Associations between provider communication and personal recovery outcomes

Trauma nursing competency in the emergency department: a concept analysis

OBJECTIVES

Despite numerous published concept analyses of nursing competency, the specific understanding of trauma nursing competency in emergency departments remains limited, with no clear definition. This study aimed to clarify the definitions and attributes of trauma nursing competencies in emergency departments.

DESIGN

Walker and Avant's method was used to clarify the concept of trauma nursing competency in emergency departments.

DATA SOURCES

PubMed, EMBASE, CINAHL and RISS were searched from inception to 23 April 2023.

ELIGIBILITY CRITERIA

Relevant studies that included combinations of the terms 'nurse', 'nursing', 'emergency', 'trauma', 'competency', 'capability' and 'skill' were selected. We restricted the literature search to English and Korean full-text publications, with no limit on the publication period; grey literature was excluded.

DATA EXTRACTION AND SYNTHESIS

This study uses defining attributes, antecedents and consequences extracted through data analysis. To aid comprehension of the model, related and contrary cases of the concept were created, and empirical referents were defined.

RESULTS

After excluding duplicates, irrelevant studies, incomplete texts and articles unrelated to the context and study population, 15 of the initial 927 studies were included. Five additional studies were added after a manual search of the references. The final concept analysis therefore included 20 studies. The attributes of trauma nursing competency for emergency nurses included 'rapid initial assessments considering injury mechanisms', 'priority determinations based on degrees of urgency and severity', 'clinical knowledge of trauma nursing', 'skills of trauma nursing', 'interprofessional teamwork' and 'emotional care'.

CONCLUSIONS

The concept analysis revealed that it is possible to promote the enhancement and development of trauma nursing competency in emergency departments across various contexts, such as clinical practice, education, research and organisational settings. This could ultimately improve trauma nursing quality and treatment outcomes.

Validation of the Korean Version of Patient-Centered Care Tool: For Outpatients

Aim

The objective of this study was to assess the validity and reliability of the Korean version of the patient-centered care (K-PCC) instrument for outpatients. The study was conducted due to the absence of a measurement tool specifically designed to evaluate patient-centered care for outpatients.

Design

This study is a methodological study to verify the validity and reliability of the Korean version of Patient-Centered Care (K-PCC) to measure patient-centeredness for outpatients.

Methods

As a first step for the evaluation of the tool, the content validity was verified by expert panel. Then, a total of 400 outpatients were recruited, and construct validity was verified through confirmatory factor analysis (CFA) as the second step for the evaluation of the tool. The convergent and discriminant validity of the tool was verified by calculating the standardized factor loads, construct reliability (CR), and average variance extracted (AVE), and calculating the correlation square between the factors as the third and fourth steps for the evaluation of the tool. And as a fifth step for the evaluation of the tool, criterion validity was evaluated by comparing the correlation with the patient-centeredness measurement tool for inpatients (PEx-inpatient). In estimating reliability, internal consistency reliability coefficients were calculated.

Results

The confirmatory factor analysis supported good fit for the Korean patient-centered care instrument (K-PCC), and the eight-factor structure was validated. The scale comprises 21 items across eight factors: patient preferences (4 items), physical comfort (2 items), coordination of care (2 items), continuity and transition (3 items), emotional support (2 items), access to medical care (3 items), information and education (2 items), and family and friends (3 items). The Cronbach's alphas ranging between 0.73 and 0.88.

Conclusion

The Korean patient-centered primary care instrument is a valid and reliable scale to measure patient-centered care for outpatients in the Korean medical environment.

Models of service delivery in adult cochlear implantation and evaluation of outcomes: A scoping review of delivery arrangements

BACKGROUND

This study aimed to describe available evidence of cochlear implantation delivery arrangements in adults and the outcomes by which these service models are measured.

METHODS

Scoping review of English language, primary studies conducted on adults (≥18 years) with ten or more subjects, published between January 2000 and June 2022, which assessed the effects of delivery arrangements of cochlear implantation were included. MEDLINE, EMBASE, CINAHL Plus, AMED, PsycINFO, LILACS, KoreaMed, IndMed, Cochrane CRCT, ISRCTN registry, WHO ICTRP and Web of Science were systematically searched. Included studies had to have a method section explicitly measure at least one of the Cochrane Effective Practice and Organization of Care (EPOC) outcome category. Criteria for systematic reviews and delivery arrangement category based on EPOC taxonomy was included in data extraction. Data was narratively synthesized based on EPOC categories.

RESULTS

A total of 8135 abstracts were screened after exclusion of duplicates, of these 357 studies fulfilled the inclusion criteria. Around 40% of the studies investigated how care is delivered, focusing on quality and safety systems. New care pathways to coordinate care and the use of information and communication technology were emerging areas. There was little evidence on continuity, coordination and integration of care, how the workforce is managed, where care is provided and changes in the healthcare environment. The main outcome measure for various delivery arrangements were the health status and performance in a test.

CONCLUSION

A substantial body of evidence exists about safety and efficacy of cochlear implantation in adults, predominantly focused on surgical aspects and this area is rapidly growing. There is a lack of evidence on aspects of care delivery that may have more impact on patients' experience such as continuity, coordination and integration of care and should be a focus of future research. This would lead to a better understanding of how patient's view CI experience, associated costs and the value of different care models.

Culture-dependent and universal constructs and promoting factors for the process of personal recovery in users of mental health services: qualitative findings from Japan

BACKGROUND

The conceptualization of personal recovery began in Europe and North America and has spread worldwide. However, the concept of personal recovery in addition to recovery-promoting factors may be influenced by culture. We explored how users of mental health services in Japan perceive their own personal recovery and the factors that promote it.

METHODS

We conducted semi-structured interviews and focus group interviews with individuals using mental health services. The interview data were analysed using thematic analysis with a grouped framework analysis approach. We used a coding framework based on the existing CHIME framework (connectedness, hope and optimism about the future, identity, meaning in life, and empowerment).

RESULTS

Data were obtained from 30 users of mental health services (mean age: 40.4 years; 46.7% women; 50.0% with schizophrenia). "Compassion for others" was newly extracted in "Connectedness", and "Rebuilding/redefining identity not being as shaped by social norms" was newly extracted in "Identity" as personal recovery. "Positive experiences in childhood" (including positive parenting support from neighbours) was newly extracted as a recovery-promoting factor.

CONCLUSIONS

Our unique findings on the rebuilding identity/defining identity free from conformity to social norms due to interactions with familiar people, including peers, may be culture dependent. This study raises overarching questions regarding how socio-cultural values influence the development of identity and personal values and how they are in turn reflected in personal recovery.

Associations between patient experience and clinical outcomes in general mental health clinics: Findings from the veterans outcomes assessment survey

For mental health, evidence linking the patients' experiences of care with treatment outcomes is limited. We report findings from the Veterans Outcome Assessment (VOA) survey of Veterans beginning treatment in Veterans Health Administration (VHA) mental health programs with follow-up after approximately 3 months. In addition to assessments of symptoms and functioning, it includes key components of the Experience of Care and Health Outcomes (ECHO) survey including patient reports of communication with clinicians and of the overall quality of mental health care. For Veterans treated in VHA general mental health clinics, significant associations between ratings of communication and quality at baseline, and both retention in treatment and patient-reported outcomes assessed at follow-up demonstrate that better patient experience predicts more favorable outcomes. Further research is necessary to determine whether including them in measurement-based care could improve outcomes by facilitating the early identification of problems in providing care.

Consumer and Family Perspectives to Achieve Mental Health Equity

Severe mental health disparities exist in the United States, with reduced access to community-based care and poorer recovery outcomes associated with people of color, women, and lesbian, gay, bisexual, or transgender individuals. One strategy to reduce these disparities is to incorporate the perspectives of mental health consumers and their families into care planning and delivery. Successful integration of personal experience with evidence-based interventions can help reduce stigma and improve retention in care. To leverage public policy to reduce mental health disparities, New York City has launched ThriveNYC, the nation's largest municipal-level investment in mental health.