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Kassymova G, Sydsjö G, Borendal Wodlin N, Nilsson L, Kjølhede P. The Impact of Symptoms of Depression, Anxiety, and Low Stress-Coping Capacity on the Effects of Telephone Follow-Up on Recovery Measures After Hysterectomy. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:304-318. [PMID: 38558946 PMCID: PMC10979684 DOI: 10.1089/whr.2023.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 04/04/2024]
Abstract
Background To investigate if symptoms of depression, anxiety, and stress-coping capacity have an impact on the effect of telephone follow-up (TFU) on trajectories of six recovery measures after hysterectomy and influence the occurrence of unplanned telephone contacts (uTCs) and unplanned visits (uVs) to health care providers. Material and Methods A post hoc nonrandomized analysis of participants enrolled in a randomized, four-armed, single-blinded, controlled multicenter intervention study comprising 487 women where the women were allocated 1:1:1:1 to one of four TFU models. The Swedish Postoperative Symptom Questionnaire (SPSQ) and two health-related quality of life questionnaires, the EuroQoL-5 dimension with three levels (EQ-5 D-3 L) and the Short-Form-Health Survey (SF-36) assessed the recovery measures. The six recovery measures consisted of the EQ-5D-3L health index, the SF-36 physical component summary (PCS) and mental component summary (MCS), and the maximum and average pain intensity, and symptom sum score obtained from the SPSQ. Psychological distress was evaluated by the psychometric forms, the Hospital Anxiety and Depression Scale and the Stress Coping Inventory. The occurrence of uTC and uV within the 6 weeks of follow-up was registered. Results Preoperative anxiety, depression, and stress-coping capacity did not modify the effects of the TFU models on the trajectories of the recovery measures, although anxiety and depression were strongly associated with all six recovery measures. uTCs, but not uVs occurred more often in the women with anxiety. Conclusions Preoperative anxiety, depression, and stress-coping capacity did not appear to influence the effects of TFU contacts on the recovery measures after hysterectomy. Preoperative anxiety seemed to increase the occurrence of uTC. Clinical Trials Registration: ClinicalTrials.gov (NCT01526668).
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Affiliation(s)
- Gulnara Kassymova
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, and Linköping University, Linköping, Sweden
| | - Gunilla Sydsjö
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, and Linköping University, Linköping, Sweden
| | - Ninnie Borendal Wodlin
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, and Linköping University, Linköping, Sweden
| | - Lena Nilsson
- Department of Biomedical and Clinical Sciences, and Linköping University, Linköping, Sweden
- Department of Anesthesiology and Intensive Care, Linköping University, Linköping, Sweden
| | - Preben Kjølhede
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, and Linköping University, Linköping, Sweden
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Bull LM, Arendarczyk B, Reis S, Nguyen A, Werr J, Lovegrove-Bacon T, Stone M, Sherlaw-Johnson C. Impact on all-cause mortality of a case prediction and prevention intervention designed to reduce secondary care utilisation: findings from a randomised controlled trial. Emerg Med J 2023; 41:51-59. [PMID: 37827821 DOI: 10.1136/emermed-2022-212908] [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: 10/14/2022] [Accepted: 09/03/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Health coaching services could help to reduce emergency healthcare utilisation for patients targeted proactively by a clinical prediction model (CPM) predicting patient likelihood of future hospitalisations. Such interventions are designed to empower patients to confidently manage their own health and effectively utilise wider resources. Using CPMs to identify patients, rather than prespecified criteria, accommodates for the dynamic hospital user population and for sufficient time to provide preventative support. However, it is unclear how this care model would negatively impact survival. METHODS Emergency Department (ED) attenders and hospital inpatients between 2015 and 2019 were automatically screened for their risk of hospitalisation within 6 months of discharge using a locally trained CPM on routine data. Those considered at risk and screened as suitable for the intervention were contacted for consent and randomised to one-to-one telephone health coaching for 4-6 months, led by registered health professionals, or routine care with no contact after randomisation. The intervention involved motivational guidance, support for self-care, health education, and coordination of social and medical services. Co-primary outcomes were emergency hospitalisation and ED attendances, which will be reported separately. Mortality at 24 months was a safety endpoint. RESULTS Analysis among 1688 consented participants (35% invitation rate from the CPM, median age 75 years, 52% female, 1139 intervention, 549 control) suggested no significant difference in overall mortality between treatment groups (HR (95% CI): 0.82 (0.62, 1.08), pr(HR<1=0.92), but did suggest a significantly lower mortality in men aged >75 years (HR (95% CI): 0.57 (0.37, 0.84), number needed to treat=8). Excluding one site unable to adopt a CPM indicated stronger impact for this patient subgroup (HR (95% CI): 0.45 (0.26, 0.76)). CONCLUSIONS Early mortality in men aged >75 years may be reduced by supporting individuals at risk of unplanned hospitalisation with a clear outreach, out-of-hospital nurse-led, telephone-based coaching care model.
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Affiliation(s)
- Lucy M Bull
- Modelling and Insights, Health Navigator, London, UK
| | | | - Sara Reis
- Modelling and Insights, Health Navigator, London, UK
| | - An Nguyen
- Data Science and Strategy, Health Navigator, London, UK
| | | | - Thomas Lovegrove-Bacon
- Strategic Development, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - Mark Stone
- North Place Clinical Lead, Staffordshire and Stoke ICB, Stafford, UK
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Vázquez-Calatayud M, Olano-Lizarraga M, Quesada-Melero AM, Rumeu-Casares C, Saracíbar-Razquin M, Paloma-Mora B. Nursing capacity building in health coaching with hospitalised chronic heart failure patients: a quasi-experimental study. Contemp Nurse 2023; 59:443-461. [PMID: 37751247 DOI: 10.1080/10376178.2023.2262612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Difficulty in adherence to treatment and self-care behaviours is a leading cause of preventable readmission in people with chronic heart failure (CHF). Although there is evidence of benefits of health coaching for the management of this situation, few interventions have been tested in the hospital setting. AIM To evaluate a coaching programme (H-Coaching) designed to develop nursing capacity in health coaching for chronic heart failure inpatients. METHODS A quasi-experimental pre-post study including all nurses in a single centre cardiology ward (N = 19). The intervention consisted of two training packages: (1) five theoretical-practical sessions on health-coaching competencies, emotional intelligence, communication and support of chronic heart failure patients in their illness in the hospital setting; and (2) training sessions seven months after the first training package to reinforce the theoretical and practical knowledge. On four occasions, the Competence Instrument of Health Education for the Nursing professional was used to measure nurses' knowledge, skills and attitudes in health coaching for chronic heart failure patients. RESULTS The difference between the preintervention and postintervention scores were statistically significant for knowledge [mean difference = 1.00 (95% CI -1.45 to -0.51; p = 0.000)], skills in general [mean difference = 0.50 (95% CI -1.41 to -0.21; p = 0.015)] and personal/social skills [mean difference = 1.00 (95% CI -1.10 to -0.01; p = 0.048)]. While attitudinal and affective domains did not differ, there were differences in knowledge and skills. CONCLUSION The H-Coaching programme proved to be effective for building nursing capacity in health coaching CHF inpatients. Similar programmes designed to improve knowledge in verbal and nonverbal communication techniques, and skills for coaching interventions adapted to meet the needs of individual patients, should be tested in future interventional experimental studies. CLINICAL TRIAL REGISTRATION NUMBER NCT05300880. IMPACT STATEMENT To our knowledge, this is the first nursing training intervention in health coaching for chronic heart failure the inpatient setting. This study has demonstrate improvements in both the knowledge and personal and social skills of cardiology nurses with regard to the development of health coaching in a hospital setting. Given the study design, further research is warranted. PLAIN LANGUAGE SUMMARY Many patients with chronic heart failure have problems in adhering to the treatment and self-care behaviours and this is one of the main causes of preventable readmission. To promote self-care, patients need to be empowered to integrate these habits into their daily lives and we should implement innovative strategies to achieve this. Health coaching is an ideal alternative to this but very few nurses in the hospital cardiology setting are experienced in health coaching. Our study has shown preliminary results demonstrating that a structured theoretical and practical training programme for nurses can improve nurses' knowledge and skills in health coaching for inpatient patients with chronic heart failure. This study provides an opportunity for future research to demonstrate whether nurses with this training have a positive impact on the health outcomes of chronic heart failure patients and, more specifically, on their levels of self-care and empowerment.
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Affiliation(s)
- Mónica Vázquez-Calatayud
- Clínica Universidad de Navarra, Avda. Pío XII 36, 31008 Pamplona, Spain
- School of Nursing, Universidad de Navarra, Campus Universitario, 31008 Pamplona, Spain
- University of Navarra, Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
- Navarra's Health Research Institute (IdiSNA), Pamplona, Spain
| | - Maddi Olano-Lizarraga
- School of Nursing, Universidad de Navarra, Campus Universitario, 31008 Pamplona, Spain
- University of Navarra, Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
- Navarra's Health Research Institute (IdiSNA), Pamplona, Spain
| | | | - Carmen Rumeu-Casares
- Clínica Universidad de Navarra, Avda. Pío XII 36, 31008 Pamplona, Spain
- University of Navarra, Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
| | - Maribel Saracíbar-Razquin
- School of Nursing, Universidad de Navarra, Campus Universitario, 31008 Pamplona, Spain
- University of Navarra, Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
- Navarra's Health Research Institute (IdiSNA), Pamplona, Spain
| | - Beatriz Paloma-Mora
- Clínica Universidad de Navarra, Avda. Pío XII 36, 31008 Pamplona, Spain
- University of Navarra, Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
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Romano R, Begarani F, Bignami EG, Casubolo C, Corbara R, La Sala R, La Torre P, Marletta G, Marra S, Martelli M, Minari M, Pelosi G, Sollami A, Taffurelli C, Pipio A. Health coaching for undergraduate nursing students: a pilot study for an action research. ACTA BIO-MEDICA : ATENEI PARMENSIS 2023; 94:e2023209. [PMID: 37850772 PMCID: PMC10644932 DOI: 10.23750/abm.v94i5.14526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/04/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND AND AIM The Nursing undergraduate degree educational program represents an intensive and complex course, and includes a number of professionalizing practical internships, and for these reasons it requires an action to support and improve. Coaching is based on the premise that people have personal strengths and abilities which, through a interview, can be directed to solving their problems. Several studies demonstrate the efficacy of Health Coaching in different University, but never have been measured benefits regard skills improving. The objective of the study is to assess the impact of a health coaching program on the nursing students. METHOD A pre-post quasi-experimental study was conducted, involving the activation of a Health Coaching Program for 25 nursing students selected through convenience sampling, based on their fulfillment of the inclusion criteria. The Health Coaching Program was administered by the Health Coaching Academy. RESULT This study also evaluated parameters such as: level of concentration in study, motivation, problem solving and reorganization skills, study organization skills, psycho-physical-emotional state comprehension, decision-making skills and self-esteem, noting a statistically significant increase post-HC program. A statistically significant improvement was also found in the students' perception of their own stress management skills after the course. CONCLUSION This study strengthens the hypothesis that HC programs contribute to improving performance of nursing students. Those conclusions need to be corroborated by future studies on the topic to further support the hypothesis that programs of HC within the learning nursing contexts can lead to a tangible benefit for students of the health professions.
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Affiliation(s)
- Rita Romano
- University Teaching Hospital of Parma (Italy).
| | | | - Elena Giovanna Bignami
- Department of Medicine and Surgery (Director, School of Spec. in Anesthesia, Resuscitation), University of Parma (Italy).
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Mattioli AV, Gallina S. Early cardiovascular prevention: the crucial role of nurse-led intervention. BMC Nurs 2023; 22:347. [PMID: 37784056 PMCID: PMC10546686 DOI: 10.1186/s12912-023-01511-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023] Open
Abstract
The present comment on Qiu's work intends to emphasize two points: (1) Cardiovascular prevention must start early due to the progressive nature of atherosclerosis. (2) growing evidence that coaching performed by nurses leads to effective results. Nurses can intercept the young population who must be sensitized and educated about prevention.
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Affiliation(s)
- Anna Vittoria Mattioli
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Via del pozzo, 71, Modena, 41100, Italy.
- Istituto Nazionale per le Ricerche Cardiovascolari, Bologna, Italy.
| | - Sabina Gallina
- Istituto Nazionale per le Ricerche Cardiovascolari, Bologna, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Jafar N, Huriyati E, Lazuardi L, Setyawati A. Exploring the coach-client interaction of virtual health coaching conducted in patients with type 2 diabetes mellitus: A scoping review. Diabetes Metab Syndr 2023; 17:102787. [PMID: 37301009 DOI: 10.1016/j.dsx.2023.102787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND AIMS Recent studies reported that virtual health coaching (VHCs) had greater benefits on glycemic control compared to traditional diabetes care. However, VHCs are reported to lack real-time evaluations and personalized patient feedback. To support the intention of developing high quality VHC programs, this review aimed to describe characteristics of the coach-client interaction within VHC that had beneficial impacts on patients with type 2 diabetes mellitus (T2DM) patients. METHODS We conducted a comprehensive scoping review following the six steps of the framework developed by Arksey and O'Malley. Twelve articles that met the eligibility criteria were retrieved from Medline, ProQuest, Science Direct and Scopus. RESULTS We found five key concepts regarding the characteristics of coach-client interactions. First, the discussion through smartphones involved individualized feedback and insights, goals setting, barrier identification, facilitation to change behavior, and also clients' clinical, mental, and social conditions. Second, the interactions were supported by in-app features including in-app messaging, email, in-app live video consultation and in-app discussion forums. Third, the most used time of evaluation was 12 months. Fourth, the most commonly delivered topic was lifestyle changes which were predominantly focused on dietary patterns. Fifth, most of health coaches were health liaisons. CONCLUSIONS The findings highlight the discussion points within interaction through well-planned devices combining an appropriate in-app features contribute to an effective coach-client interactions of VHC. It is expected that future studies can apply these findings as the basis to develop a single set of standards for VHCs which refer to specific patterns of patient-oriented interaction.
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Affiliation(s)
- Nuurhidayat Jafar
- Community Health Nursing Department, Nursing Faculty, Universitas Hasanuddin, Jl. Perintis Kemerdekaan km 10, Kampus Tamalanrea, Makassar, 90245, Indonesia; Doctoral Program of Medicine and Health Science, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Senolowo, Sekip Utara, Depok, Sleman, Yogyakarta, 55281, Indonesia.
| | - Emy Huriyati
- Nutrition and Health Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Senolowo, Sekip Utara, Depok, Sleman, Yogyakarta, 55281, Indonesia.
| | - Lutfan Lazuardi
- Health Policy Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Senolowo, Sekip Utara, Depok, Sleman, Yogyakarta, 55281, Indonesia.
| | - Andina Setyawati
- Department of Medical and Surgical Nursing, Nursing Faculty, Universitas Hasanuddin, Jl. Perintis Kemerdekaan km 10, Kampus Tamalanrea, Makassar, 90245, Indonesia.
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Understanding factors affecting implementation success and sustainability of a comprehensive prevention program for cardiovascular disease in primary health care: a qualitative process evaluation study combining RE-AIM and CFIR. Prim Health Care Res Dev 2023; 24:e17. [PMID: 36883652 PMCID: PMC10050826 DOI: 10.1017/s1463423623000063] [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: 03/09/2023] Open
Abstract
AIM Our aim was to evaluate the implementation process of a comprehensive cardiovascular disease prevention program in general practice, to enhance understanding of influencing factors to implementation success and sustainability, and to learn how to overcome barriers. BACKGROUND Cardiovascular disease and its risk factors are the world's leading cause of mortality, yet can be prevented by addressing unhealthy lifestyle behavior. Nevertheless, the transition toward a prevention-oriented primary health care remains limited. A better understanding of factors facilitating or hindering implementation success and sustainability of prevention programs, and how barriers may be addressed, is needed. This work is part of Horizon 2020 project 'SPICES', which aims to implement validated preventive interventions in vulnerable populations. METHODS We conducted a qualitative process evaluation with participatory action research approach of implementation in five general practices. Data were collected through 38 semi-structured individual and small group interviews with seven physicians, 11 nurses, one manager and one nursing assistant, conducted before, during, and after the implementation period. We applied adaptive framework analysis guided by RE-AIM Qualitative Evaluation for Systematic Translation (RE-AIM QuEST) and Consolidated Framework for Implementation Research (CFIR). FINDINGS Multiple facilitators and barriers affected reach of vulnerable target populations: adoption by primary health care providers, implementation and fidelity and intention to maintain the program into routine practice. In addition, our study revealed concrete actions, linked to implementation strategies, that can be undertaken to address identified barriers. Prioritization of prevention in general practice vision, ownership, and shared responsibility of all team members, compatibility with existing work processes and systems, expanding nurse's roles and upskilling competence profiles, supportive financial and regulatory frameworks, and a strong community - health care link are crucial to increase implementation success and long-term maintenance of prevention programs. COVID-19 was a major barrier to the implementation. RE-AIM QuEST, CFIR, and participatory strategies are useful to guide implementation of prevention programs in primary health care.
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Costeira C, Dixe MA, Querido A, Vitorino J, Laranjeira C. Coaching as a Model for Facilitating the Performance, Learning, and Development of Palliative Care Nurses. SAGE Open Nurs 2022; 8:23779608221113864. [PMID: 35860191 PMCID: PMC9289909 DOI: 10.1177/23779608221113864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/22/2022] [Accepted: 06/26/2022] [Indexed: 11/17/2022] Open
Abstract
Palliative care nurses experience huge pressures, which only increased with coronavirus
disease 2019 (COVID-19). A reflection on the new demands for nursing care should include
an evaluation of which evidence-based practices should be implemented in clinical
settings. This paper discusses the impacts and challenges of incorporating coaching
strategies into palliative care nursing. Evidence suggests that coaching strategies can
foster emotional self-management and self-adjustment to daily life among nurses. The
current challenge is incorporating this expanded knowledge into nurses’ coping strategies.
Coaching strategies can contribute to nurses’ well-being, empower them, and consequently
bring clinical benefits to patients, through humanized care focused on the particularities
of end-of-life patients and their families.
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Affiliation(s)
- Cristina Costeira
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Leiria, Portugal
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Maria A. Dixe
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Leiria, Portugal
| | - Ana Querido
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Leiria, Portugal
- Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, Porto, Portugal
| | - Joel Vitorino
- Palliative Care Service of Portuguese Oncology Institute of Coimbra, Coimbra, Portugal
| | - Carlos Laranjeira
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Leiria, Portugal
- Research in Education and Community Intervention (RECI I&D), Piaget Institute, Viseu, Portugal
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