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Journal Cover Journal of Advanced Nursing
  [SJR: 1.01]   [H-I: 114]   [186 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  [1589 journals]
  • Challenging rules, creating values: Park's sweet spot theory-driven
           central-‘optimum nurse staffing zone’
    • Authors: Claire Su-Yeon Park
      PubDate: 2017-12-05T04:00:28.791632-05:
      DOI: 10.1111/jan.13496
       
  • An exploratory study of safety culture, biological risk management and
           hand hygiene of healthcare professionals
    • Authors: Laurence Bernard; Alain Biron, Geneviève Lavigne, Julie Frechette, Agnès Bernard, Jonathan Mitchell, Mélanie Lavoie-Tremblay
      Abstract: AimsThe objectives of the study were to: (1) examine the relationships between three different qualitative perceptions of safety culture and the Canadian Patient Safety Climate Survey factors; (2) determine whether these perceptions are associated with different hand hygiene practices.BackgroundHealthcare-associated infections and safety cultures are a worldwide issue. During the A/H1N1 Influenza pandemic, Europe and North America did not have the same responses. Importantly, healthcare professionals' perceptions can influence patient safety through infection prevention practices like hand hygiene.DesignA cross-sectional design was used with data collected in 2015.MethodsThe Canadian Patient Safety Culture Survey and hand hygiene observations were gathered from three healthcare centres (two Canadian and one European). Descriptive analyses and ANOVAs were conducted to explore healthcare professionals' safety perceptions and practices.ResultsThe rates of hand hygiene practices varied widely between the three sites, ranging from 35–77%. One site (Site 3) was found to have the highest scores of management follow-up, feedback about incidents, supervisory leadership for safety, unit learning culture and senior leadership support for safety, and the highest levels of overall patient safety grades for the unit and organization.ConclusionThe quantitative results of this study support the previously described model based on qualitative results: individual culture, blaming culture and collaborative culture. Differences between continents emerged regarding infection prevention practices and the way we qualify infections. The results raise concerns about infection practices and about safety cultures and challenges worldwide.
      PubDate: 2017-12-05T03:55:46.014059-05:
      DOI: 10.1111/jan.13500
       
  • The experience of stigma in inflammatory bowel disease: An interpretive
           (hermeneutic) phenomenological study
    • Authors: Lesley Dibley; Christine Norton, Elizabeth Whitehead
      Abstract: AimTo explore experiences of stigma in people with inflammatory bowel disease.BackgroundDiarrhoea, urgency and incontinence are common symptoms in inflammatory bowel disease. Social rules stipulate full control of bodily functions in adulthood: poor control may lead to stigmatization, affecting patients’ adjustment to disease. Disease-related stigma is associated with poorer clinical outcomes, but qualitative evidence is minimal.DesignAn interpretive (hermeneutic) phenomenological study of the lived experience of stigma in inflammatory bowel disease.MethodsForty community-dwelling adults with a self-reported diagnosis of inflammatory bowel disease were recruited purposively. Participants reported feeling stigmatized or not and experiencing faecal incontinence or not. Unstructured interviews took place in participants’ homes in the United Kingdom (September 2012 – May 2013). Data were analysed using Diekelmann's interpretive method.FindingsThree constitutive patterns—Being in and out of control, Relationships and social Support and Mastery and mediation—reveal the experience of disease-related stigma, occurring regardless of continence status and because of name and type of disease. Stigma recedes when mastery over disease is achieved through development of resilience—influenced by humour, perspective, mental well-being and upbringing (childhood socialization about bodily functions). People travel in and out of stigma, dependent on social relationships with others including clinicians and tend to feel less stigmatized over time.ConclusionEmotional control, social support and mastery over disease are key to stigma reduction. By identifying less resilient patients, clinicians can offer appropriate support, accelerating the patient's path towards disease acceptance and stigma reduction.
      PubDate: 2017-12-05T03:40:26.129169-05:
      DOI: 10.1111/jan.13492
       
  • Factors predicting Registered Nurses’ intentions to leave their
           organization and profession: A job demands-resources framework
    • Authors: Willoughby Moloney; Peter Boxall, Matthew Parsons, Gordon Cheung
      Abstract: AimsTo develop a comprehensive model of nursing turnover intention by examining the effects of job demands, job resources, personal demands and personal resources on burnout and work engagement and subsequently on the intention to leave the organization and profession.BackgroundThe ageing population and a growing prevalence of multimorbidity are placing increasing strain on an ageing nursing workforce. Solutions that address the anticipated nursing shortage should focus on reducing burnout and enhancing the engagement of Registered Nurses (RNs) to improve retention.DesignA cross-sectional survey design.MethodData were collected in 2014–2015 via an e-survey from 2,876 RNs working in New Zealand. Data were analysed with structural equation modelling.ResultsHigher engagement results in lower intention to leave the organization and profession. Burnout has significant effects on intentions to leave through lower engagement. While most of the demands and resources’ variables (except professional development) have effects on intentions to leave, greater workload and greater work-life interference result in higher burnout and are the strongest predictors of intentions to leave. Greater emotional demands (challenges) and greater self-efficacy also have strong effects in lowering intentions to leave through higher engagement.ConclusionsEmployee burnout and work engagement play an important role in transmitting the impacts of job demands, job resources, personal demands and personal resources into RN intention to leave the organization and profession. Work-life interference and high workloads are major threats to nursing retention while challenge demands and higher levels of self-efficacy support better retention.
      PubDate: 2017-12-05T03:37:21.159855-05:
      DOI: 10.1111/jan.13497
       
  • Mediating role of psychological well-being in the relationship between
           organizational support and nurses’ outcomes: A cross-sectional study
    • Authors: Saeed Pahlevan Sharif; Ashraf Sadat Ahadzadeh, Hamid Sharif Nia
      Abstract: AimTo examine the relationship between organizational support for nursing practice and nurse-assessed quality of care and nurses’ job satisfaction in hospital settings and to investigate the mediating role of psychological well-being in the aforementioned relationships.BackgroundThere has been growing concern about quality of care in healthcare organizations. The past research has documented the effect of nurse practice environment on nurses’ quality of care and job satisfaction. However, little is known about the underlying mechanism behind these associations.DesignA cross-sectional survey was undertaken.MethodsData were collected from two large public hospitals in Iran between February - March 2017. A sample of 345 nurses participated in the study. Data were analysed using descriptive statistics and partial least squared-structural equation modelling.ResultsThe results showed that nurses’ perception of organizational support was related to their quality of care, job satisfaction and psychological well-being. Also, there was a positive relationship between nurses’ psychological well-being and their quality of care and job satisfaction. Moreover, psychological well-being partially mediated the relationship between organizational support with nurse-assessed quality of care and nurses’ job satisfaction.ConclusionThe findings suggest that organizational support for nursing practice and psychological well-being are two factors that contribute to caring behaviour of nurses and their job satisfaction. Also, positively perceived organizational support generates favourable psychological well-being which in turn enhances nurses’ quality of care and job satisfaction. The findings highlight the importance of establishing a supportive nurse practice environment and paying attention to the nurses’ psychological well-being in healthcare sectors.
      PubDate: 2017-12-05T03:31:11.506203-05:
      DOI: 10.1111/jan.13501
       
  • Salutogenic Healthy Ageing Programme Embracement (SHAPE) for senior-only
           households: A study protocol
    • Authors: Betsy Seah; Yanika Kowitlawakul, Srinivasan Chokkanathan, Jeane Jin Yi Fong, Geir Arild Espnes, Emily Ang, Wenru Wang
      Abstract: AimsTo evaluate the effectiveness of a multi-dimensional community-based health promotion and risk prevention programme, named Salutogenic Healthy Ageing Programme Embracement (SHAPE) for senior-only households in Singapore.BackgroundIn view of ageing population and its significant impacts on economy, societal structure and policy-making, healthy ageing emerges as an important concept in maintaining health through the engagement of health-promoting behaviour and risk prevention actions in older people.DesignA stratified randomized control trial with process evaluation is proposed.MethodologyThe salutogenic model, which focuses on positive well-being and optimizing health outcomes, provides an underpinning theoretical framework for this study. SHAPE is a 12-week intervention programme comprising of both weekly group-based activity sessions and home visits. One hundred and fifty-four eligible participants will be stratified and randomly allocated to either the SHAPE intervention or the control group. Both outcome and process evaluation will be conducted. Outcome measures include sense of coherence, quality of life, health-promoting behaviours, self-efficacy and other health-related outcomes. These data will be collected at four time points: baseline, 3 months, 6 months and 12 months. Individual qualitative face-to-face interviews will be conducted for older people receiving SHAPE to explore their views on the programme.DiscussionThe use of salutogenic model breaks away from the negatively connoted conventional biomedical model and addresses optimization of positive health, providing an overall holistic approach to care of older people. The intervention SHAPE seeks to identify, equip and strengthen resources for senior-only households, encouraging the adaption of health-promoting and risk-preventing actions to achieve better health outcomes and higher quality of life.
      PubDate: 2017-12-05T03:26:33.032335-05:
      DOI: 10.1111/jan.13502
       
  • Structured nurse-led follow-up for patients after discharge from the
           intensive care unit: Prospective quasi-experimental study
    • Authors: Rannveig J. Jónasdóttir; Christina Jones, Gisli H. Sigurdsson, Helga Jónsdóttir
      Abstract: AimsThe aim of this study was to describe a structured 3-month nurse-led follow-up of patients after discharge from intensive care and measure its effects on health status.BackgroundPatients requiring intensive care stay frequently have lengthy and incomplete recovery suggesting need for additional support. The effects of intensive care nurse-led follow-up have not been sufficiently elucidated.DesignA prospective, quasi-experimental study of patients who received structured nurse-led follow-up from intensive care nurses after discharge from intensive care until 3 months afterwards. The control group received usual care.MethodsOf 574 patients assessed for eligibility, from November 2012 - May 2015, 168 were assigned to the experimental group (N = 73) and the control group (N = 75). Primary outcome was health status, measured with eight scales of Short Form-36v2, before the intensive care admission and at four time points until 12 months after intensive care. A mixed effect model tested differences between the groups over time. Criteria for Reporting Development and Evaluation of Complex Interventions 2 guideline, guided the reporting of the intervention.ResultsThe structured nurse-led follow-up did not improve patients’ health status compared with usual care (mixed effect model, p = .078–.937).ConclusionThe structured nurse-led follow-up did not reveal an effect on the intensive care patients studied. Further examination of intensive care nurse-led follow-up is needed, taking into account the heterogeneity of the patient population, variations in length of ward stay, patients’ health care needs during the first week at home after discharge from general ward and health status before intensive care admission.
      PubDate: 2017-12-05T03:20:48.899738-05:
      DOI: 10.1111/jan.13485
       
  • A peer learning intervention targeting newly graduated nurses: A
           feasibility study with a descriptive design based on the Medical Research
           Council framework
    • Authors: Ylva Pålsson; Maria Engström, Christine Leo Swenne, Gunilla Mårtensson
      Abstract: AimsTo describe the feasibility of a peer learning intervention targeting newly graduated nurses. Feasibility was tested concerning consistency of the theoretical description of peer learning with empirical findings in a new context, compliance and acceptability, as well as usability of a questionnaire measuring the intended future outcome variables.BackgroundNewly graduated nurses who meet, socialize and share experiences have described supporting each other's ability to cope with stress. Peer learning involves individuals in a similar situation learning from and with each other through interaction. When implementing new interventions, feasibility studies are used to minimize problems in future evaluation studies.DesignQuasi-experimental design with an intervention group, followed over time using descriptive methods. The study was based on the Medical Research Council framework.MethodsRepeated semi-structured interviews, a checklist for fidelity and a questionnaire were conducted with 10 newly graduated nurses from January - March 2015. The intervention's main component included pairs of newly graduated nurses working the same shift and having joint responsibility for a group of patients for a period of three weeks. The intervention also included three months of regular reflection by the pair.FindingsUsing deductive analysis, the peer learning intervention was found to be consistent with the theoretical description. Due to the compliance and acceptability, there were lessons learned. The tested questionnaire was found to be useful.ConclusionsThis peer learning intervention seems to be feasible in this context. The present study will serve as the basis for a future full-scale evaluation study.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-29T12:05:24.792822-05:
      DOI: 10.1111/jan.13513
       
  • What is the Value of Values Based Recruitment for Nurse Education
           Programmes'
    • Authors: Johanna E. Groothuizen; Alison Callwood, Ann Gallagher
      Abstract: AimA discussion of issues associated with Values Based Recruitment for nurse education programmes.BackgroundValues Based Recruitment is a mandatory element in selection processes of students for Higher Education healthcare courses in England, including all programmes across nursing. Students are selected on the basis that their individual values align with those presented in the Constitution of the National Health Service. However, there are issues associated with the use of values as selection criteria that have been insufficiently addressed. These are discussed.DesignDiscussion paper.Data SourcesThis article is based on documents published on the website of the executive body responsible for the implementation of a policy regarding Values Based Recruitment in Higher Education Institutions up until June 2017 and our evaluation of the conceptualisation of Values Based Recruitment, underpinned by contemporary theory and literature.Implications for nursingValues Based Recruitment influences who is accepted onto a nurse education programme, but there has been limited critical evaluation regarding the effectiveness of employing values as selection criteria. Values are subject to interpretation and evidence regarding whether or how Values Based Recruitment will improve practice and care is lacking. The issues discussed in this article show that Higher Education Institutions offering nursing courses, whether in England or in other countries, should be critical and reflective regarding the implementation of Values Based Recruitment methods.ConclusionWe call for a debate regarding the meaning and implications of Values Based Recruitment and further research regarding its validity and effectiveness.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-29T08:35:29.277714-05:
      DOI: 10.1111/jan.13512
       
  • Instruments to assess patient comfort during hospitalization: A
           psychometric review
    • Authors: Sonia Lorente; Josep-Maria Losilla, Jaume Vives
      Abstract: AimTo analyse the psychometric properties and the utility of instruments used to measure patient comfort, physical, social, psychospiritual and/or environmental, during hospitalization.BackgroundThere are no systematic reviews nor psychometric reviews of instruments used to measure comfort, which is considered an indicator of quality in health care associated with quicker discharges, increased patient satisfaction and better cost–benefit ratios for the institution.DesignPsychometric review.Data sourcesMEDLINE, CINAHL, PsycINFO, Web of Knowledge, ProQuest Thesis&Dissertations, Google.Review methodsWe limited our search to studies published between 1990-2015. The psychometric analysis was performed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN), along with the Quality Criteria for Measurement Properties. The utility of the instruments was assessed according to their cost-efficiency, acceptability and educational impact. Protocol registration in PROSPERO, CRD42016036290.ResultsInstruments reviewed showed moderate methodological quality and their utility was poorly reported. Thus, we cannot recommend any questionnaire without reservations, but the Comfort Scale, the General Comfort Questionnaire and their adaptations in adults and older patients, the Psychosocial Comfort Scale and the Incomfort des Patients de Reanimation are the most recommendable instruments to measure comfort.ConclusionsThe methodology of the studies should be more rigorous and authors should adequately report the utility of instruments. This review provides a strategy to select the most suitable instrument to assess patient comfort according to their psychometric properties and utility, which is crucial for nurses, clinicians, researchers and institutions.
      PubDate: 2017-11-29T06:37:18.622577-05:
      DOI: 10.1111/jan.13495
       
  • Unpacking action research and implementation science: Implications for
           nursing
    • Authors: Mary Casey; Denise O' Leary, David Coghlan
      Abstract: AimThe aim of this study was to unpack the key concepts of action research and implementation science thereby enabling appropriate use of these methods in nursing.BackgroundA key issue in action research is not so much the methodology employed to gather data/evidence but who decides the research agenda and who benefits from it. Implementation science is a way to ensure that evidence is translated into practice. The question arises as to how action research and implementation may be understood in relation to one another in nursing.DesignDiscussion PaperData sourcesThis discussion paper is based on our own experiences and offers an exploration of action research and implementation science with the aim of clarifying what each involves and what synergies, if any, exist between them.Implications for NursingUsing action research to secure the voice of patients in their own care is essential to delivering quality nursing care. Using implementation science frameworks to get research evidence into practice is effective. Familiarity with both these concepts may enable their improved use and have a positive impact on quality of care.ConclusionThere is a tension between action researchers and the protagonists of implementation science related to perceived “trade offs” between what constitutes “science” and the necessity of community participation. Nevertheless, the use of an implementation science framework in an action research approach can reduce the research practice time lag and action research provides sound theoretical and philosophical underpinnings that can be used by those in the implementation science field.
      PubDate: 2017-11-29T06:36:26.207937-05:
      DOI: 10.1111/jan.13494
       
  • The importance of ethical aspects when implementing eHealth services in
           healthcare: A discussion paper
    • Authors: Lisa Skär; Siv Söderberg
      Abstract: AimThe aim of this paper was to discuss the importance of ethical aspects when implementing eHealth services in health care.BackgroundChallenges in healthcare today include a growing older population and, as a consequence, an increased need for healthcare services. One possible solution is the use of eHealth services.DesignDiscussion paper.Data sourcesResearch literature published from 2000–2017 in CINAHL, PubMed and Scopus.Implications for nursingImplementing eHealth services in health care involves ethical challenges where different technologies can solve different problems in different ways. eHealth services should therefore be developed and implemented based on the patient's specific needs and conditions for use and in accordance with the healthcare professionals' presumption to provide high-quality care.ConclusionTo preserve patients' integrity, dignity and autonomy, healthcare professionals must include ethical aspects when implementing and using eHealth services in health care. Healthcare professionals have to take responsibility for the eHealth services introduced, explaining why and how they are implemented based on a person-centred approach. More knowledge is needed about ethical aspects when implementing eHealth services to improve the quality of care.
      PubDate: 2017-11-29T06:34:32.502135-05:
      DOI: 10.1111/jan.13493
       
  • Research recruitment: A marketing framework to improve sample
           representativeness in health research
    • Authors: Sarah J. Howcutt; Anna L. Barnett, Sofia Barbosa-Boucas, Lesley A. Smith
      Abstract: AimsThis discussion paper proposes a five-part theoretical framework to inform recruitment strategies. The framework is based on a marketing model of consumer decision-making.BackgroundRespondents in surveys are typically healthier than non-respondents, which has an impact on the availability of information about those most in need. Previous research has identified response patterns, provided theories about why people participate in research and evaluated different recruitment strategies. Social marketing has been applied successfully to recruitment and promotes focus on the needs of the participant, but little attention has been paid to the periods before and after participant–researcher contact (during advertising and following completion of studies). We propose a new model which conceptualises participation as a decision involving motivation, perception of information, attitude formation, integration of intention and action and finally evaluation and sharing of experience.DesignDiscussion paper.Data sourcesThis discussion paper presents a critical review. No literature was excluded on date and the included citations span the years 1981–2017.Implications for nursingThe proposed framework suggests that researchers could engage a broader demographic if they shape research design and advertising to perform functions that participants are seeking to achieve. The framework provides a novel and useful conceptualisation of recruitment which could help to inform public engagement in research design, researcher training and research policy.ConclusionThis framework challenges researchers to investigate the goals of the potential participants when designing a study's advertising and procedures.
      PubDate: 2017-11-29T06:22:55.494681-05:
      DOI: 10.1111/jan.13490
       
  • Personal, professional and workplace factors that contribute to burnout in
           Australian midwives
    • Authors: Jennifer Fenwick; Anna Lubomski, Debra K Creedy, Mary Sidebotham
      Abstract: AimThis study aimed to identify personal, professional and workplace factors that contribute to burnout in midwives.BackgroundBurnout is prevalent in the midwifery workforce. Burnout adversely affects the well-being of midwives, diminishes the quality of care they provide and can shorten career duration.DesignSelf-administered online survey. The survey included the Copenhagen Burnout Inventory and personal and professional variables related to age, children, years of experience, role, model of care and satisfaction with work life. Midwives were invited to participate via an email sent from the Australian College of Midwives and through professional networks between June and July 2014. Variables associated with burnout were entered in a multinomial logistic regression.ResultsA total of 1,037 responses were received and 990 analysed. The prevalence of moderate to severe personal (N = 643; 64.9%) and work-related burnout (N = 428; 43.8%) were high. Having children, providing caseload midwifery care and working in a regional area were associated with low burnout. However, midwives registered for 5–10 years were more likely to report work and client-related burnout. Similarly, midwives reporting a lack of satisfaction with work–life balance were also more likely to report personal and work-related burnout.ConclusionsFamily-friendly work environments that facilitate work–life balance can help to reduce the personal and organizational costs of burnout. Similarly, providing continuity of midwifery care in a caseload model can facilitate work–life balance and provide significant mental health benefits to participating midwives.
      PubDate: 2017-11-27T04:11:10.600204-05:
      DOI: 10.1111/jan.13491
       
  • The experience of palliative care service provision for people with
           non-malignant respiratory disease and their family carers: An all-Ireland
           qualitative study
    • Authors: Clare Mc Veigh; Joanne Reid, Philip Larkin, Sam Porter, Peter Hudson
      Abstract: AimTo explore specialist and generalist palliative care provision for people with non-malignant respiratory disease, in rural and urban areas in the North and Republic of Ireland.BackgroundGlobally, palliative care is recommended as an appropriate healthcare option for people with advanced non-malignant lung disease. Yet, there is limited evidence regarding the integration of palliative care for this client group.DesignQualitative study.MethodsConvenience sample of 17 bereaved carers and 18 healthcare professionals recruited from two rural and two urban sites on the Island of Ireland. Data were collected throughout 2012 and 2013 through semi-structured interviews with carers of patients with Chronic Obstructive Pulmonary Disease (N = 12), interstitial lung disease (N = 4) or bronchiectasis (N = 1) who had died 3–18 months previously; and four focus groups with healthcare professionals. Data were analysed using a thematic analysis framework.ResultsCarers’ interviews yielded three overarching themes: (1) lack of preparedness for death, due to ambiguity regarding disease trajectory; (2) lack of consistency in palliative care delivery, in relation with the receipt of generalist and specialist palliative care; and (3) role ambiguity, related to their caregiving role. Focus groups identified two overarching themes: (1) barriers to appropriate palliative care; and (2) the future direction of palliative care for patient with non-malignant respiratory disease.ConclusionThe uncertain disease trajectory was not only experienced by carers but also healthcare professionals. Although referral to specialist palliative care services was perceived as increasing, the availability and coordination of generalist and specialist palliative care services were fragmented and varied dependent on geographical location.
      PubDate: 2017-11-27T04:10:55.701717-05:
      DOI: 10.1111/jan.13453
       
  • Increased hope following successful treatment for hepatitis C infection
    • Authors: Benedikte Bjøro; Olav Dalgard, Håvard Midgard, Hans Verbaan, Milada Cvancarova Småstuen, Tone Rustøen
      Abstract: AimsTo evaluate hope in hepatitis C patients 9 years after curative treatment with pegylated interferon and ribavirin.BackgroundSuccessful treatment of hepatitis C leads to improved quality of life in responders compared with non-responders. The long-term effect of successful treatment on hope in these patients is not known.DesignCross-sectional follow-up study of patients who displayed a sustained virological response to previous hepatitis C treatment.MethodsPatients infected with hepatitis C genotype 2 or 3 from a randomized controlled study during 2004–2006 were included. A representative subgroup of those who achieved a sustained virological response was re-evaluated in 2012–2014. The patients were examined, had a blood test and completed a questionnaire (Herth Hope Index and demographic and clinical characteristics). The hope level was compared between patients and an age-matched sample from the general population (N = 1,481). The data were analysed using multiple regression.ResultsA total of 104 Norwegian and Swedish hepatitis C patients were included in this follow-up study; their mean age was 48 years, and 61% were men. Patients treated for hepatitis C scored higher than the general population on the total Herth Hope Index and for 11 of the 12 individual items. Age, gender, educational level, employment status and civil status were associated with a higher Herth Hope Index in those who had received hepatitis C treatment.ConclusionPatients achieving a sustained viral response had a higher hope level than the general population 9 years after successful treatment of hepatitis C virus infection.
      PubDate: 2017-11-24T02:40:25.678269-05:
      DOI: 10.1111/jan.13487
       
  • Pierre Bourdieu's Theory of Practice offers nurses a framework to uncover
           embodied knowledge of patients living with disabilities or illnesses: A
           discussion paper
    • Authors: Sarah Oerther; Daniel B. Oerther
      Abstract: AimTo discuss how Bourdieu's theory of practice can be used by nurse researchers to better uncover the embodied knowledge of patients living with disability and illness.BackgroundBourdieu's theory of practice has been used in social and healthcare researches. This theory emphasizes that an individual's everyday practices are not always explicit and mediated by language, but instead an individual's everyday practices are often are tacit and embodied.DesignDiscussion paper.Data SourcesOvid MEDLINE, CINAHL and SCOPUS were searched for concepts from Bourdieu's theory that was used to understand embodied knowledge of patients living with disability and illness. The literature search included articles from 2003 – 2017.Implications for NursingNurse researchers should use Bourdieu's theory of practice to uncover the embodied knowledge of patients living with disability and illness, and nurse researchers should translate these discoveries into policy recommendations and improved evidence-based best practice. The practice of nursing should incorporate an understanding of embodied knowledge to support disabled and ill patients as these patients modify “everyday practices” in the light of their disabilities and illnesses.ConclusionBourdieu's theory enriches nursing because the theory allows for consideration of both the objective and the subjective through the conceptualization of capital, habitus and field. Uncovering individuals embodied knowledge is critical to implement best practices that assist patients as they adapt to bodily changes during disability and illness.
      PubDate: 2017-11-24T02:40:22.797955-05:
      DOI: 10.1111/jan.13486
       
  • From job stress to intention to leave among hospital nurses: A structural
           equation modelling approach
    • Authors: Wen-Yen Lo; Li-Yin Chien, Fang-Ming Hwang, Nicole Huang, Shu-Ti Chiou
      Abstract: AimsThe aim of this study was to examine the structural relationships linking job stress to leaving intentions through job satisfaction, depressed mood and stress adaptation among hospital nurses.BackgroundHigh turnover among nurses is a global concern. Structural relationships linking job stress to leaving intentions have not been thoroughly examined.DesignTwo nationwide cross-sectional surveys of full-time hospital staff in 2011 and 2014.MethodsThe study participants were 26,945 and 19,386 full-time clinical nurses in 2011 and 2014 respectively. Structural equation modelling was used to examine the interrelationships among the study variables based on the hypothesized model. We used cross-validation procedures to ensure the stability and validity of the model in the two samples.ResultsThere were five main paths from job stress to intention to leave the hospital. In addition to the direct path, job stress directly affected job satisfaction and depressed mood, which in turn affected intention to leave the hospital. Stress adaptation mitigated the effects of job stress on job satisfaction and depressed mood, which led to intention to leave the hospital. Intention to leave the hospital preceded intention to leave the profession. Those variables explained about 55% of the variance in intention to leave the profession in both years.ConclusionThe model fit was good for both samples, suggesting validity of the model. Strategies to decrease turnover intentions among nurses could focus on creating a less stressful work environment, increasing job satisfaction and stress adaptation and decreasing depressed mood. Hospitals should cooperate in this issue to decrease nurse turnover.
      PubDate: 2017-11-24T02:35:28.603565-05:
      DOI: 10.1111/jan.13481
       
  • Patient perspectives on barriers and enablers to the use and effectiveness
           of de-escalation techniques for the management of violence and aggression
           in mental health settings
    • Authors: Owen Price; John Baker, Penny Bee, Andrew Grundy, Anne Scott, Debbie Butler, Lindsey Cree, Karina Lovell
      Abstract: AimInvestigate patient perspectives on barriers and enablers to the use and effectiveness of de-escalation techniques for aggression in mental health settings.BackgroundDe-escalation techniques are the recommended first-line intervention for the management of aggression in mental health settings internationally, yet use of higher risk restrictive practices persists. This indicates de-escalation techniques are not used at optimum frequency and/or there are important factors limiting their use and effect.DesignDescriptive qualitative research using semi-structured interviews and Framework Analysis.MethodsInpatient interviews (N = 26) exploring staff, patient and environmental factors influencing the use and effectiveness of staff de-escalation were conducted mid-2014. Three service user researchers led analysis.ResultsData were synthesized in three deductive themes relating to staff, patient and environmental influences on the use and effectiveness of de-escalation techniques. The dominant view was that restrictive practices, rather than de-escalation techniques, are used in response to escalating patient behaviour. Under-use of de-escalation techniques was attributed to: lack of staff reflection on culture and practice and a need to retain control/dominance over patients. Ward rules, patient factors and a lack of staff respect for patients diluted their effectiveness. Participants identified a systematic process of de-escalation, rule subversion, reduced social distance and staff authenticity as enablers of effective de-escalation.ConclusionThis study investigated patient perspectives on staff, patient and environmental influences on the use and effectiveness of de-escalation techniques. Our framework of barriers and enablers provides indicators of organizational/behaviour change targets for interventions seeking to reduce violence and restrictive practices through enhanced de-escalation techniques.
      PubDate: 2017-11-24T02:00:42.025521-05:
      DOI: 10.1111/jan.13488
       
  • Impact of weight stigma on physiological and psychological health outcomes
           for overweight and obese adults: A systematic review
    • Authors: Ya-Ke Wu; Diane C. Berry
      Abstract: AimTo summarize the associations between weight stigma and physiological and psychological health for individuals who are overweight or obese.BackgroundWeight stigma can be defined as individuals experiencing verbal or physical abuse secondary to being overweight or obese. Weight stigma has negative consequences for both physiological and psychological health.DesignA quantitative systematic review.Data sourcesPubMed, PsycINFO, CINAHL and MEDLINE from 1 January 1 2008 - 30 July 30 2016.Review methodsA systematic review was conducted using the Cochrane Collaboration guidelines, the PRISMA statement guidelines and the quality assessment from the National Heart, Lung and Blood Institute. Inclusion criteria consisted of quantitative studies that examined the associations between weight stigma and physiological and psychological health outcomes in adults who were overweight or obese. Exclusion criteria consisted of qualitative studies, literature reviews, expert opinions, editorials and reports on weight stigma without health outcomes or with behavioral outcomes and intervention studies that reduced weight stigma. A quality appraisal of the selected studies was conducted.ResultsA total of 33 studies met the eligibility criteria. Weight stigma was positively associated with obesity, diabetes risk, cortisol level, oxidative stress level, C-reactive protein level, eating disturbances, depression, anxiety, body image dissatisfaction and negatively associated with self-esteem among overweight and obese adults.ConclusionWeight stigma is associated with adverse physiological and psychological outcomes. This conclusion highlights the need to increase public and professional awareness about the issue of weight stigma and the importance of the further development of assessment and prevention strategies of weight stigma.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-23T21:30:51.6794-05:00
      DOI: 10.1111/jan.13511
       
  • Louisa May Alcott and Hospital Sketches: An Innovative Approach to Gender
           and Nursing Professionalization
    • Authors: Ana Choperena Armendáriz; Julie Fairman
      Abstract: AimTo show the development of an emerging nursing profession through the eyes of Louisa May Alcott and Hospital Sketches.BackgroundIn Hospital Sketches, Louisa May Alcott recounts her experiences when she worked as a nurse of injured soldiers during the American Civil War, in an autobiographically and masked-referential way, which allows her to negotiate between transgression and convention. Unlike other reviews, in this paper the relevance of nursing remains highlighted.DesignDiscussion paper.Data sourcesExisting literature on data bases, history books and our own reading of facts.Implications for nursingIlluminating overlooked meanings hidden in nurses’ personal sources enables to approach their contribution to history, improve their visibility and project the future of nursing. Nursing care, whether domestic or professional, was and remains a catalyst for change.ConclusionThrough Alcott's words we understand the transition of nursing care as a gradual extension of the middle class woman's domestic role and a progressive definition of nurses’ identity. In particular, we highlight how certain professional nursing nuances which appear in the text are compatible with the gradual extension of the boundaries of women′s domesticity. Furthermore, Alcott′s use of literary devices reveals the delicate balance between women's domestic role and some new nursing professional features, which anticipates nursing professionalization.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-23T21:25:25.649534-05:
      DOI: 10.1111/jan.13510
       
  • Music for reducing the anxiety and pain of patients undergoing the biopsy:
           a meta-analysis
    • Authors: Mingzhi Song; Nanyang Li, Xianbin Zhang, Yuru Shang, Litao Yan, Jin Chu, Ran Sun, Yun Xu
      Abstract: AimThis study aimed to evaluate the efficacy of music therapy for reducing the anxiety and pain of patients who underwent the biopsy.BackgroundMusic can affect human anxiety and pain by triggering a neuroendocrine effect. Clinical study results indicated that music can influence the anxiety and pain caused by invasive procedures. There is no effective solution for anxiety and pain arising from a biopsy. Although researchers in this field have different views, music still holds promise in reducing the anxiety and pain in patients undergoing the biopsy.DesignSystematic review and meta-analysis of randomized controlled trials.Data SourcesSystematic searches were conducted in Pubmed, Embase, Medline and Cochrane databases for studies reported in the English language. The review period covered 2000 - December 2016. The outcome measure of interest was anxiety and pain.MethodsThis review followed Cochrane methods. Studies were selected according to the PICOS framework. The methodological quality of studies was assessed with the Cochrane risk of bias tool. A systematic review of effectiveness was conducted by using GRADE approach.ResultsNine randomized controlled trials with a total of 326 participants in the music intervention group and 323 controls met the inclusion criteria. Music had a tendency towards decreasing systolic blood pressure before the biopsy, State-Trait Anxiety Inventory scores after the biopsy, diastolic blood pressure after the biopsy and heart rate after the biopsy. Similarly, music also tended to be more effective for controlling pain after the biopsy. There was moderate quality evidence for the outcome: State-Trait Anxiety Inventory scores after the biopsy; and low or very low quality evidence for other outcomes.ConclusionMusic can be used for patients before and during the biopsy procedure. This approach may be performed by nurses to promote the recovery of patients after the biopsy.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-23T21:20:32.550176-05:
      DOI: 10.1111/jan.13509
       
  • Mentor judgements and decision making in the assessment of student nurse
           competence in practice: a mixed-methods study
    • Authors: Sarah Burden; Anne Elizabeth Topping, Catherine O'Halloran
      Abstract: AimTo investigate how mentors form judgements and reach summative assessment decisions regarding student competence in practice.BackgroundCompetence assessment is a significant component of pre-registration nursing programmes in the UK. Concerns exist that assessments are subjective, lack consistency and that mentors fail to judge student performance as unsatisfactory.DesignA two stage sequential embedded mixed methods design. Data collected 2012-2013.MethodsThis study involved a whole student cohort completing a UK undergraduate adult nursing programme (N=41). Stage 1: quantitative data on mentor conduct of assessment interviews and the final decision recorded (N=330 from 270 mentors) was extracted from student Practice Assessment Documents (PADs). Stage 2: mentor feedback in student PADs was used in Stimulated Recall interviews with a purposive sample of final placement mentors (N=17). These were thematically analysed. Findings were integrated to develop a theoretically driven model of mentor decision making.ResultsCourse assessment strategies and documentation had limited effect in framing mentor judgements and decisions. Rather, mentors amassed impressions, moderated by expectations of an ‘idealised student’ by practice area and programme stage that influenced their management and outcome of the assessment process. These impressions were accumulated and combined into judgements that informed the final decision. This process can best be understood and conceptualised through the Brunswik's lens model of social judgement.ConclusionMentor decisions were reasoned and there was a shared understanding of judgement criteria and their importance. This impression based nature of mentor decision making questions the reliability and validity of competency based assessments used in nursing pre-registration programmes.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-23T21:10:41.131806-05:
      DOI: 10.1111/jan.13508
       
  • Can sleep quality and burnout affect the job performance of shift-work
           nurses' A hospital cross-sectional study
    • Authors: Fabio Giorgi; Antonella Mattei, Ippolito Notarnicola, Cristina Petrucci, Loreto Lancia
      Abstract: AimThe aim of this study was to investigate any possible relationship between sleep disorders, burnout and job performance in a shift-work population of nurses.BackgroundSleep disorders and burnout can affect the job performance of nurses in terms of efficiency, productivity, task execution speed and supervision, which can be compromised when work shifts are organized on a 24-hour schedule and when the shift itself is irregular.DesignA cross-sectional observational study was conducted from August 2014 - January 2015 on a sample of 315 shift-work nurses across 39 wards in seven central Italian hospitals.MethodsThe Pittsburgh Sleep Quality Index was used to detect the presence of sleep disorders, the Copenhagen Burnout Inventory was used to detect the presence of any possible type of burnout and the Job Performance Scale was used to measure job performance. Data analysis was mainly based on a multivariate logistic regression to identify variables significantly associated with investigated outcomes.ResultsOn shift-work nurses' sleep quality and burnout correlated positively. The female gender and personal burnout were significantly associated with impaired sleep quality, while working in the psychiatric setting, working a long cycle shift pattern and experiencing daytime dysfunction were significantly associated with burnout. A significant negative association between patient-related burnout and job performance was observed.ConclusionSpecific characteristics of shift-work nurses can directly affect sleep quality and burnout and indirectly job performance. This evidence offers healthcare administrators opportunities to intervene with measures to promote nurse's health, well-being and safety.
      PubDate: 2017-11-22T00:01:06.688817-05:
      DOI: 10.1111/jan.13484
       
  • Older people's experiences of nurse–patient telephone communication in
           the primary healthcare setting
    • Authors: Susan Waterworth; Deborah Raphael, John Parsons, Bruce Arroll, Merryn Gott
      Abstract: AimTo determine which aspects of primary nurse–patient telephone communication are viewed positively or negatively in terms of meeting the older persons’ needs.BackgroundHealth professionals are increasingly being called on to develop different ways of working and increase their capacity to meet the needs of an ageing population. In some countries, telephone communication between primary nurses and patients in General Practice is already seen as a routine practice, but determining the value of this type of communication as a specific health service needs more understanding.DesignA qualitative exploratory study as the aim was to explore the older person's experiences.MethodsSemi-structured interviews were conducted with 21 older people from General Practices in New Zealand during 2014–2015. Thematic analysis was informed by a constructivist grounded theory approach.FindingsThe overarching theme was the difficulties older people face in making decisions about whether to contact a health professional by telephone and whether this should be the Primary nurse. Accounting for some of their symptoms as age related added to the uncertainty of decision-making. Importantly, some older people were not raising concerns e.g. emotional state.ConclusionDecision-making by older people around treatment seeking is complex. Increasing the awareness of the nurse role in the General Practice is integral to creating a health system which will meet the needs of a growing older population. Primary care practices can review their systems to better inform older people how the nurse-telephone role as a specific health service works and what they can expect when using this service.
      PubDate: 2017-11-17T05:42:12.672668-05:
      DOI: 10.1111/jan.13449
       
  • Meta-analysis of the effectiveness of nursing discharge planning
           interventions for older inpatients discharged home
    • Authors: Cédric Mabire; Andrew Dwyer, Antoine Garnier, Joanie Pellet
      Abstract: AimTo determine the effectiveness of nursing discharge planning interventions on health-related outcomes for older inpatients discharged home.BackgroundInadequate discharge planning for the ageing population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing interventions for older people. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be evaluated in practice.DesignSystematic review and meta-analysis.Data SourcesA systematic search was undertaken across 13 databases to retrieve published and unpublished studies in English between 2000–2015.Review MethodsCritical appraisal, data extraction and meta-analysis followed the methodology of the Joanna Briggs Institute.ResultsThirteen studies were included in the review, 2 of 13 were pilot studies and one had a pre-post design. Included studies involved 3,964 participants with a median age of 77 years. Nurse discharge planning did not significantly reduce hospital readmission or quality of life, except readmission was lower across studies conducted in the USA. The overall effect score for nurse discharge planning on length of stay was statistically significant and positive.ConclusionNursing discharge planning is a complex intervention and difficult to evaluate. Findings suggest that nursing discharge planning for older inpatients discharged home increases the length of stay yet neither reduces readmission rate nor improves quality of life.
      PubDate: 2017-11-17T05:35:26.033356-05:
      DOI: 10.1111/jan.13475
       
  • Systematic review: Effective home support in dementia care, components and
           impacts – Stage 2, effectiveness of home support interventions
    • Authors: Paul Clarkson; Jane Hughes, Brenda Roe, Clarissa M. Giebel, David Jolley, Fiona Poland, Michele Abendstern, Helen Chester, David Challis,
      Abstract: AimThe aim of this study was to explicate the outcomes of home support interventions for older people with dementia and/or their carers to inform clinical practice, policy and research.BackgroundMost people with dementia receive support at home. However, components and effectiveness of home support interventions have been little explored.DesignSystematic review with narrative summary.Data sourcesElectronic searches of published studies in English using PubMed, Cochrane Central Register of Controlled Trials, PsychINFO, CINAHL, Applied Social Science Index and CSA Social Services s. Databases and sources were searched from inception to April 2014 with no date restrictions to locate studies.Review methodsThe PRISMA statement was followed and established systematic review methods used. Using 14 components of care for people with dementia and their carers, identified previously, data across studies were synthesized. Interventions were grouped and described and effectiveness ratings applied. Qualitative studies were synthesized using key themes.ResultsSeventy studies (four qualitative) were included. Most were directed to carers and of high quality. Seven interventions for carers and two for people with dementia were identified, covering 81% of studies. Those relating to daily living, cognitive training and physical activity for people with dementia were absent. Measures of effectiveness were influenced mainly by the intensity (duration and frequency) of interventions. Those containing education, social support and behaviour management appeared most effective.ConclusionThese interventions reflect emergent patterns of home support. Research is required to identify effective interventions linked to the stage of dementia, which can be applied as part of routine clinical care.
      PubDate: 2017-11-17T05:31:44.198545-05:
      DOI: 10.1111/jan.13460
       
  • False gold: Safely navigating open access publishing to avoid predatory
           publishers and journals
    • Authors: Terence V. McCann; Meg Polacsek
      Abstract: AimThe aim of this study was to review and discuss predatory open access publishing in the context of nursing and midwifery and develop a set of guidelines that serve as a framework to help clinicians, educators and researchers avoid predatory publishers.BackgroundOpen access publishing is increasingly common across all academic disciplines. However, this publishing model is vulnerable to exploitation by predatory publishers, posing a threat to nursing and midwifery scholarship and practice. Guidelines are needed to help researchers recognize predatory journals and publishers and understand the negative consequences of publishing in them.DesignDiscussion paper.Data sourcesA literature search of BioMed Central, CINAHL, MEDLINE with Full Text and PubMed for terms related to predatory publishing, published in the period 2007–2017.Implications for NursingLack of awareness of the risks and pressure to publish in international journals, may result in nursing and midwifery researchers publishing their work in dubious open access journals. Caution should be taken prior to writing and submitting a paper, to avoid predatory publishers.FindingsThe advantage of open access publishing is that it provides readers with access to peer-reviewed research as soon as it is published online. However, predatory publishers use deceptive methods to exploit open access publishing for their own profit. Clear guidelines are needed to help researchers navigate safely open access publishing.ConclusionA deeper understanding of the risks of predatory publishing is needed. Clear guidelines should be followed by nursing and midwifery researchers seeking to publish their work in open access journals.
      PubDate: 2017-11-17T05:30:24.400366-05:
      DOI: 10.1111/jan.13483
       
  • Factors associated with change in health-related quality of life among
           individuals treated with long-term mechanical ventilation, a 6-year
           follow-up study
    • Authors: Heidi Markussen; Sverre Lehmann, Roy M. Nilsen, Gerd K. Natvig
      Abstract: AimsTo examine changes and explanatory variables for changes in health-related quality of life in patients treated with long-term mechanical ventilation over a 6-year period.BackgroundLong-term mechanical ventilation is a treatment for individuals with chronic hypercapnic respiratory failure, primarily caused by neuromuscular diseases, obesity hypoventilation syndrome, chronic obstructive pulmonary and restrictive thoracic diseases. Studies on long-term outcome on health-related quality of life and factors influencing it are lacking.DesignProspective cohort study.MethodsData were collected from the Norwegian Long-Term-Mechanical-Ventilation Registry and from patient-reported questionnaire in 2008 and 2014. Health-related quality of life was measured by the Severe Respiratory Insufficiency questionnaire, containing 49 items and seven subdomains. Linear mixed effects models were used to measure changes and identify factors for changes.ResultsAfter 6 years, 60 patients were still participating, out of 127 at baseline. Health-related quality of life improved significantly in the total score and in four subdomains of the questionnaire. Satisfaction with training in long-term mechanical ventilation was an explanatory variable for improved ‘psychological well-being’ and follow-up for improvement of ‘anxiety’. Side effects of the treatment like facial soreness were associated with the total score. High age and high forced vital capacity were related to lower ‘physical function’ and improved ‘social functioning’, respectively.ConclusionLong-term mechanical ventilation over 6 years improved health-related quality of life in most patients. Patient training, follow-up and reduction of side effects, largely delivered by trained nurses, contribute to achieve the main goal of the treatment—improved health-related quality of life.
      PubDate: 2017-11-17T05:26:03.415864-05:
      DOI: 10.1111/jan.13472
       
  • Factors influencing nurse-assessed quality nursing care: a cross-sectional
           study in hospitals
    • Authors: Ying Liu; Yupin Aungsuroch
      Abstract: AimTo propose a hypothesized theoretical model and apply it to examine the structural relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care.BackgroundImproving quality nursing care is a first consideration in nursing management globally. A better understanding of factors influencing quality nursing care can help hospital administrators implement effective programs to improve quality of services. Although certain bivariate correlations have been found between selected factors and quality nursing care in different study models, no studies have examined the relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care in a more comprehensive theoretical model.DesignA cross-sectional survey.MethodsThe questionnaires were collected from 510 Chinese nurses in four Chinese tertiary hospitals in January 2015. The validity and internal consistency reliability of research instruments were evaluated. Structural equation modelling was used to test a theoretical model.ResultsThe findings revealed that the data supported the theoretical model. Work environment had a large total effect size on quality nursing care. Burnout largely and directly influenced quality nursing care, which was followed by work environment and patient-to-nurse ratio. Job satisfaction indirectly affected quality nursing care through burnout.ConclusionsThis study shows how work environment past burnout and job satisfaction influences quality nursing care. Apart from nurses’ work conditions of work environment and patient-to-nurse ratio, hospital administrators should pay more attention to nurse outcomes of job satisfaction and burnout when designing intervention programs to improve quality nursing care.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-17T00:45:19.805072-05:
      DOI: 10.1111/jan.13507
       
  • Job satisfaction, work environment, and successful aging: determinants of
           delaying retirement among acute care nurses
    • Authors: Michele Wargo-Sugleris; Wendie Robbins, Christianne Joy Lane, Linda. R. Phillips
      Abstract: AimTo determine the relationships between job satisfaction, work environment and successful aging and how these factors relate to Registered Nurses’ intent to retire.BackgroundAlthough little studied, retention of older nurses by delaying early retirement, before age 65, is an important topic for research. Qualitative and quantitative studies have indicated that job satisfaction work environment and successful aging are key motivators in acute care Registered Nursesretention and/or delaying retirement. This study was designed to provide information to administrators and policy makers about retaining older, experienced RNs longer and more productively.DesignThis was a correlational, descriptive, cross-sectional study.MethodsAn on-line survey of acute care Registered Nurses (N=2,789) aged 40 years or older working in Florida was conducted September to October 2013. Participants completed items related to job satisfaction, work environment, successful aging and individual characteristics. Hypotheses derived from the modified Ellenbecker's Job Retention Model were tested using regression analysis.ResultsJob satisfaction scores were high. Highest satisfaction was with scheduling issues and co-workers; lowest with advancement opportunities. Successful aging scores were also high with 81% reporting excellent or good health. Work environment explained 55% of the variance in job satisfaction. Years to retirement were significantly associated with successful aging (p< .001), age (p
      PubDate: 2017-11-17T00:40:22.566358-05:
      DOI: 10.1111/jan.13504
       
  • Effectiveness of an intensive intervention to improve lifestyles in
           subjects with intermediate cardiovascular risk (DATE study): study
           protocol for a randomized controlled trial
    • Authors: Natalia Sanchez-Aguadero; Sara Mora-Simon, Jose I Recio-Rodriguez, Rosario Alonso-Dominguez, Jesus Gonzalez-Sanchez, Cristina Martin-Martin, Manuel A Gomez-Marcos, Emiliano Rodriguez-Sanchez, Luis Garcia-Ortiz
      Abstract: AimTo evaluate the effectiveness of an intensive intervention led by primary care nurses for lifestyle modification among subjects with intermediate cardiovascular risk.BackgroundCardiovascular diseases may be prevented by adopting healthy lifestyles. Interventions focused on populations at risk are more efficient than those aimed at the general population. More than 50 per cent of cardiovascular events occur in subjects with intermediate cardiovascular risk, but only a few studies have targeted this population.DesignA randomized controlled trial approved in January 2017.MethodsWe will recruit 208 participants aged 35-74 years who have intermediate cardiovascular risk. Subjects will be selected by consecutive sampling and will be randomized into a control group or intervention group. Individual standardised brief counselling on healthy lifestyles will be provided to both groups. Additionally, individuals from the intervention group will receive four weekly group sessions focusing on cardiovascular risk, healthy diet, moderation in alcohol consumption, daily physical activity, stress management and smoking cessation, as well as two motivational follow-up calls. The primary outcome will be the lifestyle modification measured by total steps recorded by a pedometer, total score on the Mediterranean Diet Adherence Screener and percentage of current smokers.DiscussionThis study will allow us to investigate whether an intensive intervention based on a multifactorial group approach is more effective in lifestyle modification than individual standardised brief counselling among adults with intermediate cardiovascular risk. Our results could lead to the establishment of new strategies for cardiovascular risk management.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-17T00:35:24.323639-05:
      DOI: 10.1111/jan.13503
       
  • Factors Associated with Continued Smoking after Treatment of Oral Cavity
           Cancer: An Age and Survival Time-Matched Study
    • Authors: Su-Ling Chang; Cheng-Hsing Lo, Hsi-Ling Peng, Chien-Rong Chen, Shu-Chen Wu, Shu-Ching Chen
      Abstract: AimsThe aims of this study of oral cavity cancer patients were to compare the social support, depression, nicotine dependence, physical function and social-emotional function of those who continued smoking with those who quit smoking, with matching by age and survival time and to identify the predictors of continued smoking during the survival period.BackgroundPatients who continue to smoke after cancer treatment may have an wiimpact on treatment response and survival.DesignA cross-sectional survey was conducted.MethodsThis study compared 92 patients with oral cavity cancer who continued smoking with 92 patients who quit smoking, with matching for age and survival time between January 2015 - November 2015. Conditional logistic regression analysis was used to compare the two groups.ResultsThe quit smoking group had significantly more social support, less depression and greater social-emotional function than the continued smoking group. Patients who were unmarried, received surgery without reconstruction, had poor social support and had poor social-emotional function were more likely to continue smoking.ConclusionsPatients with oral cavity cancer were more likely to continue smoking after treatment if they had low social support, depression, greater nicotine dependence and poor social-emotional function. Healthcare professionals should pay more attention to social support, psychological status and nicotine dependence of patients who were treated for oral cavity cancer.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-17T00:30:26.416213-05:
      DOI: 10.1111/jan.13506
       
  • Subjective Cognitive Complaints, Psychosocial Factors, and Nursing Work
           Function in Nurses Providing Direct Patient Care
    • Authors: Tammy Barbe; Laura P. Kimble, Cynthia Rubenstein
      Abstract: AimsThe aim of this study was to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care.BackgroundCognitive functioning is a critical component for nurses in the assurance of error prevention, identification and correction when caring for patients. Negative changes in nurses’ cognitive and psychosocial functioning can adversely affect nursing care and patient outcomes.DesignA descriptive correlational design with stratified random sampling.MethodThe sample included 96 nurses from the major geographic regions of the USA. Over nine months in 2016-2017, data were collected using a web-based survey. Stepwise multiple linear regression analyses were used to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function.ResultsOverall, participants reported minimal work function impairment and low levels of subjective cognitive complaints, depression and stress. In multivariate analyses, depression was not associated with nurses’ work function. However, perceived stress and subjective concerns about cognitive function were associated with greater impairment of work function.ConclusionNurses experiencing subjective cognitive complaints should be encouraged to address personal and environmental factors that are associated with their cognitive status. Additionally, stress reduction in nurses should be a high priority as a potential intervention to promote optimal functioning of nurses providing direct patient care. Healthcare institutions should integrate individual and institutional strategies to reduce factors contributing to workplace stress.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-17T00:25:23.397418-05:
      DOI: 10.1111/jan.13505
       
  • Patient perspectives of maintaining dignity in Indonesian clinical care
           settings: A qualitative descriptive study
    • Authors: Nurfika Asmaningrum; Yun-Fang Tsai
      Abstract: AimTo gain an understanding towards the perspectives of hospitalized inpatients in Indonesia regarding maintaining dignity during clinical care.BackgroundDignity is a basic human right that is crucial for an individual's well-being. Respect for a person as a valuable human is a concept that is comparable to treating a person with dignity. Maintaining patient's dignity is an ethical goal of nursing care. Nevertheless, the concept is highly dependent on cultural context. This issue has not been well studied in Indonesia.DesignThis study used a qualitative descriptive design.MethodsThirty-five participants were recruited by purposive sampling from medical to surgical wards of six public hospitals in Eastern Java, Indonesia. Data were collected in 2016 through individual face-to-face semi-structured interviews. Inductive content analysis was applied to the data.FindingsFour major categories which described qualities of nursing care essential for maintaining a patient's dignity in clinical care settings were revealed: (1) responsiveness; (2) respectful nurse–patient relationships; (3) caring characteristics and (4) personalized service.ConclusionsOur findings provide a cultural viewpoint of dignity for care recipients in Indonesia. The findings provide empirical support for linking dignified care and person-centred care principles with regards to cultural sensitivity. Nurses must not only be clinically competent but also culturally competent. The ability to provide culturally competent care is important for nurses as a strategy to maintain patient dignity during hospitalized care.
      PubDate: 2017-11-09T05:55:25.573279-05:
      DOI: 10.1111/jan.13469
       
  • A systematic review of characteristics of couple-based intervention
           studies addressing sexuality following cancer
    • Authors: Jona Ingibjorg Jonsdottir; Helga Jonsdottir, Marianne E. Klinke
      Abstract: AimTo describe the characteristics of couple-based intervention studies that address sexuality following cancer.BackgroundSexuality-related problems are common among cancer survivors and their partners.DesignSystematic literature review with a narrative summary of results.Data sourcesElectronic searches were conducted in PubMed, CINAHL and PsychINFO. We included studies published from 1 January 2009 - 31 December 2016. Additional information was retrieved by scrutinizing reference lists, conducting citation tracking and contacting authors. We included all types of quantitative intervention studies published in the English language which contained outcome measures corresponding to the neo-theoretical framework of sexuality—sexual function, sexual relationship and sexual self-concept.Review MethodsOur review was guided by the Joanna Briggs Institute reviewer's manual. Data were extracted and appraised using the standardized checklists for quantitative studies. This assessment was conducted independently by two reviewers. A third reviewer was involved if consensus could not be reached.ResultsFourteen studies were included. Interventions were delivered face-to-face, by telephone or via the Internet. Sessions ranged from 1-8, with a duration from 2-22 weeks. Most studies offered ≥3 sessions. Interventions addressed unique concerns and/or provided general education. There was little agreement on the use of outcome measures. Most studies inadequately described fidelity to the study protocol and the training of interventionists.ConclusionThere was no clear consensus about how couple-based interventions are best structured. The results provide tentative evidence for how the quality of future research studies can be improved and how knowledge can be used in clinical practice.
      PubDate: 2017-11-09T05:50:33.919442-05:
      DOI: 10.1111/jan.13470
       
  • Randomized controlled trial on the effectiveness of a multicomponent
           intervention on migraine: A study protocol
    • Authors: Vishnu Renjith; Aparna Pai, Kurupath Radhakrishnan, Baby S Nayak, Elsa Sanatombi Devi, Elissa Ladd, Anice George
      Abstract: AimTo describe a randomized controlled trial protocol that evaluates the effectiveness of a multicomponent intervention in improving the outcomes (quality of life, disability, intensity, frequency and duration) of patients with migraine.BackgroundMigraine affects various facets of Quality of Life and results in moderate to high levels of disability among migraineurs. Migraine pain can be intense and unremitting that can interfere with the daily routine and reduce the ability to think and function normally. Many people can lower their risk of a migraine by simply avoiding stress, getting enough sleep, eating regularly and by avoiding triggers. Hence, the present study aims at evaluating the effectiveness of a multicomponent intervention in managing migraine headaches. The multicomponent intervention includes behavioural lifestyle modification program and sessions of pranayama (a form of yogic breathing exercise).DesignThe study is a prospective, randomized, controlled, single-blinded trial with parallel arms.MethodsThe study participants are randomized to intervention and control arms. The participants randomized to the intervention arm would receive the specific multicomponent intervention based on the protocol. The participants in the control arm would receive routine care. They are followed up for 24 weeks and the outcomes are assessed.DiscussionVarious studies report that non-pharmacological therapies and integrative therapies play a major role in the management of migraine headaches. The findings of the study are expected to open up new horizons in health care arena emphasizing the use of non-pharmacological therapy for less focused areas of primary care health problems such as migraine.Trial RegistrationThe trial is registered with the Clinical Trials Registry India (CTRI). The CTRI India is one of the primary registries in the WHO registry network (Ctri.nic.in, ). CTRI reference ID: CTRI/2015/10/006282.
      PubDate: 2017-11-09T05:50:23.648348-05:
      DOI: 10.1111/jan.13478
       
  • Effects and associations of nutrition in patients with venous leg ulcers:
           A systematic review
    • Authors: Georgina A Barber; Carolina D Weller, Simone J Gibson
      Abstract: AimsTo identify the associations and effects of nutritional characteristics and interventions on ulcer outcomes in adult patients with venous leg ulcers.BackgroundVenous leg ulcers are the most prevalent type of lower limb ulcer; however, little evidence exists regarding the relationship between nutritional status and ulcer healing.DesignA systematic search of English language articles was conducted using the Cochrane Collaboration Handbook for Systematic Reviews of Interventions.Data sourcesA search of databases Ovid MEDLINE, EMBASE, Cochrane, CINAHL and Scopus was performed for studies published between January 2004 - May 2017.Review methodsQuality of the included studies was assessed using the Cochrane Collaboration's Risk of Bias Assessment tool and the relevant Joanna Briggs Institute quality appraisal checklists.ResultsTwenty studies met the inclusion criteria. All participants had Clinical Aetiology Anatomy Pathophysiology classification C5 (healed) or C6 (active) ulcers. Studies were conducted in a range of clinical settings with relatively small sample sizes. The majority of patients were overweight or obese. Increased body mass index was associated with delayed wound healing. Vitamin D, folic acid and flavonoids were associated with some beneficial effects on ulcer healing. Dietary intakes of omega-3 fatty acids, vitamin C and zinc were low for some patients.ConclusionCurrent evidence suggests that venous leg ulcer patients are more likely to be overweight or obese. However, evidence for weight management improving wound healing is lacking. Micronutrients, including vitamin D and folic acid, may improve wound healing in at-risk patients.
      PubDate: 2017-11-09T04:55:39.040103-05:
      DOI: 10.1111/jan.13474
       
  • Treatment abandonment in children with cancer in Sub-Saharan Africa:
           Systematic literature review and meta-analysis
    • Authors: Rikka Mansell; Edward Purssell
      Abstract: AimsTo establish and quantify the main reasons for treatment abandonment in children with cancer in Sub-Saharan Africa through a systematic review of the literature.BackgroundGreat advances have been made in the treatment of childhood cancer, however this requires that families are able to complete treatment. Failure to do this is referred to as treatment abandonment, which is recognized as a reason for treatment failure.DesignSystematic review and meta-analysis of data on the reasons for treatment abandonment in Sub-Saharan Africa.Data sourcesOvid MEDLINE 1946 to May Week 1 2017 and Embase 1974 to 2017 Week 19. Additional hand-searching was undertaken.Review methodsTwo reviewers independently screened papers and extracted the data. The R package meta was used to calculate the relative risk of treatment abandonment or the proportion of parents stating a reason.ResultsThe relative risk of treatment abandonment was highest for not being in a research cohort; followed by mothers only having primary education, being HIV negative, parents not being employed, travel and no insurance. When parents who had abandoned treatment were asked, the most common reason was finance, followed by insurance, transport, lack of social support, their child appearing well, fear and waiting.ConclusionsMore data are needed on the extent of treatment abandonment in different countries. Clinicians should encourage parents without insurance to enrol onto the relevant insurance programme straight after diagnosis, provide housing for patients and families close to the treatment centres and to develop treatment at more localized centres.
      PubDate: 2017-11-09T04:46:29.961665-05:
      DOI: 10.1111/jan.13476
       
  • “Meal realities” — An ethnographic exploration of hospital mealtime
           environment and practice
    • Authors: Ella Ottrey; Judi Porter, Catherine E. Huggins, Claire Palermo
      Abstract: AimTo explore and understand patterns of mealtime culture, environment and social practice from the perspective of staff, volunteers and visitors on the hospital ward.BackgroundInadequate food intake is a common and complex problem in hospital and can lead to malnutrition. Mealtime interventions have been implemented to address this problem with limited success. A better understanding of mealtime environment and practice is needed to ascertain which interventions are more likely to be effective in addressing inadequate food intake in hospital.DesignA qualitative, ethnographic approach was used to promote a comprehensive understanding of mealtime environment and practice.MethodsSixty-seven hours of fieldwork was conducted August–October 2015. More than 150 participants were observed and 61 unique participants were interviewed in 75 interviews. Data analysis followed an inductive, thematic approach, informed by systems and complexity theory.FindingsThemes of “patient centredness” and “system” and their disharmonious interrelationship emerged. Staff, volunteers and visitors strive for patient centredness at mealtimes. The routine and structured nature of the meal and care systems was constantly in tension with providing patients the care they needed.ConclusionThe findings of this study expose the challenges associated with maintaining patient centredness at mealtimes in complex healthcare and foodservice systems. This facilitates a better understanding of why inadequate food intake is difficult to address in the hospital setting and highlights the need to support strategies that approach foodservice processes and nutritional care as complex and non-linear.
      PubDate: 2017-11-09T04:45:27.450554-05:
      DOI: 10.1111/jan.13477
       
  • Choice of clinical supervisor: Cunning or collusion'
    • Authors: Priya Martin; Derek Milne
      PubDate: 2017-11-09T04:40:24.078238-05:
      DOI: 10.1111/jan.13471
       
  • The Female Self-Advocacy in Cancer Survivorship Scale: A Validation Study
    • Authors: Teresa L. Hagan; Susan M. Cohen, Margaret Q. Rosenzweig, Kristin Zorn, Clement A. Stone, Heidi S. Donovan
      Abstract: AimTo develop and psychometrically test the validity of the Female Self-Advocacy in Cancer Survivorship Scale.BackgroundFemale cancer survivors need to self-advocate to overcome challenges associated with cancer yet no valid measure of self-advocacy exists.DesignInstrument development. Mixed-mode cross-sectional survey design.ParticipantsWe recruited adult females (18+ years) (N=317) with a history of invasive cancer from local and national tumor registries and advocacy organizations to complete online or paper questionnaires.MethodsBetween July 2014 and March 2015 to evaluate the construct validity based on evidence of the scale's: (1) internal structure consistent with the underlying model of self-advocacy; (2) sensitivity to differences between groups known to differ in self-advocacy skills; (3) relationships between self-advocacy and key potential predictors (openness and conscientiousness; information engagement; social support) and outcomes (symptom burden and health care utilization); (4) relationships between self-advocacy and related concepts (patient activation; self-advocacy within another patient population); and (5) relationships between self-advocacy and criterion measures. Analyses included an exploratory factor analysis, t-tests, and bi-variate correlations using validated, reliable measures for constructs.ResultsEvidence from all five hypotheses supported the construct validity of the Female Self-Advocacy in Cancer Survivorship Scale. The factor analysis confirmed the three underlying dimensions of self-advocacy resulting in a 20-item measure with strong internal consistency that explained almost half of response variance.ConclusionThe Female Self-Advocacy in Cancer Survivorship Scale is a valid, reliable measure of how well adult female cancer survivors can get their needs met in the face of adversity.This article is protected by copyright. All rights reserved.
      PubDate: 2017-11-08T16:40:26.86192-05:0
      DOI: 10.1111/jan.13498
       
  • Relationship and variation of diabetes related symptoms, sleep disturbance
           and sleep-related impairment in adults with type 2 diabetes
    • Authors: Bingqian Zhu; Laurie Quinn, Cynthia Fritschi
      Abstract: AimThe objective of this study was to examine whether diabetes-related symptoms (e.g. fatigue, neuropathic pain, diabetes distress and depressive symptoms) were related to sleep disturbance and sleep-related impairment in adults with type 2 diabetes while controlling for potential covariates.BackgroundIn people with type 2 diabetes, sleep disturbance and sleep-related impairment are common and likely associated with diabetes-related symptoms. However, limited research has investigated the predictive ability of diabetes-related symptoms on sleep.DesignA correlational, cross-sectional design was used.MethodsData were collected at a large university in the Midwestern United States from September 2013–March 2014. Multiple linear regression analyses were used to examine the relationship of diabetes-related symptoms (fatigue, neuropathic pain, distress and depressive symptoms) to sleep disturbance and sleep-related impairment. The instruments included Patient-Reported Outcomes Measurement Information System instruments, Diabetes Symptom Checklist and Diabetes Distress Scale.FindingsIn this study of adults with type 2 diabetes (N = 90; 52.2% female, mean age 57.4 years), gender, A1C, neuropathic pain and fatigue were significantly related to sleep disturbance when age, diabetes duration, depressive symptoms and distress were controlled. Those variables collectively explained 52% of the variation in sleep disturbance. Fatigue was significantly associated with sleep-related impairment when the same covariates were controlled.ConclusionFindings suggested that diabetes-related symptoms, including neuropathic pain and fatigue, are strongly related to sleep disturbance and sleep-related impairment in adults with type 2 diabetes, underscoring the need to include detailed assessments of neuropathic pain and fatigue when evaluating sleep.
      PubDate: 2017-11-08T00:01:20.178242-05:
      DOI: 10.1111/jan.13482
       
  • General and professional values of student nurses and nurse educators
    • Authors: Olga Riklikiene; Laima Karosas, Snieguole Kaseliene
      Abstract: AimThe aim of this study was to explore and compare the self-reported general and professional values in undergraduate student nurses and nurse educators in Lithuania.BackgroundContemporary nursing requires strong moral motivation and clear values as nurses confront many ethical dilemas in their practice. Students acquire essential values of the nursing profession through the appropriate role modelling of their educators. Nursing students seek to become capable in providing ethical and professional patient care while their educators attempt to model desired behaviours.DesignA national cross-sectional comparative study was carried out in March 2011. Four-hundred eight respondents participated: 316 undergraduate nursing students and 92 nurse educators.MethodsA 57-item questionnaire was delivered to nursing programs at three universities and six colleges. Permission to conduct the study was granted by The Center on Bioethics.ResultsStudent nurses and their educators rated the general value of altruism equally. Educators, in comparison with students, ranked honesty and intellectualism significantly higher and more often admired truth-telling in any circumstance. Students were more likely to avoid intellectual challenges in reading and placed lower importance on academic qualifications for career advancement. The professional nursing values of honesty, intellectualism and authority were ranked significantly higher by nurse educators than student nurses.ConclusionsThe study revealed differences in self-reported general and professional values in undergraduate student nurses and nurse educators. The values of nurse educators were not always stronger than those of students. Positive relationships between particular general and professional values in both students and educators confirmed the link between professional and personal values.
      PubDate: 2017-10-30T04:12:20.395223-05:
      DOI: 10.1111/jan.13473
       
  • Resumption of intercourse, self-reported decline in sexual intercourse and
           dyspareunia in women by mode of birth: A prospective follow-up study
    • Authors: José-Matías Triviño-Juárez; Dulce Romero-Ayuso, Beatriz Nieto-Pereda, Maria João Forjaz, Cristina Oliver-Barrecheguren, Sonia Mellizo-Díaz, Beatriz Avilés-Gámez, Begoña Arruti-Sevilla, Juan-José Criado-Álvarez, Consuelo Soto-Lucía, Rosa Plá-Mestre
      Abstract: AimTo evaluate the association between mode of birth and the resumption of sexual intercourse, self-reported decline in sexual intercourse and dyspareunia in women at the 6th week and 6th month postpartum.BackgroundInterest in the relationship between mode of birth and postpartum sexual functioning is increasing. However, previous findings are contradictory.DesignProspective, longitudinal, observational study.MethodThe participants comprised 552 healthy primiparous women aged 18–45 years who gave birth at a hospital between February 2013 - April 2014. Interviews were performed at the hospital and via telephone at the 6th week and 6th month postpartum. We constructed multivariate logistic regression models to examine the relationship between mode of birth and resumption of intercourse, self-reported decline in sexual intercourse and dyspareunia at the 6th week and 6th month postpartum.ResultsAt the 6th week postpartum, forceps-assisted birth, combination of episiotomy plus perineal tear and belonging to a higher socio-economic status were related to a higher risk of non-resumption of sexual intercourse, while breastfeeding was related to a higher probability of dyspareunia. At the 6th month postpartum, the likelihood of self-reported decline in sexual intercourse was higher among women who screened positive for postpartum depression and a higher number of breastfeeding women reported a decline in sexual intercourse and dyspareunia. Furthermore, at the 6th month postpartum, women who reported the use of emergency services for a health problem had a higher risk of not having resumed intercourse and of experiencing dyspareunia.
      PubDate: 2017-10-30T03:35:23.865044-05:
      DOI: 10.1111/jan.13468
       
  • Lessons from a lost world: Messages from the mental hospital era
    • Authors: Niall McCrae
      PubDate: 2017-10-30T03:30:42.082448-05:
      DOI: 10.1111/jan.13467
       
  • Examining missed care in community nursing: A cross section survey design
    • Authors: Amanda Phelan; Sandra McCarthy, Elizabeth Adams
      Abstract: AimTo examine the prevalence of missed care in the community nursing.BackgroundPrevious studies have used a missed care framework to identify challenges routine nursing care in acute care environments. Several issues related to quality of care, safe staffing, job satisfaction and poor teamwork. However, this concept has not been examined in the community nursing context.DesignA cross-sectional survey design was used to explore the concept of missed care in community nursing using demographical information, community nursing roles and reasons for missed care.MethodsOnline questionnaires were completed by 458 community nurses in the Republic of Ireland to determine the prevalence of and reasons for missed care (31 July–25 September 2015).Results/FindingsWith a response rate of 29%, findings were above 70% in several routine care responsibilities. Other findings point to a higher level of missed care in nurses who had less than five years’ experience and other variables such as age, those who worked additional unpaid hours and there were some regional variations.ConclusionThe results of the study indicate a high prevalence of missed care in the community nurses surveyed and that preventative care was the type of care most likely to be missed. This has serious implications for a nursing service that is preventative in nature and suggests that the missed care framework could benefit workforce planning for community nursing services both in Ireland and elsewhere. Accordingly, policy, practice and educational reforms are fundamental to meet current and future population needs.
      PubDate: 2017-10-30T03:25:21.432394-05:
      DOI: 10.1111/jan.13466
       
  • The relationship between emotional intelligence, previous caring
           experience and successful completion of a pre-registration
           nursing/midwifery degree
    • Authors: Austyn Snowden; Rosie Stenhouse, Lorraine Duers, Sarah Marshall, Fiona Carver, Norrie Brown, Jenny Young
      Abstract: AimTo examine the relationship between baseline emotional intelligence and prior caring experience with completion of pre-registration nurse and midwifery education.BackgroundSelection and retention of nursing students is a global challenge. Emotional intelligence is well-conceptualized, measurable and an intuitive prerequisite to nursing values and so might be a useful selection criterion. Previous caring experience may also be associated with successful completion of nurse training.DesignProspective longitudinal study.MethodSelf-report trait and ability emotional intelligence scores were obtained from 876 student nurses from two Scottish Universities before they began training in 2013. Data on previous caring experience were recorded. Relationships between these metrics and successful completion of the course were calculated in SPSS version 23.ResultsNurses completing their programme scored significantly higher on trait emotional intelligence than those that did not complete their programme. Nurses completing their programme also scored significantly higher on social connection scores than those that did not. There was no relationship between “ability” emotional intelligence and completion. Previous caring experience was not statistically significantly related to completion.ConclusionStudents with higher baseline trait emotional intelligence scores were statistically more likely to complete training than those with lower scores. This relationship also held using “Social connection” scores. At best, previous caring experience made no difference to students' chances of completing training. Caution is urged when interpreting these results because the headline findings mask considerable heterogeneity. Neither previous caring experience or global emotional intelligence measures should be used in isolation to recruit nurses.
      PubDate: 2017-10-27T02:30:36.448927-05:
      DOI: 10.1111/jan.13455
       
  • Experience of the waiting area as perceived by haemodialysis patients and
           family carers
    • Authors: Yoonsoo Kim; Miyoung Kim, Pratibha Bhandari, Sujin Choi
      Abstract: AimTo identify the meaning of the waiting area based on the experiences of haemodialysis patients and their carers and to develop an optimal social environment for meaningful nursing care.BackgroundHaemodialysis patients require treatment three times a week and they and their carers spend much of their time in waiting areas, where they experience a unique culture. Limited qualitative research has focused on the culture of the waiting area among haemodialysis patients in South Korea.DesignA qualitative study using an ethnographic approach.MethodsEighteen participants were recruited in a hospital waiting area. The data were collected via participant observations and interviews from 24 November 2015–21 April 2016. Spradley's research sequence was employed to analyse the data.ResultsThree themes were identified that describe the unique characteristics of the waiting area: sharing information and consoling, inhabiting a separate area of ease and discomfort and experiencing vigilance and unsure stillness. The overarching theme was a boundary space that presented antithetical and dynamic patterns.ConclusionsThis study contributes to a better understanding of the distinct culture experienced by haemodialysis patients in the waiting area and the findings can help nurses deliver more meaningful care. Nursing interventions germane to psychological and emotional support and applicable nursing education should be seriously considered for haemodialysis waiting rooms.
      PubDate: 2017-10-25T01:20:21.36889-05:0
      DOI: 10.1111/jan.13448
       
  • Systematic psychometric review of self-reported instruments to assess
           patient safety culture in primary care
    • Authors: Melissa Desmedt; Jochen Bergs, Sonja Vertriest, Annemie Vlayen, Ward Schrooten, Johan Hellings, Dominique Vandijck
      Abstract: AimsTo give an overview of empirical studies using self-reported instruments to assess patient safety culture in primary care and to synthesize psychometric properties of these instruments.BackgroundA key condition for improving patient safety is creating a supportive safety culture to identify weaknesses and to develop improvement strategies so recurrence of incidents can be minimized. However, most tools to measure and strengthen safety culture have been developed and tested in hospitals. Nevertheless, primary care is facing greater risks and a greater likelihood of causing unintentional harm to patients.DesignA systematic literature review of research evidence and psychometric properties of self-reported instruments to assess patient safety culture in primary care.Data SourcesThree databases until November 2016.Review MethodsThe review was carried out according to the protocol for systematic reviews of measurement properties recommended by the COSMIN panel and the PRISMA reporting guidelines.ResultsIn total, 1.229 records were retrieved from multiple database searches (Medline = 865, Web of Science = 362 and Embase = 2). Resulting from an in-depth literature search, 14 published studies were identified, mostly originated from Western high-income countries. As these studies come with great diversity in tools used and outcomes reported, comparability of the results is compromised. Based on the psychometric review, the SCOPE-Primary Care survey was chosen as the most appropriate instrument to measure patient safety culture in primary care as the instrument had excellent internal consistency with Cronbach's alphas ranging from 0.70-0.90 and item factor loadings ranging from 0.40-0.96, indicating a good structural validity.ConclusionThe findings of the present review suggest that the SCOPE-Primary Care survey is the most appropriate tool to assess patient safety culture in primary care. Further psychometric techniques are now essential to ensure that the instrument provides meaningful information regarding safety culture.
      PubDate: 2017-10-25T00:10:56.629749-05:
      DOI: 10.1111/jan.13464
       
  • Developing a positive patient experience with nurses in general practice:
           An integrated model of patient satisfaction and enablement
    • Authors: Jane Desborough; Christine Phillips, Jane Mills, Rosemary Korda, Nasser Bagheri, Michelle Banfield
      Abstract: AimTo develop a conceptual model that provides a comprehensive understanding of the structures and processes underpinning patient enablement and satisfaction in general practice nurse consultations.BackgroundCurrent evidence regarding patient satisfaction and enablement arising from general practice nursing care is either quantitative or qualitative. To date, no studies have integrated the results of mixed methods research to provide a deeper understanding of processes that facilitate their achievement.DesignA concurrent mixed methods study.MethodsOur 2013–2014 concurrent mixed methods study comprised a quantitative study that analysed variables identified in interviews with general practice nurses, patients and practice managers with data from a cross-sectional survey of 678 patients receiving nursing care in 21 general practices; and a qualitative study that used a grounded theory approach to in-depth interviews with nurses and patients from these same practices. Using joint displays, we compared and integrated the results of the multilevel analyses and the grounded theory model derived from these studies.FindingsWe conceptualized a model—‘developing a positive patient experience with nurses in general practice’—in which time, continuity of care, nursing scope of practice and autonomy, and patients’ health conditions provide platforms for the processes of triggering healthcare partnerships and tailoring care in nurse consultations.ConclusionThis model builds on previous evidence describing processes and characteristics that optimize the quality of care in general practice nurse consultations. It provides a practical tool to inform education and training for general practice nurses and other clinicians.
      PubDate: 2017-10-25T00:00:32.850874-05:
      DOI: 10.1111/jan.13461
       
  • A systematic review of qualitative research into people's experiences of
           living with venous leg ulcers
    • Authors: Patrick Phillips; Elizabeth Lumley, Rosie Duncan, Ahmed Aber, Helen Buckley Woods, Georgina L. Jones, Jonathan Michaels
      Abstract: AimTo systematically identify, evaluate and synthesize qualitative research that examined the symptoms and health-related quality of life themes that are important from the perspective of patients with venous leg ulceration.BackgroundVenous leg ulceration is a common chronic condition; the symptoms and associated treatments have a negative effect on health-related quality of life. Qualitative research methods can provide insight into the personal experiences of patients with venous leg ulceration.DesignQualitative evidence synthesis (using framework synthesis).Data SourcesMultiple electronic databases including MEDLINE, EMBASE, PsycINFO and CINAHL were comprehensively searched from inception to November 2015.Review MethodsSystematic identification, quality assessment and synthesis of existing qualitative research were performed; framework synthesis was conducted on included studies. An inductive approach was used and emergent themes were identified. The final stage in the synthesis involved the development of new interpretations.ResultsThirteen studies met the inclusion criteria; the overall quality of the included studies was good. Four overarching themes were identified; physical impact, psychological impact, social impact and treatment and, in these, further subthemes were identified. Ulcer and treatment-related pain, as well as odour and exudate appeared to have significant and direct negative effects on quality of life, with additional and cumulative effects on sleep, mobility and mood.ConclusionThe themes identified in this review should be considered by professionals providing services, care and treatment for venous leg ulcer patients and in the selection, or development, of patient-reported outcome measures for use with this population.
      PubDate: 2017-10-24T23:55:22.229262-05:
      DOI: 10.1111/jan.13465
       
  • RN4CAST@IT-Ped: Nurse staffing and children's safety
    • Authors: Loredana Sasso; Annamaria Bagnasco, Paolo Petralia, Silvia Scelsi, Milko Zanini, Gianluca Catania, Giuseppe Aleo, Nicoletta Dasso, Silvia Rossi, Roger Watson, Walter Sermeus, Giancarlo Icardi, Linda H. Aiken
      PubDate: 2017-10-24T23:40:25.122745-05:
      DOI: 10.1111/jan.13462
       
  • An integrative review of the psychosocial facilitators and challenges of
           continuous subcutaneous insulin infusion therapy in type 1 diabetes
    • Authors: Marlene Payk; Tracy Robinson, Deborah Davis, Marjorie Atchan
      Abstract: AimTo use systematic methods to explore the psychosocial facilitators and challenges of insulin pump therapy among people with type 1 diabetes.BackgroundInsulin pump therapy is now widely accepted in the management of type 1 diabetes. Given the increasing use of insulin pumps, it is timely to review the evidence relating to the psychosocial impacts of this therapy which have not been addressed in previous reviews.DesignAn integrative review of the literature (January 2005–February 2017).Data sourcesA systematic search of electronic databases: CINAHL, Cochrane, Medline, PsycINFO and Scopus.Review methodsEmpirical literature reporting psychosocial facilitators and challenges of insulin pump therapy were eligible for inclusion. A constant comparative method was used to guide the review. Quality appraisal was performed using the Mixed Methods Appraisal Tool Version 2011.ResultsThirty-five potential articles identified from titles and abstracts were reviewed. Of these, 13 articles were included in the final review. Psychosocial facilitators of insulin pump therapy included the flexibility and freedom it provided for living with diabetes, enhancing social situations and daily management. In contrast, challenges included the demands of pump therapy, self-consciousness in wearing the pump and fear of hypoglycaemia and pump failure.ConclusionFindings can be used by health professionals to inform people embarking on insulin pump therapy and prepare them with regard to expectations of the treatment. Further research is required to explore the role of diabetes health professional in providing psychosocial support to people with type 1 diabetes on insulin pump therapy.
      PubDate: 2017-10-19T04:10:24.838448-05:
      DOI: 10.1111/jan.13463
       
  • Using blogs to explore the lived-experience of life after stroke: “A
           journey of discovery I never wanted to take”
    • Authors: Caroline M. Thomas; Rhoda Allison, Jos M. Latour
      Abstract: AimsTo explore the lived-experiences of stroke survivors as expressed in blogs and to discover the role the blogs play in the writers’ lives.BackgroundStroke can be a devastating, life changing event. Previous qualitative studies tend to examine one aspect of life after stroke. As stroke often has multiple effects, it is necessary to look widely at its lived-experience. New resources which can enable researchers to explore the lived-experience of stroke are blogs.DesignPhenomenological exploration using an interpretive thematic analysis.MethodsThe Internet was searched for stroke survivors’ blogs (January–March 2016) using pre-set criteria, seeking blogs with entries over an extended time (>1 year). Suitable blogs were identified and codes of meaning were identified and developed into categories, subthemes and themes.FindingsEight blogs were identified for analysis. Of the 40 categories, eight subthemes were assimilated; internal dialogue, emotions, transition, stroke effects, health care, “in the world”, relationships, rehabilitation. Two main themes were identified related to perspectives of lived-experience; Internal relationship with “self” and External relationship with “the world”. Participants expressed loss and initially strove to regain their “old” lives, their focus being recovery and independence.ConclusionStroke survivors must transition from their previous life to a new and initially unwelcome way of being. Rehabilitation should respect this process and support stroke survivors as they undertake this individual journey.
      PubDate: 2017-10-19T04:00:29.568033-05:
      DOI: 10.1111/jan.13457
       
  • Nursing service innovation: A case study examining emergency nurse
           practitioner service sustainability
    • Authors: Amanda Fox; Glenn Gardner, Sonya Osborne
      Abstract: AimThis research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service.BackgroundPlanning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision.DesignThis research used case study methodology (Yin, ).MethodsData were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions.FindingsIn this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse.ConclusionThis research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability.
      PubDate: 2017-10-19T04:00:24.050291-05:
      DOI: 10.1111/jan.13454
       
  • Systematic review and meta-analysis of non-pharmacological interventions
           to reduce the symptoms of mild to moderate anxiety in pregnant women
    • Authors: Kerry Evans; C Jane Morrell, Helen Spiby
      Abstract: AimTo assess the effectiveness of non-pharmacological interventions for pregnant women with symptoms of mild to moderate anxiety.BackgroundMany pregnant women experience mild to moderate symptoms of anxiety and could benefit from additional support. Non-pharmacological interventions have been suggested for use during pregnancy.DesignA systematic review of randomized controlled trials.Data sourcesRandomized controlled trials published since 1990, identified from electronic databases: Medline; CINAHL; Maternity and Infant Care; PsycINFO; Cochrane Database of Systematic Reviews; CENTRAL; EMBASE; Centre for Reviews and Dissemination; Social Sciences Citation Index; ASSIA; HTA Library; Joanna Briggs Institute Evidence-Based Practice database; Allied and Complementary Medicine.Review methodsConducted according to the Centre for Reviews and Dissemination procedure. Papers were screened (N = 5,222), assessed for eligibility (N = 57) and selected for inclusion (N = 25). The Cochrane Collaboration's tool for assessing risk of bias was used. Papers were assessed for clinical and statistical heterogeneity and considered for meta-analysis. Descriptive analysis of the data was conducted.ResultsPsychological, mind-body, educational and supportive interventions were delivered individually and to groups of pregnant women over single or multiple sessions. The State-Trait Anxiety Inventory was the most commonly used anxiety measure. In 60% of studies there were fewer than 40 participants. Meta-analysis of three studies indicated no observed beneficial effect in the reduction of anxiety.ConclusionThere was insufficient evidence from which to draw overall conclusions regarding the benefit of interventions. Results were predominantly based on small samples. Many papers provided an inadequate description of methods which prevented a full assessment of methodological quality.
      PubDate: 2017-10-16T02:35:25.024644-05:
      DOI: 10.1111/jan.13456
       
  • Using narrative inquiry to listen to the voices of adolescent mothers in
           relation to their use of social networking sites (SNS)
    • Authors: Samantha Nolan; Joyce Hendricks, Moira Williamson, Sally Ferguson
      Abstract: AimThis article presents a discussion highlighting the relevance and strengths of using narrative inquiry to explore experiences of social networking site (SNS) use by adolescent mothers.BackgroundNarrative inquiry as a method reveals truths about holistic human experience. Knowledge gleaned from personal narratives informs nursing knowledge and clinical practice. This approach gives voice to adolescent mothers in relation to their experiences with SNS as a means of providing social support.DesignDiscussion paper.Data sourcesThis paper draws and reflects on the author's experiences using narrative inquiry and is supported by literature and theory. The following databases were searched: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science and Health Collection (Informit). Key terms and Boolean search operators were used to broaden the search criteria. Search terms included: adolescent mother, teenage mother, “social networking sites”, online, social media, Facebook, social support, social capital and information. Dates for the search were limited to January 1995–June 2017.Implications for practice/researchNarrative research inherently values the individual “story” of experience. This approach facilitates rapport building and methodological flexibility with an often difficult to engage sample group, adolescents.ConclusionNarrative inquiry reveals a deep level of insight into social networking site use by adolescent mothers. The flexibility afforded by use of a narrative approach allows for fluidity and reflexivity in the research process.
      PubDate: 2017-10-16T02:30:30.50199-05:0
      DOI: 10.1111/jan.13458
       
  • How does role transition affect the experience of trainee Advanced
           Clinical Practitioners: Qualitative evidence synthesis
    • Authors: Gregory M. Moran; Stuart Nairn
      Abstract: BackgroundAdvanced Clinical Practitioners have been developed to address current and future gaps in the medical workforce. Insight into problems associated with Advanced Clinical Practitioner transition may help present and future trainees adapt to their changing and demanding health environment.AimsTo identify potential problems experienced by trainee Advanced Clinical Practitioners during transition and what the implications might be for workforce planning.DesignA qualitative evidence synthesis to examine the issue of role transition for Advanced Clinical Practitioners.Data sourcesThe electronic databases accessed (1997–2016) were MEDLINE, EMBASE, CINAHL, BNI, AMED and PubMed and also included Researchgate, thesis publications, hand searching and NHS staffing reports.Review methodsEleven studies were identified between 1997 - 2016. Thematic synthesis was undertaken, creating codes, descriptive and analytical themes. Quality appraisal of individual studies was conducted using the tool of Walsh and Downe.FindingsSix analytical themes were identified that addressed the key issues of transition discussed in the 11 articles and which were directly related to the proposed research project: experience of change, orientation to role, mentorship, clinical skills, clinical supervision and Masters’ level education.ConclusionsFindings from all 11 articles were similar. Where these six themes were ignored, there was often either a failure to reach expected goals or resignation from the role. Future employers must ensure that they establish a comprehensive orientation and education programme to be certain that qualified Advanced Clinical Practitioners are suitably prepared for their role in health care.
      PubDate: 2017-10-08T21:40:26.013955-05:
      DOI: 10.1111/jan.13446
       
  • Predictors of depressive symptoms among psychiatric nurses who suffered
           from workplace violence
    • Authors: Hsiu-Fen Hsieh; Hsiu-Hung Wang, Shu-Hua Shen, Yu-Chi Li
      Abstract: AimsWe examined the possible factors that contributed to or prevented developing depressive symptoms among psychiatric nurses who suffered from workplace violence under Hill's ABC-X Model.BackgroundWorkplace violence-related depressive symptoms are some of the major causes leading to impaired quality of life of victims and a heavy burden on society.DesignThis is a cross-sectional and correlational study.MethodAll participants were recruited from psychiatric wards of six hospitals in Taiwan. The data were collected through structured questionnaires from October 2013–March 2014 and a total of 278 psychiatric wards nurses participated in this study and completed all questionnaires. Logistic regression was used to examine the relationships among types and severity of violence, social support and depressive symptoms.ResultsOf assaulted psychiatric ward nurses, 75.9% had depressive symptoms and those with higher family support had significantly lower depressive symptoms.ConclusionsFamily support plays the most important role among assaulted psychiatric ward nurses as a protective factor against developing depressive symptoms in this study.
      PubDate: 2017-10-06T03:06:03.428783-05:
      DOI: 10.1111/jan.13451
       
  • Tainted love: Gothic imaging of nurses in popular culture
    • Authors: Margaret McAllister; Donna Lee Brien, Lorna Piatti-Farnell
      Abstract: AimsTo discuss representations of nursing in popular culture using the Contemporary Gothic theory.BackgroundNursing is stereotypically known as a caring profession. Caring in both the natural and professional perspectives is inextricably attached to love and love, we are told, is universal. In popular culture, however, there are numerous examples of nurses being portrayed in ways where love—its expression and its practice—has been transgressed or tainted. Exploring this dark side of nursing, even if fictitious, is significant because it illuminates social and cultural tensions.DesignDiscussion paper.Data sourcesCINAHL, Scopus and Humanities International Databases were searched for terms related to nursing, love, abject and the gothic, published between 1990–2016. Four popular culture texts which ranged in genre and gothic elements were selected for analysis.Implications for nursingThe types of transgressive love these nurses express to patients ranges from the obsessive and the pornographic, to the monstrous. We suggest this positioning illuminates a hidden reality that nursing work is at once intimate and personal but also hidden, profane, repellent, horrifying and feared. Nursing's allure for storytellers may rest in its association with the abject. How nurses find redemption, satisfaction and meaning in these locations is relevant for how we can imbue our lives and work with greater humanity.ConclusionThe Contemporary Gothic is a useful tool in exposing and exploring ambiguous, challenging and taboo aspects of nursing in society. Such and analysis helps to explain phenomena—including nursing itself—which exists in the shadow of dominant and often stereotyped discourses.
      PubDate: 2017-10-05T01:40:22.23658-05:0
      DOI: 10.1111/jan.13452
       
  • Barrier-free communication in maternity care of allophone migrants: BRIDGE
           study protocol
    • Authors: Paola Origlia Ikhilor; Gabriele Hasenberg, Elisabeth Kurth, Barbara Stocker Kalberer, Eva Cignacco, Jessica Pehlke-Milde
      Abstract: AimTo describe communication and access barriers encountered by allophone women of different migration backgrounds in the Swiss maternity care services, from the perspective of users, healthcare professionals and intercultural interpreters.BackgroundIn addition to the challenges of maternal adjustment, pregnant migrant women must also deal with an unfamiliar health service system. Some must overcome language barriers and the stress of uncertain residence status. Limited access to maternity care increases perinatal morbidity and mortality. Almost 10% of foreigners speak none of Switzerland's official languages. Factors that facilitate or hinder communication between migrant women and perinatal healthcare professionals are under-studied and must be understood if we are to overcome those barriers in clinical practice.DesignQualitative exploratory study with quantitative sub-study.MethodsParticipants will be drawn from German to speaking regions of Switzerland. We will conduct focus group discussions and semi-structured interviews with users in their own language (Albanian and Tigrinya) and with healthcare professionals and intercultural interpreters (March–June 2016), then perform Thematic Analysis on the data. In the sub-study, midwives will report their experience of using a telephone interpreting service during postnatal home visits in a questionnaire (October 2013–March 2016). Data will be analysed with descriptive statistics.DiscussionOur study will reveal patterns in communications between allophone migrant women and healthcare providers and communication barriers. By incorporating multiple perspectives, we will describe the challenges all parties face. Our results will inform those who draft recommendations to improve provision of maternity care to allophone women and their families.Trial RegistrationClinicalTrials.gov ID: BernUAS NCT02695316.
      PubDate: 2017-10-05T01:30:36.936382-05:
      DOI: 10.1111/jan.13441
       
  • Integrative review of the social determinants of health in older adults
           with multimorbidity
    • Authors: Melissa Northwood; Jenny Ploeg, Maureen Markle-Reid, Diana Sherifali
      Abstract: AimTo examine how the social determinants of health have been considered in conceptualizations of multimorbidity in older adults in the literature and to identify implications for nursing practice, research and healthcare planning and policy.BackgroundThe common conceptualization of multimorbidity is the presence of multiple chronic conditions where one is not more central than others.DesignThe integrative review methodology of Whittemore and Knafl was employed. The World Health Organization Social Determinants of Health framework was used to determine how the social determinants of health have been considered in conceptualizations of multimorbidity.Data sourcesA search of electronic databases (2000–2015) generated 22 relevant articles, including quantitative and qualitative studies and grey literature reports.Review methodsA systematic process was used to appraise the quality of the documents, conduct qualitative data analysis procedures of data extraction, coding and theme development, and synthesize conclusions.ResultsCurrent conceptualizations of multimorbidity provide limited consideration of the complex interplay of multimorbidity with the broader social determinants of health. Gender, education, behaviours and the health system were the most commonly cited determinants. Ethnicity, socioeconomic status/social class and material circumstances received little attention. Most of the dimensions of socioeconomic political context were not discussed.ConclusionThe predominant conceptualization of multimorbidity focuses on the biomedical dimensions of multimorbidity. Consequently, nursing practice, research and policy informed by this literature could inadvertently sustain the mismatch between the needs of older adults with multimorbidity and the services they receive. Future research to inform a new conceptualization is necessary.
      PubDate: 2017-10-05T00:15:33.926792-05:
      DOI: 10.1111/jan.13408
       
  • An exploration of co-parenting in the context of caring for a child
           prenatally diagnosed and born with a complex health condition
    • Authors: Anne Chevalier McKechnie; Jamie Rogstad, Katherine M. Martin, Karen F. Pridham
      Abstract: AimThe aim of this study was to describe co-parenting communication in couples in the context of caregiving for children prenatally diagnosed and born with complex health conditions.BackgroundFoetal diagnosis of complex health conditions such as heart, central nervous system, or abdominal anomalies are confirmed more often than ever before. Following diagnosis, parents face challenges beginning before birth. The quality of co-parenting, when two individuals relate to each other as parents and share parental responsibilities, can have an impact on child health and development. Yet, little is known about co-parenting during the transition to parenthood after foetal diagnosis.DesignThis secondary analysis of interview data was informed by Bowlby's theoretical work on a parent's view of self as caregiver and the literature on co-parenting.MethodsData were drawn from a larger, mixed methods, longitudinal study and included audio-recorded interviews conducted with 16 parents participating as eight couples after foetal diagnosis during the third trimester of pregnancy in 2011–2012 and again when children were 14–37 months old in 2014. Analysis of interviews transcribed verbatim focused on co-parenting communication.FindingsCo-parenting communication regarding support, agreement and information sharing and a new category of shared meaning were related to the diagnosis before birth. Later, couples evolved in their co-parenting communication while caring for their toddlers and working towards achieving a sense of normalcy.ConclusionVariation in co-parenting communication among couples preparing and caring for children with complex health conditions, including the development of a shared meaning of the child's diagnosis, needs further investigation to inform nursing assessment and guide tailored interventions.
      PubDate: 2017-10-04T03:42:51.360905-05:
      DOI: 10.1111/jan.13415
       
  • Colorectal cancer in Taiwan: A case-control retrospective analysis of the
           impact of a case management programme on refusal and discontinuation of
           treatment
    • Authors: Ting-Yu Chiang; Chao-Hui Wang, Yu-Fen Lin, Jeng-Fu You, Jinn-Shiun Chen, Shu-Ching Chen
      Abstract: AimsThe purposes of this study were to identify the impact of a case management programme on the related factors of refusing treatment or discontinuing treatment in Taiwanese colorectal cancer patients.BackgroundSide effects of anti-cancer treatments are associated with refusing treatment and discontinuing treatment.DesignThis case–control study, longitudinal database and secondary analysis of population-based data was conducted from 2009–2012.MethodsLogistic regression was used to reveal the factors related to refusing or discontinuing treatment.ResultsOf the 68 patients who refused treatment, the top reasons for refusing treatment were patients or their family considered the patients poor physical condition, difficulty in enduring any condition likely to cause physical discomfort from the disease treatment, selected complementary and alternative medicine, patients or their families or friends experienced negative treatment effects and worried about the side effects of treatment, older age, poor family support and lost contact. Of the 278 patients who discontinued treatment, the most common reasons for discontinuing treatment were patients or their families or friends experienced negative treatment effects and worried about the side effects of treatment, inconvenient transportation, patients or their family considered the patients poor physical condition, difficulty in enduring any condition likely to cause physical discomfort from the disease treatment, poor treatment effect and selected complementary and alternative medicine.ConclusionCase managers can provide positive communication and available resources in relation to cancer treatment. A case management programme can help patients cope with the difficulties encountered during the treatment period.
      PubDate: 2017-10-04T03:06:29.627241-05:
      DOI: 10.1111/jan.13443
       
  • A meta-analysis of the effect on maternal health of upright positions
           during the second stage of labour, without routine epidural analgesia
    • Authors: Ayse Deliktas; Kamile Kukulu
      Abstract: AimTo detect the effect on maternal health of upright positions during the second stage of labour.BackgroundMaternal position during labour has an important effect on maternal and foetal health.DesignA meta-analysis was used based on the Cochrane Handbook.Data sourcesRandomized/non-randomized clinical trials were searched with English and Turkish key words in databases (CINAHL, Medline, Science Direct, Springer Link, Ovid, Cochrane Central Register of Controlled Trials, Networked Digital Library of Theses & Dissertations, Proquest, ULAKBİM (Turkish Academic Network and Information Center) and YÖK (Turkish Council of Higher Education) (1970-December 2015).Review methodsAccording to inclusion criteria, eligible studies were identified. Data extraction was performed and the bias risks of the studies were assessed independently by two authors. The publication bias of the main outcomes was examined. The overall effect size was calculated by risk ratio with a random effects model. Statistical heterogeneity tests and sensitivity analyses were performed.ResultsThe criteria for the meta-analysis were met by 22 articles. It was detected that the ratio of instrumental labour and episiotomy was lower but the haemorrhage ratio was higher in women. There was no statistical effect of upright position on the other maternal outcomes.ConclusionThe reductions in these ratios improved comfort. Due to methodological shortcomings of the studies, the increased ratio of postpartum haemorrhage should be interpreted with caution. Researchers are recommended to conduct studies rigorously. In addition, healthcare professionals are recommended to decide the appropriate birth position by considering the individual risk factors and preferences of the women.
      PubDate: 2017-10-04T03:01:19.686798-05:
      DOI: 10.1111/jan.13447
       
  • Clinical evaluation of a new pressure ulcer risk assessment instrument,
           the Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE T)
    • Authors: Susanne Coleman; Isabelle L. Smith, Elizabeth McGinnis, Justin Keen, Delia Muir, Lyn Wilson, Nikki Stubbs, Carol Dealey, Sarah Brown, E. Andrea Nelson, Jane Nixon
      Abstract: AimTo test the psychometric properties and clinical usability of a new Pressure Ulcer Risk Assessment Instrument including inter-rater and test–retest reliability, convergent validity and data completeness.BackgroundMethodological and practical limitations associated with traditional Pressure Ulcer Risk Assessment Instruments, prompted a programme to work to develop a new instrument, as part of the National Institute for Health Research funded, Pressure UlceR Programme Of reSEarch (RP-PG-0407-10056).DesignObservational field test.MethodFor this clinical evaluation 230 patients were purposefully sampled across four broad levels of pressure ulcer risk with representation from four secondary care and four community NHS Trusts in England. Blinded and simultaneous paired (ward/community nurse and expert nurse) PURPOSE-T assessments were undertaken. Follow-up retest was undertaken by the expert nurse. Field notes of PURPOSE-T use were collected. Data were collected October 2012–January 2013.ResultsThe clinical evaluation demonstrated “very good” (kappa) inter-rater and test–retest agreement for PURPOSE-T assessment decision overall. The percentage agreement for “problem/no problem” was over 75% for the main risk factors. Convergent validity demonstrated moderate to high associations with other measures of similar constructs.ConclusionThe PURPOSE-T evaluation facilitated the initial validation and clinical usability of the instrument and demonstrated that PURPOSE-T is suitable of use in clinical practice. Further study is needed to evaluate the impact of using the instrument on care processes and outcomes.
      PubDate: 2017-09-28T06:10:37.030079-05:
      DOI: 10.1111/jan.13444
       
  • The feasibility and acceptability of nurse-led chronic disease management
           interventions in primary care: An integrative review
    • Authors: Catherine Stephen; Susan McInnes, Elizabeth Halcomb
      Abstract: AimsTo explore the feasibility and acceptability of nurse-led chronic disease management and lifestyle risk factor reduction interventions in primary care (general practice/family practice).BackgroundGrowing international evidence suggests that interventions delivered by primary care nurses can assist in modifying lifestyle risk factors and managing chronic disease. To date, there has been limited exploration of the feasibility and acceptability of such interventions.DesignIntegrative review guided by the work of Whittemore and Knafl ().Data SourcesDatabase search of CINAHL, Medline and Web of Science was conducted to identify relevant literature published between 2000–2015.Review MethodsPapers were assessed for methodological quality and data abstracted before thematic analysis was undertaken.ResultsEleven papers met the inclusion criteria. Analysis uncovered four themes: (1) facilitators of interventions; (2) barriers to interventions; (3) consumer satisfaction; and (4) primary care nurse role.ConclusionLiterature supports the feasibility and acceptability of nurse-led interventions in primary care for lifestyle risk factor modification. The ongoing sustainability of these interventions rests largely on organizational factors such as funding, educational pathways and professional support of the primary care nursing role. Further robust research around primary care nurse interventions is required to strengthen the evidence base.
      PubDate: 2017-09-25T05:40:24.852742-05:
      DOI: 10.1111/jan.13450
       
  • Psychometric testing of the revised “Families’ Importance in Nursing
           Care—Nurses’ Attitudes instrument”
    • Authors: Benjamin R. Mackie; Andrea Marshall, Marion Mitchell, Michael J. Ireland
      Abstract: BackgroundThe validity of instruments is crucial in ensuring that data collected are sound and that these data represent what the instrument claims to measure. When an instrument is revised or used in a different population, it is useful to re-examine its construct validity.AimTo test the psychometrics properties of an instrument—the revised Families’ Importance In Nursing Care—Nurses’ Attitudes, designed to measure nurse’ attitudes towards involving family in nursing care in an adult acute care setting.Design and methodologyA cross-sectional survey design was used in April–May 2016 with a sample of Enrolled and Registered Nurses (N = 212) to test the factor structure of the revised Families’ Importance In Nursing-Nurses’ Attitudes instrument. The instrument had 26 items with a five-point Likert response scale. Principle components analysis and exploratory factor analysis were performed with oblique rotations to assess the internal structure of the instrument.SettingA regional referral hospital in Queensland, Australia.ResultsUsing Principal Components Analysis and Principal Axis Factoring, we obtained the same factor structure to that originally identified for the instrument. Our results suggested the removal of six items to refine the instrument and achieve simple structure.ConclusionThe removal of several items, relabeling of factors and residual cross-loading issues suggest that further revisions to the instrument are needed.
      PubDate: 2017-09-20T06:05:44.989333-05:
      DOI: 10.1111/jan.13442
       
  • Learning theories and tools for the assessment of core nursing
           competencies in simulation: A theoretical review
    • Authors: Patrick Lavoie; Cécile Michaud, Marilou Bélisle, Louise Boyer, Émilie Gosselin, Myrian Grondin, Caroline Larue, Stéphan Lavoie, Jacinthe Pepin
      Abstract: AimTo identify the theories used to explain learning in simulation and to examine how these theories guided the assessment of learning outcomes related to core competencies in undergraduate nursing students.BackgroundNurse educators face the challenge of making explicit the outcomes of competency-based education, especially when competencies are conceptualized as holistic and context dependent.DesignTheoretical review.Data SourcesResearch papers (N = 182) published between 1999–2015 describing simulation in nursing education.Review MethodsTwo members of the research team extracted data from the papers, including theories used to explain how simulation could engender learning and tools used to assess simulation outcomes. Contingency tables were created to examine the associations between theories, outcomes and tools.ResultsSome papers (N = 79) did not provide an explicit theory. The 103 remaining papers identified one or more learning or teaching theories; the most frequent were the National League for Nursing/Jeffries Simulation Framework, Kolb's theory of experiential learning and Bandura's social cognitive theory and concept of self-efficacy. Students’ perceptions of simulation, knowledge and self-confidence were the most frequently assessed, mainly via scales designed for the study where they were used. Core competencies were mostly assessed with an observational approach.ConclusionThis review highlighted the fact that few studies examined the use of simulation in nursing education through learning theories and via assessment of core competencies. It also identified observational tools used to assess competencies in action, as holistic and context-dependent constructs.
      PubDate: 2017-09-20T06:00:38.658373-05:
      DOI: 10.1111/jan.13416
       
  • Outcomes of interventions for nurse leaders’ well-being at work: A
           quantitative systematic review
    • Authors: Arja Häggman-Laitila; Johanna Romppanen
      Abstract: AimsThe aim of this study was to gather, assess and synthesize current research knowledge on interventions that aimed to improve nurse leaders’ well-being at work.BackgroundThe research evidence on interventions for nurse leaders’ well-being at work has been sporadic and there are a lack of evidence-based recommendations for effective interventions that inform practice, future studies and education.DesignA quantitative systematic review, in accordance with the Cochrane Collaboration procedures and the reporting guidance in the PRISMA statement.MethodsCINAHL, Cochrane, EBSCO, PubMed, PsycInfo and Scopus databases were searched from 2009 - December 2016. The final data consisted of five studies, which were assessed with the Cochrane Risk of Bias Tool. The data were summarized narratively.ResultsThe interventions were mainly concerned with stress management and were targeted at individuals. Four of the five interventions examined produced statistically significant outcomes on well-being at work.ConclusionsStress management interventions that included mental exercises were the most successful. Interventions primarily reduced the stress experienced by participants, but the evidence on the stability of these outcomes was poor because of the short follow-up periods. The certainty of evidence was low, indicating that the use of these interventions among nurse leaders might be beneficial. Further studies are needed to provide more reliable recommendations for their use. As the performance of nurse leaders influences organizations, through interpersonal relationships, it is important to pay more attention in the future to the development of organization- and person-directed interventions and their combinations. A structural empowerment approach should also be considered.
      PubDate: 2017-09-20T06:00:24.715796-05:
      DOI: 10.1111/jan.13406
       
  • Nurse versus physician-led care for obstructive sleep apnea: A systematic
           review and meta-analysis of randomised trials
    • Authors: Fengqiu Gong; Xiaojun Chen, Yaoye Wu, Dianye Yao, Lihong Xie, Qiuyi Ouyang, Ping Wang, Gang Niu
      Abstract: AimTo evaluate the effectiveness of nurse-led care for obstructive sleep apnoea compared with physician-led care.BackgroundThe incidence of obstructive sleep apnoea is increasing worldwide. There is a need for cost-effective care models to ease off the pressure on tertiary care centres and divert care to the community.DesignSystematic review and meta-analysis.Data sourcesWe searched major electronic databases (MEDLINE, EMBASE, AMED, British Nursing Index, CINAHL, HMIC, PsycINFO, Health Business Elite and the Cochrane Central Register of Controlled Trials CENTRAL) from inception till December 2016 using a structured search strategy for all randomised trials evaluating nurse-led treatment interventions for adults with obstructive sleep apnoea compared with physician-led ones. We screened relevant articles against a predefined inclusion criteria. We applied no search limitations.Review methodsWe assessed the risk of bias as per Cochrane recommendations. We calculated Weighted Mean Difference with 95% confidence intervals for continuous outcomes and used a random-effects model to meta-analyse data.ResultsWe screened 309 articles and only four studies met our inclusion criteria. All studies used continuous-positive airway pressure as the main treatment strategy with similar compliance rate in both comparison groups. The scores of the Epworth Sleepiness Scale, the SF-36 questionnaires for vitality, physical function and the SF-36 mental health were all similar between the two groups. There was a significant heterogeneity in all meta-analyses (I2>92%).ConclusionNurse-led care for adults with obstructive sleep apnoea is non-inferior to physician-led care. More research is needed to standardise nurse-led interventions and evaluate their long-term effectiveness and cost-effectiveness.This article is protected by copyright. All rights reserved.
      PubDate: 2017-05-24T18:30:31.648536-05:
      DOI: 10.1111/jan.13346
       
  • 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
       
  • 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
       
  • 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
       
  • 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
       
  • Issue Information
    • Pages: 2779 - 2780
      PubDate: 2017-11-15T20:32:46.273797-05:
      DOI: 10.1111/jan.13138
       
  • Brenda Roe and Rita Pickler
    • Authors: Roger Watson
      Pages: 2781 - 2781
      PubDate: 2017-11-15T20:32:47.266226-05:
      DOI: 10.1111/jan.13480
       
  • A quantitative systematic review of the effects of training interventions
           on enhancing the competence of nursing staff in managing challenging
           patient behaviour
    • Authors: Sirpa Tölli; Pirjo Partanen, Raija Kontio, Arja Häggman-Laitila
      Pages: 2817 - 2831
      Abstract: AimsThis systematic quantitative review identifies and summarizes the current knowledge and effects of training interventions for managing patients' challenging behaviour.BackgroundChallenging behaviour is an acknowledged worldwide healthcare problem and its management can have a huge impact on quality of care. Evidence-based training interventions that focus on managing challenging behaviour are needed, but few tools for the systematic evaluation of these interventions are currently offered.DesignA quantitative systematic review following the 2008 Centre for Reviews and Dissemination guidelines.Data SourcesCINAHL, Scopus, PsycInfo, PubMed and Cochrane were searched using the same terms for papers published in English from 2005–2015.Review MethodsStudies were assessed for quality and risk of bias, according to the Cochrane Effective Practice and Organisation of Care Group criteria. A narrative summary was conducted.ResultsWe included 17 studies and evaluated 16 training interventions. Interventions were classified into four key themes: disengagements, communication, controlling behavioural symptoms and restrictive measures. Our review showed that interventions were more likely to decrease violent incident rates and increase staff confidence than change staff attitudes or increase knowledge. The elements of competence used to manage challenging behaviour were measured unilaterally. The evidence provided by studies was largely weak.ConclusionThe variety of measurements used in the studies made comparing the effectiveness of the training interventions difficult. An individual's competence to manage challenging behaviour needs to be defined and a comprehensive scale for evaluating competence is also needed. Patient safety should be included in future evaluations.
      PubDate: 2017-07-07T04:45:46.799097-05:
      DOI: 10.1111/jan.13351
       
  • Instruments to assess self-care among healthy children: A systematic
           review of measurement properties
    • Authors: Ana-María Urpí-Fernández; Edurne Zabaleta-Del-Olmo, Javier Montes-Hidalgo, Joaquín Tomás-Sábado, Juan-Francisco Roldán-Merino, María-Teresa Lluch-Canut
      Pages: 2832 - 2844
      Abstract: AimTo identify, critically appraise and summarize the measurement properties of instruments to assess self-care in healthy children.BackgroundAssessing self-care is a proper consideration for nursing practice and nursing research. No systematic review summarizes instruments of measurement validated in healthy children.DesignPsychometric review in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) panel.Data sourcesMEDLINE, CINAHL, PsycINFO, Web of Science and Open Grey were searched from their inception to December 2016.Review methodsValidation studies with a healthy child population were included. Search was not restricted by language. Two reviewers independently assessed the methodological quality of included studies using the COSMIN checklist.ResultsEleven studies were included in the review assessing the measurement properties of ten instruments. There was a maximum of two studies per instrument. None of the studies evaluated the properties of test–retest reliability, measurement error, criterion validity and responsiveness. Internal consistency and structural validity were rated as “excellent” or “good” in four studies. Four studies were rated as “excellent” in content validity. Cross-cultural validity was rated as “poor” in the two studies (three instruments) which cultural adaptation was carried out.ConclusionThe evidence available does not allow firm conclusions about the instruments identified in terms of reliability and validity. Future research should focus on generate evidence about a wider range of measurement properties of these instruments using a rigorous methodology, as well as instrument testing on different countries and child population.
      PubDate: 2017-07-11T03:30:36.31591-05:0
      DOI: 10.1111/jan.13360
       
  • Overview of systematic reviews: Effective home support in dementia care,
           
    • Authors: Paul Clarkson; Jane Hughes, Chengqiu Xie, Matthew Larbey, Brenda Roe, Clarissa M. Giebel, David Jolley, David Challis,
      Pages: 2845 - 2863
      Abstract: AimTo synthesize evidence to identify the components of effective psychosocial interventions in dementia care to inform clinical practice, policy and research.BackgroundWith population ageing, dementia represents a significant care challenge with 60% of people with dementia living at home.DesignOverview of systematic reviews with narrative summary.Data sourcesElectronic searches of published systematic reviews in English using Cochrane Database of Systematic Reviews, DARE and EPPI-Centre, between September 2013 - April 2014.Review methodsSystematic reviews were appraised against Cochrane Collaboration levels of effectiveness. Components of psychosocial interventions were identified with their theoretical rationale. Findings were explored with a Patient, Public and Carer Involvement group.ResultsThirty-six systematic reviews were included. From interventions, 14 components were identified, nine for people with dementia and five for carers, mostly undertaken in nursing/care homes. For people with dementia, there was evidence of effectiveness for cognitive stimulation and cognitive training, but less evidence for sensory stimulation, reminiscence, staff education, behavioural therapy and ADL training. For carers, there was evidence of effectiveness for education and training, psychotherapy and counselling.ConclusionThere was a lack of definitive evidence of effectiveness for most psychosocial interventions. Further studies with stronger methodology or replication of existing studies would strengthen the evidence base. Few interventions were undertaken with people with dementia and their carers living at home. Further work will investigate the extent to which components identified here are present in models of home support for people with dementia and carers and their effectiveness.
      PubDate: 2017-07-07T04:30:31.298945-05:
      DOI: 10.1111/jan.13362
       
  • Uncovering the decision-making work of transferring dying patients home
           from critical care units: An integrative review
    • Authors: Yanxia Lin; Michelle Myall, Nikki Jarrett
      Pages: 2864 - 2876
      Abstract: AimsTo understand how decisions are made to transfer dying patients home from critical care units.BackgroundMany people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear.DesignIntegrative review.Data sourcesSeven bibliographic databases (origin–2015), grey literature and reference lists were searched.Review methodsAn integrative review method was used to synthesize data from diverse sources. Papers were selected through title and abstract screening and full-text reviewing, using inclusion and exclusion criteria derived from review questions. Following quality appraisal, data were extracted and synthesized using normalization process theory as a framework.ResultsThe number of patients transferred home ranged from 1–346, with most papers reporting on the transfer of one or two patients. Four themes regarding transfer decision-making work were generated: divergent views and practice, multiple stakeholders’ involvement in decision-making, collective work and limited understanding of individuals’ experiences.ConclusionThe practice of transferring patients home to die and its decision-making varies internationally and is usually influenced by the care system, culture or religion. It is less common to transfer patients home to die from critical care units in western societies. A better understanding of the decision-making work was obtained but mainly from the perspective of hospital-based healthcare professionals. Further research is needed to develop decision-making practice guidance to facilitate patients’ wishes to die at home.
      PubDate: 2017-07-17T00:00:22.331975-05:
      DOI: 10.1111/jan.13368
       
  • Early warning systems and rapid response to the deteriorating patient in
           hospital: A systematic realist review
    • Authors: Jennifer McGaughey; Peter O'Halloran, Sam Porter, Bronagh Blackwood
      Pages: 2877 - 2891
      Abstract: AimTo determine the Rapid Response System programme theory and investigate how the mechanisms of implementation and the characteristics of context combine to enable or constrain the implementation of Rapid Response Systems and the achievement of desired outcomes.BackgroundRapid Response Systems have been implemented internationally to improve the recognition and management of patient deterioration, reduce the need for cardiopulmonary resuscitation and improve patient outcomes.DesignRealist review.Data sourcesWe searched DARE, CENTRAL, NHSEED, MEDLINE, Medline In Process, EMBASE, CINAHL, PubMed, Scopus, The Web of Science and PychInfo databases from 1997 - 2017 in addition to purposively searching the grey literature looking for articles supporting, refuting or explaining Rapid Response System programme theories.Review methodsIncluded studies were critically appraised and graded using the Critical Appraisal Skills Programme tool. Data extraction and synthesis investigated the Rapid Response System theoretical propositions against the empirical evidence to refine Rapid Response System programme theories.ResultsThe review found that the Rapid Response System programme theory achieved desired outcomes when there were sufficient skills mix of experienced staff, EWS protocols were used flexibly alongside clinical judgement and staff had access to ongoing, multiprofessional, competency-based education. However, ward cultures, hierarchical referral systems, workload and staffing resources had a negative impact on the implementation of the Rapid Response System.ConclusionTo improve the recognition and management of patient deterioration, policymakers need to address those cultural, educational and organizational factors that have an impact on the successful implementation of Rapid Response Systems in practice.
      PubDate: 2017-09-20T05:50:30.794928-05:
      DOI: 10.1111/jan.13398
       
  • Characteristics of highly rated leadership in nursing homes using item
           response theory
    • Authors: Annica Backman; Karin Sjögren, Marie Lindkvist, Hugo Lövheim, David Edvardsson
      Pages: 2903 - 2913
      Abstract: AimTo identify characteristics of highly rated leadership in nursing homes.BackgroundAn ageing population entails fundamental social, economic and organizational challenges for future aged care. Knowledge is limited of both specific leadership behaviours and organizational and managerial characteristics which have an impact on the leadership of contemporary nursing home care.DesignCross-sectional.MethodFrom 290 municipalities, 60 were randomly selected and 35 agreed to participate, providing a sample of 3605 direct-care staff employed in 169 Swedish nursing homes. The staff assessed their managers’ (n = 191) leadership behaviours using the Leadership Behaviour Questionnaire. Data were collected from November 2013 - September 2014, and the study was completed in November 2016. A two-parameter item response theory approach and regression analyses were used to identify specific characteristics of highly rated leadership.ResultsFive specific behaviours of highly rated nursing home leadership were identified; that the manager: experiments with new ideas; controls work closely; relies on subordinates; coaches and gives direct feedback; and handles conflicts constructively. The regression analyses revealed that managers with social work backgrounds and privately run homes were significantly associated with higher leadership ratings.ConclusionThis study highlights the five most important leadership behaviours that characterize those nursing home managers rated highest in terms of leadership. Managers in privately run nursing homes and managers with social work backgrounds were associated with higher leadership ratings. Further work is needed to explore these behaviours and factors predictive of higher leadership ratings.
      PubDate: 2017-07-05T02:05:27.381859-05:
      DOI: 10.1111/jan.13353
       
  • Comparing anger, anger expression, life stress and social support between
           Korean female nursing and general university students
    • Authors: Won Hee Jun; Gyungjoo Lee
      Pages: 2914 - 2922
      Abstract: AimsTo compare anger, anger expression, life stress and social support among female students at a nursing university and a general university and to examine factors affecting anger in each group.BackgroundUniversity students typically experience constant stress resulting from factors like academic requirements, personal relationships and career decisions; this tends to promote anger. Particularly, nursing students’ anger can negatively affect the quality of care that they provide, and also their mental health. Therefore, anger management of nursing students is very important in the training and development of future nurses. Nursing education needs to confirm factors associated with anger of nursing students compared with general university students to develop specific intervention programs for decreasing their anger levels.DesignA descriptive, cross-sectional design was used.MethodsParticipants were 286 female students (146 from a nursing university and 140 from a general university); they completed self-report surveys examining anger, anger expression, life stress and social support. A stepwise multiple regression analysis was done to identify factors affecting anger. Data were collected from 15 May–10 June 2016.Results/FindingsIn the stepwise multiple regression analysis, we entered three anger expression factors, eight life stress factors and social support as explanatory variables; factors affecting anger among nursing students were anger-out and same-sex peer relationship stress. In general university students, anger-out, anger-control and anger-in were identified as factors affecting anger.ConclusionBecoming proficient in beneficial anger expression techniques and reducing stress from same-sex peer relationships will reduce anger among female nursing students.
      PubDate: 2017-06-29T03:30:34.84071-05:0
      DOI: 10.1111/jan.13354
       
  • Registered Nurses’ and nurse assistants’ responses to older persons’
           expressions of emotional needs in home care
    • Authors: Jessica Höglander; Jakob Håkansson Eklund, Hilde Eide, Inger K Holmström, Annelie J Sundler
      Pages: 2923 - 2932
      Abstract: AimThis study aims to explore nurse assistants’ and Registered Nurses’ responses to older persons’ expressions of emotional needs during home care visits.BackgroundCommunication is a central aspect of care. Older persons might express different emotions and needs during home care visits and such expressions can be challenging to respond to. Little is known about communication in home care or nursing staff responses to older persons’ expressed emotional needs.DesignDescriptive, cross-sectional design on nursing staff responses to older persons’ negative emotions in home care.MethodsCollected data consisted of audio recordings of home care visits between older persons and nursing staff. Data were collected between August 2014–November 2015. The nursing staff responses to older persons’ negative emotions in the communication were analysed with the Verona Coding Definitions of Emotional Sequences (VR-CoDES).ResultsThe nursing staff most often give non-explicit responses, providing space for further disclosure of older persons’ expressed negative emotions. Such responses were more frequent if the nursing staff had elicited the older persons’ expressions of a negative emotion than if such expressions were elicited by the older persons themselves. Most frequent types of responses were backchannel, active invitation or information advice.ConclusionThe nursing staff responses were mainly non-explicit responses providing space for older persons to tell more about their experiences. Such responses can be discussed in terms of person-centred communication and is important for the comfort of emotional concerns.
      PubDate: 2017-07-05T02:00:43.396253-05:
      DOI: 10.1111/jan.13356
       
  • Acute fatigue predicts sickness absence in the workplace: A 1-year
           retrospective cohort study in paediatric nurses
    • Authors: Knar Sagherian; George J. Unick, Shijun Zhu, Debra Derickson, Pamela S. Hinds, Jeanne Geiger-Brown
      Pages: 2933 - 2941
      Abstract: AimsTo examine the relationship between fatigue and sickness absence in nurses from a paediatric hospital over 12 months of follow-up. A secondary aim was to identify other work and personal factors that predict sickness absence.BackgroundSickness absence is often related to worker-fatigue, yet few studies have explored this relationship in nurses despite documented high fatigue levels.DesignThe study used retrospective cohort design.MethodsBaseline data on 40 nurses from an intervention study were linked to absence data using the hospital's attendance records (2012–2013). A total of 6,057 work shifts were studied of which 5.2% were absence episodes. Fatigue was measured by the Occupational Fatigue Exhaustion Recovery scale. The questionnaire included instruments assessing sleep disturbances, workload and personal characteristics. Generalized linear mixed models were used to test the associations between fatigue, work, personal factors and sickness absence, while accounting for non-independency of repeated measures.ResultsWith 1SD increase in acute fatigue scores, nurses were 1.29 times more likely to be absent from work. Factors such as intershift recovery, perceived workload, obstructive sleep apnoea and marital status also predicted sickness absence, that is, with 1SD increase in workload scores, nurses were 1.23 times more likely to be absent from work. Nurses with obstructive sleep apnoea had two times higher odds of sickness absence.ConclusionSickness absence is related to acute fatigue in paediatric nurses and to workload. Nursing leaders can monitor these factors to reduce sickness absence and screen for sleep apnoea and assist nurses in receiving the appropriate treatments.
      PubDate: 2017-07-05T01:50:53.033393-05:
      DOI: 10.1111/jan.13357
       
  • The association between the physical environment and the well-being of
           older people in residential care facilities: A multilevel analysis
    • Authors: Susanna Nordin; Kevin McKee, Helle Wijk, Marie Elf
      Pages: 2942 - 2952
      Abstract: AimsTo investigate the associations between the quality of the physical environment and the psychological and social well-being of older people living in residential care facilities.BackgroundMany older people in care facilities have cognitive and physical frailties and are at risk of experiencing low levels of well-being. High-quality physical environments can support older people as frailty increases and promote their well-being. Although the importance of the physical environment for residents’ well-being is recognized, more research is needed.DesignA cross-sectional survey of 20 care facilities from each of which 10 residents were sampled. As the individual resident data were nested in the facilities, a multilevel analysis was conducted.MethodsData were collected during 2013 and 2014. The care facilities were purposely sampled to ensure a high level of variation in their physical characteristics. Residents’ demographic and health data were collected via medical records and interviews. Residents’ well-being and perceived quality of care were assessed via questionnaires and interviews. Environmental quality was assessed with a structured observational instrument.ResultsMultilevel analysis indicated that cognitive support in the physical environment was associated with residents’ social well-being, after controlling for independence and perceived care quality. However, no significant association was found between the physical environment and residents’ psychological well-being.ConclusionOur study demonstrates the role of the physical environment for enhancing the social well-being of frail older people. Professionals and practitioners involved in the design of care facilities have a responsibility to ensure that such facilities meet high-quality specifications.
      PubDate: 2017-07-07T04:25:32.350689-05:
      DOI: 10.1111/jan.13358
       
  • From intention to STI prevention: An online questionnaire on barriers and
           facilitators for discussing sexual risk behaviour among HIV nurses
    • Authors: Suzanne de Munnik; Sigrid C.J.M. Vervoort, Heidi S.M. Ammerlaan, Gerjo Kok, Chantal Daas
      Pages: 2953 - 2961
      Abstract: AimsWe aimed to elucidate facilitators and barriers that HIV nurses experience in discussing sexual risk behaviour with HIV-positive men who have sex with men, using variables from a previous qualitative study and the theory of planned behaviour.BackgroundHIV-positive men who have sex with men are frequently diagnosed with sexually transmitted infections, which can be reduced if HIV nurses discuss sexual risk behaviour.DesignAn online questionnaire was disseminated in April 2015 among all HIV nurses in the Netherlands.MethodsWe assessed variables, such as attitudes, shame, ability, knowledge and time concerns. A regression analysis was conducted with “intention to discuss sexual risk behaviour” as an outcome variable.ResultsThe questionnaire was completed by 60 of 79 HIV nurses. Overall, participants reported high intentions to discuss sexual risk behaviour, and 38% of the variance was explained by attitude, sexual preference, knowing ways to introduce the topic and experiencing enough time or viewing it as a priority. In addition, high intenders significantly differed from low intenders in “experienced shame,” “relation with patients,” “non-verbal communication,” “subjective norm” and “knowledge.”ConclusionImproving sexual health in HIV care translates into improving opportunities and the facilitating factors in initiating the discussion of sexual risk behaviour rather than removing barriers HIV nurses experience. Interventions should mainly focus on improving the HIV nurses’ perceived ability to initiate the topic of sexual risk behaviour and to utilize the jargon and terminology that is commonly used among men who have sex with men.
      PubDate: 2017-08-01T05:15:50.228925-05:
      DOI: 10.1111/jan.13372
       
  • Balancing competing needs mediates the association of caregiving demand
           with caregiver role strain and depressive symptoms of dementia caregivers:
           A cross-sectional study
    • Authors: Hsin-Yun Liu; Ching-Tzu Yang, Yu-Nu Wang, Wen-Chuin Hsu, Tzu-Hsin Huang, Yueh-E Lin, Chin-Yi Liu, Yea-Ing L. Shyu
      Pages: 2962 - 2972
      Abstract: AimsTo examine the role of balancing competing needs in the relationship between caregiving demand and caregiving outcomes (caregivers’ role strain and depressive symptoms).BackgroundCaregivers who do not balance competing needs are more likely to experience negative caregiving outcomes, suggesting that balance mediates between caregiving demand and caregiving outcomes. Identifying a mediator of negative caregiving effects may help in developing tailored interventions for family caregivers of persons with dementia.DesignA cross-sectional, correlational design.MethodsData were collected from family caregivers’ self-completed questionnaires between March 2013 - April 2014. A convenience sample of 120 family caregivers and care receivers with dementia was enrolled. We examined whether balance mediated the relationship between caregiving demand and caregiving outcomes (caregivers’ role strain and depressive symptoms) by multiple regression analysis. To evaluate the significance of the indirect effect of caregiver balance, we used the Sobel test and Monte Carlo method, an alternative approach to testing mediation.ResultsBalancing competing needs completely mediated the association of caregiving demand with depressive symptoms and partially mediated the association of caregiving demand with role strain.ConclusionAssessing caregivers’ self-perceived sense of balance may help to identify caregivers at high risk for role strain and depressive symptoms. Interventions to enhance caregivers’ perceived sense of balance between competing needs may provide a strategy for reducing the negative effects of caregiving.
      PubDate: 2017-08-17T05:25:36.531188-05:
      DOI: 10.1111/jan.13379
       
  • Resilience as a moderator of the indirect effects of conflict and workload
           on job outcomes among nurses
    • Authors: Julie Jean Lanz; Valentina Bruk-Lee
      Pages: 2973 - 2986
      Abstract: AimTo examine the relative effects of interpersonal conflict and workload on job outcomes (turnover intentions, burnout, injuries) and examine if resilience moderates the indirect effects of conflict and workload on job outcomes via job-related negative effect.BackgroundThere is interest in understanding resilience in the nursing profession. Placing resilience in the context of the Emotion-Centred Model of Occupational Stress (Spector, ) is a novel approach to understanding how resilience ameliorates the negative effects of workplace stressors.DesignThis study used a two-wave survey design to collect data from 97 nurses across medical units.MethodsNurses working in the US were recruited in June 2014 using Qualtrics Panels, an online survey platform service that secures participants for research. Nurses were contacted via email at two time points, two weeks apart and provided a link to an online survey. SPSS v. 23 and PROCESS v2.15 were used to analyse regressions and moderated mediation.Results/FindingsInterpersonal conflict predicted turnover intentions and burnout; workload predicted injuries. Job-related negative affect mediated the relationships between stressors and job outcomes except for the direct effect of workload on injuries. Low resilience increased the magnitude of the indirect effects of conflict on job outcomes.ConclusionJob characteristics like workload predicted unique variability in self-reported physical injuries. Conflict at work, a social stressor, predicted well-being and job attitudes. Highly resilient nurses bounced back after experiencing conflict in the workplace. Resilience should be explored for its potential as a method to reduce the negative effects of social stressors.
      PubDate: 2017-08-15T02:30:36.331543-05:
      DOI: 10.1111/jan.13383
       
  • First-time fathers’ postnatal experiences and support needs: A
           descriptive qualitative study
    • Authors: Shefaly Shorey; Cindy-Lee Dennis, Shiho Bridge, Yap Seng Chong, Eleanor Holroyd, Hong-Gu He
      Pages: 2987 - 2996
      Abstract: AimTo explore first-time fathers’ postnatal experiences and support needs in the early postpartum period.BackgroundThe postnatal period is a stressful transition period for new fathers. It is imperative to understand their needs and experiences to provide appropriate support for them. The majority of previous studies were based in Western countries and explored fathers’ needs during pregnancy and childbirth, with few studies conducted in the postnatal period. In Singapore, a multiracial society with differing paternal cultural values from its Western counterparts, there is considerable need to examine the experiences and needs of first-time fathers.DesignA descriptive qualitative design was used.MethodsData were collected from November 2015–January 2016. Fifteen first-time fathers were recruited from two postnatal wards of a public hospital, using a purposive sampling method. A semi-structured interview guide was used to conduct face-to-face interviews. A thematic analysis was conducted and ethics approval was sought for this study.ResultsFour overarching themes and seventeen subthemes were generated. The four overarching themes were: (1) No sense of reality to sense of responsibility; (2) Unprepared and challenged; (3) Support: needs, sources, experience and attitude; and (4) Future help for fathers.ConclusionFathers undergo a transition phase where they have unmet support needs during the early postnatal period. Understanding and addressing these needs may facilitate smooth transition to fatherhood. This study's findings can be used to involve fathers and design future supportive educational programs to promote positive parenting experiences and family dynamics.
      PubDate: 2017-06-21T03:30:46.533807-05:
      DOI: 10.1111/jan.13349
       
  • A narrative evaluation of a community-based nurse navigation role in an
           urban at-risk community
    • Authors: Janice Feather; Nancy Carter, Ruta Valaitis, Helen Kirkpatrick
      Pages: 2997 - 3006
      Abstract: AimsTo explore community members’ stories of their experiences with a Nurse Navigator programme serving an urban neighbourhood and primary care practice to address persistent health and social barriers adversely affecting health equity and well-being.BackgroundIn response to striking health and social inequalities existing across neighbourhoods in a large southern city in Ontario, Canada, a pilot programme was designed to improve health and social outcomes in a specific “at-risk” neighbourhood. The programme includes nurse-led navigation support for individuals and families and networking to facilitate improved service integration at a systems level.DesignA narrative inquiry approach based on the Three-Dimensional Narrative Inquiry Space method, as described by Clandinin & Connelly (Narrative inquiry: Experience and story in qualitative research, ).MethodsA thematic analysis of nine community members’ life stories from narrative semi-structured interviews (January–June 2014) in conjunction with field notes, observations and documents. Participants’ life stories created a common narrative of the experience of navigation in a community setting.FindingsThere were four main themes: “opening the door”; “more than just a conversation”; “making connections”; and “on a new trajectory”. Participants valued the development of a therapeutic relationship, which optimized social inclusion, barrier reduction and connectivity to supportive health and social services.ConclusionsThe relational process of navigation as an antecedent to barrier reduction has direct implications for programme development, continuing education of navigators and quality improvement of existing navigation services. Study findings have implications for development of navigation competencies for nurses working with priority populations to address health inequities.
      PubDate: 2017-06-29T03:21:19.611124-05:
      DOI: 10.1111/jan.13355
       
  • The perceptions of key stakeholders of the roles of specialist and
           advanced nursing and midwifery practitioners
    • Authors: Mary Casey; Laserina O'Connor, Emma Nicholson, Rita Smith, Denise O'Brien, Denise O'Leary, Gerard M Fealy, Martin S Mcnamara, Diarmuid Stokes, Claire Egan
      Pages: 3007 - 3016
      Abstract: AimTo explore the perceptions of key stakeholders of the roles of specialist and advanced nursing and midwifery practitioners.BackgroundThere is evidence that the contribution of these roles to patient care is poorly understood.DesignThis research took place over 2 months in 2015 and is part of a larger study involving a rapid review to inform policy development on the specialist and advanced nursing and midwifery practice in Ireland. As an added value, a qualitative element involving thematic analysis was undertaken with key stakeholders.MethodsA phenomenological qualitative study was conducted incorporating semi-structured interviews with key stakeholders (n = 15). Purposive sampling with maximum diversity was used to recruit a wide range of perspectives.FindingsParticipant's perspectives led to seven themes: Impact of these roles; role preparation, experience and organizational support; specialist and advanced practice roles in an interdisciplinary context; different folks but not such different roles; impact of specialist and advanced practice roles on patient outcomes; barriers and facilitators to enacting specialist and advanced practice roles; future development of these roles.ConclusionThere is acknowledgement of the positive impact of specialist and advanced practitioners; however, the evidence is currently not conclusive. Preparation for these roles needs to reflect changes in the calibre of today's professional applicants, and organizational support is paramount to their successful execution. The contribution of their activity to patient outcome needs to be made visible to enhance these roles and to justify the development of new roles across a variety of healthcare areas.
      PubDate: 2017-07-12T20:00:31.581654-05:
      DOI: 10.1111/jan.13359
       
  • Ethics, intimacy and sexuality in aged care
    • Authors: Catherine Cook; Vanessa Schouten, Mark Henrickson, Sandra McDonald
      Pages: 3017 - 3027
      Abstract: AimTo analyse the accounts of staff, family and residents to advance ethical insights into intimacy and sexuality in residential care.BackgroundDiscourses of ageing readily construct people in residential aged care as postsexual, vulnerable and at risk of sexual exploitation, and therefore, expressions of intimacy and sexuality may be responded to as deviant and inherently risky. Staff may manage decision-making tacitly, without recourse to policies and education.DesignThe proof-of-concept study used a discursive methodology, identifying discourses that shape diverse meanings of intimacy, sexuality and ageing. Data analysis involved thematic analysis.MethodsSemi-structured interviews were conducted with four participants in 2015 as part of a mixed-methods study. This article reports on the qualitative data.ResultsFour themes were identified in the data analysis: mediated intimate relationships and everyday ethics; self-referential morality; knowing the person then and now; and juggling ethical priorities. Data indicated that participants used their personal moral compass to inform their decision-making, without any related policies and applied ethics and communication education. As a result, staff described moral uncertainty and moral distress. Staff indicated that there were tensions in terms of the role of proxy decision-makers, as there were situations where staff believed they were more aware of residents’ current wishes and cognitive capabilities than family members.ConclusionsStaff, families and residents routinely address intimacy and sexuality in aged care. Ethically informed education and policies may enhance the role of staff as advocates, ensuring older people living in RAC are as at home and autonomous as possible.
      PubDate: 2017-07-16T23:55:20.121322-05:
      DOI: 10.1111/jan.13361
       
  • The embodied nurse: Interdisciplinary knowledge exchange between
           compassionate nursing and recent developments in embodied leadership
           studies
    • Authors: Kushwanth Koya; Jane Anderson, Petia Sice
      Pages: 3028 - 3040
      Abstract: AimsTo report a potential knowledge exchange between nursing studies and the results obtained from a study conducted into the attributes of embodied leadership.BackgroundLeadership theories have been applied to evaluate, improve, and train nursing practitioners in several previous studies. However, leadership research has entered a new phase where the focus is to produce sustainable leaders through authenticity and compassion, the same two characteristics identified as being of most success in emergent nursing practice. There are few studies that have indicated a knowledge exchange between the latest developments in leadership studies and nursing.DesignAn exploratory and qualitative study.MethodsBetween February 2012 - July 2012, a focused sample of 14 medical care professionals was interviewed across a chain of hospitals. The aim was to evaluate embodied leadership characteristics and understand the factors that contribute to the manifestation of these characteristics. The transcribed interviews were analysed using thematic analysis.FindingsSeveral factors that contribute to the characteristics of embodied leadership have been identified in the interviews and in subsequent literature searches on the characteristics and contributing factors found to be associated with nursing research. These could prompt a knowledge exchange.ConclusionThe results suggest common ground between nursing and contemporary leadership research in the exposition of behaviours; namely, being non-judgmental, listening actively, reflective practice and embracing uncertainty. Several implications can therefore be expected through the exchange of knowledge resulting from collaboration between researchers in the two disciplines.
      PubDate: 2017-07-20T03:15:36.398297-05:
      DOI: 10.1111/jan.13363
       
  • Women's expectations and experiences of rupture of membranes and views of
           the potential use of reagent pads for detecting amniotic fluid
    • Authors: Helen Spiby; Sara Borrelli, Anita J Hughes
      Pages: 3041 - 3049
      Abstract: AimsTo explore first-time mothers’ expectations and experiences regarding rupture of membranes at term and their views on the potential use of reagent pads that detect amniotic fluid.BackgroundThere is little information available on women's experiences of spontaneous rupture of membranes, or interest in using methods to confirm rupture of membranes (e.g. reagent pads).DesignDescriptive qualitative study, using focus groups and telephone interviews with women during pregnancy and after the birth of their first baby. Thematic analysis was undertaken to analyse women's responses.MethodsEthics committee approval was obtained. Twenty-five women participated in the study of whom 13 contributed both during pregnancy and postpartum between October 2015–March 2016.FindingsThree overarching themes were identified from the data from women's expectations and experiences: uncertainty in how, when and where membranes may rupture; information which was felt to be limited and confirmation of rupture of membranes. The potential use of reagent pads met with varied responses.ConclusionWomen were interested in having facts and figures regarding rupture of membranes, such as characteristics of liquor; volume and probability of membranes rupturing spontaneously at term. Use of a pad as a means of confirmation was viewed as helpful, although the potential for increasing anxiety was raised.
      PubDate: 2017-07-16T23:45:19.78095-05:0
      DOI: 10.1111/jan.13365
       
  • Nurse managers: Determinants and behaviours in relation to patient and
           visitor aggression in general hospitals. A qualitative study
    • Authors: Birgit Heckemann; Karin A Peter, Ruud JG Halfens, Jos MGA Schols, Gerjo Kok, Sabine Hahn
      Pages: 3050 - 3060
      Abstract: Aim(s)To explore nurse managers’ behaviours, attitudes, perceived social norms, and behavioural control in the prevention and management of patient and visitor aggression in general hospitals.BackgroundPatient and visitor aggression in general hospitals is a global problem that incurs substantial human suffering and organizational cost. Managers are key persons for creating low-aggression environments, yet their role and behaviours in reducing patient and visitor aggression remains unexplored.DesignA qualitative descriptive study underpinned by the Reasoned Action Approach.Method(s)Between October 2015–January 2016, we conducted five focus groups and 13 individual interviews with nurse leaders in Switzerland. The semi-structured interviews and focus groups were recorded, transcribed, and analysed in a qualitative content analysis.FindingsWe identified three main themes: (i) Background factors: “Patient and visitor aggression is perceived through different lenses”; (ii) Determinants and intention: “Good intentions competing with harsh organizational reality”; (iii) Behaviours: “Preventing and managing aggressive behaviour and relentlessly striving to create low-aggression work environments”.Conclusion(s)Addressing patient and visitor aggression is difficult for nurse managers due to a lack of effective communication, organizational feedback loops, protocols, and procedures that connect the situational and organizational management of aggressive incidents. Furthermore, tackling aggression at an organizational level is a major challenge for nurse managers due to scant financial resources and lack of interest. Treating patient and visitor aggression as a business case may increase organizational awareness and interest. Furthermore, clear communication of expectations, needs and resources could optimize support provision for staff.
      PubDate: 2017-07-16T23:50:37.028836-05:
      DOI: 10.1111/jan.13366
       
  • Pain associated with pressure injury: A qualitative study of
           community-based, home-dwelling individuals
    • Authors: Debra Jackson; Lisa Durrant, Emily Bishop, Helen Walthall, Ria Betteridge, Sarah Gardner, Wendy Coulton, Marie Hutchinson, Stephen Neville, Patricia M. Davidson, Kim Usher
      Pages: 3061 - 3069
      Abstract: AimsThe aim of this study was to provide deep insights into the pain associated with pressure injuries in home-dwelling individuals using narrative accounts.BackgroundPressure injuries or pressure ulcers are burdensome and costly. Prevalence data, surveys and systematic reviews demonstrate that pain associated with pressure injury is widespread, but voices of home-dwelling patients have remained largely unheard.DesignConcurrent mixed methods case study of a UK community of approximately 50,000 adults.MethodsQualitative interviews, conducted in 2016, of 12 home-dwelling adult participants with a current pressure injury (n = 10), or a recently healed pressure injury (n = 2).FindingsPain had an adverse impact on activities of daily living, mobility and sleep. Participants described days that were clouded in pain; a pain they felt was poorly understood and often out of control. Thematic content analysis revealed two major themes; these are: Poorly controlled pain: “I just want the pain to go away”; and, Uncertainty for the future: “it almost seems insurmountable.”ConclusionFindings of our study support the need to develop an appropriate assessment tool for pressure injury patients in the community to enable healthcare professionals and patients to recognize and manage pressure injury-related pain effectively.
      PubDate: 2017-07-26T04:05:24.4463-05:00
      DOI: 10.1111/jan.13370
       
  • Visual methods in health dialogues: A qualitative study of public health
           nurse practice in schools
    • Authors: Hilde Laholt; Marilys Guillemin, Kim Mcleod, Randi Elisabeth Olsen, Geir Fagerjord Lorem
      Pages: 3070 - 3078
      Abstract: AimsWe aimed to explore how using visual methods might improve or complicate the dynamics of the health dialogue between public health nurses (PHNs) and school pupils. This was done from the perspective of PHNs, specifically examining how they understood their role and practice as a PHN and the application of visual methods in this practice.BackgroundThe health dialogue is a method used by PHNs in school nursing in Norway. In this practice, there can be communicative barriers between pupils and PHNs. Investigating how PHNs understand their professional practice can lead to ways of addressing these communicative barriers, which can affect pupil satisfaction and achievement of health-related behaviours in the school context. Specifically, the use of visual methods by PHNs may address these communicative barriers.DesignThe research design was qualitative, using focus groups combined with visual methods.MethodsWe conducted focus group interviews using a semi-structured discussion guide and visual methods with five groups of PHNs (n = 31) working in northern Norwegian school health services. The data were collected during January and February 2016. Discussions were audio recorded, transcribed and coded into themes and sub-themes using systematic text condensation and drawings were analysed using interpretive engagement, a method of visual analysis.FindingsDrawings and focus group discussions showed that PHNs perceived their professional practice as primarily a relational praxis. The PHNs used a variety of visual methods as part of the health dialogue with school pupils. This active use of visualization worked to build and strengthen relations when words were inadequate and served to enhance the flexible and relational practice employed by the PHNs.ConclusionsPHNs used different kinds of visualization methods to establish relations with school pupils, especially when verbalization by the pupils was difficult. PHNs were aware of both the benefits and challenges of using visualization with school pupils in health education. We recommend the use of visual methods in schools because they are useful for PHNs, other health professionals and teachers working with children and young people in developing relations, particularly where verbal communication may be a challenge.
      PubDate: 2017-08-04T06:40:32.104968-05:
      DOI: 10.1111/jan.13371
       
  • Coping strategies and social support needs of experienced and
           inexperienced nurses performing shiftwork
    • Authors: Jane Gifkins; Rebecca Loudoun, Amy Johnston
      Pages: 3079 - 3089
      Abstract: AimThe aim of this investigation was to compare perceptions of nurses exposed to short or longer term shift work and their experiences working under this type of scheduling.BackgroundShift work is a crucial component of nurses' working lives, ensuring continuous care for patients. This study fills a research gap around the personal experiences of shift working nurses and the strategies used to manage the impacts of shift work.DesignQualitative case study design.MethodsConstructivist methodology, including in-depth semi-structured interviews conducted in 2015, was used for the study. Iterative review and inductive analysis of transcripts from nine recently graduated nurses and twelve experienced nurses enabled identification and verification of key themes.FindingsThree main areas of difference between new and experienced nurses relating to shift work challenges in a nursing environment emerged: perceptions about the utility of working in shifts, coping strategies and social support at home and work. Most experienced nurses found shift work advantageous, especially those with dependents. Coping strategies included flexible shift arrangements in both groups. Experienced nurses detailed the importance of support from family and friends while inexperienced nurses described feeling disconnected from social supports. Experienced nurses cited a lack of support from nursing managers as problematic.ConclusionsFindings suggest shift selection mitigated challenges of shift work for both inexperienced and experienced nurses, indicating autonomous roster selection is critical. Similarly, social support at work from senior nurses and management and at home played an important role in nurses' coping.
      PubDate: 2017-07-28T06:05:33.867398-05:
      DOI: 10.1111/jan.13374
       
  • Handing over patients from the ICU to the general ward: A focused
           ethnographical study of nurses' communication practice
    • Authors: Gitte Bunkenborg; Tina Bitsch Hansen, Bibi Hølge-Hazelton
      Pages: 3090 - 3101
      Abstract: AimTo explore nursing practice and perception of engaging in communicative interaction when handing over multi-morbid patients from the ICU to general medical or surgical wards.BackgroundCommunication failures impose risks to patient safety. ICU and general ward nurses communicate in writing and verbally when handing over patients from one setting to another. A deeper understanding of nurses' communicative interaction and of nurses' perception of their interaction is crucial to facilitate clinical interventions focusing to improve patient safety.DesignAn explorative, qualitative design using focused ethnography was applied to the study.MethodsParticipant observation of 22 clinical situations of handing over patients from the ICU to general wards was conducted in November and December 2015, followed by five focus group interviews, three interviews with general ward nurses and two with ICU nurses in January–February 2016. Observation notes and interview transcripts were analysed using content analysis.FindingsThe theme “Communicative interaction as a process of sharing and adopting ownership” and the subtheme “Communicative interaction influenced by nurses individual expectations towards patient status and the handing over process” emerged from observation notes. From transcribed focus group interviews, the theme “Balancing and negotiating when passing on, consuming and adapting knowledge” was identified.ConclusionA lack of shared goals regarding handing over patients from a high monitoring unit to general wards causes communicative and collaborative difficulties, loss of information and potential risks to patients. Organizational attention in relation to ICU discharge is crucial to improve collaboration, communication and patient safety.
      PubDate: 2017-08-14T02:40:20.72971-05:0
      DOI: 10.1111/jan.13377
       
  • Austerity, new public management and missed nursing care in Australia and
           New Zealand
    • Authors: Eileen Willis; Jenny Carryer, Clare Harvey, Maria Pearson, Julie Henderson
      Pages: 3102 - 3110
      Abstract: AimsTo outline the way the culture of austerity arising from the Global Financial Crisis has been used by Australian and New Zealand governments to maintain and extend healthcare budget cuts, through new public management strategies leading to missed nursing care.BackgroundTen years on the cost of the Global Financial Crisis continues to be borne by tax payers and those employed by the welfare state, yet analysis shows clearly that it was caused by a failure to adequately regulate markets, particularly the banks and multinational corporations. In health care, one of the impacts is increased workload for nurses leading to missed care.Design/MethodsRegistered Nurses and midwives (n = 7,302) completed the MISSCARE surveys between 2012 - 2015, in four Australian states and New Zealand providing quantitative and qualitative responses. The qualitative comments were analysed using a template analysis approach based on key features of New Public Management.FindingsSixty-two qualitative responses identified measures in place directly linked to austerity and new public management strategies that impacted on the quality of patient care and nursing work, as well as contributing to missed care.ConclusionOpportunities for resistance may lie outside public and private health organizations in civil society, in the nurse union movements and other health and nursing professional associations.
      PubDate: 2017-08-14T02:45:19.693227-05:
      DOI: 10.1111/jan.13380
       
  • Enactors of horizontal violence: The pathological bully, the
           self-justified bully and the unprofessional co-worker
    • Authors: Rosemary A. Taylor; Steven S. Taylor
      Pages: 3111 - 3118
      Abstract: AimTo suggest an alternative approach to improving recognition of horizontal violence using enactor types identified in a study exploring nurses’ perceptions of horizontal violence.BackgroundHorizontal violence is an umbrella term used to describe a range of aggressive behaviours between nurse colleagues. It is suggested that nurses do not recognize the phenomenon when they witness or experience it, contributing to its perpetuation.DesignThis was a qualitative, descriptive study undertaken to inform theory development and the design of future interventions to address horizontal violence.MethodObservation, document review and semi-structured interviews took place in two inpatient hospital units in the Northeastern United States between June - November 2012. Ongoing analysis identified three distinct types of enactors of horizontal violence.FindingsNurse participants rarely used terms from hospital policies or nursing literature to describe behaviours associated with horizontal violence but identified behaviours by describing the attributes of the enactor and the situation. Three enactor types were disaggregated from the data: the pathological bully, the self-justified bully and the unprofessional co-worker.ConclusionFindings support previous research suggesting nurses do not recognize aggressive behaviours when they witness or experience them and do not have a name for those who enact these behaviours. This disaggregation of enactors of horizontal violence into recognizable types introduces an alternative approach to addressing the phenomenon. Development of instruments to identify these enactors, as well as testing of these instruments, is required to establish the utility of this disaggregation in nursing practice and in designing future interventions.
      PubDate: 2017-08-04T06:45:19.023216-05:
      DOI: 10.1111/jan.13382
       
  • Early warning systems and rapid response to the deteriorating patient in
           hospital: A realist evaluation
    • Authors: Jennifer McGaughey; Peter O'Halloran, Sam Porter, John Trinder, Bronagh Blackwood
      Pages: 3119 - 3132
      Abstract: AimTo test the Rapid Response Systems programme theory against actual practice components of the Rapid Response Systems implemented to identify those contexts and mechanisms which have an impact on the successful achievement of desired outcomes in practice.BackgroundRapid Response Systems allow deteriorating patients to be recognized using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff.DesignRealist evaluation.MethodsThe research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation. We used various mixed methods including individual and focus group interviews, observation of nursing practice between June–November 2010 and document analysis of Early Warning Systems audit data between May–October 2010 and hospital acute care training records over 4.5 years from 2003–2008. Data were analysed using NiVivo8 and SPPS.ResultsA cross-case analysis highlighted similar patterns of factors which enabled or constrained successful recognition, referral and response to deteriorating patients in practice. Key enabling factors were the use of clinical judgement by experienced nurses and the empowerment of nurses as a result of organizational change associated with implementation of Early Warning System protocols. Key constraining factors were low staffing and inappropriate skill mix levels, rigid implementation of protocols and culturally embedded suboptimal communication processes.ConclusionSuccessful implementation of Rapid Response Systems was dependent on adopting organizational and cultural changes that facilitated staff empowerment, flexible implementation of protocols and ongoing experiential learning.
      PubDate: 2017-08-23T02:07:09.643878-05:
      DOI: 10.1111/jan.13367
       
  • Does age matter' A mixed methods study examining determinants of good
           recovery and resilience in young and middle-aged adults following
           moderate-to-severe traumatic brain injury
    • Authors: Caroline Arbour; Nadia Gosselin, Marie-Josée Levert, Jérôme Gauvin-Lepage, Bernard Michallet, Hélène Lefebvre
      Pages: 3133 - 3143
      Abstract: AimTo examine whether age contributes to functional recovery and resilience after moderate-to-severe traumatic brain injury.BackgroundThe ability to recover may change across the lifespan, but the influence of age on brain injury outcome is understudied.DesignMixed methods study.MethodsAll adults of working age (18–64 years) discharged from a level I trauma centre between 2010–2013 after sustaining a moderate-to-severe traumatic brain injury were considered. Functional recovery was assessed during a telephone interview with the Glasgow Outcome Scale-Extended 12–36 months postinjury. A subgroup completed the Connor-Davidson Resilience Scale and a face-to-face interview about resilience.ResultsNinety-seven young (mean age: 27 years; 75% male) and 47 middle-aged brain trauma survivors (mean age: 53 years; 75% male) completed the telephone interview. Eight young and five middle-aged adults were also assessed for resilience. Overall, young participants experienced more severe head injuries. Yet, they achieved slightly higher levels of functional recovery compared with middle-aged ones as per the Glasgow Outcome Scale-Extended. Controlling for CT scan findings and posttraumatic amnesia duration, age was not found to be associated to functional recovery in adults of working age. Although both groups showed similar levels of resilience, young participants discussed the challenges related to “having more time on their hands” and “being a changed person”, two elements perceived positively by middle-aged ones.ConclusionWhile age does not appear to interfere with functional recovery in adults of working age, younger brain trauma survivors could benefit from nursing interventions to strengthen their resilience process related to re-employment orientation and identity.
      PubDate: 2017-08-01T05:31:37.258354-05:
      DOI: 10.1111/jan.13376
       
  • Recognizing European cancer nursing: Protocol for a systematic review and
           meta-analysis of the evidence of effectiveness and value of cancer nursing
           
    • Authors: Pauline Campbell; Claire Torrens, Daniel Kelly, Andreas Charalambous, Nuria Domenech-Climent, Iveta Nohavova, Ulrika Östlund, Elisabeth Patiraki, David Salisbury, Lena Sharp, Theresa Wiseman, Wendy Oldenmenger, Mary Wells
      Pages: 3144 - 3153
      Abstract: AimTo identify, appraise and synthesize the available evidence relating to the value and impact of cancer nursing on patient experience and outcomes.BackgroundThere is a growing body of literature that recognizes the importance and contribution of cancer nurses, however, a comprehensive review examining how cancer nurses have an impact on care quality, patient outcomes and overall experience of cancer, as well as cost of services across the entire cancer spectrum is lacking.DesignA systematic review and meta-analysis using Cochrane methods.MethodsWe will systematically search 10 electronic databases from 2000, with pre-determined search terms. No language restrictions will be applied. We will include all randomized and controlled before-and-after studies that compare cancer nursing interventions to a standard care or no intervention. Two reviewers will independently assess the eligibility of the studies and appraise methodological quality using the Cochrane Risk of Bias tool. Disagreements will be resolved by discussion and may involve a third reviewer if necessary. Data from included studies will be extracted in accordance with the Template for intervention Description and Replication reporting guidelines. Missing data will be actively sought from all trialists. Data will be synthesized in evidence tables and narrative to answer three key questions. If sufficient data are available, we will perform meta-analyses.DiscussionThis review will allow us to systematically assess the impact of cancer nursing on patient care and experience. This evidence will be used to determine implications for clinical practice and used to inform future programme and policy decisions in Europe.
      PubDate: 2017-08-25T05:40:58.252565-05:
      DOI: 10.1111/jan.13392
       
  • Which priority indicators to use to evaluate nursing care performance'
           A discussion paper
    • Authors: Carl-Ardy Dubois; Danielle D'amour, Isabelle Brault, Clémence Dallaire, Johanne Déry, Arnaud Duhoux, Mélanie Lavoie-Tremblay, Luc Mathieu, Hermès Karemere, Arnaud Zufferey
      Pages: 3154 - 3167
      Abstract: AimsA discussion of an optimal set of indicators that can be used on a priority basis to assess the performance of nursing care.BackgroundRecent advances in conceptualization of nursing care performance, exemplified by the Nursing Care Performance Framework, have revealed a broad universe of potentially nursing-sensitive indicators. Organizations now face the challenge of selecting, from this universe, a realistic subset of indicators that can form a balanced and common scorecard.DesignDiscussion paper drawing on a systematic assessment of selected performance indicators.Data sourcesPrevious works, based on systematic reviews of the literature published between 1990 - 2014, have contributed to the development of the Nursing Care Performance Framework. These works confirmed a robust set of indicators that capture the universe of content currently supported by the scientific literature and cover all major areas of nursing care performance. Building on these previous works, this study consisted in gathering the specific evidence supporting 25 selected indicators, focusing on systematic syntheses, meta-analyses and integrative reviews.Implications for nursingThis study has identified a set of 12 indicators that have sufficient breadth and depth to capture the whole spectrum of nursing care and that could be implemented on a priority basis.ConclusionsThis study sets the stage for new initiatives aiming at filling current gaps in operationalization of nursing care performance. The next milestone is to set up the infrastructure required to collect data on these indicators and make effective use of them.
      PubDate: 2017-08-01T05:21:07.392798-05:
      DOI: 10.1111/jan.13373
       
  • The use of advanced web-based survey design in Delphi research
    • Authors: Christopher Helms; Anne Gardner, Elizabeth McInnes
      Pages: 3168 - 3177
      Abstract: AimA discussion of the application of metadata, paradata and embedded data in web-based survey research, using two completed Delphi surveys as examples.BackgroundMetadata, paradata and embedded data use in web-based Delphi surveys has not been described in the literature. The rapid evolution and widespread use of online survey methods imply that paper-based Delphi methods will likely become obsolete. Commercially available web-based survey tools offer a convenient and affordable means of conducting Delphi research. Researchers and ethics committees may be unaware of the benefits and risks of using metadata in web-based surveys.DesignDiscussion paper.Data sourcesTwo web-based, three-round Delphi surveys were conducted sequentially between August 2014 - January 2015 and April - May 2016. Their aims were to validate the Australian nurse practitioner metaspecialties and their respective clinical practice standards. Our discussion paper is supported by researcher experience and data obtained from conducting both web-based Delphi surveys.Implications for nursingResearchers and ethics committees should consider the benefits and risks of metadata use in web-based survey methods. Web-based Delphi research using paradata and embedded data may introduce efficiencies that improve individual participant survey experiences and reduce attrition across iterations. Use of embedded data allows the efficient conduct of multiple simultaneous Delphi surveys across a shorter timeframe than traditional survey methods.ConclusionThe use of metadata, paradata and embedded data appears to improve response rates, identify bias and give possible explanation for apparent outlier responses, providing an efficient method of conducting web-based Delphi surveys.
      PubDate: 2017-07-28T06:12:07.637181-05:
      DOI: 10.1111/jan.13381
       
  • Development and psychometric testing of a new instrument to measure the
           caring behaviour of nurses in Italian acute care settings
    • Authors: Michela Piredda; Valerio Ghezzi, Elisa Fenizia, Anna Marchetti, Tommasangelo Petitti, Maria Grazia De Marinis, Alessandro Sili
      Pages: 3178 - 3188
      Abstract: AimTo develop and psychometrically test the Italian-language Nurse Caring Behaviours Scale, a short measure of nurse caring behaviour as perceived by inpatients.BackgroundPatient perceptions of nurses’ caring behaviours are a predictor of care quality. Caring behaviours are culture-specific, but no measure of patient perceptions has previously been developed in Italy. Moreover, existing tools show unclear psychometric properties, are burdensome for respondents, or are not widely applicable.DesignInstrument development and psychometric testing.MethodItem generation included identifying and adapting items from existing measures of caring behaviours as perceived by patients. A pool of 28 items was evaluated for face validity. Content validity indexes were calculated for the resulting 15-item scale; acceptability and clarity were pilot tested with 50 patients. To assess construct validity, a sample of 2,001 consecutive adult patients admitted to a hospital in 2014 completed the scale and was split into two groups. Reliability was evaluated using nonlinear structural equation modelling coefficients. Measurement invariance was tested across subsamples.ResultsItem 15 loaded poorly in the exploratory factor analysis (n = 983) and was excluded from the final solution, positing a single latent variable with 14 indicators. This model fitted the data moderately. The confirmatory factor analysis (n = 1018) returned similar results. Internal consistency was excellent in both subsamples. Full scalar invariance was reached, and no significant latent mean differences were detected across subsamples.ConclusionThe new instrument shows reasonable psychometric properties and is a promising short and widely applicable measure of inpatient perceptions of nurse caring behaviours.
      PubDate: 2017-08-15T02:05:24.470317-05:
      DOI: 10.1111/jan.13384
       
  • Breastfeeding in the context of domestic violence—a cross-sectional
           study
    • Authors: Hafrún Finnbogadóttir; Li Thies-Lagergren
      Pages: 3209 - 3219
      Abstract: AimsTo determine the differences in breastfeeding among women who did and did not experience domestic violence during pregnancy and postpartum in a Swedish context. In addition, to identify possible differences regarding breastfeeding between groups with or without a history of violence. Further, determine the relationship between exclusive breastfeeding and symptoms of depression.BackgroundHistory of violence may increase the risk of depression and a decrease in, or cessation of, breastfeeding.DesignThe study has a cross-sectional design.MethodsData were collected prospectively from March 2012 - May 2015. A cohort of 731 mothers answered a questionnaire from a larger project (1.5 years postpartum).ResultsBreastfeeding was reported by 93.7% of participants. Women exposed to domestic violence during pregnancy and/or postpartum (4.5%) were just as likely to breastfeed as women who had not reported exposure to domestic violence. There were no statistically significant differences between the groups with or without a history of violence regarding exclusive breastfeeding. Women reporting several symptoms of depression breastfed exclusively to a lesser extent compared with women who had a few symptoms of depression.ConclusionDomestic violence did not influence breastfeeding prevalence or duration. Breastfeeding did not differ in women with or without a history of violence. Symptoms of depression influenced duration of exclusive breastfeeding. Beyond recognizing women who are exposed to violence, it is important to identify and to support pregnant women and new mothers with symptoms of depression as their health and the health of their infants depends on the mothers’ mental well-being.
      PubDate: 2017-06-07T03:10:22.816967-05:
      DOI: 10.1111/jan.13339
       
  • Validation and adaptation of the danger assessment-5: A brief intimate
           partner violence risk assessment
    • Authors: Jill Theresa Messing; Jacquelyn C. Campbell, Carolyn Snider
      Pages: 3220 - 3230
      Abstract: AimsThe aim of this study was to assess the predictive validity of the DA-5 with the addition of a strangulation item in evaluating the risk of an intimate partner violence (IPV) victim being nearly killed by an intimate partner.BackgroundThe DA-5 was developed as a short form of the Danger Assessment for use in healthcare settings, including emergency and urgent care settings. Analyzing data from a sample of IPV survivors who had called the police for domestic violence, the DA-5 was tested with and without an item on strangulation, a potentially fatal and medically damaging IPV tactic used commonly by dangerous abusers.DesignResearchers interviewed a heterogeneous sample of 1,081 women recruited by police between 2009–2013 at the scene of a domestic violence call; 619 (57.3%) were contacted and re-interviewed after an average of 7 months.MethodsThe predictive validity of the DA-5 was assessed for the outcome of severe or near lethal IPV re-assault using sensitivity, specificity and ROC curve analysis techniques.ResultsThe original DA-5 was found to be accurate (AUC = .68), equally accurate with the strangulation item from the original DA substituted (AUC = .68) and slightly more accurate (but not a statistically significant difference) if multiple strangulation is assessed.ConclusionWe recommend that the DA-5 with the strangulation item be used for a quick assessment of homicide or near homicide risk among IPV survivors. A protocol for immediate referral and examination for further injury from strangulation should be adopted for IPV survivors at high risk.
      PubDate: 2017-11-15T20:32:53.194394-05:
      DOI: 10.1111/jan.13459
       
  • Corrigendum
    • Pages: 3231 - 3231
      PubDate: 2017-10-30T04:08:26.876153-05:
      DOI: 10.1111/jan.13479
       
  • Forthcoming Contents
    • Pages: 3232 - 3232
      PubDate: 2017-11-15T20:32:45.314841-05:
      DOI: 10.1111/jan.13137
       
  • Issue Information
    • Pages: 3233 - 3233
      PubDate: 2017-11-15T20:33:02.000364-05:
      DOI: 10.1111/jan.13489
       
 
 
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