Assessing nursing staff's competences in mobility support in nursing-home care: development and psychometric testing of the Kinaesthetics Competence (KC) observation instrument

[The development of kinaesthetic competence in acute inpatient care: a feasibility study with a pre-posttest design]

The development of kinaesthetic competence in acute inpatient care: a feasibility study with a pre-posttest design Abstract: Background: Most patients in acute care hospitals experience movement limitations due to surgery or a general deterioration of their condition. Therefore, nurses need a high level of competence in movement promotion. Aim: The aim of this study was to evaluate the feasibility of a three-day advanced kinaesthetics training course followed by six months of practical support to promote kinaesthetic competence in inpatient acute care and the competence development achieved as a result. Methods: The evaluation of the nurses' effectiveness was conducted using a pre- and post-measurement of kinaesthetic competence through a self-assessment questionnaire and an observation protocol. The evaluation of feasibility was done through a semi-structured questionnaire. Results: Eight nurses rated their kinaesthetics competence as good before (mean: 10,8 on a scale of 4-16) and very good after the intervention (mean: 13,2). The kinaesthetics trainer assessed the competence before as sufficient (mean: 9,4 on a scale of 4-16) and very good (mean: 14,5) after the practical support. The need to make practical support more flexible is highlighted in the qualitative data. Conclusion: The results demonstrate that a three-day training followed by six months of practical support has a positive impact on nurses' kinaesthetic competence.

Effect of an educational intervention on nurses' competence in activities of daily living support in end-of-life care using a pretest-posttest repeated measures design

BACKGROUND

Most patients in specialized palliative care units need nursing support to perform activities of daily living (ADL), such as using a toilet or transferring out of a bed or chair. To deliver high-quality ADL support that facilitates patients' movement and protects nurses' musculoskeletal health, nurses need appropriate knowledge and skills. The objective of this study is to investigate the impact of education based on the "Advanced Kinaesthetics in Palliative care (AdKinPal) program" on the competence in Kinaesthetics, self-efficacy regarding ADL support in end-of-life care and musculoskeletal complaints of nurses from specialist palliative care units.

METHODS

A pretest-posttest repeated measures design was applied. The study took place in three specialised units for palliative care in Switzerland between June 2018 and April 2020. All the nurses who worked in participating wards (n = 62) and fulfilled the inclusion criteria were asked to participate. The intervention - the AdKinPal program - is an education-based training program conducted for six months. We took measurements using self-administered questionnaires at three points before and after the intervention. Using descriptive statistics, repeated measurement analysis of variance (ANOVA) and independent-samples t-tests, we analysed the participants' demographic characteristics as well as developments over time and relationships between the three outcome variables: Kinaesthetics competence, self-efficacy regarding ADL support in end-of-life care and musculoskeletal complaints.

RESULTS

Fifty-nine nurses and one physiotherapist participated, and 38 participants (63%) responded to all three questionnaires. The AdKinPal training improved the nurses' perceived Kinaesthetics competence and self-efficacy regarding ADL support in end-of-life care. Participants who reported lower back, neck or shoulder pain had a significantly lower Kinaesthetics competence.

CONCLUSIONS

The AdKinPal program can raise nurses' Kinaesthetics competence. Thereby, patients' autonomy and quality of life could be supported, and symptom management could be enhanced in a holistic manner. Furthermore, the AdKinPal program fosters nurses' self-efficacy in ADL support in end-of-life care. A strong sense of self-efficacy enhances professional well-being in many ways. Additionally, the nursing staff's musculoskeletal health can be promoted by enhancing their Kinaesthetics competence.

TRIAL REGISTRATION

DRKS00015908. Registration Date 23.11.2018.

Exploring the effect of problem based facilitatory teaching approach on motivation to learn: a quasi-experimental study of nursing students in Tanzania

Background

Academic motivation is most important as a key determinant of competent and motivated nurses who are often considered as frontline healthcare providers who devote most of their time taking care of clients and patients. However, most of them demonstrate remarkable differences in their academic performances during their schooling that might be due to the differences in their academic motivation and achievement motivation. There appears a growing concern to rethink the approaches on how nurses are prepared, explore, and test novel approaches for delivering the nursing curricula. This study tested the effect of Problem Based Facilitatory Teaching pedagogy on academic motivation among nursing students in Tanzania, higher learning institutions.

Methods

A pre-post-test controlled quasi-experimental study of 401 purposively selected participants was conducted between February and June 2018. The study was not a clinical randomized controlled trial and thus it has not been identified in the title and no summary of trial design, its methods, results, and conclusion. The Auditing Inventory developed by the researcher measured the intervention and a Questionnaire titled “Academic Motivation Scale,” was adopted to measure academic motivation. Statistical Product for Service Solutions software program version 23 was used to perform descriptive analysis to establish participants’ sociodemographic profiles. Regression analysis was performed to determine the association between variables.

Results

Findings revealed that 65.8% of participants were males. Post-test findings showed 70.3% of participants demonstrated the motive to learn contrary to 34.9% at baseline. The odds of an intervention to influence academic motivation among participants was higher than the control (AOR = 1.720; p < 0.05; 95%CI: 1.122, 2.635). However, the intervention demonstrated little influence on the extrinsic motivation to learn (AOR = 0.676, p > 0.05, 95%CI: 0.405, 1.129) and Amotivation to learn (AOR = 0.538, p > 0.05; 95%CI: 0.283, 1.022) compared to the control.

Conclusion

The Problem Based Facilitatory Teaching pedagogy was a predictive factor to intrinsic academic motivation among nursing students. The approach demonstrated educational potentials to change the spectrum of nursing competency and quality of care to patients or clients. This study suggests problem-based facilitatory teaching pedagogy be integrated into the nursing curriculum in Tanzania as it is feasible.

The Development of a Standardized Framework for Primary Nurse Specialists in Diabetes Care in China: A Delphi Study

BACKGROUND

The number of patients with diabetes has been increasing rapidly according to a 2017 report by the International Diabetes Federation. Diabetes has become one of the most challenging public health problems, and there will be an estimated 143 million patients with diabetes in China by 2035. This puts considerable pressure on nurses who specialize in the care of patients with diabetes in China and increases related social and financial burdens. Clinical practice has proven that strengthening the core competencies of nurses and establishing an evaluation system of core competencies improve both healthcare quality and patient quality of life. However, no core-competence system framework currently addresses the unique characteristics of nurses in China.

PURPOSES

The purpose of this study was to construct a core-competence system framework for primary nurse specialists in diabetes care.

METHODS

A brainstorming approach was conducted that worked to conceptualize the core competencies of nurse specialists in diabetes care in China. Next, a study group organized this information and conducted a seminar; 50 experts and patients with diabetes were invited to develop the first draft of the framework. Afterward, 50 experts were selected to participate in the Delphi survey. Most indicators were retained after a three-round Delphi process, and the superiority chart was used to determine the weights of the six dimensions.

RESULTS

Forty-seven experts completed the consultation. The experts' rate of response ranged from 94% to 100%, the authority coefficient was .91, and the Kendall's coefficients of concordance in Grades 1-3 were .793, .418, and .542, respectively. An increasingly detailed, three-grade system framework was developed, including six first-grade indicators (diabetes professional knowledge, diabetes-related knowledge, communication skills and health education ability, specialized skills, clinical judgment, and specialty development capacity), 23 second-grade indicators, and 87 third-grade indicators. The weights of the six first-grade indicators were .221, .149, .192, .209, .160, and .069, respectively.

CONCLUSIONS

The core-competence system framework includes six core competencies, which represent the main characteristics of primary nurse specialists in diabetes care who are highly recommended by experts. It is important to keep in mind that this is only a theoretical framework and thus must be further tested in clinical practice settings in China.

The self-reported and observed competence of nursing staff in mobility care based on Kinaesthetics in nursing homes - A cross-sectional study

BACKGROUND

The majority of care-dependent persons living in nursing homes have mobility impairment affecting the physical, psychological, and social aspects of the persons' lives. Therefore, nursing staff needs competence to provide good mobility enhancing care.

AIM

This study assesses the self-reported and observed competence of nursing home staff in mobility care based on Kinaesthetics in order to increase attention about nursing staff's impact on nursing home residents' mobility.

METHODS

A cross-sectional study design involving a survey and an observational study was employed. Survey data were collected using the Kinaesthetics Competence Self-Evaluation (KCSE) scale. For the observational study, data were collected with a video camera and rated using the Kinaesthetics Competence Observation (KCO) instrument. Data were analysed using descriptive statistics, correlation methods and a generalised linear model.

RESULTS

The majority of survey participants (n = 180) indicated their competence in mobility care based on Kinaesthetics as very good (mean score 13, SD 1.44, on a scale from 4 to 16). The observed competence of nursing staff (n = 40) was good (mean score 10.8, SD 2.44, out of a possible score from 4 to 16). Positive correlations were found between self-reported or observed competence in mobility care based on Kinaesthetics and employment rate, work experience in nursing home care and Kinaesthetics training.

CONCLUSION

A combined assessment of self-evaluation and observation is recommended in order to get a comprehensive picture of knowledge, skills, attitude and dynamic state of nursing staffs' competence in mobility care based on Kinaesthetics.

[Mutual guiding and following of movement - The interaction process in mobilisation based on the example of kinaesthetics: A qualitative study]

Background: Mobility impairment is often seen as a reason for needing long-term care. Thus, promoting mobility becomes increasingly significant in nursing homes. The kinaesthetic approach offers a way to support nursing home residents in using their own resources to maintain or improve their mobility. Aim: The present study intends to identify the characteristics of the interaction between nursing home residents with impaired mobility and kinaesthetic trainers during mobilisation. Methods: This secondary analysis comprises nine video sequences interpreted according to Grounded Theory-principles. The findings are described in a basic model. Results: The interaction with nursing home residents is focused on adapted movement support. This assistance shows a positive effect on residents’ self-activity in the tracking process and in the context of other strategies. Intervening conditions like residents’ daily constitution have an influence on nurses’ kinaesthetic strategies. Thereby, nurses have to be highly competent in self-perception. Conclusion: Adapted movement support proves to be a phenomenon basing on the nurse-resident-interaction and allowing residents to actively participate in collaborative action.

Mobility care in nursing homes: development and psychometric evaluation of the kinaesthetics competence self-evaluation (KCSE) scale

BACKGROUND

Impaired mobility is a prevalent condition among care-dependent persons living in nursing homes. Therefore, competence development of nursing staff in mobility care is important. This study aimed to develop and initially test the Kinaesthetics Competence Self-Evaluation (KCSE) scale for assessing nursing staff's competence in mobility care.

METHODS

The KCSE scale was developed based on an analysis of the concept of nurses' competence in kinaesthetics. Kinaesthetics is a training concept that provides theory and practice about movement foundations that comprise activities of daily living. The scale contains 28 items and four subscales (attitude, dynamic state, knowledge and skills). Content validity was assessed by determining the content validity index within two expert panels. Internal consistency and construct validity were tested within a cross-sectional study in three nursing homes in the German-speaking region of Switzerland between September and November 2015.

RESULTS

The content validity index for the entire scale was good (0.93). Based on a sample of nursing staff (n = 180) the internal consistency results were good for the whole scale (Cronbach's alpha = 0.91) and for the subscales knowledge and skills (α = 0.91, 0.86), acceptable for the subscale attitude (α = 0.63) and weak for the subscale dynamic state (α = 0.54). Most items showed acceptable inter-item and item-total correlations. Based on the exploratory factor analysis, four factors explaining 52% of the variance were extracted.

CONCLUSION

The newly developed KCSE scale is a promising instrument for measuring nursing staff's attitude, dynamic state, knowledge, and skills in mobility care based on kinaesthetics. Despite the need for further psychometric evaluation, the KCSE scale can be used in clinical practice to evaluate competence in mobility care based on kinaesthetics and to identify educational needs for nursing staff.