Nurses' perceptions of their role with respect to promoting physical activity in adult patients: a systematic review

AIMS AND OBJECTIVES

To identify the nurses' perceptions of their role with respect to promoting physical activity in adult patients and factors related to this role perceptions.

BACKGROUND

Ageing and chronic diseases are often accompanied by a decrease in physical activity. Nurses are in an excellent position to promote physical activity, because of their close and frequent interactions with patients. However, they often fail to actively stimulate patients to physical activity due to a lack of time, competing priorities and their focus on acute problems. Unclear was how nurses view their professional role in the promotion of physical activity.

DESIGN

Systematic literature review.

METHODS

PubMed, COCHRANE and CINAHL EBSCO were searched for papers published from 2006 to September 2019. Two reviewers independently assessed the methodological quality, using MMAT criteria. Thematic synthesis was used to analyse the data. The PRISMA statement was followed for reporting.

RESULTS

Overall, 10 quantitative, eight qualitative and one mixed methods study were included in the review. Analyses of these studies resulted in six themes: (1) active and professional role; (2) the recognised importance; (3) fear of patient falling; (4) patient's present health and need; (5) interdisciplinary context and responsibility; and (6) nurses' knowledge.

CONCLUSIONS

Nurses perceive they have an active role in the promotion of physical activity and consider it as important and part of their professional role. Clear guidance increased education and stronger awareness of guidelines might enable nurses to translate their perceived role into daily practice. This will enhance professional fulfilment as well as patients' physical activity.

RELEVANCE TO CLINICAL PRACTICE

The findings guide the development of interventions that aim to improve nursing care with respect to the promotion of physical activity and help managers and educators to provide appropriate resources and education.

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.

Perception From Barrier and Facilitator for Providing Early Rehabilitation Care for RTI Victims

Background:

Road traffic injuries (RTIs) are a major public health problem and the most important cause of disability, morbidity and mortality worldwide. Early rehabilitation can play a significant role in minimizing complications, morbidity and mortality.

Objectives:

The aim of this study was to describe perceptions of barriers precluding provision of early rehabilitation care for RTI victims.

Patients and Methods:

A qualitative content analysis was carried out on 15 nurses with at least one year experience caring for RTI victims. The nurses were selected from various wards (emergency, orthopedic, neurosurgery, and clinic) of Sina and Imam Khomeini Hospitals via targeted sampling. Data were collected through semi-structured interviews and targeted sampling until data saturation. Data were analyzed and assessed.

Results:

After continuous analysis and comparison of data, major causes precluding nurses from early rehabilitation of RTI patients were retrieved. These barriers included: (a) lack of insight, (b) lack of comprehensive care (c) excessive costs; facilitating factors included (d) training for cooperation and (e) support for coping.

Conclusions:

The findings of this study show that the need for early rehabilitation in the hospital phase of care for RTI victims is needed. Knowledge about the barriers precluding nurses from early rehabiltiation of RTI patients and facilitators that can help health care workers and policy makers eliminate the barriers precluding early rehabilitation can help health care workers, especially nurses enable patients get over their disability and gain social and family support.

An exploration of knowledge and practice of patient handling among undergraduate occupational therapy students

PURPOSE

To explore knowledge and practice relating to patient handling among final year occupational therapy students in the Republic of Ireland.

METHOD

We conducted a survey of final year students in three out of four occupational therapy programs in the Republic of Ireland (n = 81). The survey measured students' knowledge of manual handling principles and techniques and explored their experiences and ability to apply this knowledge to clinical situations.

RESULTS

All students (n = 81) had undertaken training in patient handling. Just under half of students (n = 35, 43.2%) had received additional training outside of the university setting. Overall knowledge of safe patient handling principles techniques and risk assessment was low (Mean Score = 15.71/28; SD = 3.81). Participants who received additional training achieved a lower mean total score (M = 13.89, SD = 3.54) than those who only undertook university-based training (M = 18.11; SD = 2.66; t(79) = -5.87; p < 0.05). The majority of participants reported intermittent use of taught principles while on clinical practice placements (n = 50, 61.8%) Reasons for not using taught principles included; selection of alternative technique by supervisor (n = 30, 56.6%); lack of available equipment (n = 13, 24.5%) and lack of time (n = 13, 24.5%).

CONCLUSIONS

While occupational therapy students in Ireland receive training in safe patient handling they appear to have limited knowledge of best practice and experience difficulties in applying their learning to clinical situations. There is an urgent need to consider the effectiveness of current educational strategies in this area. Implications for Rehabilitation Safe patient handling is a key component in preventing musculoskeletal injury among rehabilitation professionals The extent to which pre-professional training prepares rehabilitation professionals to practice safe patient handling is unclear Occupational therapy students in this study had limited knowledge of safe patient handling and had difficulty applying their learning to clinical practice Alternative education models are required to support development of safe patient handling skills. Educators may wish to consider how safe patient handling can be embedded across curricula to avoid the challenges of once off instruction and massed practice.