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Christophersen L, Brotto G. The Effectiveness of Educational Interventions for Mental Health Professionals in Reducing Stigmatization Toward People with Pedophilia: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024:15248380241262286. [PMID: 39092869 DOI: 10.1177/15248380241262286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
Mental Health Professionals (MHP) often harbor strong negative attitudes toward people with a sexual attraction to children, hindering the provision of essential treatment. This reluctance stems from pervasive stigmatization, contributing to mental health issues among people with pedophilia and exacerbating risk factors associated with child sexual abuse. Limited research and small sample sizes in prior studies underscore the need to conduct a meta-analysis, examining the effectiveness of educational interventions as a tool for reducing stigmatization toward people with pedophilia in MHP. Eight studies meeting specific inclusion criteria were identified through a literature search. These criteria included (a) peer-reviewed empirical, (b) quantitative data, (c) a focus on attitudes toward people with pedophilia, (d) a sample of MHP that might come in contact with people with pedophilia (or the general public), (e) the intervention is educational, (f) the educational intervention is based on people with pedophilia, (g) pre- and post-test data, and (h) be written in English. Comparable variables within these studies encompassed dangerousness, social distance, intentionality, deviance, punitiveness, anger, sympathy, and motivation to treat. The intervention significantly improved perceptions of dangerousness (d = 0.65), social distance (d = 0.33), intentionality (d = 0.38), and punitiveness (d = 0.77). However, it showed non-significant effects on deviance (d = 0.22), anger (d = -0.22), sympathy (d = -0.12), and motivation to treat (d = -0.04). These findings indicate that educational interventions can reduce MHP stigmatization toward people with pedophilia, especially with contact-based and sufficiently prolonged interventions.
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Davis CE, Eche-Ugwu IJ, Alcindor N. Social Media Use and Psychological Distress Among Undergraduate Nursing Students: A Review. J Nurs Educ 2024; 63:540-545. [PMID: 39120510 DOI: 10.3928/01484834-20240502-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
BACKGROUND Undergraduate nursing students experience high stress and use social media sites at high rates. Yet, there is a paucity of literature focused on understanding the association between social media use and psychological distress among undergraduate nursing students. METHOD Guided by Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a systematic review was conducted on the association between social media use and psychological distress among undergraduate nursing students. RESULTS Ten articles met the inclusion criteria. Most of the included studies used cross-sectional designs. The findings indicated that undergraduate nursing students who followed social media sites were more likely to report symptoms of psychological distress, particularly significant depressive and anxiety symptoms. CONCLUSION Undergraduate nursing students who use social media are likely to experience psychological distress. Combined interventions focused on minimizing social media use and reducing academic stress may help foster the psychological health of nursing students. [J Nurs Educ. 2024;63(8):540-545.].
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Affiliation(s)
- Ché-Anne Davis-Leahy
- Sixth Former, creative, navigator of chronic health conditions, and author of 15 Minutes
| | - Nadia Somers
- Clinical psychologist supporting young people and families in the paediatric endocrine department at the Evelina London Children's Hospital and in private practice
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Li E, Kealy D, Aafjes-van Doorn K, McCollum J, Curtis JT, Luo X, Silberschatz G. "It Felt Like I Was Being Tailored to the Treatment Rather Than the Treatment Being Tailored to Me": Patient Experiences of Helpful and Unhelpful Psychotherapy. Psychother Res 2024:1-15. [PMID: 38833539 DOI: 10.1080/10503307.2024.2360448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/21/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVE This qualitative study explores patients' experiences of psychotherapy, focusing on elements perceived as helpful or unhelpful and suggestions for improvement in the context of public mental health care. METHODS A total of 148 adults (Mean age = 32.24, SD = 9.92) who had been or are currently receiving psychological treatment from the National Health Service (NHS) responded to an online survey. The survey included open-ended questions regarding their experiences of psychotherapy, asking them to identify helpful or unhelpful aspects, and suggestions for improvement. Using thematic analysis, key themes were identified. RESULTS The analysis highlighted the patient's preference for personalized treatment, the importance of therapeutic alliance, the demand for depth in therapy, and life skills and agency as therapeutic outcomes. Participants suggested improvements such as more tailored approaches and stronger therapist-patient relationships, supporting an adaptable, patient-centered model. CONCLUSION The study highlights challenges in public mental health services where patients might feel their specific needs are not being recognized and met and underscores the importance of personalized treatment plans that satisfy and evolve with patient needs, suggesting that therapists must be attentive and responsive to individual desires to enhance the patient experience.
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Affiliation(s)
- Elizabeth Li
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud Centre, London, UK
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - James McCollum
- San Francisco Psychotherapy Research Group, San Francisco, CA, USA
| | - John T Curtis
- San Francisco Psychotherapy Research Group, San Francisco, CA, USA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Xiaochen Luo
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, USA
| | - George Silberschatz
- San Francisco Psychotherapy Research Group, San Francisco, CA, USA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
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Seewald A, Rief W. Therapist's warmth and competence increased positive outcome expectations and alliance in an analogue experiment. Psychother Res 2024; 34:663-678. [PMID: 37531315 DOI: 10.1080/10503307.2023.2241630] [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: 04/17/2023] [Revised: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 08/04/2023] Open
Abstract
Objective: The quality of the therapeutic alliance, treatment motivation, outcome expectations (OE), and specific health behaviour predicts psychotherapy success. Therapists should be able to improve these factors to optimize outcomes. This study investigated the therapist's interpersonal behaviour to optimize alliance, motivation, OE, and health behaviour. Method: A stressed study sample (N = 465) completed an online analogue experiment. We gave participants positive information about psychotherapy effectiveness and varied the therapist's interpersonal behaviour along the dimensions of warmth and competence.Results: High (vs. low) competence and high (vs. low) warmth increased alliance, OE, and help-seeking scores, while high (vs. low) competence increased motivation to do psychotherapy. We found no effects on health behaviour.Conclusion: In contrast to previous correlational analyses, our experimental study supports the causal role of the therapist's warmth and competence and its impact on alliance, motivation, and OE. We discuss approaches for future studies and clinical implications.
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Affiliation(s)
- Anna Seewald
- Department of Psychology, Clinical Psychology & Psychotherapy, University of Marburg, Marburg, Germany
| | - Winfried Rief
- Department of Psychology, Clinical Psychology & Psychotherapy, University of Marburg, Marburg, Germany
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Smith B, Chukwuere PC, Sehularo LA. Exploring presence practices: a study of unit managers in a selected Provincial Hospital in Free State Province. BMC Nurs 2024; 23:367. [PMID: 38822312 PMCID: PMC11140984 DOI: 10.1186/s12912-024-02023-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/17/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Nursing presence depends on an individual's belief system, truths, sensory experience, professional skills, and active listening. Thus, one may assume that presence occurs when nurses care for patients in a kind and compassionate way. This study aimed to explore and describe presence practices amongst unit managers in a selected provincial hospital in Free State Province. METHODS A qualitative research approach with an exploratory descriptive contextual research design was employed in this study. A purposive nonprobability sampling technique was utilised to select participants. Data were collected through semi-structured interviews and analysed using the six steps of thematic qualitative data analysis. The study's trustworthiness was ensured through ascertaining credibility, dependability, confirmability, transferability, and authenticity. Approval to conduct the study was obtained from the North-West University Health Research Ethics Committee (NWU-HREC), DoH in the Free State Province, and the CEO (the gatekeeper) of the selected hospital. RESULTS Four themes were generated, namely, presence practices amongst unit managers in a selected provincial hospital in Free State, the impact of presence practices on hospital dynamics in a selected provincial hospital in Free State, unit managers' practices of relational care and human connectedness in the unit, and the perceptions of unit managers on barriers to presence practices in a selected provincial hospital in Free State. Each of these themes presents categories and sub-categories. Unit managers actively foster supportive work cultures, effective management, human connectedness and relational care, and effective communication to yield team cohesion and positive impacts on patient care. Unit managers also display resilience and highlight the need for ongoing support from colleagues and top management. CONCLUSION Unit managers exhibit diverse presence practices which emphasise their commitment through visibility and accessibility despite staff shortages and resource constraints.
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Affiliation(s)
- Bernardine Smith
- NuMIQ Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, North West Province, South Africa
| | - Precious Chibuike Chukwuere
- NuMIQ Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, North West Province, South Africa.
| | - Leepile Alfred Sehularo
- Lifestyle Diseases Research Focus Area, Faculty of Health Sciences, North-West University, Mafikeng, North West Province, South Africa
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Kodzo LD, Danso NAA, Budu JT, Akriti KB, Hussain A, Zhang R. Experience of psychosocial rehabilitation; perspectives of depressed adolescents. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02473-z. [PMID: 38809300 DOI: 10.1007/s00787-024-02473-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/18/2024] [Indexed: 05/30/2024]
Abstract
Given the multifaceted character of depression and its related symptoms, an adolescent living with it is at increased risk for a wide range of adverse events. This research aimed to understand and characterize the psychosocial rehabilitation experiences of depressed teenage participants in the Greater Accra Region of Ghana. A cross-sectional semi-structured interview design influenced by an interpretive phenomenological analysis (IPA) technique was adopted. We employed a nonprobability, purposeful sampling approach to recruit twenty-one adolescents (6 males, 15 females) diagnosed with depression from the community after one month of discharge from admission and undergoing psychosocial rehabilitation. Using separate interviews, we gathered and analyzed data using interpretive phenomenological analysis to produce themes and sub-themes. These were presented with the participants' direct quotations. We discovered that the perspectives of adolescents' psychosocial rehabilitation experience include hopelessness and suicide ideation, coping difficulties, undesirable attitudes from support networks, challenges related to school, and isolation. Participants suggested appropriate therapeutic environments, encouraging support systems, and the media's role in preventing and treating depression among young people as rehabilitation approaches that could assist adolescents to remain lucid for longer intervals. These results shed light on the tragic realities faced by depressed adolescents. There is an urgent need to put well-defined structures in place to aid their rehabilitation and develop coping strategies for a better life.
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Affiliation(s)
- Lalit Dzifa Kodzo
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
- Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
- School of International Education, Southern Medical University, Guangzhou, China
- Organization of African Academic Doctors (OAAD), Off Kamiti Road, Nairobi, Kenya
| | | | | | | | - Abid Hussain
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Ruixing Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China.
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Lechner BE, Kukora SK, Hawes K. Equity, inclusion and cultural humility: contemporizing the neonatal intensive care unit family-centered care model. J Perinatol 2024; 44:760-766. [PMID: 38532086 DOI: 10.1038/s41372-024-01949-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/29/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
Existing NICU family centered care models lack the key elements of equity, inclusion and cultural humility. These models were conceived to support families during the stressful life event of an infant's NICU admission. Their development, however, occurred prior to recognition of the medical field's systematic shortcomings in providing equitable care and their impact on outcome disparities for marginalized communities; thus, they do not include cultural or equitable healthcare considerations. Given the significant neonatal care inequities for marginalized groups, incorporating the experience of these patients in a targeted manner into family centered care frameworks is of critical importance to ensure culturally humble and thus more just and equitable treatment. Here, we review past approaches to NICU family centered care and propose a novel, updated framework which integrates culturally humble care into the NICU family centered care framework.
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Affiliation(s)
- Beatrice E Lechner
- Division of Neonatology, Women & Infants Hospital of Rhode Island, Providence, RI, USA.
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.
| | - Stephanie K Kukora
- Division of Neonatology and Bioethics Center, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics and Department of Medical Humanities and Bioethics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Katheleen Hawes
- Division of Neonatology, Women & Infants Hospital of Rhode Island, Providence, RI, USA
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
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De Brochowski V, Rubin GJ, Webster RK. The effect of nocebo explanation and empathy on side-effect expectations of medication use following a fictional GP consultation. PSYCHOL HEALTH MED 2024; 29:809-821. [PMID: 37491019 DOI: 10.1080/13548506.2023.2240072] [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: 11/29/2021] [Accepted: 07/18/2023] [Indexed: 07/27/2023]
Abstract
The simple act of informing patients about side-effects increases the likelihood they will experience them (i.e. the nocebo effect). Explaining this psychological phenomenon could help to reduce side-effect experience, however, it is yet to be explored if this can be applied to clinical settings where new medication is prescribed. In addition, the degree to which a health-care provider empathetically communicates this to patients may have an impact. To investigate this, we carried out 2 × 2 factorial trial to assess the effect of nocebo explanation and empathy (plus their interaction) on side-effect expectations following a fictional GP consultation prescribing a new medication. Overall, 208 participants were randomised to watch one of the four fictive GP consultations and play the role of the patient. In all videos, participants received information about the reason for the consultation, the recommendation of a new fictive medicine, how to take it, benefits and side-effects. The videos differed in whether the GP provided an explanation of the nocebo effect (yes/no) and whether they communicated in an empathetic style (yes/no). After watching the video, participants were asked about their side-effect expectations and rated the quality of the GP's communication. Two-way ANOVAs revealed no main effect of nocebo explanation on expectation of side-effects warned or not warned about in the consultation. However, there was a main effect of empathy, with participants watching the empathetic consultations having significantly lower expectations of non-warned-about side-effects. There was no significant interaction. Findings suggest that explaining the nocebo effect and GP empathy did little to allay expectations of side-effects that were specifically mentioned in the consultation. However, GP empathy had an effect by helping to reduce additional side-effect expectations participants still had. Future work should extend these findings to real GP consultations where the full dimensions of empathy can be explored.
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Affiliation(s)
- Valentine De Brochowski
- Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - G James Rubin
- Health Protection Research Unit in Emergency Preparedness and Response at, King's College London, London, United Kingdom
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10
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Giorgi F, Fanali A, Tramonti F. A critical evaluation of choice negotiation for patient-centred medicine and psychotherapy. J Eval Clin Pract 2024. [PMID: 38308615 DOI: 10.1111/jep.13968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 01/11/2024] [Indexed: 02/05/2024]
Abstract
STUDY AIMS The present paper aimed at discussing how the process of decision-making should be taken care of in healthcare services. METHODS This is a position paper based on a review of the relevant literature about meaning-making processes in medical encounters and psychotherapy. DISCUSSION Authors argued that choice options could be perceived as meaningful by patients if their uncertainties were taken into account and grounded on mutual understanding and reciprocal trust. To this end, any decision-making process should satisfy the patient's legitimate expectations by making choices and habits compatible. CONCLUSION In depht analysis of meaning-making processes is crucial for better refining good practices of shared decision-making.
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Feo R, Young JA, Urry K, Lawless M, Hunter SC, Kitson A, Conroy T. 'I wasn't made to feel like a nut case after all': A qualitative story completion study exploring healthcare recipient and carer perceptions of good professional caregiving relationships. Health Expect 2024; 27:e13871. [PMID: 37858980 PMCID: PMC10726062 DOI: 10.1111/hex.13871] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Professional caregiving relationships are central to quality healthcare but are not always developed to a consistently high standard in clinical practice. Existing literature on what constitutes high-quality relationships and how they should be developed is plagued by dyadic conceptualisations; discipline, context and condition-specific research; and the absence of healthcare recipient and informal carer voices. This study aimed to address these issues by exploring how healthcare recipients and carers conceptualise good professional caregiving relationships regardless of discipline, care setting and clinical condition. DESIGN A qualitative story completion approach was used. Participants completed a story in response to a hypothetical stem that described a healthcare recipient (and, in some instances, carer) developing a good relationship with a new healthcare provider. Stories were analysed using reflexive thematic analysis. PARTICIPANTS Participants were 35 healthcare recipients and 37 carers (n = 72 total). RESULTS Participants' stories were shaped by an overarching discourse that seeking help from new providers can elicit a range of unwanted emotions for both recipients and carers (e.g., anxiety, fear, dread). These unwanted emotions were experienced in relation to recipients' presenting health problems as well as their anticipated interactions with providers. Specifically, recipient and carer characters were fearful that providers would dismiss their concerns and judge them for deciding to seek help. Good relationships were seen to develop when healthcare providers worked to relieve or minimise these unwanted emotions, ensuring healthcare recipients and carers felt comfortable and at ease with the provider and the encounter. Participants positioned healthcare providers as primarily responsible for relieving recipients' and carers' unwanted emotions, which was achieved via four approaches: (1) easing into the encounter, (2) demonstrating interest in and understanding of recipients' presenting problems, (3) validating recipients' presenting problems and (4) enabling and respecting recipient choice. Participants' stories also routinely oriented to temporality, positioning relationships within recipients' and carers' wider care networks and biographical and temporal contexts. CONCLUSION The findings expand our understanding of professional caregiving relationships beyond dyadic, static conceptualisations. Specifically, the findings suggest that high-quality relationships might be achieved via a set of core healthcare provider behaviours that can be employed across disciplinary, context and condition-specific boundaries. In turn, this provides a basis to support interprofessional education and multidisciplinary healthcare delivery, enabling different healthcare disciplines, specialties, and teams to work from the same understanding of what is required to develop high-quality relationships. PATIENT OR PUBLIC CONTRIBUTION The findings are based on stories from 72 healthcare recipient and carer participants, providing rich insight into their conceptualisations of high-quality professional caregiving relationships.
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Affiliation(s)
- Rebecca Feo
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Jessica A. Young
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Kristi Urry
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- School of PsychologyUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Michael Lawless
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Sarah C. Hunter
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Alison Kitson
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Tiffany Conroy
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
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Coelho J, Moreno Poyato A, Roldán Merino J, Sequeira C, Sampaio F. Perspectives of adult patients with mental health disorders on the relationship with nurses: a focus group study. BMC Nurs 2024; 23:9. [PMID: 38163914 PMCID: PMC10759621 DOI: 10.1186/s12912-023-01663-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND The relationship between the nurse and the patient with mental health disorder is crucial to the recovery process. Thus, patients with mental health disorders should be active subjects in this relationship by having autonomy and self-determination. METHODS This study aimed to explore the perspectives of adult patients with mental health disorders on the relationship with nurses. A qualitative, descriptive, and exploratory study was conducted in March 2023, using focus group meetings in an association to support patients with severe mental health disorders in the Northern region of Portugal. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). A total of 8 patients participated in the study. Two focus group meetings were conducted. The inductive method was used, and content analysis of the transcripts was performed. The QDA Miner Lite 4.0 and Microsoft Excel were used for content analysis. RESULTS Participants considered the relationship with nurses important for their recovery and expected nurses to provide support and help, being able to identify their needs, thus personalising their care. Attitudinal and communication aspects were also considered crucial for establishing a solid, trusting, and meaningful relationship. CONCLUSION According to the findings nursing care is expected to focus on the patient, his/her preferences, expectations, and the uniqueness of each individual. The results of this study may be useful for the reflection and improvement of nurses in their relational and communication skills and the driving force for nursing students' awareness of the perspective of the relationship with patients with mental health disorder and its relevance.
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Affiliation(s)
- Joana Coelho
- Research and Development Unit, Northern Health Higher School of the Portuguese Red Cross, Oliveira de Azeméis, 3720-126, Portugal.
- Faculty of Medicine, University of Porto, Porto, 4200-319, Portugal.
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, 4200-450, Portugal.
| | - Antonio Moreno Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, Barcelona, 08007, Spain
- NURSEARCH - 2021 SGR 01083, Mental Health, Psychosocial and Complex Nursing Care Research Group, Universitat de Barcelona, Barcelona, 08007, Spain
| | - Juan Roldán Merino
- NURSEARCH - 2021 SGR 01083, Mental Health, Psychosocial and Complex Nursing Care Research Group, Universitat de Barcelona, Barcelona, 08007, Spain
- Campus Docent Sant Joan de Déu, University of Barcelona, Barcelona, 08830, Spain
| | - Carlos Sequeira
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, 4200-450, Portugal
- Nursing School of Porto, Porto, 4200-072, Portugal
| | - Francisco Sampaio
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, 4200-450, Portugal
- Nursing School of Porto, Porto, 4200-072, Portugal
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Jarrett M. Commentary: Psychometric properties of the Turkish version of the therapeutic relationship assessment scale for nurses. J Res Nurs 2023; 28:642-643. [PMID: 38162711 PMCID: PMC10756172 DOI: 10.1177/17449871231215747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Affiliation(s)
- Manuela Jarrett
- Assistant Professor in Mental Health Nursing, University of Birmingham, Birmingham, UK
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Lin T, Nan X. A Scoping Review of Emerging COVID-19 Health Communication Research in Communication and Media Journals. HEALTH COMMUNICATION 2023; 38:2570-2581. [PMID: 35768394 DOI: 10.1080/10410236.2022.2091916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This article reports a scoping review of emerging research on COVID-19 health communication. We reviewed and analyzed 206 articles published in 40 peer-reviewed communication journals between January 2020 to April 2021. Our review identified key study characteristics and overall themes and trends in this rapidly expanding field of research. Our review of health communication scholarship during the early stages of the COVID-19 pandemic suggests that health communication scholars have risen to the challenges and interrogated important issues in COVID-19 communication at the individual, group, organizational, and societal levels. We identified important gaps that warrant future research attention including experimental research that seeks to test the causal effects of communication, studies that evaluate communication interventions in under-served populations, research on mental health challenges imposed by the pandemic, and investigations on the promise of emerging communication technologies for supporting pandemic mitigation efforts.
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Affiliation(s)
- Tong Lin
- Department of Communication, University of Maryland
| | - Xiaoli Nan
- Department of Communication, University of Maryland
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Fernandes JB, Ferreira N, Domingos J, Ferreira R, Amador C, Pardal N, Castro C, Simões A, Fernandes S, Bernardes C, Vareta DA, Peças D, Ladislau D, Sousa N, Duarte A, Godinho C. Health Professionals' Motivational Strategies to Enhance Adherence in the Rehabilitation of People with Lower Limb Fractures: Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7050. [PMID: 37998282 PMCID: PMC10671680 DOI: 10.3390/ijerph20227050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/28/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Patients with lower limb fractures require rehabilitation but often struggle with adherence to interventions. Adding motivational strategies to rehabilitation programs can increase patient adherence and enhance outcomes. This review aims to identify the motivational strategies used by health professionals in the rehabilitation of people with lower limb fractures. We used Arksey and O'Malley's methodological framework to structure and conduct this scoping review. The literature search was performed using the Scopus, CINAHL, MEDLINE, Nursing & Allied Health, and Cochrane Central Register of Controlled Trials databases. The final search was conducted in February 2023. A total of 1339 articles were identified. After selecting and analyzing the articles, twelve studies were included in this review. Health professionals use several strategies to motivate patients with lower limb fractures to adhere to rehabilitation programs. These strategies include building a therapeutic alliance, increasing patients' health literacy, setting achievable goals, personalizing the rehabilitation program, managing unpleasant sensations of exercise, using persuasion, providing positive reinforcement, avoiding negative emotional stimulation, and helping to seek support. The motivational strategies identified may help professionals to increase patient adherence to rehabilitation for lower limb fractures. This knowledge will allow these professionals to help patients overcome barriers to rehabilitation, enhance their motivation, and ultimately improve their recovery outcomes.
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Affiliation(s)
- Júlio Belo Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
- Nurs* Lab, 2829-511 Almada, Portugal
| | - Noélia Ferreira
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
- Nurs* Lab, 2829-511 Almada, Portugal
| | - Josefa Domingos
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
| | - Rui Ferreira
- Department of Nursing, Hospital Garcia de Orta, 2805-267 Almada, Portugal (C.A.)
| | - Catarina Amador
- Department of Nursing, Hospital Garcia de Orta, 2805-267 Almada, Portugal (C.A.)
| | - Nelson Pardal
- Department of Nursing, Hospital Garcia de Orta, 2805-267 Almada, Portugal (C.A.)
| | - Cidália Castro
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
- Nurs* Lab, 2829-511 Almada, Portugal
| | - Aida Simões
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
- Nurs* Lab, 2829-511 Almada, Portugal
| | - Sónia Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
- Nurs* Lab, 2829-511 Almada, Portugal
| | - Catarina Bernardes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
- Nurs* Lab, 2829-511 Almada, Portugal
| | - Diana Alves Vareta
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
- Nurs* Lab, 2829-511 Almada, Portugal
| | - Dina Peças
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
- Nurs* Lab, 2829-511 Almada, Portugal
| | - Dora Ladislau
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
- Nurs* Lab, 2829-511 Almada, Portugal
| | - Natacha Sousa
- Regional Health Administration of Lisbon and Tagus Valley, Community Care Unit-Integrating Health, 1500-534 Lisbon, Portugal
| | - Andreia Duarte
- Department of Nursing, Setúbal Hospital Centre, 2900-182 Setúbal, Portugal
| | - Catarina Godinho
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal; (N.F.); (J.D.); (C.B.); (D.A.V.); (D.P.); (C.G.)
- Nurs* Lab, 2829-511 Almada, Portugal
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Metta E, Shayo EH, Ngalesoni F, Kalolo A, Nyamuryekung'e K, Mboya IB, Ndumwa HP, Njiro BJ, Amour MA. The role of trust in the implementation and uptake of COVID-19 response measures: a qualitative study of health professionals' experiences in Tanzania. BMC Health Serv Res 2023; 23:1077. [PMID: 37817175 PMCID: PMC10566036 DOI: 10.1186/s12913-023-10043-3] [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: 03/02/2023] [Accepted: 09/17/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Even though trust is placed at the central point in ensuring proper functioning of the health systems, studies remain scant on how it affects both the implementation and uptake of COVID-19 response measures in low- and middle-income countries such as Tanzania. This study, therefore, explored the role of trust in the implementation and uptake of recommended COVID-19 response measures including vaccines from the perspective of health professionals in Tanzania. METHODS This cross-sectional qualitative study was implemented in four of Tanzania's thirty-one regions. Qualitative data was collected through 26 in-depth interviews held with regional and district disease outbreak response teams, district cold chain co-ordinators and health facility in-charges. In addition, five focus group discussions and seven group interviews were conducted with healthcare workers from the lower-level health facilities. Thematic analysis was conducted and applied the trust constructs. RESULTS Interpersonal trust and health system trust emerged as two major themes in the study. Interpersonal trust was reported to stem from lack of transparency that instigated fear, worries, and confusion regarding the implementation and uptake of the recommended response measures. The distrust was mainly between health professionals in health facilities and those assigned to isolation centres as well as between patients and community members. On the other hand, the health system trust was shaped by mixed feelings regarding COVID-19 vaccine national decisions, and conflicting messages from national officials, politicians and religious leaders on COVID-19 responses, safety, and effectiveness of the vaccines. Questions surrounding the short duration of clinical trials, indeterminate post-vaccination protection duration, impotence-linked beliefs, freemasonry notion and unclear vaccinated cards information are other reported contributory factors to mistrust in the health system. However, after a comprehensive health education and experience in COVID-19 vaccination administration most professionals affirmed the effectiveness of the vaccines in limiting infections and its severe consequences. CONCLUSION Participants indicated limited trust at both interpersonal and health system levels aggravated by lack of transparency, unclear and conflicting messages on COVID-19 infections and response measures. Enforced transparency on pandemics alongside standardised messages from the reliable sources is crucial in enhancing trust in implementation and uptake of the recommended response measures.
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Affiliation(s)
- Emmy Metta
- Department of Behavioral Sciences, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.
| | - Elizabeth H Shayo
- National Institute for Medical Research, P.O. Box 9653, Dar es Salaam, Tanzania
| | - Frida Ngalesoni
- AMREF Health Africa in Tanzania, P.O. Box 2773, Dar es Salaam, Tanzania
| | - Albino Kalolo
- Department of Public Health, St. Francis University College of Health, and Allied Sciences, P.O. Box 175, Morogoro, Tanzania
| | - Kasusu Nyamuryekung'e
- Department of Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Innocent B Mboya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
- Department of Translational Medicine, Lund University, 202 13 Malmö, P.O. Box 50332, Malmö, Sweden
| | - Harrieth P Ndumwa
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Belinda J Njiro
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Maryam A Amour
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
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Armstrong R, Schimke E, Mathew A, Scarinci N. Interprofessional Practice Between Speech-Language Pathologists and Classroom Teachers: A Mixed-Methods Systematic Review. Lang Speech Hear Serv Sch 2023; 54:1358-1376. [PMID: 37668590 DOI: 10.1044/2023_lshss-22-00168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Abstract
PURPOSE There is an important need for interprofessional practice (IPP) between speech-language pathologists (SLPs) and classroom teachers (CTs) in mainstream schools to support student outcomes. This mixed methods systematic review aimed to synthesize existing literature to describe the experiences of IPP between SLPs and CTs in mainstream schools. METHOD A systematic review protocol was utilized to conduct a comprehensive search of six databases (PubMed Central, EMBASE, Cochrane Library, CINAHL EBSCO, ERIC, and ProQuest Dissertations & Theses Global) using key words related to the research question. A total of 1,876 unique studies were retrieved. Of these, 18 studies were identified as relevant to the research question, as they described the experiences of IPP between SLPs and CTs. Thematic analysis was used to analyze the quantitative and qualitative studies. RESULTS Six main themes describing IPP experiences were identified: (1) what are you bringing to the collaboration table? (2) putting the value in collaboration, (3) sharing is collaborating, (4) the nature of collaboration varies, (5) the educational context matters, and (6) influences to collaboration beyond professional control. CONCLUSIONS IPP between SLPs and CTs is complex, with various facilitators and barriers to IPP emerging within the education context. Competencies for SLPs and CTs related to having a shared understanding, adequate communication, and building relationships with each other help support IPP in schools. The utilization of a relationship-centered care approach between SLPs and CTs is also important to foster and support student outcomes. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24018732.
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Affiliation(s)
- Rebecca Armstrong
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Emma Schimke
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Akhila Mathew
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Miller DC, Schoen SA, Schmitt CM, Porter LM. Adolescents' and Adults' Perceptions of Sensory-Based Interventions: A Qualitative Analysis. Am J Occup Ther 2023; 77:7705205160. [PMID: 37768991 DOI: 10.5014/ajot.2023.050198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
IMPORTANCE Adolescents and adults report that their sensory integration and processing differences affect their occupational performance and quality of life, thus requiring effective sensory-focused interventions. Researchers have yet to investigate this population's experience of occupational therapy interventions designed to remediate these challenges. OBJECTIVE To explore the perceived experience of adolescents and adults with respect to (1) response to intervention, (2) strategies offered to manage sensory differences, and (3) need for services on completion of an intervention. DESIGN Retrospective, qualitative study. SETTING Zoom or phone call. PARTICIPANTS Eleven adolescents and adults with sensory integration and processing differences who had previously completed occupational therapy interventions. INTERVENTION Sensory-based intervention based on the principles of Ayres Sensory Integration® (ASI) and the Sensory Therapies and Research Frame of Reference. OUTCOMES AND MEASURES A semistructured interview to obtain data, followed by an in-depth analysis using an inductive coding process to group initial open codes into themes and common subthemes Results: Open codes were grouped into three core themes: (1) therapist-related factors (what the therapist did in treatment); (2) client-related factors (what the client experienced); and (3) follow-up (future needs of the clients). Four main subthemes of the client-therapist relationship emerged: (1) therapeutic alliance; (2) education and knowledge; (3) strategies, tools, and resources; and (4) future needs. CONCLUSIONS AND RELEVANCE This study provides a perspective on the experience of adolescents and adults specific to the impact of a sensory-focused occupational therapy intervention on their daily lives. This will help occupational therapists when designing interventions for current and future clients. What This Article Adds: This study highlights the need for further research addressing effective sensory-based interventions for adolescents and adults. It also captures which components of intervention clients deemed helpful and identifies potential targets for future intervention.
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Affiliation(s)
- Dana C Miller
- Dana C. Miller, OTD, OTR/L, is Occupational Therapist, Atrium Health, Charlotte, NC. At the time of this study, she was Doctoral Student, Occupational Therapy Department, Wingate University, Wingate, NC
| | - Sarah A Schoen
- Sarah A. Schoen, PhD, OTR/L, is Director of Research, STAR Institute, Centennial, CO, and Associate Professor, Occupational Therapy, Rocky Mountain University of Health Professions, Provo, UT;
| | - Carolyn M Schmitt
- Carolyn M. Schmitt, OTD, OTR/L, is Occupational Therapist, Greenwood, CO. At the time of this study, she was Lead Occupational Therapist, STAR Institute, Centennial, CO
| | - Lisa M Porter
- Lisa M. Porter, PhD, OTD, OTR/L, is Assistant Professor, School of Occupational Therapy, Pacific University, Hillsboro, OR. At the time of this study, she was Assistant Professor, Department of Occupational Therapy, Tennessee State University, Nashville
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Anim SB, Spurlark R, Turkson-Ocran RA, Bohr N, Soco C, Simonovich SD. A Systematic Review of the Relationship Between Discrimination, Racism, and Type 2 Diabetes Healthcare Outcomes for Black Americans. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01751-x. [PMID: 37580438 DOI: 10.1007/s40615-023-01751-x] [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: 05/15/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Disparities in type 2 diabetes (T2DM) risk, care, and complications impact Black Americans more than that of their White counterparts. This study aims to examine the association between discrimination, racism, and T2DM care and outcomes in Black Americans. METHOD The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS A total of six original research articles met the inclusion criteria, comprising three quantitative and three qualitative studies. Overall, the systematic review findings revealed that among Black Americans, perceived interpersonal discrimination and racism by healthcare professionals are associated with patients' behaviors that impact T2DM outcomes. The findings also revealed that provider-level factors such as communication, provider assumptions and attitudes, information sharing, shared decision-making, and disease management behaviors might influence T2DM outcomes in this population. DISCUSSION Better T2DM-related outcomes depend on optimal disease control through adequate disease management. Building a therapeutic and culturally appropriate relationship free of discrimination and racism is vital for optimal disease management and decreasing health disparities in this patient population. CONCLUSION Perceived interpersonal racism and discrimination by healthcare providers, among other sociocultural factors, play a crucial role in influencing some patient behaviors that affect T2DM health outcomes in this population. Efforts to decrease health disparities in this specific community should also focus on interventions addressing provider-level factors and behaviors perceived as racist or discriminatory.
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Affiliation(s)
- Sandra B Anim
- DePaul University School of Nursing, Chicago, IL, USA
| | | | | | | | - Cheryl Soco
- DePaul University School of Nursing, Chicago, IL, USA
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Nelson C, Mandrusiak A, Forbes R. Embarking on a cultural journey: a qualitative study of new graduate physiotherapists' experiences of working in First Nations Australian health settings. Physiother Theory Pract 2023:1-11. [PMID: 37585714 DOI: 10.1080/09593985.2023.2246547] [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: 05/08/2023] [Revised: 07/10/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Internationally, there is growing momentum in the physiotherapy profession to improve the cultural safety and capabilities of physiotherapists. In Australia, this is essential given the important role physiotherapists play in the delivery of healthcare to First Nations Australians. Understanding the experiences of the newest members of the profession who work with First Nations Australians is an important step in exploring the broader professions' cultural safety journey. OBJECTIVE To explore new graduate physiotherapists' experiences working in First Nations Australian health settings. METHODS The study used an interpretative phenomenological approach through semi-structured interviews to explore the experiences of seven new graduate physiotherapists, in their first 2 years of practice. All participants worked within a First Nations Australian health setting for some or all of their experience as a new graduate physiotherapist. RESULTS Three themes were generated: 1) enrichment through connection; 2) navigating challenges; and 3) a catalyst for self-reflection. CONCLUSION New graduate physiotherapists reported positive experiences when working within a First Nations Australian health setting, underpinned by building a strong therapeutic relationship through rapport building; navigating challenges alongside their clients; and delving into critical self-reflection.
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Affiliation(s)
- Curtley Nelson
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
| | - Allison Mandrusiak
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
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Shields GS, Fisher M, Vega MO. Teaching power skills to improve physician self-efficacy, reduce burnout, and improve patient outcomes. Future Healthc J 2023; 10:119-123. [PMID: 37786631 PMCID: PMC10540802 DOI: 10.7861/fhj.2023-0050] [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: 10/04/2023]
Abstract
If doctors had a way to improve their patients' healthcare experience, improve service feedback, reduce complaints, increase treatment adherence and reduce non-attendance, while at the same time combatting burnout and compassion fatigue in clinicians and enhancing collaborative working between staff and care teams, and all for zero direct cost, could anyone argue against such an intervention? In this paper, we present the views of the educators and clinicians at Maudsley Learning that training in communication and psychological 'power skills' is not only feasible, but crucially important for physicians at all stages of training to improve both patient care and the wellbeing of clinicians themselves. We explore some of the key relevant skills and present examples of high-fidelity simulation training that demonstrate the efficacy of this modality in improving individual skills and confidence as well as inter-team and interdisciplinary working.
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Affiliation(s)
- Gregory S Shields
- Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, UK
| | - Megan Fisher
- Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, UK
| | - Marta Ortega Vega
- Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, UK
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Sherriff B, Clark C, Killingback C, Newell D. Musculoskeletal practitioners' perceptions of contextual factors that may influence chronic low back pain outcomes: a modified Delphi study. Chiropr Man Therap 2023; 31:12. [PMID: 37020314 PMCID: PMC10075502 DOI: 10.1186/s12998-023-00482-4] [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: 09/07/2022] [Accepted: 03/03/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Optimal shaping of contextual factors (CFs) during clinical encounters may be associated with analgesic responses in treatments for musculoskeletal pain. These CFs (i.e., the patient-practitioner relationship, patient's and practitioner's beliefs/characteristics, treatment characteristics, and environment) have not been widely evaluated by musculoskeletal practitioners. Understanding their views has the potential to improve treatment quality and effectiveness. Drawing on a panel of United Kingdom practitioners' expertise, this study aimed to investigate their perceptions of CFs during the management of patients presenting with chronic low back pain (LBP). METHODS A modified two-round online Delphi-consensus survey was conducted to measure the extent of panel agreement regarding the perceived acceptability and influence of five main types of CFs during clinical management of patients with chronic LBP. Qualified musculoskeletal practitioners in the United Kingdom providing regular treatment for patients with chronic LBP were invited to take part. RESULTS The successive Delphi rounds included 39 and 23 panellists with an average of 19.9 and 21.3 years of clinical experience respectively. The panel demonstrated a high degree of consensus regarding approaches to enhance the patient-practitioner relationship (18/19 statements); leverage their own characteristics/beliefs (10/11 statements); modify the patient's beliefs and consider patient's characteristics (21/25 statements) to influence patient outcomes during chronic LBP rehabilitation. There was a lower degree of consensus regarding the influence and use of approaches related to the treatment characteristics (6/12 statements) and treatment environment (3/7 statements), and these CFs were viewed as the least important. The patient-practitioner relationship was rated as the most important CF, although the panel were not entirely confident in managing a range of patients' cognitive and emotional needs. CONCLUSION This Delphi study provides initial insights regarding a panel of musculoskeletal practitioners' attitudes towards CFs during chronic LBP rehabilitation in the United Kingdom. All five CF domains were perceived as capable of influencing patient outcomes, with the patient-practitioner relationship being perceived as the most important CF during routine clinical practice. Musculoskeletal practitioners may require further training to enhance their proficiency and confidence in applying essential psychosocial skills to address the complex needs of patients with chronic LBP.
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Affiliation(s)
- Bronwyn Sherriff
- Department of Rehabilitation and Sport Sciences, Faculty of Health and Social Sciences, Bournemouth University, 504 Bournemouth Gateway Building, 10 St Paul's Lane, Bournemouth, Dorset, BH8 8AJ, England.
- AECC University College, Bournemouth, England.
| | - Carol Clark
- Department of Rehabilitation and Sport Sciences, Faculty of Health and Social Sciences, Bournemouth University, 504 Bournemouth Gateway Building, 10 St Paul's Lane, Bournemouth, Dorset, BH8 8AJ, England
| | - Clare Killingback
- Department of Sport, Health and Exercise Sciences, Faculty of Health Sciences, University of Hull, Hull, England
| | - Dave Newell
- AECC University College, Bournemouth, England
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Peart T, Kerr D, Searby A. Novice nurses' experiences in provision of mental ill health care within a regional emergency department: A descriptive qualitative study. Int J Ment Health Nurs 2023; 32:458-468. [PMID: 36562518 DOI: 10.1111/inm.13108] [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] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
Emergency departments are often the first point of contact for individuals presenting to healthcare services for assistance and treatment for mental ill health. Emergency departments, particularly those in regional areas, can experience high staff turnover and rely on novice nurses for workforce sustainability. The aim of this paper is to explore the experiences of novice nurses (nurses with <3 years of experience) in providing care to individuals presenting with mental ill health in the emergency department. Semi-structured interviews were conducted with novice nurses (N = 13) in a regional emergency department, using qualitative description as the guiding framework. The following three main themes were identified: (i) confidence in providing quality and safe nursing care, (ii) perceived barriers to providing quality and safe nursing care, and (iii) factors that increase confidence. Our findings indicate that proving safe and appropriate nursing care is affected in novice nurses by factors that lead to a perceived lack of confidence, such as how individuals present to the emergency department (e.g. intoxicated or violent), an inability to conduct conversations to assess accurately and perceived shortfalls in the emergency department environment itself. Future research should examine the curriculum for relevance of undergraduate education regarding acute mental health presentations and develop training strategies that enhance communication with individuals who present to the emergency department with mental ill health.
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Affiliation(s)
- Talitha Peart
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia.,Ballarat Health Services, Ballarat, Victoria, Australia
| | - Debra Kerr
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Adam Searby
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
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Forchuk C, Gyamfi S, Hassan H, Lucyk B, Booth R. Homeowner perspectives on the implementation of the Community Homes for Opportunity (CHO) program: an ethnographic group homes study in Southwestern Ontario Canada. BMC Public Health 2023; 23:585. [PMID: 36991379 PMCID: PMC10053089 DOI: 10.1186/s12889-023-15512-2] [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: 03/09/2022] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The global extant literature acknowledge that housing serves as a key social determinant of health. Housing interventions that involve group homes have been found to support the recovery of persons with mental illness and those with addiction issues. The current study explored the views of homeowners in relation to a supportive housing program called Community Homes for Opportunity (CHO) that modernised a provincial group home program (Homes for Special Care [HSC]) and provided recommendations for improving the program implementation in other geographical areas of Ontario. METHODS We applied ethnographic qualitative techniques to purposefully recruit 36 homeowner participants from 28 group homes in Southwest Ontario, Ontario Canada. Focus group discussions were conducted at two time points, during CHO program implementation (Fall 2018, and post implementation phases (Winter 2019) respectively. RESULTS Data analysis yielded 5 major themes. These include: (1) general impressions about the modernization process, (2) perceived social, economic and health outcomes, (3) enablers of the modernization program, (4) challenges to implementation of the modernization program, and (5) suggestions for implementation of the CHO in future. CONCLUSIONS A more effective and expanded CHO program will need the effective collaboration of all stakeholders including homeowners for successful implementation.
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Affiliation(s)
- Cheryl Forchuk
- Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, Lawson Health Research Institute, Arthur Labatt School of Nursing, Western University London, Parkwood Institute Mental Health Care Building, 550 Wellington Road, Suite B3-110, P.O. Box 5777, London, STN B, N6A 4V2, Canada.
| | - Sebastian Gyamfi
- Lawson Health Research Institute, Arthur Labatt School of Nursing, Parkwood Research Institute, Western University, London, Canada
| | - Heba Hassan
- Lawson Health Research Institute, Parkwood Research Institute, London, ON, Canada
| | - Bryanna Lucyk
- Lawson Health Research Institute, Parkwood Research Institute, London, ON, Canada
| | - Richard Booth
- Lawson Health Research Institute, Arthur Labatt School of Nursing, Western University, London, Canada
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Martínez-Angulo P, Muñoz-Mora M, Rich-Ruiz M, Ventura-Puertos PE, Cantón-Habas V, López-Quero S. "With your age, what do you expect?": Ageism and healthcare of older adults in Spain. Geriatr Nurs 2023; 51:84-94. [PMID: 36921397 DOI: 10.1016/j.gerinurse.2023.02.020] [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: 01/18/2023] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/17/2023]
Abstract
INTRODUCTION Ageism could influence the relationship between older patients' meeting needs and healthcare professionals' answers. AIMS To highlight the experience of older adults with healthcare systems, how they perceive ageism from their healthcare providers, and to explore the relationship between perceived ageism and self-perception of aging (SPA). METHODS We conducted an exploratory qualitative study. The participants were 14 women over 65 who lived alone in their homes. RESULTS Professional responses ignored the expression of preferences of the older patients and excluded them from decision-making processes. These answers influenced older patients' use of health services. Moreover, the negative aspects predominated in a SPA influenced by the internalization of stereotypes and a relationship weighed down by ageist behaviors on the part of health professionals. CONCLUSION Explicit situations of ageism influence an imbalance in power relations between older patients and healthcare professionals, a misuse of health services, and a negative SPA.
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Affiliation(s)
- Pablo Martínez-Angulo
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba 14004, Spain; Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), Córdoba 14071, Spain
| | - Margarita Muñoz-Mora
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba 14004, Spain; Hospital Universitario Reina Sofía (HURS), Córdoba 14004, Spain
| | - Manuel Rich-Ruiz
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba 14004, Spain; Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba 14004, Spain; Ciber Fragility and Healthy Aging (CIBERFES), Madrid 28029, Spain; Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Pedro E Ventura-Puertos
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba 14004, Spain; Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), Córdoba 14071, Spain
| | - Vanesa Cantón-Habas
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba 14004, Spain; Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba 14004, Spain
| | - Salvador López-Quero
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), Córdoba 14071, Spain; Department of Language Sciences, Faculty of Philosophy and Letters, University of Córdoba (UCO), Córdoba, Andalucía 14003, Spain
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Perinchery-Herman S. Primary Care Ethics is Just Medical Ethics: A Philosophical Argument for the Feasibility of Transitioning Acute Care Ethics to the Primary Care Setting. HEC Forum 2023; 35:73-94. [PMID: 33842989 DOI: 10.1007/s10730-021-09451-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 11/25/2022]
Abstract
Whether practiced by ethics committees or clinical ethicists, medical ethics enjoys a solid foundation in acute care hospitals. However, medical ethics fails to have a strong presence in the primary care setting. Recently, some ethicists have argued that the reason for this disparity between ethics in the acute and primary care setting is that primary care ethics is distinct from acute care ethics: the failure to translate ethics to the primary care setting stems from the incorrect belief that acute care ethics can be applied to the primary care setting. In this paper, I argue that primary care ethics and acute care ethics are species of the same ethical genus, and that the ethical differences are not ones of kind but of circumstance. I do this by appealing to the role obligations that underlie acute care and primary care clinicians' medical ethical obligations and the shared institutions that ground those obligations.
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Mudd A, Feo R, Pinero de Plaza MA, Tieu M, Paia SY, Cleland J, Windle A, George S, Thompson MQ, Ambagtsheer RC, Muller A, Hall A, Lange B. The Use of Digital Technologies in the Inpatient Setting to Promote Communication During the Early Stage of an Infectious Disease Outbreak: A Scoping Review. Telemed J E Health 2023; 29:172-197. [PMID: 35758765 DOI: 10.1089/tmj.2021.0615] [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] [Indexed: 11/12/2022] Open
Abstract
Background: Infectious disease outbreaks disrupt inpatient clinical care and have an impact on staff and patients' ability to communicate with each other and with the wider community. Digital technology may offer opportunities for communication in the inpatient setting during infectious disease outbreaks. Aim: This scoping review aimed to investigate the use of digital technology in the inpatient setting to promote communication in the early stages of an infectious disease outbreak. Methods: There were three aspects to this scoping review: (1) a database search of Ovid MEDLINE (MEDLINE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Association for Computing Machinery Digital Library (ACM) and IEEE Xplore (IEEE) exploring peer-reviewed articles, (2) a gray literature search, and (3) a media search. Results: Results focused on the early stages of the COVID-19 pandemic. Thirty-eight peer-reviewed articles were extracted from the database search. There were three main areas of investigation: study characteristics, technology features, and benefits and barriers. Forty-four websites were searched for the gray literature search focusing on policy and guidance. Eighteen media articles were retrieved focusing on patients' use of technology and community involvement. Conclusion: Results demonstrate the diverse use of digital technology in the inpatient setting to facilitate communication during the early stages of the COVID-19 pandemic. However, the articles provide limited data to allow readers to fully understand and reproduce described actions. Furthermore, there was limited guidance to support clinicians to communicate using digital technology to create trusting therapeutic relationships. Areas for future development include standard reporting process for technology hardware, software, and content; and structured reporting and evaluation of the implementation of technologies.
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Affiliation(s)
- Alexandra Mudd
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Rebecca Feo
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Maria A Pinero de Plaza
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, Adelaide, Australia
| | - Matthew Tieu
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Shila Y Paia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Jenny Cleland
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Alice Windle
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Stacey George
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.,Northern Adelaide Local Health Network, Allied Health Division, Lyell McEwin Hospital, Adelaide, Australia
| | - Mark Q Thompson
- National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, Adelaide, Australia.,Adelaide Geriatrics Training & Research with Aged Care Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Rachel C Ambagtsheer
- National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, Adelaide, Australia.,Health Vertical, Torrens University Australia, Adelaide, Australia
| | - Amanda Muller
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Anna Hall
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Belinda Lange
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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DiFabio D, Moodie S, O’Hagan R, Pardal S, Glista D. Barriers and facilitators to paediatric caregivers' participation in virtual speech, language, and hearing services: A scoping review. Digit Health 2023; 9:20552076231216684. [PMID: 38033515 PMCID: PMC10687955 DOI: 10.1177/20552076231216684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/02/2023] Open
Abstract
Purpose Virtual care-related technologies are transforming the way in which health services are delivered. A growing number of studies support the use of virtual care in the field of audiology and speech-language pathology; however, there remains a need to identify and understand what influences caregiver participation within the care that is virtual and family-focused. This review aimed to identify, synthesize, and summarize the literature around the reported barriers and facilitators to caregiver participation in virtual speech/hearing assessment and/or intervention appointments for their child. Methods A scoping review was conducted following the Joanna Briggs Institute manual for evidence synthesis. A search was conducted using six databases including MEDLINE, CINAHL, SCOPUS, ERIC, Nursing and Allied Health, and Web of Science to collect peer-reviewed studies of interest. Data was extracted according to a protocol published on Figshare, outlining a predefined data extraction form and search strategy. Results A variety of service delivery models and technology requirements were identified across the 48 included studies. Caregiver participation was found to vary across levels of attendance and involvement according to eight categories: Attitudes, child behavioral considerations, environment, opportunities, provider-family relationship, role in care process, support, and technology. Conclusions This review presents a description of the key categories reported to influence caregiver participation in virtual care appointments. Future research is needed to explore how the findings can be used within family-centered care models to provide strategic support benefiting the use and outcomes of virtual care.
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Affiliation(s)
- Danielle DiFabio
- School of Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - Sheila Moodie
- School of Health and Rehabilitation Sciences, Western University, London, ON, Canada
- The National Centre for Audiology, Western University, London, ON, Canada
- The School of Communication Sciences and Disorders, Western University, London, ON, Canada
| | - Robin O’Hagan
- The National Centre for Audiology, Western University, London, ON, Canada
| | - Simrin Pardal
- School of Health Studies, Western University, London, ON, Canada
| | - Danielle Glista
- School of Health and Rehabilitation Sciences, Western University, London, ON, Canada
- The National Centre for Audiology, Western University, London, ON, Canada
- The School of Communication Sciences and Disorders, Western University, London, ON, Canada
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Ramirez A, Mathis KJ, Moore AM, Tovar A. Developing Motivational Interviewing Skills Among Undergraduate Nursing Students. J Psychosoc Nurs Ment Health Serv 2022; 61:17-24. [PMID: 36322871 DOI: 10.3928/02793695-20221027-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The current study evaluated changes in undergraduate nursing students' knowledge and self-efficacy in motivational interviewing. Fourth-year undergraduate nursing students completed a hybrid, online curriculum. Changes in knowledge and self-efficacy were assessed using a pretest/posttest design. Repeated measures analysis of variance was used to determine differences between knowledge and self-efficacy mean scores. Of the 144 students who participated in the study, 88.2% were female, 96.5% were non-Hispanic/Latino, 88.9% were White, and mean age was 21.3 years. There were significant increases in knowledge and self-efficacy mean scores between pre-survey and post-survey 1 and 2. There were no differences between post-surveys 1 and 2 scores. A hybrid, online curriculum using asynchronous modules and synchronous simulation training can facilitate nursing students' learning experiences and enhance knowledge and self-efficacy about motivational interviewing. [Journal of Psychosocial Nursing and Mental Health Services, 61(5), 17-24.].
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Sriwatanathamma P, Sirivesmas V, Simatrang S, Bhowmik NH. Gamifying Cognitive Behavioral Therapy Techniques on Smartphones for Bangkok’s Millennials with Depressive Symptoms: Interdisciplinary Game Development (Preprint). JMIR Serious Games 2022; 11:e41638. [PMID: 37171845 DOI: 10.2196/41638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 03/01/2023] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND There is serious concern over the annual increase in depressive symptoms among millennials in Bangkok, Thailand. Their daily routine revolves around the use of their smartphones for work and leisure. Although accessibility to mental health care is expanding, it cannot keep up with the demand for mental health treatment. Outside Thailand, multiple projects and studies have attempted to merge gamification mechanisms and cognitive behavioral therapy (CBT) to create mobile health intervention apps and serious games with positive feedback. This presents an opportunity to explore the same approach in Thailand. OBJECTIVE This study investigated the development process of gamifying CBT techniques to support game mechanics in a visual narrative serious game, BlueLine. The primary target of this research is Bangkok's millennials. In the game, players play as Blue, a Bangkok millennial who struggles to live through societal norms that influence his digital life and relationships. Through in-game scenarios, players will learn and understand how to lessen the impact of depressive symptoms via gamified interactions on their smartphones. METHODS First, this paper follows each development step of solidifying BlueLine's game structure by integrating the Activating Events, Beliefs, Consequences, Disputation of Beliefs and Effective New Approaches (ABCDE) model and narrative in games. Second, the approach to select CBT and related therapeutic elements for gamification is based on suitability to the game structure. Throughout the process, CBT experts in Thailand have reviewed these scenarios. The approach forms the base of the player's interactions throughout the scenarios in BlueLine, broken down into 4 types of gamified mechanisms: narrative, verbal interactions, physical interactions, and social media interactions. RESULTS With the game structure based on the ABCDE model, BlueLine scenarios implement gamified mechanisms in conjunction with the following CBT and related therapeutic elements: behavioral activation, self-monitoring, interpersonal skills, positive psychology, relaxation and mindful activities, and problem-solving. In each scenario, players guide Blue to overcome his triggered dysfunctional beliefs. During this process, players can learn and understand how to lessen the impact of depressive symptoms through gamified interactions. CONCLUSIONS This paper presents the development process of gamifying CBT and related therapeutic techniques in BlueLine game scenarios. A scenario can harbor multiple techniques, including behavioral activation, self-monitoring, interpersonal skills, positive psychology, relaxation and mindful activities, and problem-solving. BlueLine's game structure does not limit the fact that the same combination of CBT elements ties each gamified mechanism.
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31
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GENC E. Development of Culturally Informed Trauma Therapy Approach for Muslim Refugee Families. SPIRITUAL PSYCHOLOGY AND COUNSELING 2022. [DOI: 10.37898/spiritualpc.1113571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Refugees from predominantly Muslim countries have been exposed to severe traumatic experiences in their country of origin. Further their stress continues during the resettlement process in the host country. Although the number of Muslim refugees is increasing in the U.S. and Europe, the existing literature is not adequate to derive a conclusion on treatment efficacy for specifically traumatized Muslim refugee families. An inadequate treatment approach for this population may result in negative/ineffective therapy outcomes. Thus, the aim of this study is to develop a culturally responsive treatment model. For this purpose, this study offers an integrated family-based therapy approach, which is influenced by narrative, art, and narrative exposure approaches for refugee families. This integrated family therapy model consists of 12 weekly sessions and includes 4 phases: a) diagnostic interview, b) narration of the life story, c) exposure to the trauma, and d) re-narrate and reprocessing of the traumatic events. Future studies should test the feasibility and effectiveness of the integrated model using the randomized controlled trials, as the acquisition of such treatment models is essential to the development of a culturally sensitive treatment model for Muslim refugees.
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Attivissimo LA, Friedman MI, Williams M, Rimar A, Nouryan C, Patel V, Kozikowski A, Zhang M, Pekmezaris R. Goals of care conversation education program: An intervention to help health care professionals break bad news to patients with advanced illness. GERONTOLOGY & GERIATRICS EDUCATION 2022; 43:407-417. [PMID: 33627035 DOI: 10.1080/02701960.2021.1893171] [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: 06/12/2023]
Abstract
The purpose of the study was to measure the effectiveness of communication skills intervention results for healthcare professionals. A multi-site pretest-posttest survey assessing the efficacy of a Goals of Care conversation education program. The program aimed to educate healthcare professionals concerning having Goals of Care conversations with patients and families. This research was implemented in a large healthcare organization in the Northeastern United States. This study found significant differences between pretests and posttests across professions, palliative care specialty, degree types, and years of experience in the participant's self-reported ability and comfort levels in having conversations about Goals of Care with patients and families. Providing education on Goals of Care was effective in improving the knowledge and comfort of health care professionals with conducting advanced illness conversations.
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Affiliation(s)
| | - M Isabel Friedman
- Department of Clinical Transformation, Northwell, Lake Success, New York, USA
| | - Myia Williams
- Department of Medicine, Northwell Health, Manhasset, New York, USA
| | - Alexander Rimar
- Department of Medicine, Long Island Jewish Medical Center, Queens, New York, USA
| | - Christian Nouryan
- Department of Medicine, Northwell Health, Manhasset, New York, USA
- Department of Medicine, The Feinstein Institute for Medical Research, Manhasset, New York, USA
- Department of Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Vidhi Patel
- Department of Medicine, Northwell Health, Manhasset, New York, USA
| | - Andrzej Kozikowski
- Department of Medicine, Northwell Health, Manhasset, New York, USA
- Department of Medicine, The Feinstein Institute for Medical Research, Manhasset, New York, USA
- Department of Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Meng Zhang
- Department of Medicine, The Feinstein Institute for Medical Research, Manhasset, New York, USA
| | - Renee Pekmezaris
- Department of Medicine, Northwell Health, Manhasset, New York, USA
- Department of Medicine, The Feinstein Institute for Medical Research, Manhasset, New York, USA
- Department of Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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Johnston-Devin C, Oprescu F, Wallis M, Gray M. Educational considerations for health professionals to effectively work with clients with complex regional pain syndrome. PLoS One 2022; 17:e0269337. [PMID: 35696357 PMCID: PMC9191715 DOI: 10.1371/journal.pone.0269337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
People living with complex regional pain syndrome (CRPS), a rare chronic pain disorder, must become experts in their own self-management. Listening to the voice of the patient is often advocated in the pain literature. However, the patient’s option is rarely asked for or considered by clinicians, even when they live with a condition that health professionals have rarely heard of.
Purpose
To explore what people living with complex regional pain syndrome (CRPS) think health professionals should know about their condition to provide appropriate care.
Design
A heuristic, hermeneutic phenomenological study was conducted asking people about their experiences living with CRPS. This paper reports on the findings of an additional question asked of all participants.
Participants
Seventeen people living with complex regional pain syndrome were interviewed.
Findings
Overwhelmingly, participants felt that health professionals do not know enough about CRPS, or chronic pain and believe their health outcomes are affected by this lack of knowledge. Sub-themes identified were don’t touch unless I say it is okay; be patient with the patient/ it is important to develop a relationship; educate yourself and educate the patient; choose your words carefully and refer to others as needed. An additional theme, it is very hard to describe CRPS was also identified.
Conclusions
Including patients as a member of the healthcare team is recommended to help people take control and self-manage their pain. For true patient centered care to be achieved, health professionals must accept and respect patients’ descriptions of pain and their pain experience. This may require additional health professional education at both undergraduate and post-graduate levels in pain and communication to increase their bedside manner and therapeutic communication to deliver care in partnership with the patient.
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Affiliation(s)
- Colleen Johnston-Devin
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia
- * E-mail:
| | - Florin Oprescu
- School of Health and Sport Science, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Marianne Wallis
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
| | - Marion Gray
- School of Health and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia
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Akbari M, Seydavi M, Rowhani NS, Nouri N. Psychological predictors of treatment adherence among patients with diabetes (types I and II): Modified information-motivation-behavioural skills model. Clin Psychol Psychother 2022; 29:1854-1866. [PMID: 35510374 DOI: 10.1002/cpp.2746] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/23/2022] [Accepted: 04/29/2022] [Indexed: 11/05/2022]
Abstract
Non-adherence to medical regimens among patients with diabetes is a well-recognized concern in health care. Modified information, motivation, behavioural skills (IMB) model by adding an emotion component to it was tested to explore predictors of treatment adherence among 1,125 Iranian patients with diabetes type I (T1D) and type II (T2D) and due to other medical conditions. The modified IMB model explained 35% of the treatment adherence with large effect-sizes f2 = 0.56 to 0.69. Self-compassion and interpersonal communication between staff and patients (ICSP) were significant predictors of treatment adherence among patients with T1D, T2D and diabetes due to other medical conditions, while both outperformed the other significant predictors of treatment adherence, i.e., illness perception and social support in all groups. Distress intolerance was a significant predictor of treatment adherence only in patients with T2D. In addition, patients, based on their type of diabetes, exhibited different patterns of illness perception in predicting treatment adherence. Among T2D patients and those with diabetes due to other medical conditions, gender (male; only in T2D) and being single were significant predictors of treatment adherence, while age and diabetes duration were not. Finally, the model demonstrated that above and beyond demographic features, self-compassion, interpersonal communication between patients and health care staff, distress intolerance, perceived social support and illness perception were significant predictors of treatment adherence among patients with diabetes.
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Affiliation(s)
- Mehdi Akbari
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Mohammad Seydavi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Nayyereh S Rowhani
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Naemeh Nouri
- Department of Educational Psychology, Shiraz University, Shiraz, Iran
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Poulin LIL, Skinner MW. Emotional geographies of loss in later life: An intimate account of rural older peoples' last move. Soc Sci Med 2022; 301:114965. [PMID: 35468388 DOI: 10.1016/j.socscimed.2022.114965] [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: 11/05/2021] [Revised: 02/15/2022] [Accepted: 04/04/2022] [Indexed: 10/18/2022]
Abstract
Providing a rural example of the interconnection between aging, emotion, time and place, this paper explores the intimate experiences of loss as older adults move into long-term care settings. Drawing on findings from a qualitative case study of transitions in care in rural Canada, we demonstrate the spatial and temporal dimensions of the experiences of older adults and their carers. In so doing, we highlight the benefits of embracing emotional geographies of care as a new lens in transitions in care research and outline emergent questions for research, policy and practice that will enhance knowledge in the field.
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Affiliation(s)
- Laura I L Poulin
- Trent University, Trent Centre for Aging & Society, 1600 West Bank Dr., Peterborough, Ontario, K9L 0G2, Canada.
| | - Mark W Skinner
- Trent University, School of the Environment, 1600 West Bank Dr., Peterborough, Ontario, K9L 0G2, Canada.
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Perlman D, Moxham L, Patterson C, Tapsell A, Keough E. The influence of a self-determination theory grounded clinical placement on nursing student's therapeutic relationship skills: A pre-test/post-test study. Int J Ment Health Nurs 2022; 31:305-312. [PMID: 34820992 DOI: 10.1111/inm.12957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022]
Abstract
For undergraduate nursing students, an integral mode of learning is their clinical placements. Learning within the clinical setting is influenced by factors such as the facilitators, peers, unit, or department the student is placed on. What is not known is the role of a social context that is grounded in Self-Determination Theory and how this influences the development of therapeutic relationship skills among undergraduate nursing students. The aim of this study was to examine the role of autonomy support in the professional learning of undergraduate nursing students. This study employed a two-group pre-test and post-test design, with undergraduate nursing students placed in either an autonomy-supportive group or a comparison group in an Australian context. Therapeutic relationship skills were assessed at the beginning and end of their compulsory mental health clinical placement. Participants were 210 (n = 210) Australian undergraduate nursing students. Using a tertile split, 140 students were placed into one of two groups based on their perception of autonomy support at the post-test time point. Pre- and post-test therapeutic relationship data were collected for both groups. A repeated measures analysis of variance was used to examine whether engagement in different clinical placements would illicit significant differences in therapeutic relationship skills. Undergraduate nursing students who were engaged in the autonomy-supportive setting had significantly higher scores associated with the therapeutic relationship subscales: Positive Collaboration and Positive Clinical Input. The importance of the social context is underscored, which is strongly influenced by the educational leader, typically referred to as a nurse facilitator.
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Affiliation(s)
- Dana Perlman
- School of Education: Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lorna Moxham
- School of Education: Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Christopher Patterson
- School of Nursing: Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Amy Tapsell
- Global Challenges Program, Research and Innovation Division, University of Wollongong, Wollongong, New South Wales, Australia
| | - Emily Keough
- School of Psychology: Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
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Nagy A, McMahon A, Tapsell L, Deane F. The therapeutic relationship between a client and dietitian: A systematic integrative review of empirical literature. Nutr Diet 2022; 79:303-348. [PMID: 35324041 PMCID: PMC9543415 DOI: 10.1111/1747-0080.12723] [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: 10/06/2021] [Revised: 12/11/2021] [Accepted: 01/01/2022] [Indexed: 01/03/2023]
Abstract
Aim Scientific evidence underpins dietetics practice; however, evidence of how the therapeutic relationship influences outcomes is limited. This integrative review aims to provide a comprehensive overview of the topic of the therapeutic relationship between clients and dietitians in the individual counselling context by summarising empirical literature into qualitative themes. Methods An electronic literature search of the Cumulative Index of Nursing and Allied Health Literature, PsychInfo, Scopus and Web of Science databases was conducted in October 2018 and repeated in February 2021. Studies were included if they explicitly referred to the therapeutic relationship (or associated terms), were based on study data and available in full text. Extracted data were checked by a second researcher and the methodological quality was evaluated independently by two researchers using the Mixed Methods Appraisal Tool. An iterative process of qualitatively coding, categorising and comparing data to examine recurring themes was applied. Results Seventy‐six studies met the inclusion criteria. Five themes were identified which showed the extent and nature of research in this area. Studies revealed the therapeutic relationship: (i) is valued within clinical dietetic practice, (ii) involves complex and multifactorial interactions, (iii) is perceived as having a positive influence, (iv) requires skills training and (v) is embedded in practice models and tools. Conclusion Studies show the therapeutic relationship is a valued and multifactorial component of clinical dietetic practice and is perceived to positively influence the client and dietitian. Observational data are needed to assess the extent to which the strength of the therapeutic relationship might contribute to clients' health outcomes.
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Affiliation(s)
- Annaliese Nagy
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anne McMahon
- School of Health & Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Linda Tapsell
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Frank Deane
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
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38
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Otterwell S, Baker MJ. Assessment and management of a person experiencing pain from pancreatic cancer ascites: a case study. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S16-S20. [PMID: 35271354 DOI: 10.12968/bjon.2022.31.5.s16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The most common type of pancreatic cancer is pancreatic adenocarcinoma, which affects the exocrine ducts. There are many risk factors associated with pancreatic cancer, including smoking, obesity, poor diet, diabetes, inactivity and genetics. In the UK, pancreatic cancer is the 10th most common cancer with a poor prognosis, with only 24% of people surviving the first year after diagnosis and 7% surviving for 5 years. The lives of those with the condition are impacted in a number of ways. This case study of a patient with pancreatic cancer explores the nursing assessment, management and evaluation of care provided from a student nurse perspective under the supervision of a qualified nurse.
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Affiliation(s)
- Siouxsie Otterwell
- Second-year Student Nurse, Florence Nightingale School of Nursing and Midwifery, King's College London
| | - Mark J Baker
- Lecturer, Florence Nightingale School of Nursing and Midwifery, King's College London
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39
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Wilkinson A, Atlas J, Nelson K, Mulligan H. Client perceptions of engaging with a health and social care navigation service: A qualitative study. Chronic Illn 2022; 18:169-180. [PMID: 32727202 DOI: 10.1177/1742395320937046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Health and social care navigation services provide support for people with long-term conditions. Such services are available in the New Zealand (NZ) context. However little is known nationally or internationally about clients' experience of engaging with such services. This study aimed to describe client perspectives of engaging with a health and social care navigation service in a NZ metropolitan city. METHODS The manager and navigators of the service recruited clients who were previous users of the service. We individually interviewed nine clients (F = 7; M = 2; aged between 30-80 years) in their homes. Many of the participants reported social isolation, and some were without regular income. We transcribed interviews verbatim and analysed data thematically. RESULTS There was one overall theme: Restoration of my essence or being (in the Māori language, wairua), and sense of belonging (turangawaewae) through a regenerative approach developed in partnership between the navigator and the client. Thus, participants felt renewed and validated as human beings. DISCUSSION Enabling clients to feel re-valued as human beings captures the concept of personhood whereby a person has capability and capacity for life choices. We suggest enabling a client to feel valued assists in development of self-determination and consequently improved health and well-being.
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Affiliation(s)
- Amanda Wilkinson
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Janel Atlas
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Katrina Nelson
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Hilda Mulligan
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Chukwuere PC, Sehularo LA, Manyedi ME. Experiences of adolescents and parents on the mental health management of depression in adolescents, North West province, South Africa. Curationis 2022; 45:e1-e9. [PMID: 35261252 PMCID: PMC8905408 DOI: 10.4102/curationis.v45i1.2178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 12/29/2021] [Accepted: 11/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background Living with or managing an adolescent suffering from depression predisposes the adolescent and parents to various experiences, considering the multifactorial nature of depression and associated symptoms. Objective This study explored and described the experiences of adolescents and their parents on the mental health management of depression in the North West province (NWP), South Africa. Method A qualitative, exploratory, descriptive, contextual research design was adopted. Data was collect from two mental health care institutions and two mental health care units attached to two general hospitals in the NWP, SA. Thirty-two participants (18 adolescents and 14 parents) were purposefully selected for the study. Data were collected through individual interviews and analysed using Tesch’s open-coding method to generate themes and categories which were presented with the concurrent support of participants direct quotations. Results The study revealed that the experiences of adolescents with depression and their parents taking care of them at homes include the following: emotional distress, poor coping mechanisms, financial burden, repeated suicidal attempts, negative attitudes from support systems and withdrawal behaviours. Appropriate therapeutic environments, ongoing monitoring by mental healthcare practitioners and adequate support systems were suggested by participants as management approaches that could enhance the recovery of adolescents from depression. Conclusion The findings revealed the devastating experiences of adolescents with depression and their parents taking care of them in their various homes which confirms the dire need for attention on the plights of these groups in order to facilitate adolescents’ recovery and strengthen the adolescents’ and parents’ coping mechanisms for a healthier family.
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Affiliation(s)
- Precious C Chukwuere
- Department of Nursing Science, Faculty of Health Science, North-West University, Mahikeng.
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Costello J, Smith M. The BCH message banking process™, voice banking, and double-dipping™. Augment Altern Commun 2022; 37:241-250. [PMID: 35000518 DOI: 10.1080/07434618.2021.2021554] [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: 10/19/2022] Open
Abstract
Significant advances have been made in interventions to maintain communication and personhood for individuals with neurodegenerative conditions. One innovation is Message Banking, a clinical approach first developed at Boston Children's Hospital (BCH). This paper outlines the Message Banking process as implemented at BCH, which includes the option of "Double Dipping," where banked messages are mined to develop personalized synthesized voices. More than a decade of experience has led to the evolution of six core principles underpinning the BCH process, resulting in a structured introduction of the associated concepts and practices with people with amyotrophic lateral sclerosis (ALS) and their families. These principles highlight the importance of assigning ownership and control of the process to individuals with ALS and their families, ensuring that as a tool it is empowering and offers hope. Changes have been driven by feedback from individuals who have participated in the BCH process over many years. The success of the process has recently been extended through partnerships that allow the recorded messages to be used to develop individual personalized synthetic voices to complement banked messages. While the process of banking messages is technically relatively simple, the full value of the process should be underpinned by the values and principles outlined in this tutorial.
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Affiliation(s)
- John Costello
- Augmentative Communication Program and Jay S. Fishman ALS Augmentative Communication Program, Boston Children's Hospital, Adjunct Faculty Boston University, Boston, MA, USA
| | - Martine Smith
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
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The Feasibility of a Primary Care Based Navigation Service to Support Access to Health and Social Resources: The Access to Resources in the Community (ARC) Model. Int J Integr Care 2022; 22:13. [PMID: 36474646 PMCID: PMC9695153 DOI: 10.5334/ijic.6500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 10/28/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION We established a patient centric navigation model embedded in primary care (PC) to support access to the broad range of health and social resources; the Access to Resources in the Community (ARC) model. METHODS We evaluated the feasibility of ARC using the rapid cycle evaluations of the intervention processes, patient and PC provider surveys, and navigator log data. PC providers enrolled were asked to refer patients in whom they identified a health and/or social need to the ARC navigator. RESULTS Participants: 26 family physicians in four practices, and 82 of the 131 patients they referred. ARC was easily integrated in PC practices and was especially valued in the non-interprofessional practices. Patient overall satisfaction was very high (89%). Sixty patients completed the post-intervention surveys, and 33 reported accessing one or more service(s). CONCLUSION The ARC Model is an innovative approach to reach and support a broad range of patients access needed resources. The Model is feasible and acceptable to PC providers and patients, and has demonstrated potential for improving patients' access to health and social resources. This study has informed a pragmatic randomized controlled trial to evaluate the ARC navigation to an existing web and telephone navigation service (Ontario 211).
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Refaat Ahmed F, Shalaby SA. Exploring empathy and self-efficacy in communication skills among nursing students: A cross-sectional study at two universities in the MENA region. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Whitehead L, Palamara P, Allen J, Boak J, Quinn R, George C. Nurses' perceptions and beliefs related to the care of adults living with multimorbidity: A systematic qualitative review. J Clin Nurs 2021; 31:2716-2736. [PMID: 34873763 DOI: 10.1111/jocn.16146] [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: 08/12/2021] [Revised: 11/07/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To identify and synthesise the available qualitative evidence on nurses' perceptions and beliefs related to the care of adults living with multimorbidity. BACKGROUND The rising prevalence of adults living with multimorbidity has increased demand for health care and challenges nursing care. No review has been conducted to date of the studies of nurses' perceptions and beliefs related to the provision of care to guide policy makers, practitioners and further research to identify and deliver quality care for persons living with multimorbidity. DESIGN Systematic review of qualitative studies conducted in line with the PRISMA checklist. METHODOLOGY Eight electronic publication databases and sources of grey literature were searched to identify original qualitative studies of the experience of nurses caring for adults with multiple chronic conditions with no restrictions on the date of publication or study context. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data were extracted using the Joanna Briggs Institute standardised data extraction tool for qualitative research. Data synthesis was undertaken through meta-aggregation. RESULTS Eleven qualitative studies were included in the review. All studies met eight or more of the 10 assessment criteria of the JBI Critical Appraisal Checklist for Qualitative Research. Four synthesised findings were generated from the aggregated findings: (i) the challenge of providing nursing care; (ii) the need to deliver holistic and person-centred nursing care; (iii) the importance of developing a therapeutic nurse-patient relationship, and (iv) delivering nursing care as part of an interprofessional care team. CONCLUSIONS The complexity of multimorbidity and the predominant single-disease model of chronic care present challenges for the delivery of nursing care to adults living with multimorbidity. RELEVANCE TO CLINICAL PRACTICE The nursing care of persons with multimorbidity needs to incorporate holistic assessment and person-centred care principles as part of a collaborative and interprofessional team approach. PROSPERO REGISTRATION CRD42020186773.
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Affiliation(s)
- Lisa Whitehead
- Centre for Nursing, Midwifery and Health Services Research, School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Peter Palamara
- Centre for Nursing, Midwifery and Health Services Research, School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Jacqueline Allen
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Jennifer Boak
- Bendigo Health, 100 Barnard Street, Bendigo, Victoria, Australia
| | - Robyn Quinn
- Australian College of Nursing, Parramatta, VIC
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Devall A, Chu J, Beeson L, Hardy P, Cheed V, Sun Y, Roberts T, Ogwulu CO, Williams E, Jones L, Papadopoulos JLF, Bender-Atik R, Brewin J, Hinshaw K, Choudhary M, Ahmed A, Naftalin J, Nunes N, Oliver A, Izzat F, Bhatia K, Hassan I, Jeve Y, Hamilton J, Deb S, Bottomley C, Ross J, Watkins L, Underwood M, Cheong Y, Kumar C, Gupta P, Small R, Pringle S, Hodge F, Shahid A, Gallos I, Horne A, Quenby S, Coomarasamy A. Mifepristone and misoprostol versus placebo and misoprostol for resolution of miscarriage in women diagnosed with missed miscarriage: the MifeMiso RCT. Health Technol Assess 2021; 25:1-114. [PMID: 34821547 DOI: 10.3310/hta25680] [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] [Indexed: 11/22/2022] Open
Abstract
TRIAL DESIGN A randomised, parallel-group, double-blind, placebo-controlled multicentre study with health economic and nested qualitative studies to determine if mifepristone (Mifegyne®, Exelgyn, Paris, France) plus misoprostol is superior to misoprostol alone for the resolution of missed miscarriage. METHODS Women diagnosed with missed miscarriage in the first 14 weeks of pregnancy were randomly assigned (1 : 1 ratio) to receive 200 mg of oral mifepristone or matched placebo, followed by 800 μg of misoprostol 2 days later. A web-based randomisation system allocated the women to the two groups, with minimisation for age, body mass index, parity, gestational age, amount of bleeding and randomising centre. The primary outcome was failure to pass the gestational sac within 7 days after randomisation. The prespecified key secondary outcome was requirement for surgery to resolve the miscarriage. A within-trial cost-effectiveness study and a nested qualitative study were also conducted. Women who completed the trial protocol were purposively approached to take part in an interview to explore their satisfaction with and the acceptability of medical management of missed miscarriage. RESULTS A total of 711 women, from 28 hospitals in the UK, were randomised to receive either mifepristone plus misoprostol (357 women) or placebo plus misoprostol (354 women). The follow-up rate for the primary outcome was 98% (696 out of 711 women). The risk of failure to pass the gestational sac within 7 days was 17% (59 out of 348 women) in the mifepristone plus misoprostol group, compared with 24% (82 out of 348 women) in the placebo plus misoprostol group (risk ratio 0.73, 95% confidence interval 0.54 to 0.98; p = 0.04). Surgical intervention to resolve the miscarriage was needed in 17% (62 out of 355 women) in the mifepristone plus misoprostol group, compared with 25% (87 out of 353 women) in the placebo plus misoprostol group (risk ratio 0.70, 95% confidence interval 0.52 to 0.94; p = 0.02). There was no evidence of a difference in the incidence of adverse events between the two groups. A total of 42 women, 19 in the mifepristone plus misoprostol group and 23 in the placebo plus misoprostol group, took part in an interview. Women appeared to have a preference for active management of their miscarriage. Overall, when women experienced care that supported their psychological well-being throughout the care pathway, and information was delivered in a skilled and sensitive manner such that women felt informed and in control, they were more likely to express satisfaction with medical management. The use of mifepristone and misoprostol showed an absolute effect difference of 6.6% (95% confidence interval 0.7% to 12.5%). The average cost per woman was lower in the mifepristone plus misoprostol group, with a cost saving of £182 (95% confidence interval £26 to £338). Therefore, the use of mifepristone and misoprostol for the medical management of a missed miscarriage dominated the use of misoprostol alone. LIMITATIONS The results from this trial are not generalisable to women diagnosed with incomplete miscarriage and the study does not allow for a comparison with expectant or surgical management of miscarriage. FUTURE WORK Future work should use existing data to assess and rank the relative clinical effectiveness and safety profiles for all methods of management of miscarriage. CONCLUSIONS Our trial showed that pre-treatment with mifepristone followed by misoprostol resulted in a higher rate of resolution of missed miscarriage than misoprostol treatment alone. Women were largely satisfied with medical management of missed miscarriage and would choose it again. The mifepristone and misoprostol intervention was shown to be cost-effective in comparison to misoprostol alone. TRIAL REGISTRATION Current Controlled Trials ISRCTN17405024. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 68. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Adam Devall
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Justin Chu
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Leanne Beeson
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Pollyanna Hardy
- National Perinatal Epidemiology Unit Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Versha Cheed
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Yongzhong Sun
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Tracy Roberts
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Chidubem Okeke Ogwulu
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Eleanor Williams
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Laura Jones
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | | | | | | | - Kim Hinshaw
- Sunderland Royal Hospital, South Tyneside & Sunderland NHS Foundation Trust, Sunderland, UK
| | - Meenakshi Choudhary
- Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Amna Ahmed
- Sunderland Royal Hospital, South Tyneside & Sunderland NHS Foundation Trust, Sunderland, UK
| | - Joel Naftalin
- University College Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Natalie Nunes
- West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, Isleworth, UK
| | - Abigail Oliver
- St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Feras Izzat
- University Hospital Coventry, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Kalsang Bhatia
- Burnley General Hospital, East Lancashire Hospitals NHS Trust, Burnley, UK
| | - Ismail Hassan
- Birmingham Women's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Yadava Jeve
- Birmingham Women's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Judith Hamilton
- Guy's and St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Shilpa Deb
- Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Cecilia Bottomley
- Chelsea and Westminster Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Jackie Ross
- King's College Hospital, King's College Hospital NHS Foundation Trust, London, UK
| | - Linda Watkins
- Liverpool Women's Hospital, Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Martyn Underwood
- Princess Royal Hospital, Shrewsbury and Telford Hospital NHS Trust, Telford, UK
| | - Ying Cheong
- Department of Reproductive Medicine, University of Southampton, Southampton, UK
| | - Chitra Kumar
- Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Pratima Gupta
- Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Rachel Small
- Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Stewart Pringle
- Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Frances Hodge
- Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Anupama Shahid
- Barts Health NHS Trust, Royal London Hospital, London, UK
| | - Ioannis Gallos
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Andrew Horne
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Siobhan Quenby
- Biomedical Research Unit in Reproductive Health, University of Warwick, Coventry, UK
| | - Arri Coomarasamy
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Chambers M, McAndrew S, Nolan F, Thomas B, Watts P, Kantaris X. Measuring therapeutic engagement in acute mental health inpatient environments: the perspectives of service users and mental health nurses. BMC Psychiatry 2021; 21:547. [PMID: 34749690 PMCID: PMC8576955 DOI: 10.1186/s12888-021-03561-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 10/05/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A key component of caring for service users (SUs) in acute mental health inpatient environments is Therapeutic Engagement (TE). To that end, the Therapeutic Engagement Questionnaire (TEQ) was developed and validated. The TEQ measures TE between SUs and registered mental health nurses (RMHNs) from the perspective of both parties and can quantify and recognise how nurses engage with SUs and monitor this activity as well as its enhancement of SU care and recovery. The aim of this study was to explore the views of SUs and RMHNs in relation to the TEQ and how it could be adopted into clinical practice within an acute inpatient environment. METHODS As part of the validation stage of the development of the TEQ, the views of 628 SUs and 543 RMHNs were collected using a qualitative approach by way of free text at the end of the questionnaire. Two questions required free text response: - 'what do you think of the TEQ?', and 'how can it be utilised?' RESULTS Following thematic analysis, it was found that both sets of participants stated that such a tool could be utilised to improve the service, could help nurses with reflective practice, be utilised as part of clinical supervision and to aid nurses' professional development. The nurse participants also stated that such a tool would help track SU participation and enablement in their care. Furthermore, the nurses noted that the tool would help to reinforce the core 'caring' value of nursing and the overall goal of recovery. The SUs added that the TEQ would recognise the work of mental health nurses and provide them with a clear opportunity to express their views in relation to nursing staff. CONCLUSIONS Therapeutic engagement (TE) has been identified as part of the repertoire of mental health nursing and both groups of participants identified how a tool to assess this construct may be utilised in day-to-day clinical practice to the benefit of each group.
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Affiliation(s)
- M. Chambers
- grid.4464.20000 0001 2161 2573Kingston University and St George’s, University of London, Faculty of Health, Social Care and Education, St George’s Campus, 6th Floor Hunter Wing, Cranmer Terrace, London, SW17 0RE UK
| | - S. McAndrew
- grid.8752.80000 0004 0460 5971University of Salford, School of Health and Society, Salford, Greater Manchester, M6 6PU UK
| | - F. Nolan
- grid.5115.00000 0001 2299 5510Anglia Ruskin University, Faculty of Health, Education, Medicine and Social Care, Bishop Hall Lane, Chelmsford, Essex CM1 1SQ UK
| | - B. Thomas
- London Southbank University, 103 Borough Road, London, SE1 0AA UK
| | - P. Watts
- Formerly of Somerset Partnership NHS Foundation Trust, Community Mental Health Nursing, 2nd Floor Mallard Court, Express Park, Bristol Road, Bristol, TA4 4RN UK
| | - X. Kantaris
- grid.4464.20000 0001 2161 2573Kingston University and St George’s, University of London, Faculty of Health, Social Care and Education, St George’s Campus, 6th Floor Hunter Wing, Cranmer Terrace, London, SW17 0RE UK
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Sukkasi S, Tunnukit P, Lerspalungsanti S. Developing Assistive Bedside Furniture for Early Postoperative Mobilization in a Healthcare Setting With an Attentive Empathetic Design Approach. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:331-346. [PMID: 34663114 DOI: 10.1177/19375867211051716] [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: 11/16/2022]
Abstract
OBJECTIVES This work endeavored to design and develop a tool to assist surgical patients with postoperative mobilization in a hospital. BACKGROUND Early postoperative mobilization after surgery can effectively help prevent complications, but it is difficult to achieve in practice. METHOD An attentive empathetic design approach was used to gain insights into the users' functional needs, characteristics, contexts, as well as their emotional needs, behaviors, and psychology. The insights led to a design that leveraged psychological heuristics and habit-building principles to effect necessary mindset and behavioral changes of the stakeholders. Over four iterations, design ideas were prototyped, tested, and improved with participation of 30 patients and 30 nurses. RESULTS Valuable insights were discovered. Most importantly, besides the medically critical need to avoid postoperative complications, the patients also had emotional needs for independence, confidence, and self-worthiness, while the nurses needed the patients' trust. Consequently, assistive bedside furniture prototypes were designed to enable the patients to move around safely by themselves. Feedback on the prototypes showed that the patients sat up more often, enjoyed doing more activities, became more confident and less fearful of moving around, and felt less burdening on the care providers. Moreover, the nurses appreciated that the prototypes reduced their patient-mobilization workload, facilitated patient empowerment, and improved their relationship with the patients. CONCLUSIONS An attentive empathetic design approach can comprehend complex challenges of and subsequently design an effective solution for healthcare contexts, in which the stakeholders' medical necessities intertwine with emotional, psychological, behavioral, and sociocultural needs.
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Affiliation(s)
- Sittha Sukkasi
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency, Pathumthani, Thailand
| | | | - Sarawut Lerspalungsanti
- National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency, Pathumthani, Thailand
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Badu E, O'Brien AP, Mitchell R, Osei A. A qualitative study of evidence-based therapeutic process in mental health services in Ghana- context-mechanisms-outcomes. BMC Health Serv Res 2021; 21:1013. [PMID: 34563183 PMCID: PMC8466714 DOI: 10.1186/s12913-021-06993-1] [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] [Received: 10/06/2020] [Accepted: 09/07/2021] [Indexed: 02/03/2023] Open
Abstract
Background Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana. Methods A purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds. Conclusion Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06993-1.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, Australia.
| | | | - Rebecca Mitchell
- Macquarie Business School, Macquarie University, Sydney, Australia
| | - Akwasi Osei
- Ghana Mental Health Authority, Ghana Health Services, Accra, Ghana
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Bennett C. Improving mental health education in nursing school. Nursing 2021; 51:48-53. [PMID: 34463654 DOI: 10.1097/01.nurse.0000769868.09336.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Nurses are at the forefront of providing care to individuals with mental illness in various healthcare settings, yet the World Health Organization and others have found that many nurses are inadequately prepared to provide mental health care. This article discusses the nurse's role in providing care to individuals with mental illness and the importance of integrating more mental health education into undergraduate nursing curricula.
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Affiliation(s)
- Courtney Bennett
- Courtney Bennett is an adult psychiatric mental health NP and family medical NP at East Mississippi State Hospital in Meridian, Miss., and a clinical adjunct instructor at the University of West Alabama in Livingston, Ala
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The TIS Methodology: An Approach for Purposeful, Relational Communication. Creat Nurs 2021; 26:175-181. [PMID: 32883817 DOI: 10.1891/crnr-d-20-00019] [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: 11/25/2022]
Abstract
Patients frequently identify communication with nurses as the most important aspect that influences their health-care experience. Nursing education curricula tend to emphasize the preparation of nurses to excel in scientific knowledge, technological expertise, and practical skills. Instruction in communication is often inadequate. While these educational programs may inform learners of what they should do to communicate effectively, they do not tell or show learners how to do it. Failure to develop theoretical instruction in fundamental interactive communication can impair nurses' ability to engage patients in meaningful relationships, and can impact the delivery of patient-centered quality care. The TIS Methodology (Theme, Invitation, Simplicity) is an innovative, systematic approach to purposeful, relational communication. TIS offers an effective way to listen attentively and engage effectively in interpersonal relationships. The primary focus of TIS is the learned ability to listen to what another is saying or meaning, and to respond appropriately. A case study approach is used to illustrate the effective application of the TIS Methodology and to enhance an understanding of TIS principles and standards.
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