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Journal Cover Journal of Advanced Nursing
  [SJR: 1.01]   [H-I: 114]   [224 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0309-2402 - ISSN (Online) 1365-2648
   Published by John Wiley and Sons Homepage  [1579 journals]
  • Doctoral snobbery: justified, or just elitism?
    • Authors: Melanie Birks; Roger Watson
      Abstract: Doctoral snobbery exists. It's a thing (Parnell, 2016). It's an extension of ‘academic snobbery’ (Martin & Sorensen, 2014) more generally, and probably originates from ‘title snobbery’ (Valverde, Mueller, Paciotti, & Conway, 2016). Successfully completing a doctoral qualification is no small achievement and so some degree of elitism is probably reasonable. But is it reasonable for there to be an elitist division between the traditional PhD and the relative newcomer, the professional doctorate? And what about the doctorate in nursing practice (DNP) now apparently overtaking the PhD in the USA? Our recent participation in a round table on doctoral education in Hong Kong prompted us to explore the issue further and, by implication, to invite further comment.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-25T10:57:08.94102-05:0
      DOI: 10.1111/jan.13326
       
  • Qualitative Research in Teen Experiences Living with Food-Induced
           Anaphylaxis: A Meta-Aggregation
    • Authors: Sara F. Johnson; Roberta L. Woodgate
      Abstract: AimTo describe the central experiences of teens living with Food-Induced Anaphylaxis as a first step in responding to health care needs in this population.BackgroundAs prevalence of allergy increases and commonly-outgrown allergies persist longer, chronic management for teens becomes increasingly important. This review seeks to understand how teens experience living with Food-Induced Anaphylaxis.DesignMeta-aggregation for qualitative systematic review, to create synthesis for clinical improvement; guided by Joanna Briggs Institute methods and their Qualitative Assessment and Review Instrument.Data SourcesSeven relevant databases were searched for original qualitative research July 2015; 10 studies (published 2007-2015) met inclusion criteria.Review MethodsBoth authors undertook critical appraisal, with consensus by discussion. Findings from line-by-line extraction were grouped into categories and syntheses. In studies with mixed populations, we included only teens (age 12-19) with Food-Induced Anaphylaxis.ResultsWe developed three syntheses from nine categories and 64 subcategories to reflect central experiences of teens with Food-Induced Anaphylaxis, including: (1) Defining the allergic self,;(2) Finding a balance; and (3) Controlling the uncontrollable. The syntheses encompass importance of allergic identity/understanding, difficulties in coping with burdens of food allergy and reflect the complex risk interactions teens must negotiate in social contexts.ConclusionThere is a need to respect teens as active participants in managing Food-Induced Anaphylaxis, while recognizing that social expectations and a lack of public awareness/safety can dangerously affect one's needs and decisions. This helps broaden how we conceptualize the needs of teens living with Food-Induced Anaphylaxis, informing ongoing care and management.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-25T10:56:58.277961-05:
      DOI: 10.1111/jan.13325
       
  • The Need to Know: the information needs of parents of infants with an
           intellectual disability – a qualitative study
    • Authors: Tracy Douglas; Bernice Redley, Goetz Ottmann
      Abstract: AimTo explore the information needs of parents of infants with an intellectual disability in the first year of life.BackgroundParents whose infant has an intellectual disability need access to information if they are to facilitate optimal care for their child. A lack of timely, accurate information provision by health professionals, particularly nurses and midwives, can increase parental stress and hinder access to the supports they and their infant require.DesignA qualitative descriptive methodology was used for the study.MethodsQualitative interviews were undertaken with parents of eleven children with intellectual disabilities in Victoria, Australia in 2014. Data were analysed using descriptive thematic analysis.FindingsParents experienced challenges accessing quality information during the first year of their child's life. Parents required incremental information provision to build a strong knowledge base to facilitate optimal care for their infants. Three types of knowledge were identified as crucial for parents: knowledge about (a) the infant's condition; (b) the infant's specific needs; and (c) available supports and services. Health professionals were the key resource to access this information.ConclusionHealth professionals’ responsibilities include providing relevant, timely information to parents of infants with intellectual disabilities. This study conceptualises three types of information parents need to develop a strong knowledge base to guide their infant's care and provides guidance concerning the optimal timing for the delivery of information.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-25T10:50:54.231304-05:
      DOI: 10.1111/jan.13321
       
  • The Effect of Adult Early Warning Systems Education on Nurses’
           Knowledge, Confidence, and Clinical Performance: A Systematic Review
    • Authors: Mohamad M. Saab; Bridie McCarthy, Tom Andrews, Eileen Savage, Frances J. Drummond, Nuala Walshe, Mary Forde, Dorothy Breen, Patrick Henn, Jonathan Drennan, Josephine Hegarty
      Abstract: AimsThis review aims to determine the effect of adult Early Warning Systems education on nurses’ knowledge, confidence and clinical performance.BackgroundEarly Warning Systems support timely identification of clinical deterioration and prevention of avoidable deaths. Several educational programmes have been designed to help nurses recognise and manage deteriorating patients. Little is known as to the effectiveness of these programmes.DesignSystematic reviewData sourcesAcademic Search Complete, CINAHL, MEDLINE, PsycINFO, PsycARTICLES, Psychology and Behavioral Science Collection, SocINDEX and the UK & Ireland Reference Centre, EMBASE, the Turning Research Into Practice database, the Cochrane Central Register of Controlled Trials (CENTRAL) and Grey Literature sources were searched between October - November 2015.Review methodsThis is a quantitative systematic review using Cochrane methods. Studies published between January 2011 - November 2015 in English were sought. The risk of bias, level of evidence and the quality of evidence per outcome were assessed.ResultsEleven articles with ten studies were included. Nine studies addressed clinical performance, four addressed knowledge and two addressed confidence. Knowledge, vital signs recording and Early Warning Score calculation were improved in the short-term. Two interventions had no effect on nurses’ response to clinical deterioration and use of communication tools.ConclusionThis review highlights the importance of measuring outcomes using standardised tools and valid and reliable instruments. Using longitudinal designs, researchers are encouraged to investigate the effect of Early Warning Systems educational programmes. These can include: interactive e-learning, on-site interdisciplinary Early Warning Scoring systems training sessions and simulated scenarios.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-25T10:50:50.805254-05:
      DOI: 10.1111/jan.13322
       
  • Readiness for Hospital Discharge: A Concept Analysis
    • Authors: Eileen Catherine Galvin; Teresa Wills, Alice Coffey
      Abstract: AimTo report on an analysis on the concept of ‘readiness for hospital discharge’.BackgroundNo uniform operational definition of ‘readiness for hospital discharge’ exists in the literature, therefore a concept analysis is required to clarify the concept and identify an up to date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research.DesignLiterature Review and Concept Analysis.MethodA review of literature conducted in 2016 involved databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied.ResultsIdentification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to ‘readiness for hospital discharge’; were extracted from the literature; physical stability, adequate support, psychological ability and adequate information and knowledge.ConclusionThis analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist health care professionals to recognise, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-25T10:50:48.665016-05:
      DOI: 10.1111/jan.13324
       
  • Is Humidified Better than Non-humidified Low Flow Oxygen Therapy? A
           Systematic Review and Meta-Analysis
    • Authors: Zunjia Wen; Wenting Wang, Haiying Zhang, Chao Wu, Jianping Ding, Meifen Shen
      Abstract: AimsTo determine the effects of low-flow oxygen therapy with humidified or non-humidified oxygen in adult patients.BackgroundAlthough non-humidified oxygen in low-flow oxygen therapy is recommended by many guidelines, humidifying oxygen regardless of oxygen flow has been routinely performed in China and Japan and further studies are needed to evaluate the evidence.DesignA systematic review and meta-analysis that comply with the recommendations of the Cochrane Collaboration were conducted.Data Sources: Studies (1980–2016) were identified by searching PUBMED, EMBASE, Science Direct, Cochrane library, CNKI and Wanfang Database.MethodsWe performed a comprehensive, systematic meta-analysis of randomized controlled trials on the efficacy of humidified and non-humidified low-flow oxygen therapy. Summary risk ratios or weighted mean differences with 95% confidence intervals were calculated using a fixed- or random-effects model.ResultsTwenty-seven randomized controlled trials with a total number of 8876 patients were included. Non-humidified oxygen offers more benefits in reducing the bacterial contamination of humidifier bottles, as shown by the mean operating time for oxygen administration and the respiratory infections compared with humidified oxygen therapy. No significant differences were found in dry nose, dry nose and throat, nosebleed, chest discomfort, the smell of oxygen and SpO2 changes.ConclusionsThe routine humidification of oxygen in low-flow oxygen therapy is not justifiable and non-humidified oxygen tend to be more beneficial. However, considering that the quality of most included studies is poor, rigorously designed, large-scale randomized controlled trials are still needed to identify the role of non-humidified oxygen therapy.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-25T10:50:44.489434-05:
      DOI: 10.1111/jan.13323
       
  • A qualitative study of community nurses’ decision-making around the
           anticipatory prescribing of end-of-life medications
    • Authors: Ben Bowers; Sarah Redsell
      Abstract: AimsTo explore community nurses’ decision-making processes around the prescribing of anticipatory medications for people who are dying.BackgroundCommunity nurses frequently initiate the prescribing of anticipatory medications to help control symptoms in those who are dying. However, little is known about their decision-making processes in relation to when they instigate anticipatory prescribing and their discussions with families and General Practitioners.DesignA qualitative interpretive descriptive enquiry.MethodsA purposive sample of eleven Community Palliative Nurses and District Nurses working in one geographical area participated. Data was collected between March and June 2016 via audio recorded semi-structured interviews and analysed inductively using Braun and Clarke's thematic analysis.ResultsThree themes were identified: 1) Drugs as a safety net. Anticipatory medications give nurses a sense of control in last days of life symptom management; 2) Reading the situation. The nurse judges when to introduce conversations around anticipatory medications, balancing the need for discussion with the dying person and their family's likely response; 3) Playing the game. The nurse owns the decision to initiate anticipatory medication prescribing and carefully negotiates with the General Practitioner.ConclusionNurses view pain control through prescribed medication as key to symptom management for dying people. Consequently, they own the role of ascertaining when to initiate discussions with families about anticipatory medicines. Nurses believe they advocate for dying person and their families’ needs and lead negotiations with General Practitioners for medications to go into the home. This nurse led care alters the traditional boundaries of the General Practitioners -nurse professional relationship.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-19T18:10:48.773134-05:
      DOI: 10.1111/jan.13319
       
  • Something has shifted: Nursing students’ global perspective following
           international clinical placements
    • Authors: Shelley Gower; Ravani Duggan, Jaya A R Dantas, Duncan Boldy
      Abstract: AimsTo examine understandings of global health issues among nursing students following participation in an international clinical placement during their pre-registration university education.BackgroundUniversities use international clinical placements, especially in developing countries, to develop cultural awareness in students, however little is known about the longer term influences on students’ understandings of global nursing.DesignA retrospective cross-sectional design was used, using an exploratory, descriptive qualitative approach.MethodsIndividual semi-structured interviews were conducted in 2014 with a purposive sample of 25 pre-registration nursing students from four Western Australian universities who undertook clinical placements across five countries. Data were analysed using inductive thematic analysis.ResultsFindings highlight that students developed new understandings around health systems including fragility of resource access, differences in clinical practice and variances in nursing roles between settings. Students also experienced challenges but were able to appreciate alternative world viewpoints.ConclusionInternational clinical placements can develop greater awareness and help students form realistic strategies for using their nursing skills globally. Pre-placement training in cultural awareness and health system realities, along with strong supervisory support, is critical to success.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-19T18:09:52.211238-05:
      DOI: 10.1111/jan.13320
       
  • The Effects of Nursing Preceptorship on New Nurses’ Competence,
           Professional Socialization, Job Satisfaction, and Retention: A Systematic
           Review
    • Authors: Ya-Ting Ke; Chia-Chi Kuo, Chich-Hsiu Hung
      Abstract: AimsTo determine the effects of nursing preceptorship on the competence, job satisfaction, professional socialization and retention of new nurses.BackgroundAlthough studies have focused on the effects of nursing preceptorship on new nurses’ competence and retention, a systematic review of the overall effects is lacking.DesignA quantitative systematic review.Data sourcesFive English/Chinese databases were searched for original articles published before June 2015 and only six articles published between 2001 - 2014 were included in the final analysis.Review methodsJoanna Briggs Methodology was used to process one randomization control trial, one quasi-experimental study and four observational studies. Two appraisers independently reviewed each study using the standardized critical appraisal tools from the Joanna Briggs Institute.ResultsThe most adopted preceptorship was a fixed preceptor/preceptee model and one-on-one for 1-3-month duration. It showed that new nurses’ overall competence increased significantly due to preceptorship. Only a few studies explored the effects of preceptorship on the job satisfaction and professional socialization of new nurses. Clear conclusions regarding the effect of preceptorship on nurses’ retention rate could not be made because of inconsistent time points for calculation and a lack of control groups in the study design.ConclusionsPreceptorship can improve new nurses’ nursing competence; however, more studies are needed to ascertain its effects on new nurses’ retention rates, job satisfaction and professional socialization to promote nursing care quality and resolve nursing shortages.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-11T08:02:47.97707-05:0
      DOI: 10.1111/jan.13317
       
  • Experiences of violence and abuse among internally displaced adolescent
           girls following a natural disaster
    • Authors: Elizabeth Sloand; Cheryl Killion, Hossein Yarandi, Phyllis Sharps, Annie Lewis-O'connor, Mona Hassan, Faye Gary, Cesar Nicole Muller, Doris Campbell
      Abstract: AimTo describe the physical, psychological and sexual violence among internally displaced adolescent girls following the 2010 Haiti earthquake and related risk factors, health concerns and cultural norms.BackgroundThousands of adolescents were displaced following the earthquake, leaving them vulnerable to abuse and violence. Displaced survivors are disproportionately vulnerable to violence after natural and man-made disasters.DesignA descriptive-correlational design was used to: 1) describe the extent of violence, health risks and concerns in the displaced adolescent girls; and 2) identify correlations in the strength and magnitude of relationships between selected variables including demographics, risk factors and cultural tolerance of violence.MethodsData were collected from participants using computer-assisted self-interviews between 2011-2013 including demographics, pre- and post-earthquake violence, perpetrators, risk factors and health consequences. Analysis included frequency, logistic regression and multiple regression.Results/FindingsA majority reported physical, psychological, or sexual abuse both pre (59%) and post (64.1%) earthquake. Pre-earthquake, abused adolescents reported the perpetrator as a boyfriend (50%) or family member (30%). Post-earthquake, 20.5% of physical abuse perpetrators were family members. Pre- and post-earthquake physical and sexual abuse did not change. The risk of being sexually abused post-earthquake increased after controlling for age and education.ConclusionDisplaced adolescent girls reported similar rates of physical and sexual abuse pre- and post-earthquake. These findings show the importance of preventive policies for adolescent girls in disaster situations in countries with low resources. Social and cultural change is critically needed since abuse was at an unacceptably high rate prior to the earthquake.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-11T07:30:38.493059-05:
      DOI: 10.1111/jan.13316
       
  • The influence of team members on nurses’ perceptions of transgressive
           behaviour in care relationships: a qualitative study
    • Authors: Tina Vandecasteele; Ann Van Hecke, Veerle Duprez, Dimitri Beeckman, Bart Debyser, Maria Grypdonck, Sofie Verhaeghe
      Abstract: AimTo gain insight into the influence of team members in how nurses perceive and address patients’ transgressive behaviour.BackgroundAggression and transgressive behaviour in healthcare have been a focus of research over the past few decades. Most studies have focused on individual nurses’ experiences with aggression and transgressive behaviour. Literature examining group dynamics in nursing teams and team members’ interactions in handling patients’ transgressive behaviour is scarce.DesignQualitative interview study.MethodsSeven focus-group interviews and two individual interviews were carried out in 2014-2016. Twenty-four nurses were drawn from eight wards in three general hospitals. Interviews were analysed using the constant comparative method influenced by the grounded theory approach.FindingsWhile elaborating how they perceived and addressed transgressive behaviour, nurses disclosed how interactions with team members occurred. Several patterns arose. Nurses talk to one another, excuse one another, fill in for one another, warn one another and protect and safeguard one another. In these patterns in reaction to patients’ transgressive behaviour, implicit group norms transpire, causing nursing teams to acquire their specific identity ‘as a group’. Consequently, these informal group norms in nursing teams impinge how nurses feel threatened by patients’ potential transgressive behaviour; gain protection from the group of nurses and conform to informal ward rules.ConclusionThe findings of this study can support intervention strategies aimed at supporting nurses and nursing teams in managing patient aggression and transgressive behaviour by identifying and explicating these group dynamics and team members’ interactions.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-11T07:07:29.33013-05:0
      DOI: 10.1111/jan.13315
       
  • Physical activity prescription by primary care nurses using health assets:
           study design of a randomised controlled trial in patients with
           cardiovascular risk factors
    • Authors: Aina Riera-Sampol; Pedro Tauler, Miquel Bennasar-Veny, Alfonso Leiva, Guillem Artigues-Vives, Joan De Pedro-Gómez, Jordi Pericàs, Carlos Moreno, Maite Arbos, Antoni Aguilo
      Abstract: AimTo analyse the efficacy of a 12-month multifactorial intervention by primary care nurses in increasing adherence to physical activity prescription (150 min/week) in patients with two or more cardiovascular risk factors and with cardiovascular risk up to 15% determined by the REGICOR equation.BackgroundIn Spain cardiovascular diseases are responsible for 30.5% of deaths. Regular physical activity decreases mortality risk due to cardiovascular diseases but the effectiveness of physical activity prescription in routine in primary care settings has been shown to be low.DesignMulticentre, single-blind, parallel randomized (in two different branches) clinical trial.MethodsAt least 368 participants will be recruited (184 control and 184 intervention), to show an 8% increase in adherence to the physical activity prescription (1.2% control group and 9.2% intervention group). Participants will be patients aged 35-75 years with at least two cardiovascular risk factors and with a cardiovascular risk of up to 15% measured using the Framingham-REGICOR equation. Intervention will be performed throughout baseline and three follow-up visits. A motivational interview, the trans-theoretical stages of changes of Prochaska and DiClemente and an individualized prescription of physical exercise using physical activity assets will be used in the intervention. Data will be collected at baseline and after the one-year intervention.DiscussionThe present study will allow us to find out whether this brief multifactorial intervention induces greater adherence to physical activity prescription than usual practice, improving the quality of patient care.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-11T06:58:23.842778-05:
      DOI: 10.1111/jan.13318
       
  • Corrigendum
    • PubDate: 2017-04-10T02:06:11.430879-05:
      DOI: 10.1111/jan.13307
       
  • Thinking ‘outside the box’
    • Authors: Claire Su-Yeon Park
      Abstract: Much evidence supports that having more nurses leads to better patient outcomes.However, why is nurse staffing still lacking in practice? Previous studies on the nursing workforce have, so far, focused on determining ‘more nurses and better patient outcomes.’ However, a controversial debate on the cost-effectiveness of hiring more nurses still continues (Aiken et al. 2011). When it comes to nursing workforce policy-materializing in practice, the inconclusiveness of nursing efficiency is considered to be one of the critical reasons for the failure to narrow the gap between the ideal and the real.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-05T16:02:28.003418-05:
      DOI: 10.1111/jan.13312
       
  • Service user engagement- a co-created interview schedule exploring mental
           health recovery in young adults
    • Authors: Claire-Odile Mccauley; Hugh Mckenna, Sinead Keeney, Derek McLaughlin
      Abstract: AimTo co-create of an interview schedule exploring mental health recovery in collaboration with young adult service users.BackgroundService user involvement in research has been increasingly recognised as providing a vital authentic insight into mental health recovery. Engagement and collaboration with service users have facilitated the exploration of inaccessible or under-investigated aspects of the lived experience of mental health recovery, not only directing the trajectory of research, but making it relevant to their own contextual experience.DesignA qualitative content analysis framework was employed in the co-creation of a semi-structured interview schedule through an engagement process with service users.MethodsTwo separate engagement groups took place at the premises of the service user organisations, between January and February 2014. Miles and Huberman's analysis framework was chosen for this phase as it enabled the visual presentation of factors, concepts or variables and the established relationship between them.ResultsThe lived experience of mental ill health in young adulthood and how this was understood by others was a particularly relevant theme for participants. Further themes were identified between the impact of painful experiences at this developmental life stage leading to a deeper understanding of others through finding meaning in their own mental health recovery journey.ConclusionOur findings identified that suffering painful experiences is an integral aspect in the process of mental health recovery. This understanding has particular relevance to mental health nursing practice, ensuring the care delivered is cognisant of the suffering or painful experiences that young adults are encountering.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-05T03:05:47.929324-05:
      DOI: 10.1111/jan.13314
       
  • Challenges in building interpersonal care in organised hospital stroke
           units: the perspectives of stroke survivors, family caregivers and the
           multidisciplinary team
    • Authors: Tony Ryan; Madeleine Harrison, Clare Gardiner, Amanda Jones
      Abstract: AimsTo explore the organised stroke unit experience from the multiple perspectives of stroke survivor, family carer and the multi-disciplinary team.BackgroundOrganised stroke unit care reduces morbidity, mortality and institutionalisation and is promoted globally as the most effective form of acute and post-acute provision. Little research has focused upon how care is experienced in this setting from the perspectives of those who receive and provide care.DesignThe study used a qualitative approach, employing Framework Analysis. This methodology allows for a flexible approach to data collection and a comprehensive and systematic method of analysis.MethodSemi-structured interviews were undertaken during 2011 and 2012 with former stroke unit stroke survivors, family carers and senior stroke physicians. In addition eight focus groups were conducted with members of the multi-disciplinary team.ResultsOne hundred and twenty five participants were recruited. Three key themes were identified across all data sets. Firstly, two important processes are described: responses to the impact of stroke; seeking information and stroke specific knowledge. These are underpinned by a third theme: the challenge in building relationships in organised stroke unit care.ConclusionsStroke unit care provides satisfaction for stroke survivors, particularly in relation to highly specialised medical and nursing care and therapy. It is proposed that moves towards organised stroke unit care, particularly with the emphasis on reduction of length of stay and a focus on hyper-acute models, have implications for interpersonal care practices and the sharing of stroke specific knowledge.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-05T02:55:28.233871-05:
      DOI: 10.1111/jan.13313
       
  • The effectiveness of massage and touch on behavioral and psychological
           symptoms of dementia: a quantitative systematic review and meta-analysis
    • Authors: Jie Wu; Yi Wang, Zhiwen Wang
      Abstract: BackgroundMany original studies have explored the effectiveness of massage and touch on behavioral and psychological symptoms of dementia. However, the study design, interventions, measurements and outcomes varied among studies.AimTo systematically evaluate the effectiveness of massage and touch on the behavioral and psychological symptoms of older people with dementia.DesignA quantitative systematic review and meta-analysis.Data sourcesCochrane Library, The Joanna Briggs Institute (JBI) Library, PubMed, CINAHL, ProQuest Health & Medical Complete, SinoMed, China National Knowledge Infrastructure (CNKI) and Wanfang were searched from the date the database established to January 2016.Review methodsRandomized controlled trials (RCTs) or quasi-experimental studies, involving massage and touch intervention for older people with dementia were considered to be included. Risk of bias assessment was performed using the Cochrane Collaboration's tool and meta-analysis was performed using Revman 5.3.ResultsA total of 11 studies, involving 526 older people were included. The results of the meta-analysis showed the total score of behavioral and psychological problems with older people with dementia and subgroup scores of physical aggressive behavior, physical non-aggressive behavior, verbal aggressive behavior and verbal non-aggressive behavior decreased significantly after receiving massage or touch, while the subgroups scores of anxiety, sadness and anger did not decreased significantly.ConclusionsDue to relatively small sample size and low quality of the included studies in this review, it is difficult to draw a conclusion on the effect of massage and touch on behavioral and psychological syndrome of dementia or implications for practice.This article is protected by copyright. All rights reserved.
      PubDate: 2017-04-05T02:51:20.33508-05:0
      DOI: 10.1111/jan.13311
       
  • A systematic review of social media in nursing and midwifery education:
           protocol
    • Authors: Siobhan O'Connor; Sarah Jolliffe, Emma Stanmore, Laoise Renwick, Terri Schmitt, Richard Booth
      Abstract: AimTo synthesise evidence on the use of social media in nursing and midwifery education.BackgroundSocial media is one type of online platform that is being explored to determine if there is value in using interactive, digital communication tools to support how nurses and midwives learn in a variety of settings.DesignA sequential explanatory synthesis approach will be used for this mixed study review.MethodFive bibliographic databases; PubMed, MEDLINE, CINAHL, Scopus and ERIC will be searched using a combination of keywords relevant to social networking and social media, nursing and midwifery and education. The search will not be limited by year of publication. Titles, abstracts and full papers will be screened by two independent reviewers against inclusion and exclusion criteria, with any disagreements resolved via a third reviewer. Selected studies will undergo quality assessment and data extraction. Data synthesis will occur in three sequential phases, with quantitative and qualitative data analysed separately and then integrated where possible to provide a conceptual framework illustrating learning via social media. Funding for this review was confirmed in May 2016 by Sigma Theta Tau International and the National League for Nursing.DiscussionThe mixed study systematic review will produce the first rigorous synthesis on the use of social media in nursing and midwifery education and will have important implications for educators as well as students. It will also highlight knowledge gaps and make recommendations on the use of this novel technology in higher and continuing education.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-31T17:00:25.292506-05:
      DOI: 10.1111/jan.13310
       
  • A Qualitative Exploration of the Experiences of Patients with Breast
           Cancer Receiving Outpatient-based Chemotherapy
    • Authors: Xiao Bin Lai; Shirley Siu Yin Ching, Frances Kam Yuet Wong
      Abstract: AimsTo understand the experiences of patients with breast cancer and their involvement during outpatient-based chemotherapy in Hong Kong.BackgroundThe outcome evaluation using a mixed-methods approach is not common in interventional studies of nurse-led chemotherapy care programmes. A qualitative approach could provide a deep understanding of the experiences of patients.DesignA qualitative study was conducted.MethodsThis is part of a randomized controlled trial of a nurse-led care programme (NCT02228200). Individual interviews were conducted in 2013 with ten patients with breast cancer after they had completed the chemotherapy. Qualitative content analysis was adopted to analyse the interviews.FindingsChemotherapy affected the patients in different ways. Some participants completed the chemotherapy treatment smoothly with minimum side effects, while others encountered many problems during the treatment, which had a great impact on their lives. Guided by their coping attitudes, which were affected by the Chinese culture, most participants adopted behavioural, social, cognitive and emotional strategies to actively cope with the chemotherapy. A few tolerated the treatment passively. Some thought that the process of undergoing chemotherapy was physically bearable, while some equated it with suffering. Others regarded it as a chance to get a new start.ConclusionThe experience of patients with breast cancer during chemotherapy can be likened to that of going on a hike. They reach the peak through different paths and bear different burdens. Yet they have to go through until the end, regardless of how much of a burden they bear and how they achieve the peak.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-31T16:50:23.54249-05:0
      DOI: 10.1111/jan.13309
       
  • Which interval is most crucial to presentation and survival in
           gastroesophageal cancer: a systematic review
    • Authors: Amanda Lee; Sam Khulusi, Roger Watson
      Abstract: AimTo identify the most crucial interval to encourage earlier diagnosis in with gastroesophageal cancer and to identify potential factors effecting this interval.BackgroundGastroesophageal malignancy is the eighth most commonly presenting cancer with one of the worst survival rates. Identifying the most crucial period for intervention to inform earlier diagnosis is an important step towards improving survival.DesignMixed methods literature review.Data SourcesCINAHL, MEDLINE and Academic search primer online databases were searched using keywords and inclusion/exclusion criteria. Empirical evidence published between 2000- 2016 with a focus on gastroesophageal cancer presentation and survival was reviewed to inform this study.Review methodsTwelve studies were extracted for further review. Selected studies were appraised and presented through Olensen's ‘delay interval’ framework to inform the most crucial interval to survival in gastroesophageal cancer.ResultsThe findings identify the patient interval as the most critical period for encouraging earlier presentation and reducing advanced stage presentation in gastroesophageal cancer. The article also highlighted some methodological limitations to cancer research, such as a lack of consensus in definitions which prevent statistical meta-analysis of cancer data, survivor bias in gastroesophageal cancer studies and a significant lack of qualitative evidence to reveal patient experience in presenting with this cancer.ConclusionFurther research into the patient interval is required to elicit information on how and why patients present with their cancer symptoms.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-31T16:45:25.03436-05:0
      DOI: 10.1111/jan.13308
       
  • Towards a Symptom Cluster Model in Chronic Kidney Disease: A Structural
           Equation Approach
    • Authors: Hayfa Almutary; Clint Douglas, Ann Bonner
      Abstract: AimsTo test a symptom cluster model in chronic kidney disease patients based on the Theory of Unpleasant Symptoms, accounting for the relationships between influencing factors, symptom experience and consequences for quality of life.BackgroundThe evaluation of symptom clusters is a new field of scientific inquiry directed toward more focused symptom management. Yet, little is known about relationships between symptom clusters, predictors and the synergistic effect of multiple symptoms on outcomes.DesignCross-sectional.MethodsData were collected from 436 patients with advanced stages of chronic kidney disease during July 2013- February 2014 using validated measures of symptom burden and quality of life. Analysis involved structural equation modeling.ResultsThe final model demonstrated good fit with the data and provided strong evidence for the predicted relationships. Psychological distress, stage of chronic kidney disease and age explained most of the variance in symptom experience. Symptom clusters had a strong negative effect on quality of life, with fatigue, sexual symptoms and restless legs being the strongest predictors. Overall the model explained more than half of the deterioration in quality of life. However, a reciprocal path between quality of life and symptom experience was not found.ConclusionsInterventions targeting symptom clusters could greatly improve quality of life in patients with chronic kidney disease. The symptom cluster model presented has important clinical and heuristic implications, serving as a framework to encourage and guide new lines of intervention research to reduce symptom burden in chronic kidney disease.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-22T11:23:12.918112-05:
      DOI: 10.1111/jan.13303
       
  • Maintaining family life balance while facing a child's imminent death
           – a mixed methods study
    • Authors: Katri Eskola; Eva Bergstraesser, Karin Zimmermann, Eva Cignacco
      Abstract: AimTo understand parents’ experiences and needs during a child's end-of-life care at home and to identify systemic factors that influence its provision.BackgroundA child's end-of-life phase is an extremely difficult time for the whole family. Parents have specific needs, especially when they care for a dying child at home.DesignConcurrent embedded mixed methods design.MethodsThis sub-study of the nationwide survey, ‘Paediatric End-of-Life Care Needs in Switzerland’ (2012-2015) included 47 children who received EOL care at home from 2011-2012. We extracted quantitative data from patients’ medical charts and obtained information via parental questionnaire and then compared parents whose child died at home or in hospital by computing generalized estimation equations. We thematically analysed interviews with parents who provided EOL care at home.ResultsParents created an intimate lifeworld and a sense of normality for the child at home. They constantly balanced the family's lifeworld with the requirements and challenges posed by the outside world. This work exhausted parents. Parental ‘readiness’ and social support drove EOL care for children at home. Parents needed practical help with housekeeping and had negative experiences when dealing with insurance. In only 34.8% of cases was a child's EOL home care supported by paediatric palliative care team.ConclusionPaediatric end-of-life care at home is only feasible if parents make extraordinary efforts. If family-centred end-of-life home care is provided by a hospital-based paediatric palliative home care team, which includes paid housekeeping help and psychological support, parents needs could be better met.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-22T11:23:11.852424-05:
      DOI: 10.1111/jan.13304
       
  • A protocol for the development of a critical thinking assessment tool for
           nurses using a Delphi technique
    • Authors: Elisabeth Jacob; Christine Duffield, Darren Jacob
      Abstract: AimThe aim of this study is to develop an assessment tool to measure the critical thinking ability of nurses.BackgroundAs an increasing number of complex patients are admitted to hospitals, the importance of nurses recognising changes in health status and picking up on deterioration is more important. To detect early signs of complication requires critical thinking skills. Registered nurses are expected to commence their clinical careers with the necessary critical thinking skills to ensure safe nursing practice. Currently there is no published tool to assess critical thinking skills which is context specific to Australian nurses.DesignA modified Delphi study will be used for the project.MethodsThis study will develop a series of unfolding case scenarios using national health data with multiple choice questions to assess critical thinking. Face validity of the scenarios will be determined by an expert reference group of clinical and academic nurses. A Delphi study will determine the answers to scenario questions. Panel members will be expert clinicians and educators from two states in Australia. Rasch analysis of the questionnaire will assess validity and reliability of the tool. Funding for the study and ethical approval were obtained in March and November 2016 respectively.DiscussionPatient outcomes and safety are directly linked to nurses’ critical thinking skills. This study will develop an assessment tool to provide a standardised method of measuring nurses’ critical thinking skills across Australia. This will provide health care providers with greater confidence in the critical thinking level of graduate registered nurses.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-22T11:23:10.61435-05:0
      DOI: 10.1111/jan.13306
       
  • Nursing judgement and decision-making using the Sedation Withdrawal Score
           (SWS) in children
    • Authors: Jennie Craske; Bernie Carter, Ian H. Jarman, Lyvonne N Tume
      Abstract: AimsThe aim of the study was to evaluate registered children's nurses’ approaches to the assessment and management of withdrawal syndrome in children.BackgroundAssessment of withdrawal syndrome is undertaken following critical illness when the child's condition may be unstable with competing differential diagnoses. Assessment tools aim to standardise and improve recognition of withdrawal syndrome. Making the right decisions in complex clinical situations requires a degree of mental effort and it is not known how nurses make decisions when undertaking withdrawal assessments.DesignCognitive interviews with clinical vignettes.MethodsInterviews were undertaken with 12 nurses to explore the cognitive processes they used when assessing children using the Sedation Withdrawal Score (SWS) tool. Interviews took place in Autumn 2013.FindingsEach stage of decision-making – noticing, interpreting and responding – presented cognitive challenges for nurses. When defining withdrawal behaviours nurses tended to blur the boundaries between Sedation Withdrawal Score signs. Challenges in interpreting behaviours arose from not knowing if the patient's behaviour was a result of withdrawal or other co-morbidities. Nurses gave a range of diagnoses when interpreting the vignettes, despite being provided with identical information. Treatment responses corresponded to definite withdrawal diagnoses, but varied when nurses were unsure of the diagnosis.ConclusionCognitive interviews with vignettes provided insight into nurses’ judgement and decision-making. The SWS does not standardise the assessment of withdrawal due to the complexity of the context where assessments take place and the difficulties of determining the cause of equivocal behaviours in children recovering from critical illness.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-22T11:22:59.87684-05:0
      DOI: 10.1111/jan.13305
       
  • The diagnosis and lived experience of Polycystic Ovary Syndrome: A
           qualitative study
    • Authors: Julie Tomlinson; Jonathan Pinkney, Linda Adams, Elizabeth Stenhouse, Alison Bendall, Oonagh Corrigan, Gayle Letherby
      Abstract: AimsTo explore the impact of the diagnosis of polycystic ovary syndrome on health/ill health identity, how women experience this diagnosis and their health beliefs.Backgroundpolycystic ovary syndrome is a common and heterogeneous condition, giving rise to a wide range of different health concerns. Previous research on polycystic ovary syndrome has been dominated by the medical perspective and less is known about the experiences and needs of women.DesignA qualitative study of 32 premenopausal adult women with polycystic ovary syndrome (diagnosis confirmed by Rotterdam criteria), aged between 18-45 years, recruited from a primary and secondary care setting.MethodsThematic analysis of transcripts from 11 focus groups conducted between 2013-2015.Results/FindingsWomen identified a range of concerns affecting personal and reproductive identity, health knowledge and beliefs: (i) delays and barriers to diagnosis; (ii) general lack of empathy by the medical profession; (iii) difficulty in accessing specialist referral; (iv) lack of information from professionals; (v) inconsistent and sometimes unsatisfactory experiences with medications; (vi) insufficient help and advice regarding in/fertility; (vii) relative lack of awareness or concern about longer term risks such as diabetes; (viii) significant discrepancies between the beliefs of women with polycystic ovary syndrome and how they experienced the attitudes of healthcare professionals.ConclusionsThere appears to be a divergence between women's experience and attitudes of healthcare professionals. The diagnosis, support and lived experience of women with polycystic ovary syndrome could be enhanced by better professional recognition of these concerns, improved knowledge and communication about polycystic ovary syndrome and better access to support and specialist advice.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-22T11:17:57.39492-05:0
      DOI: 10.1111/jan.13300
       
  • What drives perceived work intensity in neonatal intensive care units?
           Empirical evidence from a longitudinal study
    • Authors: Sandra Sülz; Kristina Langhammer, Michael Becker-Peth, Bernhard Roth
      Abstract: AimTo investigate the drivers of perceived work intensity among neonatal intensive care unit nurses.BackgroundThe consequences of high work intensity have been studied extensively, yet setting-specific drivers have received less attention.DesignProspective, longitudinal and monocentric study design.MethodsThe study combined data from standardized diary surveys and passive observations of study nurses. Data were collected over a period of six months in 2015. We considered two scenarios: (i) the perception of normal work intensity relative to non-normal work intensity; and (ii) the perception of high work intensity relative to non-high work intensity. Perceived work intensity was then analysed using mixed-effects probit regression models.ResultsWe found that when direct and indirect care were provided more frequently than administrative and other duties were performed, the evaluated nurses perceived their work intensity to be higher. We also found that nurses who more frequently provided care for sick and preterm infants were less likely to perceive their work intensity as normal and this effect was stronger among nurses who cared for infants under mechanical ventilation than nurses who cared for infants receiving non-invasive respiratory support.ConclusionIn the interest of both nurses and infants and the pursuit of a reduction in perceived work intensity and the provision of better neonatal care, caution must be applied when assigning infants to nurses. Further research is needed to validate these findings using a multicentre study design.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-22T11:17:55.192064-05:
      DOI: 10.1111/jan.13301
       
  • User compliance with documenting on a track and trigger-based observation
           and response chart: a two-phase multi-site audit study
    • Authors: Doug Elliott; Emily Allen, Sharon McKinley, Lin Perry, Christine Duffield, Margaret Fry, Robyn Gallagher, Rick Iedema, Michael Roche
      Abstract: AimsTo examine user compliance and completeness of documentation with a newly designed Observation and Response Chart and whether a rapid response system call was triggered when clinically indicated.BackgroundTimely recognition and responses to patient deterioration in hospital general wards remains a challenge for health care systems globally. Evaluating practice initiatives to improve recognition and response are required.DesignTwo-phase audit.MethodsFollowing introduction of the charts in 10 health service sites in Australia, an audit of chart completion was conducted during a short trial for initial usability (Phase 1; 2011). After chart adoption as routine use in practice, retrospective and prospective chart audits were conducted (Phase 2; 2012).FindingsOverall, 818 and 1058 charts were audited during the two phases, respectively. Compliance was mixed but improved with the new chart (4-14%). Contrary to chart guidelines, numbers rather than dots were written in the graphing section in 60% of cases. Rates of recognition of abnormal vital signs improved slightly with new charts in use, particularly for higher levels of surveillance and clinical review. Based on local calling criteria, an emergency call was initiated in 33% of cases during the retrospective audit and in 41% of cases with the new chart.ConclusionsUser compliance was less than optimal, limiting full function of the chart sections and compliance with local calling criteria. Overcoming apparent behavioural and work culture barriers may improve chart completion, aiding identification of abnormal vital signs and triggering a rapid response system activation when clinical deterioration is detected.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-22T11:17:54.034667-05:
      DOI: 10.1111/jan.13302
       
  • A framework for transition to specialty practice programmes
    • Authors: Julia Morphet; Virginia Plummer, Bridie Kent, Julie Considine
      Abstract: AimTo develop a framework for emergency nursing transition to specialty practice programmes.BackgroundTransition to Specialty Practice programmes were introduced to fill workforce shortages and facilitate the transition of nurses to specialty nursing practice. These programmes are recognized as an essential preparation for emergency nurses. Emergency nursing Transition to Specialty Practice programmes have developed in an ad hoc manner and as a result, programme characteristics vary. Variability in programme characteristics may result in inconsistent preparation of emergency nurses.DesignDonabedian's Structure-Process-Outcome model was used to integrate results of an Australian study of emergency nursing Transition to Specialty Practice programmes with key education, nursing practice and safety and quality standards to develop the Transition to Specialty Practice (Emergency Nursing) Framework.MethodsAn explanatory sequential design was used. Data were collected from 118 emergency departments over 10 months in 2013 using surveys. Thirteen interviews were also conducted. Comparisons were made using Mann–Whitney U, Kruskal–Wallis and Chi-square tests. Qualitative data were analysed using content analysis.ResultsTransition to Specialty Practice programmes were offered in 80 (72·1%) emergency departments surveyed, to improve safe delivery of patient care. Better professional development outcomes were achieved in emergency departments which employed participants in small groups (Median = 4 participants) and offered programmes of 6 months duration. Written assessments were significantly associated with articulation to postgraduate study (Chi-square Fisher's exact P = 
      PubDate: 2017-03-17T03:50:38.798696-05:
      DOI: 10.1111/jan.13279
       
  • Effects of substituting nurse practitioners, physician assistants or
           nurses for physicians concerning healthcare for the aging population: a
           systematic literature review
    • Authors: Marleen H. Lovink; Anke Persoon, Raymond T.C.M. Koopmans, Anneke J.A.H. Van Vught, Lisette Schoonhoven, Miranda G.H. Laurant
      Abstract: AimsTo evaluate the effects of substituting nurse practitioners, physician assistants or nurses for physicians in long-term care facilities and primary healthcare for the aging population (primary aim) and to describe what influences the implementation (secondary aim).BackgroundHealthcare for the aging population is undergoing major changes and physicians face heavy workloads. A solution to guarantee quality and contain costs might be to substitute nurse practitioners, physician assistants or nurses for physicians.DesignA systematic literature review.Data SourcesPubMed, EMBASE, CINAHL, PsycINFO, CENTRAL, Web of Science; searched January 1995–August 2015.Review MethodsStudy selection, data extraction and quality appraisal were conducted independently by two reviewers. Outcomes collected: patient outcomes, care provider outcomes, process of care outcomes, resource use outcomes, costs and descriptions of the implementation. Data synthesis consisted of a narrative summary.ResultsTwo studies used a randomized design and eight studies used other comparative designs. The evidence of the two RCTs showed no effect on approximately half of the outcomes and a positive effect on the other half of the outcomes. Results of eight other comparative study designs point toward the same direction.. The implementation was influenced by factors on a social, organizational and individual level.ConclusionPhysician substitution in healthcare for the aging population may achieve at least as good patient outcomes and process of care outcomes compared with care provided by physicians. Evidence regarding resource use and costs is too limited to draw conclusions.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-16T02:26:33.426297-05:
      DOI: 10.1111/jan.13299
       
  • Home-care nursing staff in self-directed teams are more satisfied with
           their job and feel they have more autonomy over patient care: A nationwide
           survey
    • Authors: Erica E.M. Maurits; Anke J.E. De Veer, Peter P. Groenewegen, Anneke L. Francke
      Abstract: Aims(1) To examine whether working in a self-directed team is related to home-care nursing staff's job satisfaction; (2) To assess the mediating effect of self-perceived autonomy over patient care; (3) To investigate the moderating effect of educational level on the association between autonomy over patient care and job satisfaction.BackgroundSelf-directed teams are being introduced in home care in several countries. It is unknown whether working in a self-directed team is related to nursing staff's job satisfaction. It is important to gain insight into this association since self-directed teams may help in retaining nursing staff.DesignA cross-sectional study based on two questionnaire surveys in 2014 and 2015.MethodsThe study involved 191 certified nursing assistants and registered nurses employed in Dutch home-care organisations (mean age of 50). These were members of the Dutch Nursing Staff Panel, a nationwide panel of nursing staff working in various healthcare settings.ResultsSelf-direction is positively related to nursing staff's job satisfaction. This relationship is partly mediated by autonomy over patient care. For certified nursing assistants and registered nurses with a bachelor's degree, a greater sense of autonomy over patient care in self-directed teams is positively related to job satisfaction. No significant association was found between autonomy over patient care and job satisfaction for registered nurses with an associate degree.ConclusionThe current study suggests that home-care organisations should consider the use of self-directed teams as this increases nursing staff's job satisfaction and may therefore help to retain nursing staff in home care.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-16T02:26:15.949339-05:
      DOI: 10.1111/jan.13298
       
  • Changes in nutritional status in nursing home residents and associated
           factors in nutritional status decline: a secondary data analysis
    • Authors: Silvia Bauer; Ruud J. G. Halfens, Christa Lohrmann
      Abstract: AimsTo describe changes in the nutritional status of nursing home residents over a period of one year and identify factors associated with a decline in nutritional status.BackgroundThe maintenance of good nutritional status is important for nursing home residents. Therefore, it is essential to identify risk factors that indicate a decline in nutritional status to take early prevention steps.DesignSecondary data analysis of repeated cross-sectional studies.MethodsData collection was performed between 2009 - 2013 using the International Prevalence Measurement of Care Problems questionnaire. Data from three purposively selected nursing homes that included 157 residents were analyzed.ResultsThe comparison between baseline data and data collected one year later showed that the nutritional status declined in 22.8% of the residents and improved in 6.5% of the cases. The BMI and changes in the BMI were significantly different between residents with stable/improved and declined nutritional status. The multivariate logistic regression analysis showed that care dependency, length of stay, changes in BMI and malnutrition risk at baseline were significantly associated with a decline in nutritional status.ConclusionThis study showed that the baseline risk of malnutrition is the most important risk factor indicating a decline in nutritional status. Therefore, health care professionals should identify the malnutrition risk and take action as early as possible.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-16T02:16:18.718245-05:
      DOI: 10.1111/jan.13297
       
  • The development of professional practice standards for Australian general
           practice nurses
    • Authors: Elizabeth Halcomb; Moira Stephens, Julianne Bryce, Elizabeth Foley, Christine Ashley
      Abstract: AimsThe aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses.BackgroundIncreasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting.DesignConcurrent mixed methods design.MethodsData collection was conducted during 2013–2014 and involved two online surveys of Registered and Enrolled Nurses currently working in general practice, a series of 14 focus groups across Australia and a series of consultations with key experts.FindingsData collection enabled the development of 22 Practice Standards separated into four domains: (i) Professional Practice; (ii) Nursing Care; (iii) General Practice Environment and (iv) Collaborative Practice. To differentiate the variations in enacting these Standards, performance indicators for the Enrolled Nurse, Registered Nurse and Registered Nurse Advanced Practice are provided under each Standard.ConclusionThe development of national professional practice standards for nurses working in Australian general practice will support ongoing workforce development. These Standards are also an important means of articulating the role and scope of the nurses’ practice for both consumers and other health professionals, as well as being a guide for curriculum development and measurement of performance.
      PubDate: 2017-03-15T22:51:54.01908-05:0
      DOI: 10.1111/jan.13274
       
  • A bibliometric analysis of the Journal of Advanced Nursing, 1976-2015
    • Authors: Danica Železnik; Helena Blažun Vošner, Peter Kokol
      Abstract: BackgroundBibliometric studies of single journals have been performed, but to the best of our knowledge, bibliometric analysis and bibliometric mapping have not yet been used to analyse the literature production of the Journal of Advanced Nursing.AimThe aim of this study was to examine the publication characteristics and development of Journal of Advanced Nursing during its 40-year history.Design/MethodUsing descriptive bibliometrics, we studied the dynamics and trend patterns of literature production and identified document types and the most prolific authors, papers, institutions and countries. Bibliometric mapping was used to visualize the content of published articles and determine the most prolific research terms and themes published in Journal of Advanced Nursing and their evolution through time. We were also interested in determining whether there were any Sleeping Beauties among the articles published in the journal.ResultsThe study revealed a positive trend in literature production, although recently, the number of articles published in Journal of Advanced Nursing has slightly decreased. The most productive institutions are from the United Kingdom, which ranks in the highest place in terms of successful publishing in the journal. Thematic analysis showed that the most prolific themes corresponded to the basic aims and scope of the journal.ConclusionJournal of Advanced Nursing contributes to advances in nursing research, practice and education as well as the quality of health care, teamwork and family care, with an emphasis on knowledge transfer and partnership between various health care professionals.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-15T09:15:28.757446-05:
      DOI: 10.1111/jan.13296
       
  • Professional values and competencies as explanatory factors for the use of
           evidence-based practice in nursing
    • Authors: Brigita Skela-Savič; Simona Hvalič-Touzery, Katja Pesjak
      Abstract: AimTo establish the connection between values, competencies, selected job characteristics and evidence-based practice use.BackgroundNurses rarely apply evidence-based practice in everyday work. A recent body of research has looked at various variables explaining the use of evidence-based practice, but not values and competencies.DesignA cross-sectional, non-experimental quantitative explorative research design.MethodsStandardized instruments were used (Nurse Professional Values Scale-R, Nurse Competence Scale, Evidence-Based Practice Beliefs and Implementation Scale). The sample included 780 nurses from 20 Slovenian hospitals. The data were collected in 2015.ResultsThe study identifies two new variables contributing to a better understanding of beliefs on and implementation of evidence-based practice, thus broadening the existing research evidence. These are the values of activism and professionalism and competencies aimed at the development and professionalization of nursing. Values of caring, trust and justice and competencies expected in everyday practice do not influence the beliefs and implementation of evidence-based practice. Respondents ascribed less importance to values connected with activism and professionalism and competencies connected with the development of professionalism. Nurses agree that evidence-based practice is useful in their clinical work, but they lack the knowledge to implement it in practice. Evidence-based practice implementation in nursing practice is low.ConclusionsStudy results stress the importance of increasing the knowledge and skills on professional values of activism and professionalism and competencies connected to nursing development. The study expands the current understanding of evidence-based practice use and provides invaluable insight for nursing managers, higher education managers and the national nursing association.
      PubDate: 2017-03-13T02:05:39.091931-05:
      DOI: 10.1111/jan.13280
       
  • Former patients’ experiences of recovery from self-harm as an
           individual, prolonged learning process. A phenomenological hermeneutical
           study
    • Authors: Randi Tofthagen; Anne Grethe Talseth, Lisbeth Maria Fagerstøm
      Abstract: AimTo explore, describe and understand former patients’ experiences of recovery from self-harm.BackgroundPrevious research shows that a person's development towards a more secure self-image, mastery of their emotions, an understanding of what triggers self-harm and mastery of new ways to cope with problems are central to recovery. Recovery from self-harm is still a relatively new field of research.DesignA phenomenological hermeneutical approach.MethodsEight participants were interviewed in 2013. Inclusion criteria: to have committed no self-harm during the past two years, to have experienced recovery and to be 18 or older. We analyzed data using a phenomenological hermeneutical method.FindingsThe findings resulted in three themes with subthemes. The first theme, the turning point, occurred at the start of the recovery process. Participants learned to choose life, verbally express their inner pain and reconcile with their life histories. In the second theme, coping with everyday life, participants learned how to choose alternative actions instead of self-harm and attend to their basic, physical needs. In the third theme, valuing close relationships and relationships with mental health nurses, participants learned to receive support from close relationships with others and mental health nurses. A tentative model illustrates the comprehensive understanding of the recovery process, described as an individual, prolonged learning process.ConclusionTo achieve recovery, persons who self-harm need guidance and knowledge of how to realize a personal learning process. More research is needed on how mental health nurses can support individual transition processes and thereby facilitate recovery.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-09T07:55:31.164625-05:
      DOI: 10.1111/jan.13295
       
  • The Content and Meaning of Administrative Work: A qualitative study of
           Nursing Practices
    • Authors: Lucie Michel; Mathias Waelli, Davina Allen, Etienne Minvielle
      Abstract: AimTo investigate the content and meaning of nurses’ administrative work.BackgroundNurses often report that administrative work keeps them away from bedside care. The content and meaning of this work remains insufficiently explored.DesignComparative case studies.MethodThe investigation took place in 2014. It was based on 254 hours of observations and 27 interviews with nurses and staff in two contrasting units: intensive care and long term care. A time and motion study was also performed over a period of 96 hours.ResultsDocumentation and Organizational Activities is composed of 6 categories; documenting the patient record, coordination, management of patient flow, transmission of information, reporting quality indicators, ordering supplies- stock management Equal amounts of time were spent on these activities in each case. Nurses did not express complaints about documentation in intensive care, whereas they reported feeling frustrated by it in long term care. These differences reflected the extent to which these activities could be integrated into nurses’ clinical work and this is in turn was related to several factors: staff ratios, informatics and relevance to nursing work.ConclusionDocumentation and Organizational Activities are a main component of care. The meaning nurses attribute to them is dependent on organizational context. These activities are often perceived as competing with bedside care, but this does not have to be the case. The challenge for managers is to fully integrate them into nursing practice. Results also suggest that nurses’ Documentation and Organizational Activities should be incorporated into informatics strategies.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-09T03:10:43.508083-05:
      DOI: 10.1111/jan.13294
       
  • A randomized controlled trial to examine the effectiveness of the
           ‘Home-but not Alone’ mobile health application educational programme
           on parental outcomes
    • Authors: Shefaly Shorey; Ying Y. Lau, Cindy-Lee Dennis, Yah Shih Chan, Wilson Wai San Tam, Yiong Huak Chan
      Abstract: AimTo examine the effectiveness of ‘Home-but not Alone’, a postnatal psychoeducational programme delivered via a mobile-health application for parents during the early postpartum period to improve parenting outcomes.BackgroundThe early postpartum period is often a challenging but crucial period for new parents. Supportive educational programmes delivered via mobile-health applications are needed to improve parenting outcomes.DesignA randomized controlled two-group pre-test and post-test design was adopted.MethodsData were collected over six months (December 2015-May 2016) from 250 participants in a tertiary teaching hospital. They were randomly assigned to the intervention (n=126) or control (n=124) groups. The intervention group received the educational programme on top of routine care while the control group only received routine care. Parental self-efficacy, social support, postnatal depression and parenting satisfaction were measured using reliable and valid instruments. A linear mixed methods analysis was used to compare the percentage change of all outcome variables from the baseline to four weeks postpartum between the groups.ResultsThe intervention group had statistically significant improvements for parental self-efficacy, social support and parenting satisfaction at four weeks postpartum compared with the control group. Postnatal depression scores did not show any significant improvement compared with the control group.ConclusionThe mobile-health application was effective in improving parental self-efficacy, social support and parenting satisfaction. Hence, it should be introduced and carried out in routine care by nurses. Further studies should focus on evaluating the effects of this programme in reducing postnatal depression among parents.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-09T03:00:27.467888-05:
      DOI: 10.1111/jan.13293
       
  • ‘Seeking authorization’: A grounded theory exploration of mentors’
           experiences of assessing nursing students on the borderline of achievement
           of competence in clinical practice
    • Authors: Simon Cassidy; Michael Coffey, Fiona Murphy
      Abstract: AimTo develop a substantive theoretical explanation of how mentors make sense of their experiences where nursing students are on the borderline of achievement of competence in clinical practice.BackgroundThe reluctance of registered nurse mentors to fail nursing students in clinical practice despite concerns about competence remains a contemporary issue in international healthcare education. Mentors’ assessment decisions have considerable impact for a variety of key stakeholders, not least for students in these circumstances.DesignGrounded theory qualitative study.MethodsPhase one involved twenty individual semi-structured interviews with nurse mentors in one United Kingdom National Health Service Health Board (July - October 2009). Phase two included eight individual semi-structured interviews and seven focus groups with mentors and practice educators (n=38) in four further Health Boards (June 2011 - February 2012). Data were analysed using open, axial and selective coding consistent with grounded theory method.FindingsThree categories ‘the conundrum of practice competence,’ ‘the intensity of nurturing hopefulness,’ and ‘managing assessment impasse,’ led to the study's substantive theoretical explanation - ‘Seeking authorization: Establishing collective accountability for mentorship.’ This demonstrates how mentors are dependent on key sources of support and feedback to validate their assessment decision-making, notwithstanding substantial personal, professional and organisational pressures.ConclusionWe conclude that management of borderline assessment situations is considerably developed by recognition of the authorizing effects of a wider community of assessors. Consequently, we identify the personal, professional and organisational implications involved in the preparation, support and regulation of mentors specifically during borderline assessment circumstances.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-09T03:00:26.040932-05:
      DOI: 10.1111/jan.13292
       
  • Developing an instrument to measure emotional behaviour abilities of
           meaningful learning through the Delphi technique
    • Authors: Lucia Cadorin; Annamaria Bagnasco, Angela Tolotti, Nicola Pagnucci, Loredana Sasso
      Abstract: AimTo identify items for a new instrument that measures emotional behaviour abilities of meaningful learning, according to Fink's Taxonomy.BackgroundMeaningful learning is an active process that promotes a wider and deeper understanding of concepts. It is the result of an interaction between new and previous knowledge and produces a long-term change of knowledge and skills. To measure meaningful learning capability, it is very important in the education of health professionals to identify problems or special learning needs. For this reason, it is necessary to create valid instruments.DesignA Delphi Study technique was implemented in four phases by means of e-mail.MethodsThe study was conducted from April–September 2015. An expert panel consisting of ten researchers with experience in Fink's Taxonomy was established to identify the items of the instrument. Data were analysed for conceptual description and item characteristics and attributes were rated. Expert consensus was sought in each of these phases. An 87·5% consensus cut-off was established.ResultsAfter four rounds, consensus was obtained for validation of the content of the instrument ‘Assessment of Meaningful learning Behavioural and Emotional Abilities’. This instrument consists of 56 items evaluated on a 6-point Likert-type scale. Foundational Knowledge, Application, Integration, Human Dimension, Caring and Learning How to Learn were the six major categories explored.ConclusionsThis content validated tool can help educators (teachers, trainers and tutors) to identify and improve the strategies to support students’ learning capability, which could increase their awareness of and/or responsibility in the learning process.
      PubDate: 2017-03-09T00:36:01.563576-05:
      DOI: 10.1111/jan.13273
       
  • Factors associated with school-aged children's body mass index in Korean
           American families
    • Authors: Myoungock Jang; Margaret Grey, Lois Sadler, Sangchoon Jeon, Soohyun Nam, Hee-Jung Song, Robin Whittemore
      Abstract: AimsTo examine factors associated with children's body mass index and obesity-risk behaviours in Korean American families.BackgroundLimited data are available about family factors related to overweight and obesity in Korean American children.DesignA cross-sectional study.MethodsConvenient sampling was employed to recruit Korean American families in the Northeast of the United States between August 2014 and January 2015. Child, family and societal/demographic/community factors were measured with self-report questionnaires completed by mothers and children. Height and weight were measured to calculate body mass index. Data were analyzed using mixed effects models incorporating within-group correlation in siblings.ResultsThe sample included 170 Korean American children and 137 mothers. In bivariate analyses, more child screen time, number of children in the household, greater parental underestimation of child's weight and children's participation in the school lunch program were significantly associated with higher child body mass index. In multivariate analyses that included variables showing significant bivariate relationship, no variable was associated with child body mass index.ConclusionThere were no child, family and societal/demographic/community factors related to child body mass index in Korean American families in the multivariate analysis, which is contrary to research in other racial/ethnic groups. In bivariate analyses, there is evidence that some factors were significantly related to child body mass index. Further research is needed to understand the unique behavioural, social and cultural features that contribute to childhood obesity in Korean American families.
      PubDate: 2017-03-07T02:26:16.347477-05:
      DOI: 10.1111/jan.13277
       
  • The effects of the empowerment education program in older adults with
           total hip replacement surgery
    • Authors: Tzu-Ting Huang; Chia-Chun Sung, Woan-Shyuan Wang, Bi-Hwa Wang
      Abstract: AimsTo measure the effectiveness of an education empowerment program on primary (self-efficacy and self-care competence) and secondary outcomes (Activities of Daily Life, mobility, depressive mood and quality of life) for older adults with total hip replacement surgery.BackgroundDegenerative arthritis is a common and serious chronic illness that impacts the quality of life of older adults. As joints continue to degenerate and the hip damaged by arthritis, activities of daily life will be difficult to perform due to severe hip pain and joint stiffness. Therefore, hip replacement surgery should be considered and effective nursing care should be provided to improve the recovery of older adults.DesignA prospective randomized control trial.MethodsA trial was conducted from September 2013 - May 2014 in two hospitals in northern Taiwan. 108 participants were random assigned to either the education empowerment group or in the comparison group. The researchers collected baseline data at admission and outcomes on the day of discharge, one month after and three months after the discharge.ResultsAfter the interventions, the education empowerment group participants demonstrated significantly higher self-care competence and self-efficacy and lower depressive inclinations compared with those in the comparison group. Participants in both groups significantly improved on activities of daily life, mobility and quality of life over the course of the interventions.ConclusionThis education empowerment intervention was very effective in enhancing participants’ outcomes. Moreover, involving both older adults and their caregivers for the participation this program is recommended for a greater impact.
      PubDate: 2017-03-06T02:21:06.836648-05:
      DOI: 10.1111/jan.13267
       
  • Support workers in community mental health teams for older people: roles,
           boundaries, supervision and training
    • Authors: Mark Wilberforce; Michele Abendstern, Sue Tucker, Saima Ahmed, Rowan Jasper, David Challis
      Abstract: AimsThe aim of this study was to explore the support worker functions in community mental health teams for older adults in relation to roles, boundaries, supervision and training.BackgroundSupport workers in community mental health teams provide important help to older people with complex mental and physical health needs in their own homes. Their numbers have grown substantially in recent years, but without professional registration there is concern that boundaries with qualified practitioners are insufficiently clear and that they do not receive the support they require.DesignQualitative research using interview data and thematic framework analysis investigated support workers’ and registered practitioners’ perspectives on roles, boundaries, supervision and training.MethodsSemi-structured face-to-face interviews were undertaken in 2011, with 42 members of nine teams spread across England, including support workers and community mental health nurses. Coding of transcribed audio-recordings and subsequent analysis was undertaken by four researchers.ResultsSupport workers undertook diverse roles and had considerable autonomy over their duties. Participants agreed about what tasks support workers should not undertake, yet there was evidence of ‘negotiated’ boundaries and examples of these being breached. Lines of authority were complex, yet support workers were supported through open communication with the wider team. Training was problematic, with few courses tailored for support workers and efforts towards formal qualification hindered by low pay and time pressures.ConclusionLocal and national attention is needed to prevent ‘drift’ into activities that both support workers and registered practitioners consider outside their remit. Barriers to training and further qualification need to be addressed.
      PubDate: 2017-03-06T02:00:26.190846-05:
      DOI: 10.1111/jan.13264
       
  • How family interactions about lifestyle changes affect adolescents'
           possibilities for maintaining weight loss after a weight-loss
           intervention: a longitudinal qualitative interview study
    • Authors: Marianne Eg; Kirsten Frederiksen, Marianne Vamosi, Vibeke Lorentzen
      Abstract: AimThis study aims to examine how family interactions related to lifestyle changes influence adolescents' potential for maintaining weight loss after participating in a weight-loss treatment programme.BackgroundObesity among adolescents is a large and complex health problem worldwide. Family support is crucial if adolescents are to benefit from weight-loss intervention.DesignQualitative research interviews with families who participated in a weight-loss programme.MethodsThe sample consisted of 10 families selected among participants in a 1-year multidisciplinary family-based weight-loss programme. Three rounds of semi-structured interviews stretching over 5 years (2010–2015) were transcribed verbatim, then analyzed using Kvale and Brinkmann's framework for working with qualitative research interviews.FindingsFive years after the intervention ended, we found that a family's interactions were a key factor in how the family handled challenges involved in changing its diet and increasing physical activity and that daily activities in modern families influenced their interaction, as activities demanded so much of the family that it was difficult to sustain the lifestyle changes necessary for the adolescent to maintain achieved weight loss. Supporting the adolescent was far more difficult than families expected; more time-consuming and also a cause of family conflicts. Siblings who did not need to lose weight played a major, but overlooked, role.ConclusionThe family's interactions and its handling of lifestyle changes were important to the adolescent's maintained weight loss. It is fundamental that the entire family is supportive, regardless of family structure and these issues ought to be addressed in future interventions.
      PubDate: 2017-03-02T22:50:25.065489-05:
      DOI: 10.1111/jan.13269
       
  • Regaining ownership and restoring belongingness: impact of family group
           conferences in coercive psychiatry
    • Authors: Ellen Meijer; Gert Schout, Gideon de Jong, Tineke Abma
      Abstract: AimThis study examined the impact of family group conferences on coercive treatment in adult psychiatry.BackgroundCoercive treatment in psychiatry infringes the fundamental rights of clients, including the right to control their lives. A promising intervention is the family group conferences, which has the potential to prevent crises through the integration of the expertise of informal and professional networks.DesignA responsive evaluation, including qualitative and quantitative methods, was deployed to study the process leading up to the FGC, the proceedings and the impact of the conference.MethodFrom 2013–2015, 41 family group conferences were studied in three regions in the Netherlands. The impact of every conference was examined with scales (ranging from 0–10) during interviews with attendees (clients, family members, friends, mental health professionals and family group conferences coordinators) who reflected on three outcome measures: belongingness, ownership and coercion.ResultsAfter the family group conferences, respondents indicated a slight reduction in their experience of coercive treatment. They also mentioned an increase in ownership and belongingness.ConclusionFamily group conferences seems a promising intervention to reduce coercion in psychiatry. It helps to regain ownership and restores belongingness. If mental health professionals take a more active role in the pursuit of a family group conferences and reinforce the plans with their expertise, they can strengthen the impact even further.
      PubDate: 2017-03-02T22:45:24.630117-05:
      DOI: 10.1111/jan.13270
       
  • Development and testing of the CALDs and CLES+T scales for international
           nursing students’ clinical learning environments
    • Authors: Kristina Mikkonen; Satu Elo, Jouko Miettunen, Mikko Saarikoski, Maria Kääriäinen
      Abstract: AimThe purpose of this study was to develop and test the psychometric properties of the new Cultural and Linguistic Diversity scale, which is designed to be used with the newly validated Clinical Learning Environment, Supervision and Nurse Teacher scale for assessing international nursing students’ clinical learning environments.BackgroundIn various developed countries, clinical placements are known to present challenges in the professional development of international nursing students.DesignA cross-sectional survey.MethodsData were collected from eight Finnish universities of applied sciences offering nursing degree courses taught in English during 2015–2016. All the relevant students (N = 664) were invited and 50% chose to participate. Of the total data submitted by the participants, 28% were used for scale validation. The construct validity of the two scales was tested by exploratory factor analysis, while their validity with respect to convergence and discriminability was assessed using Spearman's correlation.ResultsConstruct validation of the Clinical Learning Environment, Supervision and Nurse Teacher scale yielded an eight-factor model with 34 items, while validation of the Cultural and Linguistic Diversity scale yielded a five-factor model with 21 items.ConclusionA new scale was developed to improve evidence-based mentorship of international nursing students in clinical learning environments. The instrument will be useful to educators seeking to identify factors that affect the learning of international students.
      PubDate: 2017-03-02T22:40:42.577679-05:
      DOI: 10.1111/jan.13268
       
  • Residents’ engagement in everyday activities and its association with
           thriving in nursing homes
    • Authors: Sabine Björk; Marie Lindkvist, Anders Wimo, Christina Juthberg, Ådel Bergland, David Edvardsson
      Abstract: AimTo describe the prevalence of everyday activity engagement for older people in nursing homes and the extent to which engagement in everyday activities is associated with thriving.BackgroundResearch into residents’ engagement in everyday activities in nursing homes has focused primarily on associations with quality of life and prevention and management of neuropsychiatric symptoms. However, the mere absence of symptoms does not necessarily guarantee experiences of well-being. The concept of thriving encapsulates and explores experiences of well-being in relation to the place where a person lives.DesignA cross-sectional survey.MethodA national survey of 172 Swedish nursing homes (2013–2014). Resident (n = 4831) symptoms, activities and thriving were assessed by staff using a study survey based on established questionnaires. Descriptive statistics, simple and multiple linear regression, and linear stepwise multiple regression were performed.ResultsThe most commonly occurring everyday activities were receiving hugs and physical touch, talking to relatives/friends and receiving visitors, having conversation with staff not related to care and grooming. The least commonly occurring everyday activities were going to the cinema, participating in an educational program, visiting a restaurant and doing everyday chores. Positive associations were found between activity engagement and thriving, where engagement in an activity program, dressing nicely and spending time with someone the resident likes had the strongest positive association with resident thriving.ConclusionsEngagement in everyday activities can support personhood and thriving and can be conceptualized and implemented as nursing interventions to enable residents to thrive in nursing homes.
      PubDate: 2017-03-02T22:35:24.510363-05:
      DOI: 10.1111/jan.13275
       
  • First-time mothers’ choice of birthplace: influencing factors,
           expectations of the midwife's role and perceived safety
    • Authors: Sara E. Borrelli; Denis Walsh, Helen Spiby
      Abstract: AimTo explore first-time pregnant women's expectations and factors influencing their choice of birthplace.BackgroundAlthough outcomes and advantages for low-risk childbearing women giving birth in midwifery-led units and home compared with obstetric units have been investigated previously, there is little information on the factors that influence women's choice of place of birth.DesignA qualitative Straussian grounded theory methodology was adopted. Fourteen women expecting their first baby were recruited from three large National Health Service organizations that provided maternity services free at the point of care. The three organizations offered the following birthplace options: home, freestanding midwifery unit and obstetric unit. Ethical approvals were obtained and informed consent was gained from each participant.MethodsData collection was undertaken in 2013–2014. One tape-recorded face-to-face semistructured interview was conducted with each woman in the third trimester of pregnancy.FindingsFindings are presented as three main themes: (i) influencing factors on the choice of birthplace; (ii) expectations on the midwife's ‘being’ and ‘doing’ roles; (iii) perceptions of safety.ConclusionMidwives should consider each woman's expectations and approach to birth beyond the planned birthplace, as these are often influenced by the intersection of various influencing factors. Several birthplace options should be made available to women in each maternity service and the alternatives should be shared with women by healthcare professionals during pregnancy to allow an informed choice. Virtual tours or visits to the birth units could also be offered to women to help them familiarize with the chosen setting.
      PubDate: 2017-03-02T22:30:33.821691-05:
      DOI: 10.1111/jan.13272
       
  • Initial psychometric testing and validation of the Patient Participation
           in Pressure Injury Prevention scale
    • Authors: Wendy Chaboyer; Emma Harbeck, Tracey Bucknall, Elizabeth McInnes, Lukman Thalib, Jennifer Whitty, Marianne Wallis, Brigid Gillespie
      Abstract: AimsThe aim of this study was to develop the Patient Participation in Pressure Injury Prevention (PPPIP) scale and undertake initial testing of some of its psychometric properties.BackgroundClinical practice guidelines recommend patient involvement in pressure injury prevention. There is some evidence that patients are willing to participate in this activity but there are currently no instruments to measure this participation.Design: This methodological study used data collected as part of a cluster randomised trial to modify and test the PPPIP scale.MethodsA sample of 688 of patients with complete PPPIP scale data was used. A stratified random subsample, (Subsample A) was created and the remainder became Subsample B. Item analysis, exploratory factor analysis and Cronbach's alpha reliability were undertaken in Subsample A. Confirmatory factor analysis and Cronbach's alpha reliability were undertaken in Subsample B. Data collection occurred between June 2014 - May 2015.ResultsIn Subsample A (n = 320), inter-item correlations, item total correlations met the acceptance criteria and an exploratory factor analysis identified a one factor solution. In subsample B (n = 368) the confirmatory factor analysis supported this one factor. In both subsamples the Cronbach's alpha was 0.86.ConclusionThis study provides preliminary evidence of acceptable reliability and validity of the PPPIP scale in two subsamples of hospitalized patients who have limited mobility. It may be used in research and quality improvement activities. As a better conceptual understanding of patient participation emerges, the PPPIP scale may require refinement.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-02T05:35:30.833456-05:
      DOI: 10.1111/jan.13289
       
  • Quality of nursing intensity data: Inter-rater reliability of the patient
           classification after two decades in clinical use
    • Authors: Pia Liljamo; Ulla-Mari Kinnunen, Pasi Ohtonen, Kaija Saranto
      Abstract: AimsTo measure the inter-rater reliability of the Oulu Patient Classification (OPCq) and to discuss existing methods of reliability testing.BackgroundThe OPCq, part of the RAFAELA® System, has been developed to assist nursing managers with the proper allocation of nursing resources. Due to the increased intensity of inpatient care during recent years, there is a need for the reliability testing of the classification, which has been in clinical use for 20 years.DesignRetrospective statistical study.MethodsTo test inter-rater reliability, a pair of nurses classified the same patients, without knowledge of each other's ratings, as a part of annually conducted standardization. Data on the parallel classifications (n = 19,997) was obtained from inpatient units (n = 32) with different specialties at a university hospital in Finland during 2010–2015. Parallel classification practices were also analysed. The reliability of the overall classification and its subareas were calculated using suitable statistical coefficients.ResultsInter-rater reliability coefficients were a reliable or almost perfect means of considering the nursing intensity category and various practices, but there were detectable differences between subareas. The lowest agreement levels occurred in the subareas ‘Planning and Coordination of Nursing Care’ and ‘Guiding of Care/Continued Care and Emotional Support’.ConclusionsThere is a need to develop the descriptions of subareas and to clarify the related concepts. Precise nursing documentation can promote a high level of agreement and reliable results. The traditional overall proportion of agreement does not provide an adequate picture of reliability –weighted kappa coefficients should be used instead.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-02T05:35:29.765194-05:
      DOI: 10.1111/jan.13288
       
  • Matching Registered Nurse services with changing care demands (MatchRN):
           Study protocol of a natural experiment multi-center study
    • Authors: Stefanie Bachnick; Dietmar Ausserhofer, Jean-Marie Januel, Maria Schubert, René Schwendimann, Sabina De Geest, Michael Simon
      Abstract: AimTo examine how patient safety indicators and processes and structures of nursing care have changed since the 2012 introduction of Swiss Diagnosis-Related Groups.BackgroundDiagnosis-Related Groups have been implemented worldwide; yet, research findings regarding their impact on efficiency and quality of care remain inconsistent. The Matching Registered Nurse Services with Changing Care Demands study will assess how structures, processes and patient and nurse outcomes have changed in Swiss acute care hospitals since the introduction of Swiss Diagnosis-Related Groups.DesignA multi-center observational study nested in a natural experiment.MethodsTo explore the effect of implementing Diagnosis-Related Groups in Switzerland we will compare nurse and patient survey data from 2010 with data from 2015 and eventually from 2017. Initially, we will match survey data from 78 medical and surgical units of 21 hospitals that participated in 2010 and 2015. Study variables related to structures and processes of nursing care (e.g., staffing/skill mix level, nurse work environment, rationing of nursing care), as well as patient and nurse outcomes, were assessed with well-established instruments. In 2017, a follow-up survey will be conducted to explore longer-term implications. Furthermore, 6 years’ medical and surgical patient discharge data (collected 2010-2015) will be analyzed to assess changes in the severity of patient illness, length of stay and selected patient safety indicators.DiscussionThis study's results will provide evidence regarding Diagnosis-Related Groups influences on Swiss nursing services and patient safety outcomes.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-02T03:45:45.804519-05:
      DOI: 10.1111/jan.13287
       
  • Intentional Partnering: A grounded theory study on developing effective
           partnerships among nurse and physician managers as they co-lead in an
           evolving healthcare system
    • Authors: Christina Clausen; Melanie Lavoie-Tremblay, Margaret Purden, Lise Lamothe, Helene Ezer, Lynne Mcvey
      Abstract: AimTo describe the process of how nurse and physician managers in formalized dyads work together to address clinical management issues in the surgical division of one hospital setting.BackgroundNurse and physician managers are uniquely positioned to co-lead and transform healthcare delivery. However, little is known about how this management dyad functions in the healthcare settingDesignA constructivist grounded theory approach was used to investigate the process of how nurse and physician managers work together in formalized dyads in an urban Canadian university affiliated teaching hospital.MethodsData collection occurred from September 2013 - August 2014. Data included participant observation (N=142 hours) and intensive interviews (N=36) with nurse-physician manager dyads (12 nurses, 9 physicians) collected in a surgical department. Theoretical sampling was used to elaborate on properties of emerging concepts and categories.Results/FindingsA substantive theory on ‘intentional partnering’ was generated. Nurses’ and physicians’ professional agendas, which included their interests and purposes for working with each other served as the starting point of ‘intentional partnering’. The theory explains how nurse and physician managers align their professional agendas through the processes of ‘accepting mutual necessity’, ‘daring to risk (together)’ and ‘constructing a shared responsibility’. Being credible, earning trust and safeguarding respect were fundamental to communicating effectively.ConclusionIntentional partnering elucidates the relational components of working together and the strategizing that occurs as each partner deliberates on what he or she is willing to accept, risk and put into place to reap the benefits of collaborating.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-02T03:45:39.597424-05:
      DOI: 10.1111/jan.13290
       
  • Measuring hospital staff nurses perception on quality of the professional
           practice environment
    • Authors: Brigitte Johanna Maria de Brouwer; Cheryl Fingal, Lisette Schoonhoven, Marian J. Kaljouw, Theo van Achterberg
      Abstract: AimThe purpose of this study was to determine construct validity of the Dutch Essentials of Magnetism II © instrument, designed to assess nursing practice environments, using hypotheses testing.BackgroundReduction of hospital length of stay and the number of inpatient beds increases care intensity. Educational levels and numbers of nursing staff in hospitals, however, do not match this increase, resulting in a strain on quality of care and patient safety. A possible answer to existing concerns about quality of care may be the creation of a productive and healthy practice environment, as this has an impact on the quality of care. Therefore, areas requiring improvement of the practice environment have to be defined.DesignA cross-sectional, correlational study design.MethodWe determined construct validity with hypotheses testing by relating the Dutch Essentials of Magnetism II to the Dutch Practice Environment Scale of the Nursing Work Index. We formulated fifteen hypotheses prior to data-analysis; ten related to convergent validity and five related to discriminant validity. Data were collected from qualified nurses (N=259) on nine randomly selected hospital wards from March to April 2012.ResultsResponse rate was 47% (n=121). Total scores of both instruments are strongly correlated (r=0.88). In total, twelve out of fifteen hypotheses (80%) were confirmed and three were rejected.ConclusionThe D-EOMII has satisfactory construct validity for measuring the nursing practice environment in hospitals and can be used by nurses, managers, health policy makers, hospitals and governments to assess and identify processes and relationships that are in need of improvement.This article is protected by copyright. All rights reserved.
      PubDate: 2017-03-02T03:45:33.391133-05:
      DOI: 10.1111/jan.13291
       
  • Changes of perceived control after kidney transplantation: a prospective
           study
    • Authors: Torben Schulz; Jan Niesing, Jaap J. Homan van der Heide, Ralf Westerhuis, Rutger J. Ploeg, Adelita V. Ranchor
      Abstract: AimsThe aim of this study was to determine if kidney transplantation is associated with increases of perceived control and how changes of perceived control affect the course of psychological distress until 1 year after transplantation.BackgroundLow levels of perceived control are associated with reduced well-being among dialysis patients.DesignProspective longitudinal cohort study.MethodsPerceived control (Mastery Scale) and psychological distress (GHQ-12) were prospectively assessed before (T0; n = 470) and three (T1; n = 197), six (T2; n = 210) and twelve (T3; n = 183) months after transplantation. Differences between T1 and T0 perceived control were used to stratify the sample into three groups (control gain, stable control and control loss). Socio-demographic and clinical variables, including complications, were examined as potential correlates and the course of psychological was distress compared across groups. Data were collected between July 2008 - July 2013.ResultsPerceived control showed a small increase overall, with 35·1%, 50·0% and 14·9% reporting gain, stable level and loss respectively. Patients with secondary schooling were overrepresented in the control loss group. The course of psychological distress varied across perceived control change groups, with patients in the control gain group experiencing a significant reduction in psychological distress.ConclusionA considerable number of patients report increased levels of perceived control after transplantation that are associated with a subsequent decrease in psychological distress. Results emphasize the importance of perceived control and could inform interventions to facilitate well-being after kidney transplantation.
      PubDate: 2017-03-01T00:20:36.297059-05:
      DOI: 10.1111/jan.13263
       
  • Fidelity scorecard: evaluation of a caregiver-delivered symptom management
           intervention
    • Authors: Dawn Frambes; Rebecca Lehto, Alla Sikorskii, Irena Tesnjak, Barbara Given, Gwen Wyatt
      Abstract: AimTo evaluate and quantify the intervention fidelity of a symptom management protocol through implementation of a scorecard, using an exemplar study of caregiver-delivered reflexology for people with breast cancer.BackgroundStudies on caregiver-delivered symptom management interventions seldom include adequate information on protocol fidelity, contributing to potentially suboptimal provision of the therapeutic intervention, hindering reproducibility and generalizability of the results.DesignFidelity assessment of a 4-week intervention protocol in a randomized controlled trial (RCT) with data collection between 2012 - 2016.MethodsThe National Institutes of Health Behaviour Change Consortium (NIH-BCC) conceptual model for intervention fidelity guided the study. The five NIH-BCC fidelity elements are: (1) dose; (2) provider training; (3) intervention delivery; (4) intervention receipt; and (5) enactment. To illustrate the elements, an intervention protocol was deconstructed and each element quantified using a newly developed fidelity scorecard.ResultsMean scores and frequency distributions were derived for the scorecard elements. For dose, the mean number of sessions was 4·4, 96% used the correct intervention duration and 29% had 4 weeks with at least one session. Provider training was achieved at 80% of the maximum score, intervention delivery was 96%, intervention receipt was 99% and enactment indicated moderate adoption at 3·8 sessions per patient. The sample mean score was 15·4 out of 16, indicating the high overall fidelity.ConclusionResearch findings that include description of how fidelity is both addressed and evaluated are necessary for clinical translation. Clinicians can confidently recommend symptom management strategies to patients and caregivers when fidelity standards are explicitly reported and measured.
      PubDate: 2017-02-27T01:15:24.701624-05:
      DOI: 10.1111/jan.13266
       
  • Using a worst pain intensity measure in children and adolescents
    • Authors: Alexander Avian; Brigitte Messerer, Winfried Meissner, Andreas Sandner-Kiesling, Julian Kammel, Marlies Labugger, Annelie Weinberg, Andrea Berghold
      Abstract: AimsTo explore inconsistencies and the reliability in worst pain intensity ratings in children.BackgroundAsking for worst pain always requires a retrospective evaluation which is controversially discussed.DesignRetrospective analysis of registry data and a prospective study.MethodsRetrospective study: 5970 patients [age: 10·2(4·0) years, female: 41% data collection: 2008–2015]; Prospective study: 240 patients [age: 14·7(1·9) years, female: 43%, data collection 2013–2014] were included. In both studies, the number of implausible pain intensity ratings was calculated (both studies: worst pain lower than movement pain or pain at rest, prospective study: number of patients reporting lower pain intensity ratings in worst pain items for the same time period in a second assessment). Test–retest reliability was calculated for the prospective study. Changes in worst pain ratings were analyzed using Wilcoxon signed ranks test.ResultsTest–retest reliability ranged from ρ = 0·77–0·90. In the retrospective study, 8·9% (95%CI: 8·2–9·6%) of our patients reported higher movement and/or pain at rest compared with worst pain. In the prospective study, 35·8% (95%CI: 30·0–42·1%) reported higher activity pain ratings compared with worst pain ratings in at least one pain assessment; 13·8% of the pediatric patients reported lower pain intensity ratings in worst pain items in a second assessment compared with the first assessment.ConclusionNine to 36% of our patients showed inconsistent worst pain ratings. To overcome this problem, more specific pain intensity items, more than one item or a better instruction for pediatric patients could be used.
      PubDate: 2017-02-27T01:10:25.621593-05:
      DOI: 10.1111/jan.13271
       
  • A systematic review of psychometric testing of instruments that measure
           intention to work with older people
    • Authors: Chong Chin Che; Noran Naqiah Hairi, Mei Chan Chong
      Abstract: AimsTo review systematically the psychometric properties of instruments used to measure intention to work with older people.BackgroundNursing students are part of the future healthcare workforce; thus, being aware of their intention to work with older people would give valuable insights to nursing education and practice. Despite a plethora of research on measuring intention to work with older people, a valid and reliable instrument has not been identified.DesignA systematic literature review of evidence and psychometric properties.Data sourcesEight database searches were conducted between 2006 - 2016.Review methodsEnglish articles were selected based on inclusion and exclusion criteria. The COSMIN checklist was used to assess instruments reporting a psychometric evaluation of validity and reliability.ResultsOf 41 studies identified for full text review, 36 met the inclusion criteria. Seven different types of instruments were identified for psychometric evaluation. Measures of reliability were reported in eight papers and validity in five papers. Evidence for each measurement property was limited, with each instrument demonstrating a lack of information on measurement properties. Based on the COSMIN checklist, the overall quality of the psychometric properties was rated as poor to good.ConclusionNo single instrument was found to be optimal for use. Studies of high methodological quality are needed to properly assess the measurement properties of the instruments that are currently available. Until such studies are available, we recommend using existing instruments with caution.
      PubDate: 2017-02-24T03:50:23.074529-05:
      DOI: 10.1111/jan.13265
       
  • What is the impact of shift work on the psychological functioning and
           resilience of nurses' An integrative review
    • Authors: Mozhdeh Tahghighi; Clare S. Rees, Janie A. Brown, Lauren J. Breen, Desley Hegney
      Abstract: AimTo synthesise existing research to determine if nurses who work shifts have poorer psychological functioning and resilience than nurses who do not work shifts.BackgroundResearch exploring the impact of shift work on the psychological functioning and resilience of nurses is limited compared with research investigating the impact of shifts on physical outcomes.DesignIntegrative literature review.Data SourcesRelevant databases were searched from January 1995- August 2016 using the combination of keywords: nurse, shift work; rotating roster; night shift; resilient; hardiness; coping; well-being; burnout; mental health; occupational stress; compassion fatigue; compassion satisfaction; stress; anxiety; depression.Review MethodsTwo authors independently performed the integrative review processes proposed by Whittemore and Knafl and a quality assessment using the Mixed Methods Appraisal Tool by Pluye et al.ResultsA total of 37 articles were included in the review (32 quantitative, 4 qualitative, 1 mixed methods). Approximately half of the studies directly compared nurse shift workers with non-shift workers. Findings were grouped according to the following main outcomes: 1) General Psychological Well-being/Quality of Life; 2) Job satisfaction/Burnout; 3) Depression, Anxiety and Stress; and 4) Resilience/Coping. We did not find definitive evidence that shift work is associated with poorer psychological functioning in nurses. Overall, the findings suggest that the impact of shift work on nurse psychological functioning is dependent on several contextual and individual factors.ConclusionMore studies are required which directly compare the psychological outcomes and resilience of nurse shift workers with non-shift workersThis article is protected by copyright. All rights reserved.
      PubDate: 2017-02-22T21:25:28.230683-05:
      DOI: 10.1111/jan.13283
       
  • Prevalence of nursing diagnoses as a measure of nursing complexity in a
           hospital setting
    • Authors: Fabio D'Agostino; Gianfranco Sanson, Antonello Cocchieri, Ercole Vellone, John Welton, Massimo Maurici, Rosaria Alvaro, Maurizio Zega
      Abstract: AimsTo describe the prevalence of nursing diagnoses on admission among inpatient units and medical diagnoses and to analyze the relationship of nursing diagnoses to patient characteristics and hospital outcomes.BackgroundNursing diagnoses classify patients according to nursing dependency and can be a measure of nursing complexity. Knowledge regarding the prevalence of nursing diagnoses on admission and their relationship with hospital outcomes is lacking.DesignProspective observational study.MethodsData were collected for six months in 2014 in four inpatient units of an Italian hospital using a nursing information system and the hospital discharge register. Nursing diagnoses with prevalence higher or equal to 20% were considered as ‘high-frequency.’ Nursing diagnoses with statistically significant relationships to either higher mortality or length of stay were considered as ‘high-risk.’ The high-frequency/high-risk category of nursing diagnoses was identified.ResultsThe sample included 2,283 patients. A mean of 4.5 nursing diagnoses per patient was identified; this number showed a statistically significant difference among inpatient units and medical diagnoses. Six nursing diagnoses were classified as high-frequency/high-risk. Nursing diagnoses were not correlated with patient gender and age. A statistically significant perfect linear association (Spearman's correlation coefficient) was observed between the number of nursing diagnoses and both the length of stay and the mortality rate.ConclusionNursing complexity, as described by nursing diagnoses, was shown to be associated with length of stay and mortality. These results should be confirmed after considering other variables through multivariate analyses. The concept of high-frequency/high-risk nursing diagnoses should be expanded in further studies.This article is protected by copyright. All rights reserved.
      PubDate: 2017-02-22T21:25:27.033665-05:
      DOI: 10.1111/jan.13285
       
  • The mourning process of older people with dementia who lost their spouse
    • Authors: Akiko Watanabe; Sayuri Suwa
      Abstract: AimsTo explore the mourning process of people with dementia who have lost their spouse, using family caregivers’ and professionals’ perspectives and to devise grief care for people with dementia.BackgroundThere have been studies on the loss of one's spouse; however, little is known about widows and widowers with dementia as they may find it hard to tell their perception and feelings to others accurately because of cognitive impairment.DesignQualitative descriptive study using semi-structured interviews.MethodSeven family caregivers and six professional caregivers from day care centres were interviewed between June - September 2015. Qualitative content analysis was used to identify mourning behaviours of people with dementia.ResultsIn the mourning process of people with dementia, different behaviours were found according to dementia stages and different circumstances. In FAST2, they could remember their spouse's death. In FAST4 -6, it took one year to be able to perceive their spouse's death and more time to store it. In FAST 7, people with dementia did not discern his spouse's death throughout the process. Furthermore, it was revealed that people with dementia followed a different mourning process from conventional ones.ConclusionIn the care of widows and widowers with dementia it is crucial to adjust circumstances to allow people with dementia to guess reality. Further studies are needed to clarify differences between the mourning process of people with dementia and that of intact older people to develop a grief model and educational programs.This article is protected by copyright. All rights reserved.
      PubDate: 2017-02-22T21:25:23.607997-05:
      DOI: 10.1111/jan.13286
       
  • Nurses’ Response to Parents’ “Speaking-up” Efforts to Ensure their
           Hospitalized Child's Safety: An Attribution Theory Perspective
    • Authors: Sondos Basharat; Anat Drach-Zahavy
      Abstract: AimTo understand how attribution processes (control and stability), which the nurse attributes to parental involvement in maintaining child safety, determine the nurse's response to a safety alert.BackgroundParticipation of parents in maintaining their child's safety is shown to reduce the incidence of and risk of clinical errors. Unless nurses respond appropriately to parents’ safety alerts, this potential source of support could diminish.DesignA 2 (controllability: high vs. low) × 2 (consistency: high vs. low) factorial design.MethodsData were collected during the period 2013–2014 in pediatric wards. Four variants of scenarios were created corresponding to the different combinations of these variables. A total of 126 nurses read a scenario and completed self-report questionnaires measuring their response to the parent's safety alert. Additional data were collected about the manipulation check, safety norms in the ward and demographic variables. Data were analyzed using analysis of variance.FindingsResults showed a main effect of stability and a significant two-way interaction effect of stability and controllability, on a nurse's tendency to help the parent and fix the safety problem. Nurses who attributed lower controllability and lower stability to the parent's behavior tended to help the parent more than in the other three conditions. Further, safety norms were significantly related to nurses’ response.ConclusionThese findings contribute to the understanding of antecedents that affect nurses’ responses to parents’ speaking-up initiatives: whether nurses will reject or heed the alert. Theoretical and practical implications for promoting parents’ engagement in their safety are discussed.This article is protected by copyright. All rights reserved.
      PubDate: 2017-02-22T21:25:22.573224-05:
      DOI: 10.1111/jan.13282
       
  • Perceptions about the sexuality of women with fibromyalgia syndrome: a
           phenomenological study
    • Authors: Tamara María Matarín Jiménez; Cayetano Fernández-Sola, José Manuel Hernández-Padilla, Matías Correa Casado, Laura Helena Antequera Raynal, José Granero-Molina
      Abstract: AimsThe aim of this study was to explore and understand the perceptions and experiences of women with fibromyalgia syndrome regarding their sexuality.BackgroundFibromyalgia syndrome is a chronic pathology, which compromises a woman's physical, mental and emotional health. Although concerns related to sexuality are commonly reported, research has tended to focus on the physical symptoms.DesignAn interpretive qualitative research methodology using Gadamer's philosophical hermeneutics was carried out.MethodsThis qualitative study explores the sexuality of women with fibromyalgia syndrome. A focus group and semi-structured interviews were conducted with 13 women with fibromyalgia syndrome. Data were collected between April - June 2014. Participants were recruited until findings reached saturation.FindingsThree themes define the perception of sexuality for these women: (i) Physical impact: don't touch, don't look; (ii) Sexuality and identity: fighting against their loss; (iii) Impact on the relationship: sexuality as a way of connecting the couple.ConclusionDespite limitations, sexuality is important for the identity and quality of life of women with fibromyalgia syndrome. Together with the physical symptomology, guilt, fear and a lack of understanding compromise the coping process. Women need the support of their partner, their socio-family environment and health professionals. Nurses can aid the successful adjustment to sexual problems related to fibromyalgia syndrome.
      PubDate: 2017-02-22T03:50:38.19513-05:0
      DOI: 10.1111/jan.13262
       
  • The use of antioxidants in the treatment of traumatic brain injury
    • Authors: Whitney Venegoni; Qiuhua Shen, Amanda R. Thimmesch, Meredith Bell, John B. Hiebert, Janet D. Pierce
      Abstract: AimsThe aim of this study was to discuss secondary traumatic brain injury, the mitochondria and the use of antioxidants as a treatment.BackgroundOne of the leading causes of death globally is traumatic brain injury, affecting individuals in all demographics. Traumatic brain injury is produced by an external blunt force or penetration resulting in alterations in brain function or pathology. Often, with a traumatic brain injury, secondary injury causes additional damage to the brain tissue that can have further impact on recovery and the quality of life. Secondary injury occurs when metabolic and physiologic processes alter after initial injury and includes increased release of toxic free radicals that cause damage to adjacent tissues and can eventually lead to neuronal necrosis. Although antioxidants in the tissues can reduce free radical damage, the magnitude of increased free radicals overwhelms the body's reduced defence mechanisms. Supplementing the body's natural supply of antioxidants, such as coenzyme Q10, can attenuate oxidative damage caused by reactive oxygen species.DesignDiscussion paper.Data sourcesResearch literature published from 2011–2016 in PubMed, CINAHL and Cochrane.Implications for nursingPrompt and accurate assessment of patients with traumatic brain injury by nurses is important to ensure optimal recovery and reduced lasting disability. Thus, it is imperative that nurses be knowledgeable about the secondary injury that occurs after a traumatic brain injury and aware of possible antioxidant treatments.ConclusionThe use of antioxidants has potential to reduce the magnitude of secondary injury in patients who experience a traumatic brain injury.
      PubDate: 2017-02-20T02:41:49.716136-05:
      DOI: 10.1111/jan.13259
       
  • Abused women's experiences of a primary care identification and referral
           intervention: a case study analysis
    • Authors: Caroline Bradbury-Jones; Maria Clark, Julie Taylor
      Abstract: AimsThe aim of this study was to report the findings of a qualitative case study that investigated abused women's experiences of an identification and referral intervention and to discuss the implications for nurses, specifically those working in primary and community care.BackgroundDomestic violence and abuse is a significant public health issue globally but it is a hidden problem that is under-reported. In the UK, Identification and Referral to Improve Safety is a primary care-based intervention that has been found to increase referral rates of abused women to support and safety services. This paper reports on the findings of an evaluation study of two sites in England.DesignQualitative study with a case study design.MethodsIn line with case study design, the entire evaluation study employed multiple data collection methods. We report on the qualitative interviews with women referred through the programme. The aim was to elicit their experiences of the three aspects of the intervention: identification; referral; safety. Data collection took place March 2016.FindingsTen women took part. Eight had exited the abusive relationship but two remained with the partner who had perpetrated the abuse. Women were overwhelmingly positive about the programme and irrespective of whether they had remained or exited the relationship all reported perceptions of increased safety and improved health.ConclusionNurses have an important role to play in identifying domestic violence and abuse and in referral and safety planning. As part of a portfolio of domestic violence and abuse interventions, those that empower women to take control of their safety (such as Identification and Referral to Improve Safety) are important.
      PubDate: 2017-02-17T02:45:27.339399-05:
      DOI: 10.1111/jan.13250
       
  • Hermeneutic phenomenological analysis: the ‘possibility’ beyond
           ‘actuality’ in thematic analysis
    • Authors: Ken H.M. Ho; Vico C.L. Chiang, Doris Leung
      Abstract: AimsThis article discusses the ways researchers may become open to manifold interpretations of lived experience through thematic analysis that follows the tradition of hermeneutic phenomenology.BackgroundMartin Heidegger's thinking about historical contexts of understandings and the notions of ‘alētheia’ and ‘techne’ disclose what he called meaning of lived experience, as the ‘unchanging Being of changing beings’. While these notions remain central to hermeneutic phenomenological research, novice phenomenologists usually face the problem of how to incorporate these philosophical tenets into thematic analysis.DesignDiscussion paper.Data sourcesThis discussion paper is based on our experiences of hermeneutic analysis supported by the writings of Heidegger. Literature reviewed for this paper ranges from 1927 – 2014. We draw on data from a study of foreign domestic helpers in Hong Kong to demonstrate how ‘dwelling’ in the language of participants’ ‘ek-sistence’ supported us in a process of thematic analysis. Data were collected from December 2013 – February 2016.Implications for NursingNurses doing hermeneutic phenomenology have to develop self-awareness of one's own ‘taken-for-granted’ thinking to disclose the unspoken meanings hidden in the language of participants. Understanding the philosophical tenets of hermeneutic phenomenology allows nurses to preserve possibilities of interpretations in thinking. In so doing, methods of thematic analysis can uncover and present the structure of the meaning of lived experience.ConclusionWe provide our readers with vicarious experience of how to begin cultivating thinking that is aligned with hermeneutic phenomenological philosophical tenets to conduct thematic analysis.
      PubDate: 2017-02-17T02:43:42.880842-05:
      DOI: 10.1111/jan.13255
       
  • Cognitive, behavioural and psychosocial factors associated with successful
           and maintained quit smoking status among patients who received smoking
           cessation intervention with nurses’ counselling
    • Authors: Chie Taniguchi; Hideo Tanaka, Hideo Saka, Isao Oze, Kazunobu Tachibana, Yasuhiro Nozaki, Yukio Suzuki, Hisataka Sakakibara
      Abstract: AimTo identify cognitive, behavioural and psychosocial factors associated with successful and maintained quit smoking status after patients received smoking cessation intervention with nurses’ counselling.BackgroundAlthough nurses’ intervention for smoking cessation is effective for patients, few studies have been conducted to identify cognitive, behavioural and psychosocial factors associated with the success of quitting smoking.DesignProspective cohort studyMethodsIn a multi-institutional study between October 2008 - October 2014, we administered the Japanese smoking cessation therapy, which consists of smoking cessation intervention five times with nurses’ counselling over 12 weeks. Log-binomial regression analysis was performed in 1,320 participants using the following independent variables: age, gender, having a present illness, prescription, Fagerström test for nicotine dependence, strength of desire to quit, age at smoking initiation, previous abstinence, motivation of quit smoking, self-efficacy of quit smoking and Center for Epidemiologic Studies Depression Scale. Factors associated with maintained cessation for 12 months were identified in the 541 abstainers at the end of the intervention.ResultsHaving higher self-efficacy to quit smoking as assessed before the intervention was significantly associated with the success of quitting smoking at the end of the intervention. Strong desire to smoke as assessed at the end of the intervention was associated with significantly increased risk of discontinuing cessation during the 12 months after the end of the intervention.ConclusionIt is important for nurses who provide smoking cessation intervention to reinforce patients’ self-efficacy and to control the strength of the patients’ desire to smoke by behavioural counselling.
      PubDate: 2017-02-17T02:15:36.382653-05:
      DOI: 10.1111/jan.13258
       
  • Self-administered health literacy instruments for people with diabetes:
           systematic review of measurement properties
    • Authors: Eun-Hyun Lee; Chun-Ja Kim, Jiyeon Lee, Seung Hei Moon
      Abstract: AimsThe aims of this study were to identify all available self-administered instruments measuring health literacy in people with diabetes and to determine the current instrument that is the most appropriate for applying to this population in both practice and research.DesignA systematic review of measurement properties.Data sourcesMEDLINE, EMBASE and CINAHL electronic databases from their inception up to 28 March 2016.Review methodThe methodological quality of each included study was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The reported results for measurement properties in the studies were assessed according to Terwee's quality criteria.ResultsThirteen self-administered instruments measuring health literacy in people with diabetes were identified, of which six (44%) were diabetes-specific instruments. The instruments that covered the broadest contents of health literacy were the Health Literacy Scale and Health Literacy Questionnaire. The (test–retest) reliability, measurement error and responsiveness were not evaluated for any instrument, while internal consistency and hypothesis testing validity were the most frequently assessed measurement properties.ConclusionsWith the current evidence, the Health Literacy Scale may be the most appropriate instrument for patients with diabetes in practice and research. However, the structural validity of this scale needs to be further established, particularly in other language versions. It is also recommended to use the Diabetes Numeracy Test-15 along with the Health Literacy Scale to complement the lack of numeracy measures in the Health Literacy Scale.
      PubDate: 2017-02-17T02:10:27.652485-05:
      DOI: 10.1111/jan.13256
       
  • A systematic review of the psychometric properties of instruments for
           assessing the quality of the physical environment in healthcare
    • Authors: Marie Elf; Susanna Nordin, Helle Wijk, Kevin J. McKee
      Abstract: AimTo identify instruments measuring the quality of the physical healthcare environment, describe their psychometric properties.BackgroundThe physical healthcare environment is regarded as a quality factor for healthcare. To facilitate evidence-based design there is a need for valid and usable instruments that can evaluate the design of the healthcare environment.DesignSystematic psychometric review.Data sourcesA systematic literature search in Medline, CINAHL, Psychinfo, Avery index and reference lists of eligible papers (1990-2016).Review MethodCOSMIN guidelines were used to evaluate psychometric data reported.ResultsTwenty-three instruments were included. Most of the instruments are intended for for healthcare environments related to the care of older people. Many of the instruments were old, lacked strong, contemporary theoretical foundations, varied in the extent to which they had been used in empirical studies and in the degree to which their validity and reliability had been evaluated.ConclusionsAlthough we found many instruments for measuring the quality of the physical healthcare environment, none met all of our criteria for robustness. Of the instruments, The Multiphasic environmental assessment procedure, The Professional environment assessment protocol and The therapeutic environment screening have been used and tested most frequently. The Perceived hospital quality indicators is user centred and combine aspects of the physical and social environment. The Sheffield care environment assessment matrix has potential as it is comprehensive developed using a theoretical framework that has the needs of older people at the centre. However, further psychometric and user-evaluation of the instrument is required.This article is protected by copyright. All rights reserved.
      PubDate: 2017-02-16T16:55:23.619474-05:
      DOI: 10.1111/jan.13281
       
  • The economic burden of nurse-sensitive adverse events in 22
           medical-surgical units: retrospective and matching analysis
    • Authors: Eric Tchouaket; Carl-Ardy Dubois, Danielle D'Amour
      Abstract: AimsThe aim of this study was to assess the economic burden of nurse-sensitive adverse events in 22 acute-care units in Quebec by estimating excess hospital-related costs and calculating resulting additional hospital days.BackgroundRecent changes in the worldwide economic and financial contexts have made the cost of patient safety a topical issue. Yet, our knowledge about the economic burden of safety of nursing care is quite limited in Canada in general and Quebec in particular.DesignRetrospective analysis of charts of 2699 patients hospitalized between July 2008 – August 2009 for at least 2 days of 30-day periods in 22 medical-surgical units in 11 hospitals in Quebec.MethodsData were collected from September 2009 to August 2010. Nurse-sensitive adverse events analysed were pressure ulcers, falls, medication administration errors, pneumonia and urinary tract infections. Descriptive statistics identified numbers of cases for each nurse-sensitive adverse event. A literature analysis was used to estimate excess median hospital-related costs of treatments with these nurse-sensitive adverse events. Costs were calculated in 2014 Canadian dollars. Additional hospital days were estimated by comparing lengths of stay of patients with nurse-sensitive adverse events with those of similar patients without nurse-sensitive adverse events.ResultsThis study found that five adverse events considered nurse-sensitive caused nearly 1300 additional hospital days for 166 patients and generated more than Canadian dollars 600,000 in excess treatment costs.ConclusionThe results present the financial consequences of the nurse-sensitive adverse events. Government should invest in prevention and in improvements to care quality and patient safety. Managers need to strengthen safety processes in their facilities and nurses should take greater precautions.
      PubDate: 2017-02-16T01:00:26.647659-05:
      DOI: 10.1111/jan.13260
       
  • Burnout mediates the association between depression and patient safety
           perceptions: a cross-sectional study in hospital nurses
    • Authors: Judith Johnson; Gemma Louch, Alice Dunning, Olivia Johnson, Angela Grange, Caroline Reynolds, Louise Hall, Jane O'Hara
      Abstract: AimsThe aim of this study was to investigate the relationships between depressive symptoms, burnout and perceptions of patient safety. A mediation model was proposed whereby the association between symptoms of depression and patient safety perceptions was mediated by burnout.BackgroundThere is growing interest in the relationships between depressive symptoms and burnout in healthcare staff and the safety of patient care. Depressive symptoms are higher in healthcare staff than the general population and overlap conceptually with burnout. However, minimal research has investigated these variables in nurses. Given the conceptual overlap between depressive symptoms and burnout, there is also a need for an explanatory model outlining the relative contributions of these factors to patient safety.DesignA cross-sectional questionnaire was distributed at three acute NHS Trusts.MethodThree-hundred and twenty-three hospital nursing staff completed measures of depressive symptoms, burnout and patient safety perceptions (including measures at the level of the individual and the work area/unit) between December 2015 - February 2016.ResultsWhen tested in separate analyses, depressive symptoms and burnout facets were each associated with both patient safety measures. Furthermore, the proposed mediation model was supported, with associations between depressive symptoms and patient safety perceptions fully mediated by burnout.ConclusionThese results suggest that symptoms of depression and burnout in hospital nurses may have implications for patient safety. However, interventions to improve patient safety may be best targeted at improving burnout in particular, with burnout interventions known to be most effective when focused at both the individual and the organisational level.
      PubDate: 2017-02-16T00:55:46.037067-05:
      DOI: 10.1111/jan.13251
       
  • Supporting existential care with Protected Mealtimes: Patients’
           experiences of a mealtime intervention in a neurological ward
    • Authors: Malene Beck; Regner Birkelund, Ingrid Poulsen, Bente Martinsen
      Abstract: AimTo explore the experiences of patients who were admitted to the neurological ward during an intervention – inspired by Protected Mealtime – that changed the traditional mealtime practice.BackgroundMealtimes are busy events in hospitals and patients are often interrupted by high-priority tasks (e.g., taking blood samples) while eating. Protected Mealtimes is a British concept that changes the organizational structure of mealtimes and provides a focus on the mealtime by ceasing all non-acute activities while patients are eating.DesignInspired by Protected Mealtimes and based on the British Medical Research Council (MRC) guidelines, a clinical intervention called Quiet Please was developed, modified and tested in a department of neurology in November 2014.MethodsTo evaluate the Quiet Please intervention, 13 semi-structured interviews were conducted with patients who were admitted to the neurological ward. The interviews were recorded and transcribed. The data were thoroughly analyzed and interpreted with inspiration from the French philosopher, Paul Ricouer.FindingsThree themes emerged from the analysis and interpretation: 1) being powered by the bell; 2) being embraced by calmness and aesthetics; and 3) being in a trust-bearing agreement.ConclusionsPatients experienced mealtimes as meaningful events that nourished them in an existential manner because the calming and aesthetically pleasing environment made them feel embraced and allowed them to reflect on the day for a while. The mealtime change, inspired by Protected Mealtimes, made the patients feel recognized as humans and established positive mealtime experiences that were considered professional and trust bearing.This article is protected by copyright. All rights reserved.
      PubDate: 2017-02-15T23:35:34.20334-05:0
      DOI: 10.1111/jan.13278
       
  • Measuring patient engagement: which healthcare engagement behaviours are
           important to patients'
    • Authors: Huey-Ming Tzeng; James Marcus Pierson
      Abstract: Aim(s)This study identified patient healthcare engagement behaviours that are important to community-dwelling adult patients living in the southern region of the USA.BackgroundPatient engagement has been identified as a key driver for containing healthcare costs, but the public and healthcare professionals lack a scientific understanding of patient engagement. A valid tool is needed for prompting patients to discuss health activities with their healthcare providers and to obtain support.DesignThis exploratory cross-sectional survey study used a quantitative research design. It was conducted in seven senior centres in the southern region of the USA in 2015.MethodsThis project used convenience sampling to recruit subjects. Subjects were community-dwelling adult patients older than 18 years and living in the Upper Cumberland region of Tennessee. Individuals who had taken the survey previously were excluded. The survey tool, Patient Involvement Behaviors in Health Care, was developed by the authors and used for data collection.ResultsNinety-two participants completed or partially completed the survey. The response rate was 74·8%. Among the 51 identified behaviours, 17 were identified as being important by less than 95% of participants; eight of these 17 behaviours were important to less than 90% of participants.ConclusionsWe identified 34 behaviours that at least 95% of the participants indicated were important. Nurses may use this tool to help individual patients identify engagement behaviours that are important to them, to respect their personal preferences and thus improve their engagement in health care.
      PubDate: 2017-02-14T04:00:26.817155-05:
      DOI: 10.1111/jan.13257
       
  • The difficulties experienced by nurses and healthcare staff involved in
           the process of breaking bad news
    • Authors: Clare Warnock; Jean Buchanan, Angela Mary TOD
      Abstract: AimsThe aim of this study was to explore the difficulties experienced by nurses and healthcare professionals when engaging in the process of breaking bad news.BackgroundThe challenges faced by staff when breaking bad news have previously been researched in relation to particular settings or participants. This study involved staff from diverse settings and roles to develop broader insights into the range of difficulties experienced in clinical practice.DesignThe study used a descriptive survey design involving self-reported written accounts and framework analysis.MethodsData were collected using a structured questionnaire containing a free text section that asked participants to describe a difficult experience they had encountered when involved in the process of breaking bad news. Data were collected from healthcare staff from hospital, community, hospice and care home settings attending training days on breaking bad news between April 2011 and April 2014.FindingsMultiple inter-related factors presented challenges to staff engaging in activities associated with breaking bad news. Traditional subjects such as diagnostic and treatment information were described but additional topics were identified such as the impact of illness and care at the end of life. A descriptive framework was developed that summarizes the factors that contribute to creating difficult experiences for staff when breaking bad news.ConclusionThe framework provides insights into the scope of the challenges faced by staff when they engage in the process of breaking bad news. This provides the foundation for developing interventions to support staff that more closely matches their experiences in clinical practice.
      PubDate: 2017-02-14T03:55:31.187865-05:
      DOI: 10.1111/jan.13252
       
  • “Falls prevention among older people and care providers: protocol for an
           integrative review”
    • Authors: Carmen Cuesta-Benjumea; Maria Adriana Henriques, Eva Abad-Corpa, Brenda Roe, María Isabel Orts-Cortés, Beatriz Lidón-Cerezuela, Almudena Avendaño-Céspedes, José Luís Oliver-Carbonell, Carmen Sánchez-Ardila
      Abstract: AimTo review the evidence about the role of care providers in fall prevention in older adults aged ≥ 65 years, this includes their views, strategies, and approaches on falls prevention and effectiveness of nursing interventions.BackgroundSome fall prevention programmes are successfully implemented and led by nurses and it is acknowledged the vital role they play in developing plans for fall prevention. Nevertheless, there has not been a systematic review of the literature that describes this role and care providers' views on fall's prevention initiatives.DesignA convergent synthesis of qualitative, quantitative, and mixed methods studies. The eligibility criteria will be based on participants, interventions/exposure, comparisons, and outcomes for quantitative studies and on population, the phenomena of interest and the context, for qualitative studies. To extract data and assess study qualities members of the research team will work in pairs according to their expertise. The review will follow the guidelines for integrative reviews and the proposed methods will adhere to the PRISMA statement checklist complemented by the ENTREQ framework. As qualitative synthesis are emergent, all procedures and changes in procedure will be documented.DiscussionThe review has a constructivist drive as studies that combine methods ought to be paradigmatic driven. Review questions are broad to allow issues emerge and have purposefully left the design flexible to allow for adjustments as the review progresses. The review seeks to highlight the roles that care providers play in fall prevention and their views on fall's prevention initiatives.
      PubDate: 2017-02-09T23:20:40.609368-05:
      DOI: 10.1111/jan.13245
       
  • Bedside to bench: re-thinking nursing research
    • Authors: Seamus Cowman
      PubDate: 2017-02-09T23:20:32.564485-05:
      DOI: 10.1111/jan.13254
       
  • The effectiveness of interventions to enhance self-management support
           competencies in the nursing profession: a systematic review
    • Authors: Veerle Duprez; Tina Vandecasteele, Sofie Verhaeghe, Dimitri Beeckman, Ann Van Hecke
      Abstract: AimThe aim of this study was to explore the effectiveness and effective components of training interventions to enhance nurses' competencies in self-management support in chronic care.BackgroundThe growing burden of chronic diseases puts an increasing focus on nurses' self-management support of people living with a chronic illness. The most effective method to train nurses' competencies in self-management support remains unclear.DesignSystematic literature review.Data sourcesPubMed, CINAHL, Cochrane CENTRAL, EMBASE, Web of Science, ERIC and PsycARTICLES databases were searched up to August 2015.Review methodEligible studies reported on training interventions to enhance chronic care self-management support competencies in nurses. Outcomes were defined as trainees' reactions to the training (level 1), changes in trainees' competencies (level 2) or changes in trainees' performance in practice (level 3) concerning self-management support. Risk of bias was assessed. Level 1 outcomes were synthesized narratively. Standardized mean differences were calculated per study for level 2 and 3 outcomes.ResultsIn total, 25 studies were included. Twelve of these studies included level 1 outcomes, eight studies included level 2 outcomes and 10 studies included level 3 outcomes. Effect sizes in favour of training ranged from −0·36 - 1·56 (level 2) and from 0·06 - 5·56 (level 3). Theory-driven training interventions with time to practice, (video) feedback and follow-up generated the most training effects. Caution is needed due to the inconsistent study quality.ConclusionTo date, there is a knowledge gap concerning the most effective method to train nurses' competencies in self-management support. More well-designed, longitudinal studies are needed.
      PubDate: 2017-02-09T03:50:30.331857-05:
      DOI: 10.1111/jan.13249
       
  • Adaptation of the Practice Environment Scale for military nurses: A
           psychometric analysis
    • Authors: Pauline A. Swiger; Dheeraj Raju, Sara Breckenridge-Sproat, Patricia A. Patrician
      Abstract: AimThe aim of this study was to confirm the psychometric properties of Practice Environment Scale of the Nursing Work Index in a military population. This study also demonstrates association rule analysis, a contemporary exploratory technique.BackgroundOne of the instruments most commonly used to evaluate the nursing practice environment is the Practice Environment Scale of the Nursing Work Index. Although the instrument has been widely used, the reliability, validity and individual item function are not commonly evaluated. Gaps exist with regard to confirmatory evaluation of the subscale factors, individual item analysis and evaluation in the outpatient setting and with non-registered nursing staff.DesignThis was a secondary data analysis of existing survey data.MethodsMultiple psychometric methods were used for this analysis using survey data collected in 2014. First, descriptive analyses were conducted, including exploration using association rules. Next, internal consistency was tested and confirmatory factor analysis was performed to test the factor structure. The specified factor structure did not hold; therefore, exploratory factor analysis was performed. Finally, item analysis was executed using item response theory. The differential item functioning technique allowed the comparison of responses by care setting and nurse type.ResultsThe results of this study indicate that responses differ between groups and that several individual items could be removed without altering the psychometric properties of the instrument.ConclusionThe instrument functions moderately well in a military population; however, researchers may want to consider nurse type and care setting during analysis to identify any meaningful variation in responses.This article is protected by copyright. All rights reserved.
      PubDate: 2017-02-08T23:20:34.68836-05:0
      DOI: 10.1111/jan.13276
       
  • A systematic review of evidence relating to clinical supervision for
           nurses, midwives and allied health professionals
    • Authors: Alex Pollock; Pauline Campbell, Ruth Deery, Mick Fleming, Jean Rankin, Graham Sloan, Helen Cheyne
      Abstract: AimThe aim of this study was to systematically review evidence relating to clinical supervision for nurses, midwives and allied health professionals.BackgroundSince 1902 statutory supervision has been a requirement for UK midwives, but this is due to change. Evidence relating to clinical supervision for nurses and allied health professions could inform a new model of clinical supervision for midwives.DesignA systematic review with a contingent design, comprising a broad map of research relating to clinical supervision and two focussed syntheses answering specific review questions.Data sourcesElectronic databases were searched from 2005 - September 2015, limited to English-language peer-reviewed publications.Review methodsSystematic reviews evaluating the effectiveness of clinical supervision were included in Synthesis 1. Primary research studies including a description of a clinical supervision intervention were included in Synthesis 2. Quality of reviews were judged using a risk of bias tool and review results summarized in tables. Data describing the key components of clinical supervision interventions were extracted from studies included in Synthesis 2, categorized using a reporting framework and a narrative account provided.ResultsTen reviews were included in Synthesis 1; these demonstrated an absence of convincing empirical evidence and lack of agreement over the nature of clinical supervision. Nineteen primary studies were included in Synthesis 2; these highlighted a lack of consistency and large variations between delivered interventions.ConclusionDespite insufficient evidence to directly inform the selection and implementation of a framework, the limited available evidence can inform the design of a new model of clinical supervision for UK-based midwives.
      PubDate: 2017-02-08T02:57:28.134847-05:
      DOI: 10.1111/jan.13253
       
  • Facilitators' delivery of a psychosocial intervention in a controlled
           trial for men with prostate cancer and their partners: a process
           evaluation
    • Authors: Kader Parahoo; Suzanne McKenna, Gillian Prue, Oonagh McSorley, Eilis McCaughan
      Abstract: AimThe aim of this paper was to report the process evaluation of facilitators' delivery of a psychosocial intervention (called CONNECT), in a randomized controlled trial, to men with prostate cancer and their partners.BackgroundThere is a lack of information on the process of implementing psychosocial interventions in controlled trials and, in particular, on the role and performance of facilitators who deliver them. Yet, this information is crucial in assessing whether these interventions are effective or not and why.DesignQualitative design.MethodsSemi-structured qualitative interviews and diaries were used to collect data (January–October 2012) from four facilitators and a co-facilitator. Data were analysed using the Miles et al. framework.ResultsFive themes were discernible. These were ‘difficulties to keep to the structure of the intervention’, ‘selective coverage of topics’, ‘partner participation’, ‘overall impression of the group and telephone sessions’ and ‘perceived benefits to participants’. Issues such as not keeping to the aim of the intervention, deviating from the content and/or reluctance in discussing sensitive issues such as sexual health may mean that the psychosocial effects of the intervention may not have been fully realized.ConclusionsThese findings will be useful for further development and evaluation of the intervention. A tentative conceptual framework of factors, related to facilitators, influencing the fidelity of interventions in the context of controlled trials, is offered. This model, which requires further development and testing, will be useful for researchers worldwide who are involved in developing interventions and training facilitators.
      PubDate: 2017-02-08T02:52:28.927912-05:
      DOI: 10.1111/jan.13248
       
  • The 2014 International Pressure Ulcer Guideline: methods and development
    • Authors: Emily Haesler; Jan Kottner, Janet Cuddigan,
      Abstract: AimA discussion of the methodology used to develop the Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. (2014).BackgroundInternational experts representing National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance developed the second edition of this clinical guideline.DesignDiscussion paper – methodology.Data sourcesA comprehensive search for papers published up to July 2013 was conducted in 11 databases and identified 4286 studies. After critical appraisal, 356 studies were included and assigned a level of evidence.Implications for NursingGuideline recommendations provide guidance on best practice in pressure ulcer prevention and treatment. Understanding the development process of a guideline increases the meaningfulness of recommendations to clinicians.FindingsFive hundred and seventy five recommendations arose from the research and its interpretation. The body of evidence supporting each recommendation was assigned a strength of evidence. A strength of recommendation was assigned to recommendation statements using the GRADE system. Recommendations are primarily supported by a body of evidence rated as C (87% of recommendations), representing low quality and/or indirect evidence (30%) and expert opinion (57%). Two hundred and forty seven recommendations (43%) received a strong recommendation (‘Do it’).ConclusionRecommendations were developed with consideration to research of the highest methodological quality evidence and studies that add to clinical insight and provide guidance for areas of care where minimal research has been conducted. Recommendations in the guideline reflect best practice and should be implemented with consideration to local context and resources and the individual's preferences and needs.
      PubDate: 2017-02-08T02:17:48.128107-05:
      DOI: 10.1111/jan.13241
       
  • Concept analysis: lack of anonymity
    • Authors: Marilyn A. Swan; Barbara B. Hobbs
      Abstract: AimTo re-examine and expand understanding of the concept ‘lack of anonymity’ as a component of rural nursing theory.BackgroundEarly healthcare literature reports lack of anonymity as part of social and working environments, particularly rural nursing. Rural nursing theory included the first published concept analysis on lack of anonymity but lacked empirical referents. Workforce, societal and rural healthcare changes support an updated analysis. To further understand lack of anonymity, its present day use and applicability to diverse environments, research from multiple disciplines was reviewed.DesignConcept analysis.Data sourcesA literature search using eight terms in eleven databases was conducted of literature published between 2008–2013.MethodWalker and Avant's concept analysis methodology guided the analysis.ResultsThe previous concept analysis is supported in part by current literature. The defining attributes, ‘identifiable’, ‘establishing boundaries for public and private self and interconnectedness’ in a community were updated. Updated antecedents include: (i) environmental context; (ii) opportunities to become visible; (iii) developing relationships and (iv) unconscious or limited awareness of public or personal privacy. Consequences are: (i) familiarity; (ii) visibility; (iii) awareness of privacy and (iv) manage or balance of lack of anonymity. Cases were constructed and empirical referents identified.ConclusionThe concept of lack of anonymity was updated; portions of the original definition remain unchanged. Empirical referents reveal the defining attributes in daily life and may guide future research on the effect of lack of anonymity on nursing practice. This analysis advances the conceptual understanding of rural nursing theory.
      PubDate: 2017-02-08T02:12:10.928447-05:
      DOI: 10.1111/jan.13236
       
  • Nurse-perceived quality of care in intensive care units and associations
           with work environment characteristics: a multicentre survey study
    • Authors: Dewi Stalpers; Dimitri Van Der Linden, Marian J. Kaljouw, Marieke J. Schuurmans
      Abstract: AimsTo examine nurse-perceived quality of care, controlling for overall job satisfaction among critical care nurses and to explore associations with work environment characteristics.BackgroundNurse-perceived quality of care and job satisfaction have been positively linked to quality outcomes for nurses and patients. Much evidence exists on factors contributing to job satisfaction. Understanding specific factors that affect nurse-perceived quality potentially enables for improvements of nursing care quality.DesignA multicentre survey study was conducted in three Dutch intensive care units.MethodsThe Dutch version of the Essentials of Magnetism II questionnaire was used; including the single-item indicators: (i) nurse-perceived quality of care; (ii) overall job satisfaction; and (iii) 58 statements on work environments. Data were collected between October 2013 – June 2014.ResultsThe majority of 123 responding nurses (response rate 45%) were more than satisfied with quality of care (55%) and with their job (66%). No associations were found with nurse characteristics, besides differences in job satisfaction between the units. After controlling for job satisfaction, nurse-perceived quality was positively associated with the work environment characteristics: adequacy of staffing, patient-centeredness, competent peers and support for education. Patient-centeredness and autonomy were the most important predictors for overall job satisfaction.ConclusionFactors that contribute to nurse-perceived quality of care in intensive care units, independent from the effects of overall job satisfaction, were identified. Hereby, offering opportunities to maximize high quality of care to critically ill patients. Research in a larger sample is needed to confirm our findings.
      PubDate: 2017-02-07T01:40:27.507093-05:
      DOI: 10.1111/jan.13242
       
  • The concept of exposure in environmental health for nursing
    • Authors: Marcella Remer Thompson; Donna Schwartz Barcott
      Abstract: AimTo report an analysis of the concept of exposure in environmental health for nursing.BackgroundThe importance of the environment has long been recognized in nursing, although the nature and scope of the concept and how it influences health have varied over time. Exposure is the sufficient and necessary link between environment and health. In nursing practice, the word ‘exposure’ has been used frequently with no clear standard definition.DesignConcept analysis using Kim's first-level analytics.Data sourcesChronological review (1980–2015) of the nursing science literature was conducted through ProQuest Dissertations and Theses and CINAHL, followed by a multi-disciplinary search through PubMed (1980–2015), texts and the Internet to compare definitions and measurements of exposure and related concepts.MethodsExplicit and implicit conceptual definitions and measurements of exposure were identified, categorized and analysed.ResultsThe newly defined concept of ‘exposure’ is a process involves three phases: 1, contact is made between a target and one or more agents in the same environment; 2, the agent accesses the target by one or more routes of entry; and 3, the agent enters the target by crossing a barrier or boundary. Existing measurements related to each phase are identified and discussed. Definitions of ‘target’ and ‘agent’ were refined for congruency.ConclusionConsistent use of terms as defined is critical to development of nursing knowledge. These concepts should be incorporated into nursing-related research to evaluate their usefulness to nursing. Alignment of this concept with relevant theories should be critically examined.
      PubDate: 2017-02-06T02:15:36.998199-05:
      DOI: 10.1111/jan.13246
       
  • Development and validation of the pro-environmental behaviour scale for
           women's health
    • Authors: HyunKyoung Kim
      Abstract: AimThis study was aimed to develop and test the Pro-environmental Behavior Scale for Women's Health.BackgroundWomen adopt sustainable behaviours and alter their life styles to protect the environment and their health from environmental pollution. The conceptual framework of pro-environmental behaviours was based on Rogers’ protection motivation theory and Weinstein's precaution adoption process model.DesignThe cross-sectional design was used for instrument development.MethodThe instrument development process consisted of a literature review, personal depth interviews and focus group interviews. The sample comprised 356 adult women recruited in April–May 2012 in South Korea using quota sampling. For construct validity, exploratory factor analysis was conducted to examine the factor structure, after which convergent and discriminant validity and known-group comparisons were tested.ResultsPrincipal component analysis yielded 17 items with four factors, including ‘women's health protection,’ ‘chemical exposure prevention,’ ‘alternative consumption,’ and ‘community-oriented behaviour’. The Cronbach's α was 0·81. Convergent and discriminant validity were supported by performing correlations with other environmental-health and health-behaviour measures.ConclusionNursing professionals can reliably use the instrument to assess women's behaviours, which protect their health and the environment.
      PubDate: 2017-02-03T00:30:35.707917-05:
      DOI: 10.1111/jan.13233
       
  • Goals of care: a concept clarification
    • Authors: Susan Stanek
      Abstract: AimTo report an analysis and clarification of the concept of goals of care.BackgroundGoals of care have been used by healthcare providers since 1978, but no operationalized, consensual definition exists.DesignNorris's method of concept clarification was used to create an operational definition, conceptual model and testable hypotheses of goals of care from the healthcare provider's perspective.Data sourcesData came from current research reports, interviews with experts and web sites of professional organizations. Research reports were published between 2003–2013.MethodsAntecedents, definitions and consequences were systematized and organized into coherent and more abstract groups to define goals of care. A conceptual model and testable hypotheses were created from this process.ResultsGoals of care are desired health expectations that are formulated through the thoughtful interaction between a human being seeking medical care and the healthcare team in the healthcare system and are appropriate, agreed on, documented and communicated.ConclusionsDevelopment of clear goals of care can increase patient satisfaction and quality of care while decreasing costs, hospital length of stay and hospital readmission. Goals of care are dynamic and should be reassessed regularly. How and when goals of care transition from implicit to explicit should be explored further, and what prompts this transition. Nurses, physicians and healthcare providers need education on how to best fill their roles in the development of goals of care.
      PubDate: 2017-01-31T03:40:45.82353-05:0
      DOI: 10.1111/jan.13243
       
  • How education must reawaken empathy
    • Authors: Sue Dean; Margaret McAllister
      PubDate: 2017-01-31T03:35:58.990107-05:
      DOI: 10.1111/jan.13239
       
  • Aggressive Behaviour Risk Assessment Tool for newly admitted residents of
           long-term care homes
    • Authors: Son Chae Kim; Lori Young, Brigette Berry
      Abstract: AimThe aim of this study was to revise the 10-item Aggressive Behaviour Risk Assessment Tool for predicting aggressive events among residents newly admitted to long-term care homes.BackgroundThe original tool had acceptable sensitivity and specificity for identifying potentially aggressive patients in acute care medical-surgical units, but its usefulness in long-term care homes is unknown.DesignA retrospective cohort study design was used.MethodsAll residents admitted to 25 long-term care homes in western Canada were assessed for the risk of aggression using the original tool within 24 hours of admission from January 2014 - December 2014 (n = 724). Incident reports of aggressive events occurring within 30 days of admission were collected. Multiple logistic regression and receiver operating characteristics analyses were performed.ResultsFifty-three residents of 724 exhibited aggressive behaviours. The demographic variable of age less than 85 years was found to be a positive predictor of aggressive events in multivariate logistic regression model and was added to the tool. The revised six-item Aggressive Behaviour Risk Assessment Tool for Long-Term Care consists of one new item, age less than 85 years and five items from the original tool: History of physical aggression, physically aggressive/threatening, anxiety, confusion/cognitive impairment and threatening to leave. The receiver operating characteristics of the revised tool with weighted scoring showed a good discriminant ability with satisfactory sensitivity and specificity at the recommended cut-off score of 4.ConclusionThe revised six-item tool may be useful in identifying potentially aggressive residents newly admitted to long-term care homes.
      PubDate: 2017-01-31T03:31:07.063849-05:
      DOI: 10.1111/jan.13247
       
  • ‘Nursing research culture’ in the context of clinical nursing
           practice: addressing a conceptual problem
    • Authors: Connie Bøttcher Berthelsen; Bibi Hølge-Hazelton
      Abstract: AimTo report an analysis of the concept of nursing research culture in the context of clinical nursing practice.BackgroundNursing research culture should be valued for its contribution to improving patient care and should be considered as a routine hospital activity. However, the demand for efficiency, nurses’ barriers to research use and the lack of definition of the concept of nursing research culture make it difficult to establish.DesignConcept analysis.Data sourcesData were collected through a literature review in PubMed, CINAHL and PsycINFO during March 2016.MethodsWalker and Avant's eight-step framework for concept analysis.ResultsFive defining attributes of nursing research culture in the context of clinical nursing practice were identified: strong monodisciplinary nursing professionalism, academic thinking and socialization, research use as a part of daily nursing practice, acceptance by colleagues and management and facilitation of resources from management and organization.ConclusionAlthough the method of concept analysis has been criticized and heavily debated, the development of nursing research cultures based on the defining attributes and antecedents of the concept will be important to emphasize evidence-based clinical nursing care. Further research should support the development and the implementation of nursing research culture in clinical nursing practice.
      PubDate: 2017-01-11T02:20:22.499122-05:
      DOI: 10.1111/jan.13229
       
  • Issue Information
    • Pages: 997 - 997
      PubDate: 2017-04-07T03:22:39.712142-05:
      DOI: 10.1111/jan.13124
       
  • Forthcoming Contents
    • Pages: 1245 - 1245
      PubDate: 2017-04-07T03:22:43.427442-05:
      DOI: 10.1111/jan.13123
       
 
 
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