé
- School of Nursing and Health Innovations, The University of Portland, 5000 N, Willamette Blvd., Portland, OR 97203, USA
| | - Amber L. Vermeesch
- Department of Family and Community Nursing, School of Nursing, University of North Carolina Greensboro, 1007 Walker Avenue, Greensboro, NC 27402, USA
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25
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Hechinger M, Hentschel D, Aumer C, Rester C. A Conceptual Model of Experiences With Digital Technologies in Aging in Place: Qualitative Systematic Review and Meta-synthesis. JMIR Aging 2022; 5:e34872. [PMID: 36083625 PMCID: PMC9508672 DOI: 10.2196/34872] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/25/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Older adults with chronic illnesses or dependency on care who strive to age in place need support and care depending on their illness. Digital technology has enabled the possibility of supporting older adults in their wishes to age in place. However, current studies have mainly focused on the solitary evaluation of individual technologies or on evaluating technologies for specific illnesses. OBJECTIVE This study aimed to synthesize research on the experiences of older people from the Western culture with chronic illnesses or care needs and their families with digital technology for aging in place. From the meta-synthesis, a model was derived that can be useful for the development of assistive devices in old age and that can support health care providers and professionals in their work with affected individuals. METHODS A systematic review and qualitative meta-synthesis was performed using an inductive approach, as proposed by Sandelowski and Barroso. We performed a systematic literature search in 6 databases from 2000 to 2019, with an update in 2021 and, in addition, conducted a hand search in 2 databases, relevant journals, and reference lists. The results of each study were analyzed using initial and axial coding, followed by theoretical coding. A conceptual model was derived. RESULTS A total of 7776 articles were identified. Articles were screened independently by 2 authors based on the eligibility criteria. Finally, of the 7776 studies, 18 (0.23%) were included in the meta-synthesis. The derived conceptual model describes older adults with chronic illnesses or dependency on care and their family members in an individual process of reflection and decision-making, starting with the use of a digital device. Older adults live in times of change. They experience stable and unstable times of illness as they are part of a changing digital world. Hence, older adults and their families consider digital technology a solution to their current situation. As they become familiar with a specific digital technology, they refine their needs and demands, gain confidence in its use, and note its advantages and disadvantages. They weigh hopes, needs, demands, and experiences in a process of reflection to decide on convenience and inconvenience. Independent of their decision, they achieve peace of mind either with or without digital technology. This process can restart repeatedly during the illness trajectory of older adults. CONCLUSIONS This study promotes a differentiated understanding of older adults' experiences with digital technology. The conceptual model can be useful for the development of assistive technology in old age. Moreover, it can guide health care professionals in their work with older adults and their families to provide individual counseling to find the appropriate digital technology for their respective situations.
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Affiliation(s)
- Mareike Hechinger
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
| | - Diana Hentschel
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
| | - Christine Aumer
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
| | - Christian Rester
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
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The educator as facilitator of trust in the nursing education environment. PLoS One 2022; 17:e0266240. [PMID: 35994433 PMCID: PMC9394812 DOI: 10.1371/journal.pone.0266240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/17/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Trust and trusting are inclinations to believe in the honesty and sincerity of a person. Trust and trusting relationships in nursing education form the foundation of safety, acknowledging vulnerabilities and allowing reciprocal expectations and beliefs to rely on each other during the teaching and learning process. The purpose of this article is to explore the views of nurse educators in facilitating trust and trusting relationships during teaching and learning.
Methods and findings
This article focuses on the role of educators in facilitating the development of trust. A qualitative approach with a grounded theory design was used. The fourteen nurse educators included to address the first objective of the study, were purposively sampled, and the requisite data was collected by conducting individual in-depth face-to-face interviews. Initial, focus and theoretical coding were used to analyse the data until saturation was evident. The following themes emerged: competencies of the educator; setting of standards and the maintaining of consistency; and professional credibility and the value of trusting relationships. The outcome of the findings indicated that the educator plays a key role in establishing trust in nursing education. The study did not include professional nurses in practice as role-players in the nursing education environment. This could be regarded as a limitation, as the professional nurse in practice also has a teaching role, thus, indirectly, forming part of the nursing education environment. A recommendation was made that further research on trust should include professional nurses.
Conclusions
The study highlights that trust is dependent on, and facilitated by, professional conduct, ethical behaviour, competencies, knowledge and skills of the role-players in the teaching and learning environment. The recommendations made have a bearing on developing trust and trusting relationships in nursing education.
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Krityakierne T, Limphattharachai O, Laesanklang W. Nurse-patient relationship for multi-period home health care routing and scheduling problem. PLoS One 2022; 17:e0268517. [PMID: 35622818 PMCID: PMC9140252 DOI: 10.1371/journal.pone.0268517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022] Open
Abstract
This article proposes a novel dynamic objective function in a multi-period home health care (HHC) problem, known as the nurse-patient relationship (NPR). The nurse-patient relationship score indicating the trust a patient has for his or her care worker increases when the same people meet regularly and decreases when they are apart. Managing human resources in HHC is a combination of routing and scheduling problems. Due to computational complexity of the HHC problem, a 28-day home health care problem is decomposed into daily subproblems, and solved sequentially with the tabu search. The solutions are then combined to give a solution to the original problem. For problems with less complex constraints, the NPR model can also be solved using exact methods such as CPLEX. For larger scale instances, however, the numerical results show that the NPR model can only be solved in reasonable times using our proposed tabu search approach. The solutions obtained from the NPR models are compared against those from existing models in the literature such as preference and continuity of care. Essentially, the analysis revealed that the proposed NPR models encouraged the search algorithm to assign the same care worker to visit the same patient. In addition, it had a tendency to assign a care worker on consecutive days to each patient, which is one of the key factors in promoting trust between patients and care workers. This leads to the efficacy of monitoring patient’s disease progression and treatment.
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Affiliation(s)
- Tipaluck Krityakierne
- Department of Mathematics, Faculty of Science, Mahidol University, Bangkok, Thailand
- Centre of Excellence in Mathematics, CHE, Bangkok, Thailand
| | | | - Wasakorn Laesanklang
- Department of Mathematics, Faculty of Science, Mahidol University, Bangkok, Thailand
- Centre of Excellence in Mathematics, CHE, Bangkok, Thailand
- * E-mail:
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A multicenter survey of patients’ favorite type of nursing care and associated factors in Hebei Province, China. PLoS One 2022; 17:e0264169. [PMID: 35263334 PMCID: PMC8906638 DOI: 10.1371/journal.pone.0264169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 02/05/2022] [Indexed: 11/29/2022] Open
Abstract
Background Nursing care service is an important part of the healthcare system; however, patients’ favorite type of nursing care remains unknown. This study aims to investigate inpatients’ and nurses’ favorite types of nursing care and identify nurses’ learning needs. Method The study selected a province-representative sample of inpatients and nurses using a stratified random sampling method from 18 selected hospitals, including 9 Level Ⅱ hospitals and 9 Level Ⅲ hospitals in 9 cities of Hebei province. All participants were personally interviewed about their favorite type of nursing care. Multinomial logistic regression analysis was applied to analyze the potential associations between favorite nursing care and factors about inpatients and nurses. Results Data from 3,642 inpatients and 371 nurses were included for the final analysis during this survey. Among inpatients, the proportions who selected good attitude-centered, good nursing skill-centered, good environment-centered and good health education guidance-centered as their favorite types of nursing care were 49.9%, 31.8%, 5.8%, and 12.5%, respectively. Concurrently, among nurses, the proportions were 49.9%, 29.6%, 19.1%, and 1.3%, respectively. Multivariate analysis showed that most patients selected good attitude-centered nursing care as their favorite type of nursing care. However, patients who did not live with guardians and had more than one hospitalization per year were more likely to select other nursing care types. Conclusion Attitude-centered nursing care service was the favorite type of nursing care for most inpatients and nurses. Health education guidance was another main concern of inpatients. The main factors affecting the patients’ choice of favorite nursing care included patients’ living status and the number of hospitalization events per year. Nursing education should focus on nurse attitude as well as on health education guidance.
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Wang Y, Deng C, Yang L. The Healthcare Needs of International Clients in China: A Qualitative Study. Patient Prefer Adherence 2022; 16:1049-1060. [PMID: 35444408 PMCID: PMC9013666 DOI: 10.2147/ppa.s353320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Due to globalization, an increasing number of international visitors comes to China. The needs of their medical care are understudied, which can cause low patient satisfaction and lead to poor clinical outcomes for the clients. To meet those international clients' medical care needs, hospitals in China are seeking strategies to improve services. PURPOSE The aim of this study was to explore international clients' medical care experiences in China, and their perceptions of the quality of these international healthcare services. PATIENTS AND METHODS In May 2020, focus group interviews with 24 clients and four healthcare professionals were conducted in the international clinic at Sir Run Run Shaw Hospital (SRRSH). In the client group, 24 representatives of international clients from nine countries were invited and divided into three groups to discuss healthcare needs of international clients who seek healthcare in China. Four healthcare providers, including two nurses and two physicians who usually serve in the international clinic, were also interviewed. Data were analyzed using hybrid inductive/deductive thematic analysis. RESULTS Six major healthcare needs of international clients were identified, namely: needs for privacy and confidentiality; effective communication; multicultural sensitive care; pleasant environments; qualified care and procedures; and respect. International healthcare is a complex process for both international clients and healthcare professionals. CONCLUSION The government and institutional administrators around the world should construct the policies and protocols and integrate cultural competence, communication skills, and privacy and confidentiality protection into health professionals training program to ensure the quality services in the international clinics.
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Affiliation(s)
- Yehua Wang
- Department of International Healthcare Center, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Chuyao Deng
- Department of International Healthcare Center, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Lili Yang
- Nursing Education Department, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
- Correspondence: Lili Yang, Nursing Education Department, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, No.3 East Qingchun Road, Hangzhou, 310016, Zhejiang Province, People’s Republic of China, Tel +86-139-581-31637, Email
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Saron H, Carter B, Siner S, Preston J, Peak M, Mehta F, Lane S, Lambert C, Jones D, Hughes H, Harris J, Evans L, Dee S, Eyton-Chong CK, Carrol ED, Sefton G. Parents' experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic pediatric early warning system (the DETECT study): A qualitative interview study. Front Pediatr 2022; 10:954738. [PMID: 36110117 PMCID: PMC9468741 DOI: 10.3389/fped.2022.954738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Failure to recognize and respond to clinical deterioration in a timely and effective manner is an urgent safety concern, driving the need for early identification systems to be embedded in the care of children in hospital. Pediatric early warning systems (PEWS) or PEW scores alert health professionals (HPs) to signs of deterioration, trigger a review and escalate care as needed. PEW scoring allows HPs to record a child's vital signs and other key data including parent concern. AIM This study aimed to explore the experiences and perceptions of parents about the acceptability of a newly implemented electronic surveillance system (the DETECT surveillance system), and factors that influenced acceptability and their awareness around signs of clinical deterioration and raising concern. METHODS Descriptive, qualitative semi-structured telephone interviews were undertaken with parents of children who had experienced a critical deterioration event (CDE) (n = 19) and parents of those who had not experienced a CDE (non-CDE parents) (n = 17). Data were collected between February 2020 and February 2021. RESULTS Qualitative data were analyzed using generic thematic analysis. Analysis revealed an overarching theme of trust as a key factor that underpinned all aspects of children's vital signs being recorded and monitored. The main themes reflect three domains of parents' trust: trust in themselves, trust in the HPs, and trust in the technology. CONCLUSION Parents' experiences and perceptions of the acceptability of a whole-hospital, pro-active electronic pediatric early warning system (The DETECT system) were positive; they found it acceptable and welcomed the use of new technology to support the care of their child.
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Affiliation(s)
- Holly Saron
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Sarah Siner
- Clinical Research Division, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Jennifer Preston
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Matthew Peak
- NIHR Alder Hey Clinical Research Facility, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Fulya Mehta
- Department of General Paediatrics, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Steven Lane
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Caroline Lambert
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom.,Department of Infectious Diseases, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Dawn Jones
- Clinical Research Division, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Hannah Hughes
- Oncology Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Jane Harris
- Faculty of Health, Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom
| | - Leah Evans
- High Dependency Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Sarah Dee
- High Dependency Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Chin-Kien Eyton-Chong
- High Dependency Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Enitan D Carrol
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom.,Department of Infectious Diseases, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Gerri Sefton
- Paediatric Intensive Care Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
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Refaat Ahmed F, Shalaby SA. Exploring empathy and self-efficacy in communication skills among nursing students: A cross-sectional study at two universities in the MENA region. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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van Dyk EC, van Rensburg GH, van Rensburg ESJ. A model to foster and facilitate trust and trusting relationships in the nursing education context. Health SA 2021; 26:1645. [PMID: 34956655 PMCID: PMC8678963 DOI: 10.4102/hsag.v26i0.1645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/19/2021] [Indexed: 11/15/2022] Open
Abstract
Background In the nursing education context, the fostering of trust and establishing trusting relationships are important facets of teaching and learning. Aim The purpose of the study was to understand trust and trusting relationships in teaching and learning, and to develop a model to foster and facilitate trust and trusting relationships in the nursing education context. Setting Two nursing education institutions were purposively sampled that offered a comprehensive programme in nursing. Methods A grounded theory study was conducted with the aim to develop a model for trust and trusting relationships in teaching and learning. Purposive, convenience and theoretical sampling of participants were applied. The sample size consisted of 5 educators and 23 students at a university and 9 educators and 37 students at a public nursing education institution. Charmaz’s methods were used for the data analysis. Collection and analysis of data were conducted concurrently. Results Data of views from the educators and students on trust were synthesised. Themes identified were: professional relations, expectations of the role players in nursing education, creating a conducive teaching and learning context, and outcomes of lack of trust. From the findings, a substantive model to foster and facilitate trust and trusting relationships in nursing education was developed. Conclusion The study contributed to understanding trust in nursing education. Recommendations focus on fostering and facilitating self-trust and trusting relationships and also on how the model could be implemented in nursing education. Contribution Fostering and facilitating trust and trusting relationships in the nursing education context will enhance a trusting culture and contribute to the quality of teaching and learning.
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Affiliation(s)
- Ellie C van Dyk
- Department of Health Studies, Faculty of Human Sciences, University of South Africa, Pretoria, South Africa
| | - Gisela H van Rensburg
- Department of Health Studies, Faculty of Human Sciences, University of South Africa, Pretoria, South Africa
| | - Elsie S Janse van Rensburg
- Department of Health Studies, Faculty of Human Sciences, University of South Africa, Pretoria, South Africa
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Allande-Cussó R, Fernández-García E, Porcel-Gálvez AM. Defining and characterising the nurse-patient relationship: A concept analysis. Nurs Ethics 2021; 29:462-484. [PMID: 34879785 DOI: 10.1177/09697330211046651] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The nurse-patient relationship involves complex attitudes and behaviours with ethical and deontological implications. It has been linked to improvements in patient health outcomes, although there is still no consensus in the scientific literature as to the definition and characterisation of the concept. This article aim to define the concept of the nurse-patient relationship. A concept analysis was conducted using the Walker and Avant method to identify the attributes defining the nurse-patient relationship. An integrative review of the literature was conducted using the PubMed, Web of Science, Scopus, and Cumulative Index to Nursing & Allied Health Literature databases. A review of the grey literature and other minor non-indexed publications on the topic was also conducted. A total of 36 articles were included in the review. A model case, a contrary case, a related case, and empirical references were produced to clarify the concept and identify its essential attributes. The concept is defined as a helping relationship involving interaction between different players. It is the basis of nursing care and is intended to meet the healthcare needs of the individual receiving this care. It is also viewed as an intervention in itself, requiring a specific training process just like any other nursing skill. The essential attributes of the relationship are empathy, presence, contact, authenticity, trust, and reciprocity. In conclusion, the nurse-patient relationship is a helping relationship established with the patient and/or their family based on interaction, communication, respect for ethical values, acceptance, and empathy in order to encourage introspection and behavioural change. Key components include communication, active listening, and respect. Bioethical values and confidentiality must also be present to ensure that the relationship is built on equality and intimacy.
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Cilluffo S, Bassola B, Pucciarelli G, Vellone E, Lusignani M. Mutuality in nursing: A conceptual framework on the relationship between patient and nurse. J Adv Nurs 2021; 78:1718-1730. [PMID: 34873740 DOI: 10.1111/jan.15129] [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: 05/21/2021] [Revised: 10/12/2021] [Accepted: 11/27/2021] [Indexed: 11/27/2022]
Abstract
AIMS To describe and develop a conceptual framework for the process of mutuality between nurse and patient. DESIGN This was a qualitative study with a grounded theory (GT) design following the constructivist approach of Charmaz (SAGE handbook of research, 2014). METHODS A sample of 33 patients with one or more chronic diseases and 35 nurses were interviewed between July and October 2020. Comparative and simultaneous data analyses were conducted. Theoretical sampling and saturation of categories were used to define the sample size. RESULTS A conceptual framework for mutuality between nurse (mean age 42 SD ±7 years, 89% female) and patient (mean age 63 SD ±8 years, 42% female) was developed, including the mutuality process, potential influencing factors for both nurses and patients, and outcomes. The mutuality process was characterised by three dimensions: developing and going beyond, being a reference, and deciding and sharing care. Influencing factors for nurses were personal characteristics and professional organisation, while for patients these were age and past experiences. Nurse outcomes were satisfaction and quality of life; patient outcomes were improved self-care and reduction of hospitalisation and emergency admissions. CONCLUSION This study described a new conceptual framework for mutuality between nurse and patient, which could improve our understanding of the relationship between nurses and patients, thus enhancing both nurse and patient outcomes.
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Affiliation(s)
- Silvia Cilluffo
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,School of Nursing, Niguarda Hospital, University of Milan, Milan, Italy
| | - Barbara Bassola
- School of Nursing, Niguarda Hospital, University of Milan, Milan, Italy
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Maura Lusignani
- School of Nursing, Niguarda Hospital, University of Milan, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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Holmström IK, Kaminsky E, Lindberg Y, Spangler D, Winblad U. The perspectives of Swedish registered nurses about managing difficult calls to emergency medical dispatch centres: a qualitative descriptive study. BMC Nurs 2021; 20:150. [PMID: 34407818 PMCID: PMC8371756 DOI: 10.1186/s12912-021-00657-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/16/2021] [Indexed: 08/08/2023] Open
Abstract
Background Telephone triage at emergency medical dispatch centres is often challenging for registered nurses due to lack of visual cues, lack of knowledge about the patient, and time pressure – and making the right decision can be a matter of life and death. Some calls may be more difficult to handle, and more knowledge is needed about these calls to develop education and coping strategies. Therefore, the aim of this study was to describe the perspectives of registered nurses’ views about managing difficult calls to emergency medical dispatch centres. Methods A descriptive design with a qualitative inductive approach was used. Three dispatch centers in mid-Sweden were investigated, covering about 950,000 inhabitants and handling around 114,000 calls per year. Individual interviews were carried out with a purposeful sample of 24 registered nurses. Systematic text condensation was conducted. Results Seven themes were generated: calls with communication barriers, calls from agitated or rude callers, calls about psychiatric illness, calls from third parties, calls about rare or unclear situations, calls with unknown addresses and calls regarding immediate life-threatening conditions. There was a strong consensus among the registered nurses about which calls were experienced as difficult, with the exception of calls about immediate life-threatening conditions. Some registered nurses thought calls about immediate life-threatening conditions were easy to handle as they simply adhered to protocol, while others described these calls as difficult and were emotionally affected. Conclusion The registered nurses’ descriptions of difficult calls focused on the callers, while their own role, the organisational framework, and leadership were not mentioned. Many types of calls included difficulties, which could be related to the caller, their symptoms, or different circumstances. The registered nurses pointed to language barriers and rude, agitated callers as increasing problems. An investigation of actual emergency calls is warranted to examine the extent and nature of such calls.
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Affiliation(s)
- Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden. .,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Elenor Kaminsky
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ylva Lindberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Douglas Spangler
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ulrika Winblad
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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O'Conner-Von S, Bennett F. Long-Term Care Nurses and Their Experiences With Patients' and Families' End-of-Life Preferences: A Focus Group Study. J Gerontol Nurs 2021; 46:23-29. [PMID: 33232494 DOI: 10.3928/00989134-20201106-05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/08/2020] [Indexed: 11/20/2022]
Abstract
Long-term care (LTC) nurses are a critical nexus for patient communication and vital to advance care planning due to their professional role and breadth of patient relationships. The current study's aim was to explore the communication strategies Midwestern LTC nurses use to clarify patients' end-of-life (EOL) care preferences. Two focus groups used a phenomenological framework to elucidate the experiences of 14 RNs. Data analysis revealed two themes grounded in time: (a) nurses use time to assess patients' EOL situation and assist patients to discern care options; and (b) nurses educate patients about EOL care, adjust care plans, and develop trusting relationships. Two themes were grounded in clinical experience: (a) nurses become persistent advocates and educators to initiate and sustain EOL communication; and (b) nurses learn consistency in communication, including awareness of patients' nonverbal communication. Nurses shared that EOL communication is never "done"; time frames to assess, educate, and clarify are continuous. [Journal of Gerontological Nursing, 46(12), 23-29.].
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Shen L, Fei X, Zhou Y, Wang J, Zhu Y, Zhuang Y. The effect of felt trust from patients among nurses on attitudes towards nursing service delivery. J Adv Nurs 2021; 78:404-413. [PMID: 34363632 DOI: 10.1111/jan.14973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/13/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022]
Abstract
AIMS To examine how felt trust motivates nurses to desire to deliver better nursing services and how perspective taking makes nurses feel trusted by their patients. By introducing the concept of prosocial motivation into nursing research, this study further explored a boundary condition that influences the positive relationship between felt trust from patients and attitudes towards nursing service delivery. DESIGN This study used a cross-sectional and survey design. METHOD This study was conducted among 339 nurses on medical teams sent to support Hubei, China, during the COVID-19 pandemic in April 2020. RESULTS The results indicate that felt trust from patients mediated the positive relationship between perspective taking and attitudes towards nursing service delivery. In addition, prosocial motivation moderated the relationship between felt trust from patients and attitudes towards nursing service delivery, such that the relationship was stronger when prosocial motivation was high (vs. low). Prosocial motivation also moderated the indirect effects of perspective taking on attitudes towards nursing service delivery via felt trust from patients. CONCLUSION This study shows that despite the challenges posed by COVID-19, nurses who experience a high level of trust from patients are still eager to deliver high-quality nursing services, and this finding is especially salient among those with high prosocial motivation. IMPACT This study introduces felt trust from patients as a new motivational mechanism that can induce nurses' willingness to deliver better nursing services. We suggest that nurses and nurse leaders should be aware of the significance of the trust relationship between nurses and patients. Nurses need to be trained to take patients' perspectives in the interaction process, which can make them feel trusted by patients and can consequently be motivated to deliver better nursing services.
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Affiliation(s)
- Lihua Shen
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xuan Fei
- Huaiyin Normal University, Huaian, China.,Nottingham University Business School China, University of Nottingham Ningbo China, Ningbo, China
| | - Yan Zhou
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Wang
- Nottingham University Business School China, University of Nottingham Ningbo China, Ningbo, China
| | - Yue Zhu
- School of Business Administration, Zhejiang Gongshang University, Hangzhou, China
| | - Yiyu Zhuang
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Boumans J, Scheffelaar A, van Druten VP, Hendriksen THG, Nahar-van Venrooij LMW, Rozema AD. Coping Strategies Used by Older Adults to Deal with Contact Isolation in the Hospital during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147317. [PMID: 34299774 PMCID: PMC8304333 DOI: 10.3390/ijerph18147317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 11/24/2022]
Abstract
Due to the COVID-19 pandemic, many older adults have experienced contact isolation in a hospital setting which leads to separation from relatives, loss of freedom, and uncertainty regarding disease status. The objective of this study was to explore how older adults (55+) cope with contact isolation in a hospital setting during the COVID-19 pandemic in order to improve their physical and psychological wellbeing. The realist evaluation approach was used to formulate initial program theories on coping strategies used by (older) adults in an isolation setting. Twenty-one semi-structured interviews with older patients (n = 21) were analysed. This study revealed that both emotion-focused coping strategies as well as problem-focused coping strategies were used by older adults during contact isolation. The study also uncovered some new specific coping strategies. The results have useful implications for hospital staff seeking to improve the wellbeing of older adults in contact isolation in hospitals. Problem-focused coping strategies could be stimulated through staff performing care in a person-centred way. Trust in staff, as part of emotion-focused coping strategies, could be stimulated by improving the relationship between patients and staff.
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Affiliation(s)
- Jogé Boumans
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands; (A.S.); (V.P.v.D.); (A.D.R.)
- Correspondence:
| | - Aukelien Scheffelaar
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands; (A.S.); (V.P.v.D.); (A.D.R.)
| | - Vera P. van Druten
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands; (A.S.); (V.P.v.D.); (A.D.R.)
- Jeroen Bosch Academy Research, Jeroen Bosch Hospital, 5223 GZ ‘s-Hertogenbosch, The Netherlands; (T.H.G.H.); (L.M.W.N.-v.V.)
| | - Tessel H. G. Hendriksen
- Jeroen Bosch Academy Research, Jeroen Bosch Hospital, 5223 GZ ‘s-Hertogenbosch, The Netherlands; (T.H.G.H.); (L.M.W.N.-v.V.)
| | - Lenny M. W. Nahar-van Venrooij
- Jeroen Bosch Academy Research, Jeroen Bosch Hospital, 5223 GZ ‘s-Hertogenbosch, The Netherlands; (T.H.G.H.); (L.M.W.N.-v.V.)
| | - Andrea D. Rozema
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands; (A.S.); (V.P.v.D.); (A.D.R.)
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Vogel G, Joelsson-Alm E, Forinder U, Svensen C, Sandgren A. Stabilizing life: A grounded theory of surviving critical illness. Intensive Crit Care Nurs 2021; 67:103096. [PMID: 34244030 DOI: 10.1016/j.iccn.2021.103096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The experience of critical illness among patients is both complex and multifaceted. It can make patients vulnerable to long-term consequences such as impairment in cognition, mental health and physical functional ability which affects health related quality of life. This study aims to explore patients' patterns of behaviour during the process from becoming critical ill to recovery at home. DESIGN We used a classic grounded theory methodology to explore the main concern for intensive care patients. Thirteen participants were interviewed and seven different participants were observed. SETTING Three general intensive care units in Sweden, consisting of a university hospital, a county hospital and a district hospital. FINDINGS The theory Stabilizing life explains how patients' main concern, being out of control, can be resolved. This theory involves two processes, recapturing life and recoding life, and one underlying strategy, emotional balancing that is used during the whole process. CONCLUSION The process from becoming critically ill until recovery home is perceived as a constant fight in actions and mind to achieve control and stabilize life. This theory can form the basis for further qualitative and quantitative research about interventions that promotes wellbeing during the whole process.
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Affiliation(s)
- Gisela Vogel
- Department of Clinical Science and Education, Karolinska Institutet, Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden.
| | - Eva Joelsson-Alm
- Department of Clinical Science and Education, Karolinska Institutet, Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden.
| | - Ulla Forinder
- Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden.
| | - Christer Svensen
- Department of Clinical Science and Education, Karolinska Institutet, Unit of Anaesthesiology and Intensive Care, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden.
| | - Anna Sandgren
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Universitetsplatsen 1, 352 52 Växjö, Sweden.
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Bennett FB, Hadidi NN, O'Conner-Von SK. End-Of-Life Care Communication in Long-Term Care Among Nurses, Residents, and Families: A Critical Review of Qualitative Research. J Gerontol Nurs 2021; 47:43-49. [PMID: 34191654 DOI: 10.3928/00989134-20210604-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
RNs in long-term care (LTC) are a critical nexus for end-of-life (EOL) care communication with older adult residents and their families. A critical review of 17 qualitative research studies examined nurses' experience with EOL care in LTC. Findings indicate that time, preparation, advocacy, organizational resources, and a continuous, relational approach support EOL care communication. Regulatory burdens, understaffing, workflow demands, family and organizational dysfunction, anxiety, and depression impede EOL care communication. The current review revealed a gap in the literature describing LTC RNs' unique perspectives and knowledge regarding EOL care communication with residents and families. There is a current, pressing need to understand the facilitators LTC RNs use to overcome obstacles to effective EOL care communication. Future research could inform clinical practice guidelines and EOL care nursing education, enhancing LTC nurses' capacity to develop trust-based relationships and improving the efficacy of current EOL care communication interventions in LTC. [Journal of Gerontological Nursing, 47(7), 43-49.].
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Elonen I, Salminen L, Brasaitė-Abromė I, Fuster P, Kukkonen P, Leino-Kilpi H, Löyttyniemi E, Noonan B, Stubner J, Svavarsdóttir MH, Thorsteinsson H, Koskinen S. Medication calculation skills of graduating nursing students within European context. J Clin Nurs 2021; 31:548-558. [PMID: 34101280 DOI: 10.1111/jocn.15908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/29/2021] [Accepted: 05/07/2021] [Indexed: 11/26/2022]
Abstract
AIM The aim of this study is to evaluate the medication calculation skills of graduating nursing students in six European countries and analyse the associated factors. BACKGROUND Medication calculation skills are fundamental to medication safety, which is a substantial part of patient safety. Previous studies have raised concerns about the medication calculation skills of nurses and nursing students. DESIGN As part of a broader research project, this study applies a multinational cross-sectional survey design with three populations: graduating nursing students, nurse managers and patients. METHODS The students performed two calculations (tablet and fluid) testing medication calculation skills requiring different levels of conceptual understanding and arithmetic. The managers and patients answered one question about the students' medication kills. In total, 1,796 students, 538 managers and 1,327 patients participated the study. The data were analysed statistically. The STROBE guideline for cross-sectional studies was applied. RESULTS Almost all (99%) of the students performed the tablet calculation correctly, and the majority (71%) answered the fluid calculation correctly. Older age, a previous degree in health care and satisfaction with their current degree programme was positively associated with correct fluid calculations. The patients evaluated the students' medication skills higher than the nurse managers did and the evaluations were not systematically aligned with the calculation skills tested. CONCLUSIONS Nursing students have the skills to perform simple medication calculations, but a significant number of students have difficulties with calculations involving multiple operations and a higher level of conceptual understanding. Due to the variation in students' medication calculation skills and the unalignment between the managers' and patients' evaluations and the calculation tests, further research is needed. RELEVANCE TO CLINICAL PRACTICE Graduating nursing students enter clinical field as qualified professionals, but there is still room for improvement in their medication calculation skills. This calls for attention in the fields of clinical nursing, education and research.
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Affiliation(s)
- Imane Elonen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Leena Salminen
- Department of Nursing Science and Nurse Director, University of Turku, Turku University Hospital, Turku, Finland
| | | | - Pilar Fuster
- Nursing Department, Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain
| | - Pia Kukkonen
- Department of Nursing Science, University of Turku, Finland, Turku University Hospital, Turku, Finland
| | - Helena Leino-Kilpi
- FAAN, FEANS, University of Turku and Nurse Director, Turku University Hospital, Turku, Finland
| | | | - Brendan Noonan
- University College Cork, School of Nursing and Midwifery, Cork, Ireland
| | - Juliane Stubner
- Martin Luther University Halle-Wittenberg, Institute of Health and Nursing Science, Halle, Germany
| | | | - Hrund Thorsteinsson
- Faculty of Nursing, Department of Development and Education, University of Iceland, Landspitali University Hospital, Reykjavik, Iceland
| | - Sanna Koskinen
- Department of Nursing Science, University of Turku, Turku, Finland
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Feo R, Kumaran S, Conroy T, Heuzenroeder L, Kitson A. An evaluation of instruments measuring behavioural aspects of the nurse-patient relationship. Nurs Inq 2021; 29:e12425. [PMID: 34076309 DOI: 10.1111/nin.12425] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/24/2022]
Abstract
The Fundamentals of Care Framework is an evidence-based, theory-informed framework that conceptualises high-quality fundamental care. The Framework places the nurse-patient relationship at the centre of care provision and outlines the nurse behaviours required for relationship development. Numerous instruments exist to measure behavioural aspects of the nurse-patient relationship; however, the literature offers little guidance on which instruments are psychometrically sound and best measure the core relationship elements of the Fundamentals of Care Framework. This study evaluated the quality of nurse-patient relationship instruments by (1) assessing their content development and measurement properties (e.g. dimensionality, targeting, reliability, validity) and (2) mapping instrument content to the Framework's core relationship elements: trust, focus, anticipate, know, and evaluate. Twenty-seven instruments were evaluated. Findings demonstrated that patients and nurses were rarely involved in item development. Most instruments exhibited poor measurement properties, with only one instrument having complete information on all quality indicators. Instrument content focused primarily on nurses getting to know patients and earning their trust, with only 54, 18, and 1 item(s), respectively, measuring 'focus', 'anticipate' and 'evaluate'. Hence, there does not appear to be a robust instrument measuring behavioural aspects of nurse-patient relationships, nor one capturing the relationship elements of the Fundamentals of Care Framework.
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Affiliation(s)
- Rebecca Feo
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.,Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
| | - Sheela Kumaran
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Tiffany Conroy
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.,Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
| | - Louise Heuzenroeder
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Alison Kitson
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.,Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
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How do patients develop trust in community pharmacists? Res Social Adm Pharm 2021; 17:911-920. [DOI: 10.1016/j.sapharm.2020.07.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 11/22/2022]
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Morey S, Magnusson C, Steven A. Exploration of student nurses' experiences in practice of patient safety events, reporting and patient involvement. NURSE EDUCATION TODAY 2021; 100:104831. [PMID: 33676347 DOI: 10.1016/j.nedt.2021.104831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 01/26/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND/INTRODUCTION Qualified and student nurses remain at the forefront of dealing with, and reporting, patient safety events or incidents. There has been limited exploration of whether and how the patient's perspective is represented by staff or student nurses using formal reporting systems. OBJECTIVES The overall aim of the study was to explore the student nurses' experiences in practice of patient safety events they were themselves directly or indirectly involved in. This specifically explored the subsequent reporting and inclusion of the patient perspectives that may or may not have taken place. DESIGN A qualitative approach to this research was selected using the principles of thematic analysis to analyse data gathered from focus groups of student nurses across all year groups. SETTING Three universities participated in the study located in the north east, south east and east of England. PARTICIPANTS Student nurses from across the year groups attended focus groups. METHODS Following ethical approval and informed consent, participants took part in focus groups within each university setting. Data were transcribed verbatim and analysed using thematic analysis. RESULTS Three themes were identified: the benefit of reporting and patient involvement, the barriers experienced by the students in reporting and the support needed to ensure they do the right thing in practice. CONCLUSION Learning for students from patient safety incidents is important and seeking patients' views and perceptions adds to the learning experience. There are however challenges for the student in practice in both reporting and patient involvement. Resources are needed that follow and feed into the student learning alongside a workforce that see the benefit of learning from those we care for.
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Affiliation(s)
- Sarah Morey
- Northumbria University, Coach Lane Campus, Coach Lane, Newcastle-Upon-Tyne NE77TR, United Kingdom.
| | - Carin Magnusson
- University of Surrey, Stag Hill University Campus, Guildford. GU27XH, United Kingdom.
| | - Alison Steven
- Northumbria University, Coach Lane Campus, Coach Lane, Newcastle-Upon-Tyne NE77TR, United Kingdom.
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46
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Hardie P, Darley A, Redmond C, Lafferty A, Jarvis S. Interpersonal and communication skills development in nursing preceptorship education and training programmes: a scoping review protocol. HRB Open Res 2021; 4:9. [PMID: 33665546 PMCID: PMC7903201 DOI: 10.12688/hrbopenres.13201.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 11/20/2022] Open
Abstract
The preceptorship model is an education-focused model for teaching and learning within a clinical environment in nursing. It formulates a professional educational relationship between a staff nurse (preceptor) and student nurse and is based on the provision of providing patient care. Preceptorship is widely acknowledged in the literature as a positive pedagogical approach in clinical nursing education in terms of knowledge and skill acquisition, confidence, and professional socialisation of undergraduate nursing students. However, the literature also widely reports negative interpersonal experiences within this professional educational relationship resulting in negative educational experiences and in some cases, negative patient experiences. Therefore, the authors set out to examine what teaching strategies are being implemented by nurse educators to encourage the development of interpersonal and communication skills in facilitating positive interpersonal relationships between the preceptor, nursing student and patient. This paper outlines the protocol for an exploratory scoping review that aims to systematically and comprehensively map out the available published and unpublished literature on the teaching strategies to develop interpersonal and communication skills in preceptorship education and training programmes. To conduct a systematic and comprehensive scoping review, the review will be guided by the Joanna Briggs Institute and Arksey & O' Malley (2005) six-stage iterative framework, as well as PRISMA-ScR framework guidelines, to ensure the quality of the methodological and reporting approaches to the review. It is anticipated that the results of the scoping review will inform nurse educators on the current educational practices for developing interpersonal and communication skills in preceptorship education and training programmes and identify any educational practices that are worthy of further consideration for future research.
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Affiliation(s)
- Philip Hardie
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Andrew Darley
- UCD School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Catherine Redmond
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Attracta Lafferty
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Suzi Jarvis
- UCD Innovation Academy, University College Dublin, Belfield, Dublin 4, Ireland
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Hardie P, Darley A, Redmond C, Lafferty A, Jarvis S. Interpersonal and communication skills development in nursing preceptorship education and training programmes: a scoping review protocol. HRB Open Res 2021; 4:9. [PMID: 33665546 PMCID: PMC7903201 DOI: 10.12688/hrbopenres.13201.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 11/19/2023] Open
Abstract
The preceptorship model is an education-focused model for teaching and learning within a clinical environment in nursing. It formulates a professional educational relationship between a staff nurse (preceptor) and student nurse and is based on the provision of providing patient care. Preceptorship is widely acknowledged in the literature as a positive pedagogical approach in clinical nursing education in terms of knowledge and skill acquisition, confidence, and professional socialisation of undergraduate nursing students. However, the literature also widely reports negative interpersonal experiences within this professional educational relationship resulting in negative educational experiences and in some cases, negative patient experiences. Therefore, the authors set out to examine what teaching strategies are being implemented by nurse educators to encourage the development of interpersonal and communication skills in facilitating positive interpersonal relationships between the preceptor, nursing student and patient. This paper outlines the protocol for an exploratory scoping review that aims to systematically and comprehensively map out the available published and unpublished literature on the teaching strategies to develop interpersonal and communication skills in preceptorship education and training programmes. To conduct a systematic and comprehensive scoping review, the review will be guided by the Joanna Briggs Institute and Arksey & O' Malley (2005) six-stage iterative framework, as well as PRISMA-ScR framework guidelines, to ensure the quality of the methodological and reporting approaches to the review. It is anticipated that the results of the scoping review will inform nurse educators on the current educational practices for developing interpersonal and communication skills in preceptorship education and training programmes and identify any educational practices that are worthy of further consideration for future research.
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Affiliation(s)
- Philip Hardie
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Andrew Darley
- UCD School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Catherine Redmond
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Attracta Lafferty
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Suzi Jarvis
- UCD Innovation Academy, University College Dublin, Belfield, Dublin 4, Ireland
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Nikitara M, Constantinou CS, Andreou E, Latzourakis E, Diomidous M. Facilitators and barriers to the provision of type 1 diabetes inpatient care: An interpretive phenomenological analysis. Nurs Open 2021; 8:908-919. [PMID: 33570292 PMCID: PMC7877146 DOI: 10.1002/nop2.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/07/2020] [Accepted: 09/03/2020] [Indexed: 11/28/2022] Open
Abstract
AIM The aim and objective of this study was to understand how non-specialized nurses understand the possible barriers and facilitators of inpatient care for type 1 diabetes. DESIGN An interpretative phenomenology approach was conducted. METHODS The sample consisted of non-specialized nurses (N = 24) working in medical, surgical and nephrology wards in the state hospitals in Cyprus. The data were collected during 2016-2018 from one focus group with nurses (N = 6) and individual semi-structured interviews with nurses (N = 18) conducted. The Standards for Reporting Qualitative Research checklist used to ensure the quality of the study. RESULTS It is evident from the study findings that nurses experience several barriers in diabetes inpatient care reported which are of great concern since this could have adverse effects on patients' outcomes. Only one facilitator has been reported by few nurses.
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Affiliation(s)
- Monica Nikitara
- Department of Life & Health SciencesUniversity of NicosiaNicosiaCyprus
| | | | - Eleni Andreou
- Department of Life & Health SciencesUniversity of NicosiaNicosiaCyprus
| | | | - Marianna Diomidous
- Department of Public HealthNational and Kapodistrian University of AthensAthensGreece
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Groves PS, Bunch JL, Sabadosa KA, Cannava KE, Williams JK. A grounded theory of creating space for open safety communication between hospitalized patients and nurses. Nurs Outlook 2021; 69:632-640. [PMID: 33579513 DOI: 10.1016/j.outlook.2021.01.005] [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: 04/29/2020] [Revised: 11/30/2020] [Accepted: 01/10/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND There is evidence that fear of negative nurse response may prevent hospitalized patients from sharing safety concerns, adversely affecting patient safety. PURPOSE The purpose of the present study was to describe the process by which bedside nurses recognize and respond to safety concerns expressed by patients or their families. METHODS Twenty-five bedside nurses from 30 maternal-child, intensive, medical-surgical, and psychiatric inpatient units within an academic medical center participated in semi-structured interviews. Data were analyzed using grounded theory. FINDINGS Nurses reported creating space for open safety communication to foster trust and maintain patient safety and sense of security. Nurses anticipated safety concerns, invited safety discussion, were accessible, recognized insecurity, reacted in a trustworthy way, shared a plan, and followed up with patient and family. DISCUSSION This process involves multiple interacting components, yet was remarkably consistent across acute care settings, despite differences in nurses, patient populations, and unit cultures.
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DeGuzman PB, Jain N, Loureiro CG. Public Libraries as Partners in Telemedicine Delivery: A Review and Research Agenda. PUBLIC LIBRARY QUARTERLY 2021. [DOI: 10.1080/01616846.2021.1877080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Pamela B. DeGuzman
- Associate Professor, University of Virginia School of Nursing, Charlottesville, Virginia, USA
| | - Neha Jain
- Undergraduate Student, University of Virginia School of Nursing, Charlottesville, Virginia, USA
| | - Christine G. Loureiro
- Graduate Student, University of Virginia School of Nursing, Charlottesville, Virginia, USA
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