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Mashhadi-Naser S, Sabet FP, Nasiri M, Vasli P. Benefits of a family-based care transition program for older adults after hip fracture surgery. Aging Clin Exp Res 2024; 36:142. [PMID: 39002096 PMCID: PMC11246294 DOI: 10.1007/s40520-024-02794-8] [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: 05/22/2024] [Accepted: 06/21/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Hip fracture (HF) in older adults is strongly associated with a greater decline in their activities of daily living (ADLs) and health-related (HRQoL). The present study aimed to evaluate the effects of a family-based care transition program (FBCTP) on ADLs, HRQoL and social support in this age group after HF surgery. METHODS A quasi-experimental design was conducted on 100 older adults who had undergone HFS and were selected by convenience sampling and allocated to the IG (n = 50) and the CG (n = 50). Data were collected utilizing the Barthel Index, the 12-item Short Form Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support. The FBCTP was delivered in-hospital education sessions, home visit, and a follow-up and telephone counselling session. The data were collected at three stages, including the baseline, four weeks after discharge, and eight weeks later. The level of statistical significance was set at 0.05. RESULTS The results of the study indicated that the effects of time and group on the increase in ADLs were 15.2 and 36.69 (p < 0.000), respectively, following the completion of the FBCTP. Furthermore, time and group were found to have a positive effect on HRQoL, with an increase of 2.82 and 5.60 units, respectively (p < 0.000). In this context, time and group also interacted in the IG compared to the CG, with scores increasing by 1.86 units over time (p < 0.000). Although the study results indicated that social support improved by 1.98 units over time (p < 0.000), the effects of group alone and the time × group interaction were not statistically significant. This indicates that the program was not effective in accelerating social support. CONCLUSION Consequently, nurses, policymakers, and planners engaged in geriatric healthcare may utilize these results to enhance the health status of this age group following HFS.
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Affiliation(s)
- Sahar Mashhadi-Naser
- Student Research Committee, Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pashaei Sabet
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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2
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Sharma B, Mani V, Zined R, Joshi P, Srivastava SP, Alhawat S, Pandey S. Attitude of Indian nurses towards importance of families in nursing care: A cross-sectional study. J Clin Nurs 2024; 33:1798-1808. [PMID: 38031355 DOI: 10.1111/jocn.16942] [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: 04/07/2023] [Revised: 10/31/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023]
Abstract
AIMS AND OBJECTIVE To evaluate the attitudes of Indian nurses towards the importance of family involvement in nursing care and the association between nurse attitudes and sociodemographic characteristics. BACKGROUND Involving the family in the care process is crucial for delivering family- and patient-centred care and ensuring the best possible patient outcomes. Nevertheless, published literature revealed that the nurses may lack clarity regarding the role of family members in the patient's care, which in turn hinders families' participation in care. DESIGN Cross-sectional descriptive study. The STROBE checklist was used to report the present study. METHODS A total of 203 Nurses participated in a prospective cross-sectional study between May 2022 and August 2022. They were recruited through convenience sampling from two tertiary care centres in India. A two-part questionnaire was used to gather the data; the first section contained questions for gathering sociodemographic information, and the second part contained the standardized FINC-NA scale. RESULTS The mean age of the nurses was (28.08 ± 4.722) years, and their median professional experience was 2.5 (1-5.5) years. Nurses' attitude regarding family's importance in patient care was found to be significantly associated (p ≤ .05) with education level, marital status, religion and hometown region. CONCLUSION In several items Indian nurses have positive attitudes towards family involvement in care but some of the lower scoring items can present opportunities for focused improvement. Continuing development programmes about family-centered care can constitute important strategies to improve the positive attitudes of nurses towards families in practice. PATIENT AND PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Bhavna Sharma
- Baba Farid University of Health Sciences, Faridkot, Punjab, India
| | | | - Rubi Zined
- Department of Genetics, AIIMS, New Delhi, India
| | - Poonam Joshi
- College of Nursing, AIIMS, Kalyani, West Bengal, India
| | - Saumya P Srivastava
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | | | - Shivam Pandey
- Department of Biostatistics, AIIMS, New Delhi, India
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3
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Hsiao CY, Lu HL, Chiu CK, Tsai YF. Factors associated with attitudes of mental health nurses towards the importance of families in mental health nursing care. Int J Ment Health Nurs 2023; 32:1429-1438. [PMID: 37332262 DOI: 10.1111/inm.13187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023]
Abstract
Family involvement in mental healthcare is a key ingredient in the recovery of patients with mental illness. Research on the attitudes of mental health nurses regarding family involvement in mental healthcare remains limited. This study aimed to examine factors that affect the attitudes of mental health nurses towards the importance of family involvement in mental health nursing care. A descriptive, correlational study with a cross-sectional design was conducted with 162 mental health nurses at two psychiatric hospitals in Taiwan. Descriptive statistics, independent t-tests, one-way analysis of variance, and stepwise multiple linear regression analyses were applied to analyse data. Mental health nurses generally demonstrated positive attitudes towards incorporating families into nursing care. Older age, more clinical experiences in mental healthcare, and workplace (such as working in chronic psychiatric inpatient wards) were found to be key factors for mental health nurses' attitudes. Particularly, greater competence in working with families and job satisfaction were the most significant factors associated with positive attitudes of mental health nurses towards involving families as important in nursing care. Insight into correlates of mental health nurses' attitudes towards the importance of focusing on families in care is pivotal for targeted interventions to improve nurses' attitudes towards families and, thus, implement family engagement in mental healthcare practices.
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Affiliation(s)
- Chiu-Yueh Hsiao
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan, Republic of China
- Department of Psychiatry, Chang Gung Memorial Hospital, Tao-Yuan City, Taiwan, Republic of China
| | - Huei-Lan Lu
- Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan, Republic of China
| | - Chin-Kuai Chiu
- Taoyuan Psychiatric Center, Ministry of Health and Welfare, Tao-Yuan City, Taiwan, Republic of China
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan, Republic of China
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan City, Taiwan, Republic of China
- Department of Psychiatry, Chang Gung Memorial Hospital in Keelung, Keelung City, Taiwan, Republic of China
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4
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Wong WK, Ho YWB, To KL, Bressington DT. Attitudes towards family involvement in nursing care among psychiatric nurses in Hong Kong: A cross-sectional descriptive study. J Psychiatr Ment Health Nurs 2023; 30:865-874. [PMID: 36947096 DOI: 10.1111/jpm.12920] [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: 09/10/2022] [Revised: 01/12/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Family-involved interventions can result in better outcomes than traditional mental health care for both service users and their families. Nurses' attitudes towards family involvement can affect family participation in care. Earlier studies on psychiatric nurses' attitudes towards family involvement in care report ambiguous findings. Hong Kong's unique integrated cultures may influence Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The majority of psychiatric nurses had positive views on family involvement in care in Hong Kong. Four variables (i.e. gender, clinical experience, nature of working unit and family nursing training) of psychiatric nurses are associated with their attitudes towards family involvement in care in Hong Kong. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Policy makers should develop strategies to increase psychiatric nurses' awareness of the importance of family involvement in patient care. Nurse educators help to design family nursing training to enhance psychiatric nurses' competence in collaborating with families of people suffering from mental disorders. ABSTRACT INTRODUCTION: In Hong Kong, involving the family in nursing care is still optional and mainly depends on nurses' attitudes and the willingness of the family. Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care may be influenced by the unique integrated Eastern and Western cultures, however earlier studies report ambiguous findings. AIMS This study aimed to assess Hong Kong psychiatric registered nurses' attitudes towards family involvement in care and its associated factors. METHODS This study is a cross-sectional descriptive online survey with convenience sampling based on the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) instrument. RESULTS Most of the psychiatric nurses had supportive attitudes towards family involvement in care. Females with more clinical experience, working in a rehabilitation-related unit and having attended a family nursing education course were associated with positive attitudes towards family involvement in care. DISCUSSION The supportive attitude of psychiatric nurses may be explained by the shift of mental health nursing care from hospital care to community care in recent decades. IMPLICATIONS FOR PRACTICE Mental health nurse education and training in Hong Kong could place more emphasis on building family work skills, particularly for newly qualified nurses and those working in acute inpatient settings.
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Affiliation(s)
- Wai Kit Wong
- School of Nursing, Tung Wah College, Hong Kong, Hong Kong
| | - Ying Wai Bryan Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Alfaro-Díaz C, Esandi N, Pueyo-Garrigues M, Canga-Armayor N, Forjaz MJ, Rodriguez-Blazquez C, Canga-Armayor A. Psychometric Evaluation of the Spanish Families Importance in Nursing Care: Nurses' Attitudes Scale Through Classical Test Theory and Rasch Analysis. JOURNAL OF FAMILY NURSING 2023; 29:179-191. [PMID: 36647194 DOI: 10.1177/10748407221148083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Nurses' attitudes toward families play an important role in improving relationships with patients' families. It is essential to have valid and reliable instruments to assess nurses' attitudes toward involving families. The aim of this study was to analyze the psychometric properties of the refined Spanish version of the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) according to classical test theory and the Rasch model (N = 263). Cronbach's alpha values were .73 to .87 and intraclass correlation coefficients ranged from .72 to .86. Rasch analysis results suggested that it was a multidimensional scale with four dimensions and a simpler response scheme than the original scale. Except for one item, the scale was free from bias regarding age and experience time. The FINC-NA is a reliable and valid measure showing a good fit to the Rasch model and is ready to map nurses' attitudes and measure the effectiveness of family nursing educational interventions.
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Affiliation(s)
- Cristina Alfaro-Díaz
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - Nuria Esandi
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - María Pueyo-Garrigues
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - Navidad Canga-Armayor
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | | | | | - Ana Canga-Armayor
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
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Min J, An KY, Park H, Cho W, Jung HJ, Chu SH, Cho M, Yang SY, Jeon JY, Kim NK. Postoperative inpatient exercise facilitates recovery after laparoscopic surgery in colorectal cancer patients: a randomized controlled trial. BMC Gastroenterol 2023; 23:127. [PMID: 37069526 PMCID: PMC10111844 DOI: 10.1186/s12876-023-02755-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 04/02/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Early mobilization is an integral part of an enhanced recovery program after colorectal cancer surgery. The safety and efficacy of postoperative inpatient exercise are not well known. The primary objective was to determine the efficacy of a postoperative exercise program on postsurgical recovery of stage I-III colorectal cancer patients. METHODS We randomly allocated participants to postoperative exercise or usual care (1:1 ratio). The postoperative exercise intervention consisted of 15 min of supervised exercise two times per day for the duration of their hospital stay. The primary outcome was the length of stay (LOS) at the tertiary care center. Secondary outcomes included patient-perceived readiness for hospital discharge, anthropometrics (e.g., muscle mass), and physical function (e.g., balance, strength). RESULTS A total of 52 (83%) participants (mean [SD] age, 56.6 [8.9] years; 23 [44%] male) completed the trial. The median LOS was 6.0 days (interquartile range; IQR 5-7 days) in the exercise group and 6.5 days (IQR 6-7 days) in the usual-care group (P = 0.021). The exercise group met the targeted LOS 64% of the time, while 36% of the usual care group met the targeted LOS (colon cancer, 5 days; rectal cancer, 7 days). Participants in the exercise group felt greater readiness for discharge from the hospital than those in the usual care group (Adjusted group difference = 14.4; 95% CI, 6.2 to 22.6; P < 0.01). We observed a small but statistically significant increase in muscle mass in the exercise group compared to usual care (Adjusted group difference = 0.63 kg; 95% CI, 0.16 to 1.1; P = 0.03). CONCLUSION Postsurgical inpatient exercise may promote faster recovery and discharge after curative-intent colorectal cancer surgery. TRIAL REGISTRATION The study was registered at WHO International Clinical Trials Registry Platform (ICTRP; URL http://apps.who.int/trialsearch ); Trial number: KCT0003920 .
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Affiliation(s)
- Jihee Min
- National Cancer Survivorship Center, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
- Department of Sport Industry Studies, Exercise Medicine and Rehabilitation Laboratory, Yonsei University, Seoul, Republic of Korea
| | - Ki-Yong An
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Hyuna Park
- National Cancer Survivorship Center, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
| | - Wonhee Cho
- National Cancer Survivorship Center, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
| | - Hye Jeong Jung
- Department of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Sang Hui Chu
- Department of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Minsoo Cho
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Yoon Yang
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Justin Y Jeon
- National Cancer Survivorship Center, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea.
- Exercise Medicine Center for Diabetes and Cancer Patients, Yonsei University, Seoul, Republic of Korea.
- Cancer Prevention Center, Yonsei Cancer Center, Shinchon Severance Hospital, Seoul, Republic of Korea.
- Department of Sports Industry Studies, Yonsei University, Seoul, South Korea.
| | - Nam Kyu Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Petersen JJ, Østergaard B, Svavarsdóttir EK, Palonen M, Brødsgaard A. Hospital and homecare nurses' experiences of involvement of patients and families in transition between hospital and municipalities: A qualitative study. Scand J Caring Sci 2023; 37:196-206. [PMID: 36349680 DOI: 10.1111/scs.13130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 09/08/2022] [Accepted: 10/15/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Involving patients and families in nursing care is essential to improve patients' health outcomes. Furthermore, families play an essential role in supporting patients by helping nurses understand the patient's everyday life. However, families also need support. Involvement of patients and families is especially important when patients are transferred between hospital and home as transitions heighten the risk of compromising quality and safety in care. However, no consensus exists on how to involve them. Consequently, this may challenge a systematic approach toward patient and family involvement. AIM To describe hospital and homecare nurses' experiences with involving patients and their family members in nursing care in the transition between hospital and municipalities. METHOD Focus group interviews were conducted in the Gastro unit at a large university hospital in Denmark. Participants included 10 hospital nurses from three wards at the Gastro unit and six homecare nurses from one of three municipalities in the hospital catchment area (total n = 16). Data were analysed using qualitative content analysis. The study is reported according to the Consolidated Criteria for Reporting Qualitative Research. FINDINGS Our analysis revealed one overall theme - "The complexity of involvement" - based on four categories: gap between healthcare sectors increases the need for patient and family involvement, lack of time is a barrier to patient and family involvement, involvement is more than information, and involvement as a balancing act. CONCLUSION The nurses experienced patients' and families' involvement as essential, but a discrepancy was found between nurses' intentions and their actions. Aspects related to a gap between healthcare sectors and various understandings of involvement challenged the systematic involvement of patients and families in the transition between healthcare sectors. However, the nurses were highly motivated to achieve a close cross-sectoral collaboration and to show commitment towards patients and families.
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Affiliation(s)
- Julie Jacoby Petersen
- Department of Surgical Gastroenterology, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark.,Section for Nursing, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Birte Østergaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Mira Palonen
- Faculty of Social Sciences, health sciences, Tampere University, Tampere, Finland
| | - Anne Brødsgaard
- Section for Nursing, Department of Public Health, University of Aarhus, Aarhus, Denmark.,Department of Paediatrics and Adolescent Medicin, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark
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Barreto MDS, Marquete VF, Camparoto CW, García‐Vivar C, Barbieri‐Figueiredo MDC, Marcon SS. Factors associated with nurses' positive attitudes towards families' involvement in nursing care: A scoping review. J Clin Nurs 2022; 31:3338-3349. [PMID: 35083808 PMCID: PMC9786255 DOI: 10.1111/jocn.16226] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/10/2021] [Accepted: 01/11/2022] [Indexed: 12/30/2022]
Abstract
AIM To map the factors associated with nurses' positive attitudes towards families' involvement in nursing care and to identify any existing gaps in knowledge. BACKGROUND Several tools have been proposed to assess the attitudes, beliefs and practices of nurses towards families in different care contexts. However, there is a knowledge gap on how the results of these tools can identify the factors that are associated with more positive attitudes of nurses. DESIGN A scoping review based on the steps proposed by the Joanna Briggs Institute. METHODS Three independent reviewers searched the databases: PUBMED/Medline; LILACS; Virtual Health Library; PsycInfo; Google Scholar; SCOPUS and CINAHL, from 2006 to August 2021, guided by the question: What are the factors associated with nurses' positive attitudes towards families´ involvement in nursing care, in studies that used one or both of the following two scales 'Families' Importance in Nursing Care- Nurses' Attitudes' and 'Family Nursing Practice Scale'? This review was conducted in accordance with PRISMA-ScR. RESULTS Twenty-six primary studies were identified, in which 9,620 nurses participated. Positive attitudes were associated with three types of variables: (a) personal-longer working career (42.3%) and older age (26.9%); (b) educational-higher level of academic education (30.8%) and family nursing education (23.0%); and (c) workplace-working in primary health care and/or outpatient clinics (34.6%) or in a unit with philosophy/approach to families (23.0%). CONCLUSIONS Personal variables such as age and time of service are non-modifiable aspects, but educational and workplace variables are subject to intervention to improve nurses' attitudes towards families' involvement in nursing care. Continuing development programmes about family care can constitute important strategies to improve positive attitudes of nurses towards families in practice. RELEVANCE TO CLINICAL PRACTICE Recognising the characteristics associated with nurses´ positive attitudes towards families may enable the development of tailored interventions that promote family-focused care.
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Affiliation(s)
| | | | | | - Cristina García‐Vivar
- Department of Health SciencesPublic University of NavarrePamplonaSpain,IdiSNA‐Navarra Institute for Health ResearchPamplonaSpain
| | | | - Sonia Silva Marcon
- Nursing DepartmentPostgraduate Nursing ProgramState University of MaringáMaringáBrazil
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9
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Alfaro-Díaz C, Esandi N, Canga-Armayor N, Idoia Pardavila-Belio M, Pueyo-Garrigues M, Canga-Armayor A. Personal and Contextual Factors to the Successful Implementation of a Family Nursing Approach in Oncology Care. JOURNAL OF FAMILY NURSING 2022; 28:277-291. [PMID: 35414277 DOI: 10.1177/10748407221083071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The aim of this study was to explore nurses' attitudes and beliefs about the importance of families in nursing care, as well as the barriers and facilitators within the clinical context that influence the implementation offamily nursing in an in-patient oncology service. A cross-sectional study design, incorporating quantitative and qualitative measurements, was used with a sample of nurses in Spain from an oncology service (N = 39). In general, oncology nurses reported positive attitudes and beliefs about the importance of family in nursing care. However, they did not effectively involve the family in their daily clinical practice. This was due to the nurses' lack of clinical skills and competence to work with families as well as contextual factors such as the lack of time and workload that acted as barriers to the implementation of family-oriented care. This study identified areas of improvement that are needed to promote the effective and sustainable implementation of family nursing knowledge in clinical practice settings.
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Affiliation(s)
- Cristina Alfaro-Díaz
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Nuria Esandi
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Navidad Canga-Armayor
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | | | - María Pueyo-Garrigues
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Ana Canga-Armayor
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
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10
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Shamali M, Esandi Larramendi N, Østergaard B, Barbieri-Figueiredo M, Brødsgaard A, Canga-Armayor A, Dieperink KB, Garcia-Vivar C, Konradsen H, Nordtug B, Lambert V, Mahrer-Imhof R, Metzing S, Nagl-Cupal M, Imhof L, Svavarsdottir EK, Swallow V, Luttik ML. Nurses' attitudes towards family importance in nursing care across Europe. J Clin Nurs 2022. [PMID: 35818317 DOI: 10.1111/jocn.16456] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/30/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVE To explore differences in nurses' attitudes regarding the importance of family in nursing care and factors associated with nurses' attitudes across 11 European countries. BACKGROUND Family involvement in healthcare has received attention in many European healthcare systems. Nurses have a unique opportunity to promote family involvement in healthcare; however, their attitudes and beliefs may facilitate or impede this practice. DESIGN A cross-sectional survey across European countries. METHOD A broad convenience sample of 8112 nurses across 11 European countries was recruited from October 2017 to December 2019. Data were collected using the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire. We used the STROBE checklist to report the results. RESULTS There were significant differences in nurses' attitudes about families' importance in nursing care across Europe. Country was the factor with the strongest association with the total scores of the FINC-NA. Older age, higher level of education, increased years since graduation, having a strategy for the care of families in the workplace, and having experience of illness within one's own family were associated with a higher total FINC-NA score. Being male and working in a hospital or other clinical settings were associated with a lower total FINC-NA score. CONCLUSION Nurses' attitudes regarding the importance of family in nursing care vary across 11 European countries. This study highlights multiple factors associated with nurses' attitudes. Further research is necessary to gain a deeper understanding of the reasons for nurses' different attitudes and to develop a strong theoretical framework across Europe to support family involvement in patient care. The inclusion of family healthcare programs in the baccalaureate curriculum may improve nurses' attitudes. RELEVANCE FOR CLINICAL PRACTICE In clinical practice, the focus should be on identifying influencing factors on nurses' attitudes to enhance families' importance in nursing care across Europe.
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Affiliation(s)
- Mahdi Shamali
- Department of Gastroenterology, Herlev and Gentofte University Hospital, Copenhagen, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Nuria Esandi Larramendi
- Department of Nursing Care for Adult Patients, School of Nursing, Universidad de Navarra, Pamplona, Spain
| | - Birte Østergaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Maria Barbieri-Figueiredo
- Department of Nursing, University of Huelva, Huelva, Spain.,Department of Population Studies, ICBAS, University of Porto, Porto, Spain
| | - Anne Brødsgaard
- Department of Nursing and Health Care, HEALTH, Aarhus University, Aarhus, Denmark.,Departments of Paediatrics and Adolescent Medicine & Gynaecology and Obstetrics, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark
| | - Ana Canga-Armayor
- Department of Nursing Care for Adult Patients, School of Nursing, Universidad de Navarra, Pamplona, Spain
| | - Karin Brochstedt Dieperink
- Research Unit of Oncology, Odense University Hospital, Odense, Denmark.,Family Focused Healthcare Research Center (FaCe), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Cristina Garcia-Vivar
- Department of Health Sciences, Public University of Navarre, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Hanne Konradsen
- Department of Gastroenterology, Herlev and Gentofte University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhager, Denmark
| | - Bente Nordtug
- Faculty of Nursing and Health Sciences, Nord University, Nordland, Norway
| | - Veronica Lambert
- School of Nursing, Psychotherapy and Community Health, Faculty of Science and Health, Dublin City University, Dublin, Ireland
| | | | - Sabine Metzing
- School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Martin Nagl-Cupal
- Department of Nursing Science, University of Vienna, Vienna, Austria
| | - Lorenz Imhof
- Nursing Science & Care Ltd, Winterthur, Switzerland
| | | | - Veronica Swallow
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Marie Louise Luttik
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands
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11
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Farida F, Livana PH. Family Characteristics Related to Family Support in Caring for Mental Disorder Patients. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Mental disorders currently experience a very significant increase, and every year in various parts of the world the number of people with mental disorders increases. The main symptoms or symptoms that are prominent in mental disorders are in the psychiatric elements, but the main causes may be in the body (somatogenic), in the social environment (sociogenic) or psychic (psychogenic). Usually there is no single cause, but several causes at the same time. which influence each other or happen together, then arises body or soul disorders. The research design using descriptive correlation study with the research subjects were the families of patients who took patients in the psychiatric hospital of Dr. H. Soewondo numbered 145 families taken using accidental sampling technique. Data were analyzed using chi-square test. The results of the study show that there was a relationship between age, sex, and education with family support in caring for Mental disorders (p value <0.005).
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Konradsen H, Kabir ZN, Boström AM, Årestedt K. Comparison of Swedish nurses' attitudes toward involving families in care over a decade. BMC Nurs 2022; 21:52. [PMID: 35236364 PMCID: PMC8888815 DOI: 10.1186/s12912-022-00827-z] [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] [Received: 09/13/2021] [Accepted: 02/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Involving families in care benefits both patients and their families. Sweden was one of the first countries to introduce family nursing, but its effect on nurses’ attitudes toward involving families in care was unknown. First, this study aimed to investigate registered nurses’ attitudes about the importance of involving families in nursing care. Second, it aimed to compare these attitudes over a decade. Methods This comparative study was based on data from two separate studies. Data were collected using the Families Importance in Care – Nurses’ Attitudes questionnaire. The first phase of data collection took place in 2009, and the second phase was conducted in 2019. Results Overall, the nurses were positive towards involving families in care, both in 2009 and 2019. Overall, no significant difference was found between the two studies from 2009 and 2019. On a subscale level, nurses reported significantly higher levels on family as a resource in the study from 2009 compared to the study from 2019. The opposite was shown for the subscales family as a burden and family as an own resource. According to the R2 values (0.002 – 0.04), the effect sizes were small. Conclusion In Sweden, nurses’ attitudes toward involving families in care did not change over the studied decade, despite changes in nursing, healthcare-system, and society.
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Affiliation(s)
- Hanne Konradsen
- Department of Gastroenterology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark. .,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden.
| | - Zarina Nahar Kabir
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
| | - Anne-Marie Boström
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden.,R&D Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.,The Research Section, Region Kalmar County, Kalmar, Sweden
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Cranley LA, Lam SC, Brennenstuhl S, Kabir ZN, Boström AM, Leung AYM, Konradsen H. Nurses' Attitudes Toward the Importance of Families in Nursing Care: A Multinational Comparative Study. JOURNAL OF FAMILY NURSING 2022; 28:69-82. [PMID: 34493109 PMCID: PMC8814953 DOI: 10.1177/10748407211042338] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The aim of this study was to examine nurses' attitudes about the importance of family in nursing care from an international perspective. We used a cross-sectional design. Data were collected online using the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire from a convenience sample of 740 registered nurses across health care sectors from Sweden, Ontario, Canada, and Hong Kong, China. Mean levels of attitudes were compared across countries using analysis of variance (ANOVA). Multiple regression was used to identify factors associated with nurses' attitudes and to test for interactions by country. Factors associated with nurse attitudes included country, age, gender, and several practice areas. On average, nurses working in Hong Kong had less positive attitudes compared with Canada and Sweden. The effects of predictors on nurses' attitudes did not vary by country. Knowledge of nurses' attitudes could lead to the development of tailored interventions that facilitate nurse-family partnerships in care.
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Affiliation(s)
| | | | | | | | - Anne-Marie Boström
- Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Stockholm, Sweden
- Stockholms Sjukhem, Sweden
- University of Alberta, Edmonton, Canada
| | | | - Hanne Konradsen
- Karolinska Institutet, Stockholm, Sweden
- University of Copenhagen, Denmark
- Herlev and Gentofte Hospital, Denmark
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Barber B, Weeks L, Steeves-Dorey L, McVeigh W, Stevens S, Moody E, Warner G. Hospital to Home: Supporting the Transition From Hospital to Home for Older Adults. Can J Nurs Res 2021; 54:483-496. [PMID: 34704507 PMCID: PMC9597142 DOI: 10.1177/08445621211044333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background An increasing proportion of older adults experience avoidable
hospitalizations, and some are potentially entering long-term care homes
earlier and often unnecessarily. Older adults often lack adequate support to
transition from hospital to home, without access to appropriate health
services when they are needed in the community and resources to live safely
at home. Purpose This study collaborated with an existing enhanced home care program called
Home Again in Nova Scotia, to identify factors that contribute to older
adult patients being assessed as requiring long-term care when they could
potentially return home with enhanced supports. Methods Using a case study design, this study examined in-depth experiences of
multiple stakeholders, from December 2019 to February 2020, through analysis
of nine interviews for three focal patient cases including older adult
patients, their family or friend caregivers, and healthcare
professionals. Results Findings indicate home care services for older adults are being sought too
late, after hospital readmission, or a rapid decline in health status when
family caregivers are already experiencing caregiver burnout. Limitations in
home care services led to barriers preventing family caregivers from
continuing to care for older adults at home. Conclusions This study contributes knowledge about gaps within home care and transitional
care services, highlighting the importance of investing in additional home
care services for rehabilitation and prevention of rapidly deteriorating
health.
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Affiliation(s)
- Brittany Barber
- Faculty of Health, 3688Dalhousie University, Halifax, NS, Canada
| | - Lori Weeks
- School of Nursing, 3688Dalhousie University, Halifax, NS, Canada
| | - Lexie Steeves-Dorey
- Rehabilitations & Supportive Care, 432234Nova Scotia Health, Halifax, NS, Canada
| | - Wendy McVeigh
- Continuing Care Central Zone, 432234Nova Scotia Health, Halifax, NS, Canada
| | - Susan Stevens
- Continuing Care, 432234Nova Scotia Health, Halifax, NS, Canada
| | - Elaine Moody
- School of Nursing, 3688Dalhousie University, Halifax, NS, Canada
| | - Grace Warner
- School of Occupational Therapy, 3688Dalhousie University, Halifax, NS, Canada
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Geng GL, Yang WW, Shi XL, Hua JN, Cui M, Yang CFY, Geng ZH, Qian XY. Factors Associated With Informational Support in Transitional Care for Older Adults With Chronic Diseases: A Cross-Sectional Study. Clin Nurs Res 2021; 31:329-339. [PMID: 34628980 DOI: 10.1177/10547738211051881] [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: 11/17/2022]
Abstract
To evaluate the current situation and associated factors of informational support for older adults with chronic diseases in transitional care. Study was conducted in five hospitals of five different cities in Jiangsu Province, China. A random cluster sample of 800 older adults with chronic diseases responded to the informational support questionnaire of transitional care survey. Descriptive analysis, t-tests, variance analysis, and stepwise multiple linear regression were used to analyze data. The STROBE statement for observational studies was applied. Total score of ISQTC for older adults with chronic diseases was (44.05 ± 17.21). Marital status, educational level, past occupation, close friends, medical insurance, complications, and exercise habits were significantly correlated with informational support. The level of informational support in transitional care for older adults with chronic diseases was low. Clinical staff should periodically and primarily assess their informational support, help find information resources for those who have low initial informational support, and identify which information they preferred to carry out accurate transitional care.
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Affiliation(s)
| | | | - Xiao-Liu Shi
- Nantong University, Jiangsu, China.,Affiliated Hospital of Nantong University, Jiangsu, China
| | - Jia-Ning Hua
- Nantong University, Jiangsu, China.,Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Min Cui
- Nantong University, Jiangsu, China
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Andersson L, Almerud Österberg S, Årestedt K, Johansson P. Nurse anesthetist attitudes towards parental presence during anesthesia induction- a nationwide survey. J Adv Nurs 2021; 78:1020-1030. [PMID: 34462946 DOI: 10.1111/jan.15031] [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: 01/22/2021] [Revised: 07/14/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
AIMS To describe nurse anesthetists' attitudes towards the importance of parental presence during their child's anaesthesia induction and to explore associating factors. DESIGN A cross-sectional design. METHODS Nurse anesthetists from 55 Swedish hospitals were asked to participate (n = 1,285). A total of 809 completed the questionnaire, Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) during 2018. Data were analysed by descriptive statistics and multiple linear regression analysis. RESULTS Nurse anesthetists generally had a positive attitude towards the importance of parental presence. They reported a more positive attitude in family as a resource in nursing care (median = 40) followed by family as a conversational partner (median = 25), family not as a burden (median = 17) and family as its own resource (median = 13). Multiple linear regression analyses showed that working in a district hospital, working only with children, having routines/memorandum about parental presence, being a woman, allowing both parents to be present in their child's anaesthesia and greater experience of children's anesthesia, were associated with a more positive attitude. CONCLUSION This nationwide survey contributes important knowledge for understanding nurse anesthetists' attitudes and the result shows that nurse anesthetists generally have a positive attitude towards the importance of parents. Areas of improvement were, however, identified; the nurses tend to not value family as its own resource and family as a conversational partner highly. IMPACT Nurse anesthetists have a crucial role in children's anesthesia care since the quality of parental presence experience depends on a positive attitude from the nurses. Parental involvement is important to establish a child-centered anaesthesia care, which should be highlighted in the education of nurse anesthetists. Parental involvement should also be addressed in healthcare policies and routines should be established.
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Affiliation(s)
- Lisbet Andersson
- Faculty of Health and Caring Science, Linnaeus University, Växjö, Sweden
| | - Sofia Almerud Österberg
- Faculty of Health and Caring Science, Linnaeus University, Växjö, Sweden.,Department of Anesthesiology, Kronoberg County Council, Växjö, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Caring Science, Linnaeus University, Växjö, Sweden.,The Research Section, Region Kalmar County, Kalmar, Sweden
| | - Pauline Johansson
- Faculty of Health and Caring Science, Linnaeus University, Växjö, Sweden
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Fernandes CS, Magalhães B, Silva S, Edra B. (Re)'Thinking' family in nursing care in pandemic times. Int Nurs Rev 2021; 69:47-57. [PMID: 34409599 DOI: 10.1111/inr.12708] [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] [Received: 01/29/2021] [Revised: 07/19/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to identify which strategies are being adopted to deal with family restrictions in health units and assess nurses' perceptions of including families in nursing care during the current pandemic. BACKGROUND Due to the COVID-19 pandemic, health organisations limited access for visitors. INTRODUCTION Family centred care needs to be guaranteed, and alternatives for face-to-face interaction should be fostered. Therefore, there is an urgent need to rethink the family in nursing care during a pandemic. METHODS We conducted a descriptive exploratory mixed-method study in Portugal using an electronic questionnaire. The study included 192 nurses recruited using a non-probabilistic convenience sample. The study was reported using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS A total of 41.1% of participants (n = 79) reported that visits to their services were not authorised, and 66.7% (n = 128) reported resorting to video calls because of the restrictions imposed. Regarding attitude assessment, the average score of the scale was 77.9 (SD = 10.0), ranging between 26 and 98. When analysing the different dimensions of the 'Families' Importance in Nursing Care - Nurses Attitudes' scale, family data stand out as a burden. CONCLUSION Although a large percentage of participants had a positive attitude towards families and tried to find strategies to maintain family centred care, many nurses still considered the family as a burden. The current COVID-19 pandemic may have aggravated this perception. IMPLICATIONS FOR NURSING PRACTICE, NURSING POLICY AND HEALTH POLICY: The continued implementation of family centred nursing practice is essential for child-well-being, including during the current pandemic. Therefore, having intervention policies with alternative forms of care is highly recommended.
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Affiliation(s)
- Carla Sílvia Fernandes
- Nursing School of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Bruno Magalhães
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal.,Santa Maria Health School, Porto, Portugal
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Naef R, Schmid-Mohler G, Ernst J. Psychometric evaluation of the German version of the instrument: Families' Importance in Nursing Care - Nurses' Attitudes (FINC-NA). Scand J Caring Sci 2020; 35:328-339. [PMID: 33128295 DOI: 10.1111/scs.12924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/18/2020] [Accepted: 10/05/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The involvement of families in care has long been advocated for acute and critical care settings to improve quality and safety of care. Nurses' attitudes towards families influence the way they involve and partner with families in the planning and delivery of care. Therefore, instruments with proven psychometric properties are necessary to assess the attitudes of nurses towards involving families in nursing care. AIMS To cross-culturally adapt and psychometrically test the German version of the Families' Importance in Nursing Care - Nurses' Attitudes (FINC-NA) scale with acute and critical care nurses. METHODS A cross-sectional study was carried out with 316 acute-critical care nurses, who filled in the FINC-NA between December 2016 and May 2018. Exploratory factor analysis was performed to assess structural validity. Internal consistency and homogeneity were determined using Cronbach's alpha. RESULTS The four-factor structure of the FINC-NA - family as partner in care, family as resource in nursing care, family as their own resource and family as burden - was confirmed in the German version. Due to low primary and multiple loadings, seven items were removed. Moreover, five items loaded on different factors than the original version. Cronbach's alpha of factors ranged between 0.68 and 0.86. CONCLUSION The cross-cultural adaptation and psychometric testing of the German version of the FINC-NA resulted in a 19-item scale that measure nurses' attitudes towards the importance of families in nursing care. Further testing is needed to refine the structural validity and establish construct validity of the FINC-NA German version.
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Affiliation(s)
- Rahel Naef
- Center of Clinical Nursing Science, University Hospital Zurich, Switzerland.,Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | | | - Jutta Ernst
- Center of Clinical Nursing Science, University Hospital Zurich, Switzerland
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Skuladottir A, Sigurdardottir AO, Svavarsdottir EK. The better sleep better well-being programme: Educating and training community healthcare nurses in developing interventions for families of infants with moderate sleep problems: a pilot study. Scand J Caring Sci 2020; 35:268-276. [PMID: 32240544 DOI: 10.1111/scs.12844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/09/2020] [Indexed: 11/30/2022]
Abstract
The main aim of this pilot study was to evaluate the benefit of the Better Sleep Better Well-being (BSBW) educational and training intervention programme regarding infants sleep problems for Community Health Care (CHC) nurses, on their perceptions on their family nursing practice skills and on their job demand, control and support. There were 6 CHC nurses who participated in the BSBW programme, and 26 nurses in the comparison group. The programme consisted of 4 sessions (8 hours per session) of lectures on the aetiology of infants sleep problems as well as on evidence-based and family relational practices and on 20 sessions of clinical cases, scenarios, discussions and reflections. The main finding indicated that the nurses in the intervention group reported significantly higher family nursing practices skills compared to the nurses in the comparison group. The findings are promising, since they offered additional resources to the CHC nurses, in their clinical practices.
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Imanipour M, Kiwanuka F. Family nursing practice and family importance in care – Attitudes of nurses working in intensive care units. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2020.100265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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