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Niskala J, Kanste O, Tomietto M, Miettunen J, Tuomikoski A, Kyngäs H, Mikkonen K. Interventions to improve nurses' job satisfaction: A systematic review and meta‐analysis. J Adv Nurs 2020; 76:1498-1508. [DOI: 10.1111/jan.14342] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 02/06/2020] [Accepted: 02/18/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Jenni Niskala
- Research Unit of Nursing Science and Health Management University of Oulu Oulu Finland
| | - Outi Kanste
- Research Unit of Nursing Science and Health Management University of Oulu Oulu Finland
| | - Marco Tomietto
- Research Unit of Nursing Science and Health Management University of Oulu Oulu Finland
- Azienda per l'Assistenza Sanitaria n. 5 “Friuli Occidentale” Pordenone Italy
| | - Jouko Miettunen
- Center for Life Course Health Research University of Oulu Oulu Finland
- Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu Finland
| | - Anna‐Maria Tuomikoski
- Research Unit of Nursing Science and Health Management University of Oulu Oulu Finland
- Nursing Research Foundation Helsinki Finland
- The Finnish Centre for Evidence‐Based Health Care Helsinki Finland
- WHO Collaborating Centre for Nursing Helsinki Finland
- Oulu University of Applied Sciences Oulu Finland
| | - Helvi Kyngäs
- Research Unit of Nursing Science and Health Management University of Oulu Oulu Finland
- Northern Ostrobothnia Hospital District Finland
| | - Kristina Mikkonen
- Research Unit of Nursing Science and Health Management University of Oulu Oulu Finland
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Kalocsai C, Amaral A, Piquette D, Walter G, Dev SP, Taylor P, Downar J, Gotlib Conn L. "It's better to have three brains working instead of one": a qualitative study of building therapeutic alliance with family members of critically ill patients. BMC Health Serv Res 2018; 18:533. [PMID: 29986722 PMCID: PMC6038351 DOI: 10.1186/s12913-018-3341-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 06/28/2018] [Indexed: 11/10/2022] Open
Abstract
Background Studies in the intensive care unit (ICU) suggest that better communication between families of critically ill patients and healthcare providers is needed; however, most randomized trials targeting interventions to improve communication have failed to achieve family-centered outcomes. We aim to offer a novel analysis of the complexities involved in building positive family-provider relationships in the ICU through the consideration of not only communication but other important aspects of family-provider interactions, including family integration, collaboration, and empowerment. Our goal is to explore family members’ perspectives on the enablers and challenges to establishing therapeutic alliance with ICU physicians and nurses. Methods We used the concept of therapeutic alliance as an organizational and analytic tool to conduct an interview-based qualitative study in a 20-bed adult medical-surgical ICU in an academic hospital in Toronto, Canada. Nineteen family members of critically ill patients who acted as substitute decision-makers and/or regularly interacted with ICU providers were interviewed. Participants were sampled purposefully to ensure maximum variation along predetermined criteria. A hybrid inductive-deductive approach to analysis was used. Results Participating family members highlighted the complementary roles and practices of ICU nurses and physicians in building therapeutic alliance. They reported how both provider groups had profession specific and shared contributions to foster family communication, integration, and collaboration, while physicians played a key role in family empowerment. Families’ lack of familiarity with ICU personnel and processes, physicians’ sporadic availability and use of medical jargon during rounds, however, reinforced long established power differences between lay families and expert physicians and challenged family integration. Family members also identified informal interactions as missed opportunities for relationship-building with physicians. While informal interactions with nurses at the bedside facilitated therapeutic alliance, inconsistent and ad-hoc interactions related to routine decision-making hindered family empowerment. Conclusions Multiple opportunities exist to improve family-provider relationships in the ICU. The four dimensions of therapeutic alliance prove analytically useful to highlight those aspects that work well and need improvement, such as in the areas of family integration and empowerment. Electronic supplementary material The online version of this article (10.1186/s12913-018-3341-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Csilla Kalocsai
- Trauma, Emergency and Critical Care Research, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada. .,Patient/Client and Family Education, Centre for Mental Health and Addiction, 33 Russell Street, Toronto, Ontario, M5S 3M1, Canada.
| | - Andre Amaral
- Trauma, Emergency and Critical Care Research, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.,Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Dominique Piquette
- Trauma, Emergency and Critical Care Research, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.,Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Grace Walter
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Shelly P Dev
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Paul Taylor
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | - James Downar
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada.,Palliative Medicine, University of Toronto, Toronto, Canada
| | - Lesley Gotlib Conn
- Trauma, Emergency and Critical Care Research, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
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Ebert KD. Parent perspectives on the clinician-client relationship in speech-language treatment for children. JOURNAL OF COMMUNICATION DISORDERS 2018; 73:25-33. [PMID: 29567464 DOI: 10.1016/j.jcomdis.2018.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 03/12/2018] [Accepted: 03/14/2018] [Indexed: 06/08/2023]
Abstract
Few studies have explored clinician-client relationships in speech-language treatment for children, although evidence indicates that these relationships may be important. Parents play a unique role in clinician-client relationships and their views have yet to be considered in the speech-language pathology literature. This study explored parents' perspectives on the clinician-client relationship in speech-language treatment for children using both quantitative and qualitative information. An online survey collected responses from 159 parents with children enrolled in speech-language services. Respondents were asked to complete a rating of the clinician-client relationship, provide information on length of treatment and treatment setting, and respond to open-ended questions about what enhances the clinician-client relationship. Length of treatment was unrelated to the parent rating of the clinician-client relationship. However, ratings did vary by treatment setting; parents of children enrolled in treatment services in schools provided lower ratings than parents with children enrolled in other settings. Thematic analysis of parent views on what enhances the clinician-client relationship yielded four main themes: qualities of the speech-language pathologist (SLP), session characteristics, the child-SLP bond, and communication. The most frequent subthemes in the analysis related to characteristics of the sessions: the integration of play and fun, and a child-oriented approach to sessions. These results provide insight into the development of clinician-client relationships in children's speech-language treatment, with implications for both clinicians and researchers.
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Affiliation(s)
- Kerry Danahy Ebert
- Rush University, 1016D Armour Academic Center, 600 S. Paulina St., Chicago, IL, 60612, United States.
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Ebert KD. Measuring Clinician-Client Relationships in Speech-Language Treatment for School-Age Children. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:146-152. [PMID: 28124065 DOI: 10.1044/2016_ajslp-16-0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 08/13/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Clinician-client relationships may influence treatment success in speech-language pathology, but there are no established tools for measuring these relationships. This study describes the development and application of a set of scales for assessing clinician-client relationships in children's speech-language treatment. METHOD Twenty-two triads of participants completed a longitudinal study. Each triad had 1 school-age child enrolled in speech-language treatment, 1 caregiver, and 1 speech-language pathologist (SLP). The clinician-client relationship scales were administered to all 3 types of participants at study onset and again 2 weeks later. Treatment progress measures were collected 4 months later. Analyses established the reliability and validity of the clinician-client relationship scales. RESULTS Adequate internal consistency reliability and test-retest reliability were established for all 3 versions of the scale (child, caregiver, and SLP). Convergent validity was moderate between SLPs and children but lower when caregivers were included. Predictive validity analyses established significant relationships between caregiver and SLP ratings of the clinician-client relationship and future treatment progress. CONCLUSIONS This exploratory study established the viability of the clinician-client relationship scales for further development and application. The importance of establishing and utilizing measures of the clinician-client relationship in speech-language pathology is discussed.
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Scholtz S, Nel EW, Poggenpoel M, Myburgh CPH. The Culture of Nurses in a Critical Care Unit. Glob Qual Nurs Res 2016; 3:2333393615625996. [PMID: 28462324 PMCID: PMC5342286 DOI: 10.1177/2333393615625996] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 12/01/2015] [Accepted: 12/07/2015] [Indexed: 01/12/2023] Open
Abstract
Critical care nurses have to adapt to a fast-paced and stressful environment by functioning within their own culture. The objective of this study was to explore and describe the culture of critical care nurses with the purpose of facilitating recognition of wholeness in critical care nurses. The study had a qualitative, exploratory, descriptive, and contextual design. The ethnographic study included data triangulation of field notes written during 12 months of ethnographic observations, 13 interviews from registered nurses, and three completed diaries. Coding and analysis of data revealed patterns of behavior and interaction. The culture of critical care nurses was identified through patterns of patient adoption, armor display, despondency because of the demands to adjust, sibling-like teamwork, and non-support from management and medical doctors. An understanding of the complexity of these patterns of behavior and interaction within the critical care nursing culture is essential for transformation in the practice of critical care nursing.
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Affiliation(s)
| | - Elsabe W. Nel
- University of Johannesburg, Johannesburg, South Africa
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Roosevelt LK, Holland KJ, Hiser J, Seng JS. Psychometric assessment of the Health Care Alliance Questionnaire with women in prenatal care. J Health Psychol 2013; 20:1013-24. [PMID: 24155197 DOI: 10.1177/1359105313506027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The current study assessed the reliability and validity of the Health Care Alliance Questionnaire, which was developed using a Delphi process and embedded in an ongoing perinatal outcomes study. The Health Care Alliance Questionnaire exhibited content and face validity and high reliability. Results indicated concurrent validity in relation to satisfaction with practitioner and discriminant validity in relation to interpersonal sensitivity and posttraumatic stress disorder. The Health Care Alliance Questionnaire demonstrated predictive validity in relation to perceptions of practitioner's care during labor and postpartum depression. Overall, results suggest that alliance may be an important factor in maternity care processes and outcomes. Further psychometric work is warranted.
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