Theoretical Perspectives of Hospitalized Older Patients and Their Health-Related Problems and Quality of Care: Systematic Literature Review

The buffering role of social support on the severity of physical symptoms among patients living with cancer

BACKGROUND

The role of perceived social support (the individual's perception that family, friends and others are available as psychological, social and material support) and its moderating effect on the psychological and physical factors among patients suffering medical problems is still debated.

AIM

To explore the effect of perceived social support on the relationship between psychological and health-related factors on the severity of physical symptoms among patients with cancer.

METHODS

A descriptive-correlational, cross-sectional design was used to recruit 459 patients with cancer from three major hospitals in Jordan. Data were collected using a self-administered questionnaire.

RESULTS

Social support was significantly correlated to the severity of physical symptoms (p>.05) among patients with cancer, while psychological distress, sadness, disturbed body image and anxiety were not (p<.05). The multiple hierarchal regression model showed that social support has no significant moderation effect on the relationship between psychological and health-related factors and the severity of physical symptoms controlling for sociodemographic factors among patients with cancer.

CONCLUSION

Patients with cancer suffering physical and psychological disturbances do not benefit from social support as a way of controlling the severity of their symptoms. Palliative nurses need to tailor a social support intervention to their patients with cancer, in order to use both professional and family resources.

Understanding the positive outcomes of discharge planning interventions for older adults hospitalized following a fall: a realist synthesis

BACKGROUND

Older adults hospitalized following a fall often encounter preventable adverse events when transitioning from hospital to home. Discharge planning interventions developed to prevent these events do not all produce the expected effects to the same extent. This realist synthesis aimed to better understand when, where, for whom, why and how the components of these interventions produce positive outcomes.

METHODS

Nine indexed databases were searched to identify scientific papers and grey literature on discharge planning interventions for older adults (65+) hospitalized following a fall. Manual searches were also conducted. Documents were selected based on relevance and rigor. Two reviewers extracted and compiled data regarding intervention components, contextual factors, underlying mechanisms and positive outcomes. Preliminary theories were then formulated based on an iterative synthesis process.

RESULTS

Twenty-one documents were included in the synthesis. Four Intervention-Context-Mechanism-Outcome configurations were developed as preliminary theories, based on the following intervention components: 1) Increase two-way communication between healthcare providers and patients/caregivers using a family-centered approach; 2) Foster interprofessional communication within and across healthcare settings through both standardized and unofficial information exchange; 3) Provide patients/caregivers with individually tailored fall prevention education; and 4) Designate a coordinator to manage discharge planning. These components should be implemented from patient admission to return home and be supported at the organizational level (contexts) to trigger knowledge, understanding and trust of patients/caregivers, adjusted expectations, reduced family stress, and sustained engagement of families and professionals (mechanisms). These optimal conditions improve patient satisfaction, recovery, functional status and continuity of care, and reduce hospital readmissions and fall risk (outcomes).

CONCLUSIONS

Since transitions are critical points with potential communication gaps, coordinated interventions are vital to support a safe return home for older adults hospitalized following a fall. Considering the organizational challenges, simple tools such as pictograms and drawings, combined with computer-based communication channels, may optimize discharge interventions based on frail patients' needs, habits and values. Empirically testing our preliminary theories will help to develop effective interventions throughout the continuum of transitional care to enhance patients' health and reduce the economic burden of avoidable care.

The moderation effect of locus of control on the relationship between job demand and job satisfaction among nurses

BACKGROUND

Job demand and job satisfaction in nursing profession have been identified as significant indicators of quality of nursing care. Job demand is the most influential job stressor and has been connected to negative consequences on nurses' ability to function.

PURPOSE

The purpose of this study was to examine the moderating effect of work locus of control on the relationship between job demand and job satisfaction among nurses working at public hospitals.

METHODS

A quantitative, cross-sectional, correlational design was utilized to randomly recruit 427 registered nurses working at two major public hospitals. Data were collected using a self-administered questionnaire regarding job demand, job satisfaction and work locus of control.

RESULTS

Work locus of control had a significant moderating effect on the relationship between job demand and satisfaction. External locus of control had a negative effect on the job demand and job satisfaction relationship, whereas internal locus of control positively buffered this correlation.

CONCLUSION

This study adds a novel contribution to the body of knowledge that buffering effect of job demand among nurses is much dependent on appropriately enhancing internal locus of control, consequently improving job satisfaction.