Evaluation & the Health Professions最新文献

Introduction: Primary health care (PHC) is fundamental to supporting individual and community health and well-being. There is a need to better understand factors impacting on PHC nurses' and midwives' intentions to remain in PHC work. Methods: Data were obtained from the 2022 Australian Primary Health Care Nurses Association (APNA) Workforce Survey, conducted online in the final quarter of 2022. Logistic regression modelling was employed to identify explanatory factors of intention to remain working in PHC over the next 12 months (Model 1) and over the next 2-5 years (Model 2). Results: There were 3,749 valid survey responses. Key predictors determined included elements of rurality, stress at work and access to computer resources in Model 1 (n = 2995), and years of nursing experience, being First Nations, working full-time or part-time, pay and conditions, and access to education and training in Model 2 (n = 3,004). In both models, aspects of job satisfaction and working to full scope of practice were key predictors of intention to remain in PHC work. Conclusions: Key fixed and modifiable explanatory factors identified in this research point to the need for a range of local, organisational and broader-scale initiatives to support the ongoing recruitment and retention of nurses and midwives in PHC practice.

This study investigates the mediating effect of emotional labour on role stress and silence behaviour among nurses in a women-children special hospital to provide theoretical support and practical guidance for nursing management. A cross-sectional design was used. Data were collected from a grade-A tertiary women-children special hospital used convenience sampling. A path analysis of the relationships among emotional labour, role stress and silence behaviour was conducted using structural equation modelling (SEM).Statistical analysis of data and construction of SEM were conducted using the General Information Questionnaire, Role Stressors Scale, Emotional Labour Scale and Silence Behaviour Scale as survey tools along with SPSS 22.0 and AMOS 24.0 software. A total of 1,145 valid questionnaires were recovered, with an effective recovery rate of 98.5%. The respondents' scores for role stress, emotional labour and silence behaviour were 35.49 ± 4.47, 40.67 ± 5.49 and 10.14 ± 3.79, respectively. Pearson's correlation analysis revealed a positive correlation between emotional labour and role stress and silence behaviour. The SEM analysis showed that emotional labour was a mediator for role stress. Emotional labour functions as a mediator between role stress and silence behaviour among nurses in the women-children special hospital. As such, nursing managers must take nurses' emotional management skills seriously to reduce their role stress.

Clinical innovation by doctors involves the development and use of interventions that have not been formally evaluated according to the usual standards of evidence-based medicine. While the distinction between research and innovation has been discussed theoretically, little is known about how doctors working in different specialty areas define and understand clinical innovation and how they distinguish it from other related practices. In order to address this gap, this qualitative interview study explored how doctors from diverse specialties defined and understood clinical innovation. Thirty-one semi-structured interviews were conducted with Australian doctors from surgery, reproductive medicine, and cancer care. While participants defined clinical innovation in similar ways, they also identified several morally and clinically salient characteristics that distinguish different types of innovation. Based on these findings, we developed a multidisciplinary governance model for clinical innovation that accounts for its diversity and complexity. This governance model offers clear guidance for determining what types of oversight are most appropriate for different types of clinical innovation. Its benefits include that it can be applied across diverse medical specialties and used alongside existing models, such as those used to identify clinical innovation.

This study aimed to examine the measurement invariance of the Basic Psychological Need Satisfaction Subscale (BPNSS) and compare the latent factor means of basic psychological needs between individuals with psychiatric and non-psychiatric disabilities. This cross-sectional study included 97 individuals with psychiatric and 102 individuals with non-psychiatric disabilities. Prior to comparing scores on basic psychological needs across these groups, we evaluated the measure invariance of the BPNSS and confirmed scalar invariance. Individuals with psychiatric disabilities had significantly lower autonomy scores than those with non-psychiatric disabilities. There were no significant mean differences in competence and relatedness between the groups. These findings suggest wide applicability of the BPNSS across individuals with psychiatric and non-psychiatric disabilities. Practitioners should support individuals with psychiatric disabilities to improve their autonomy. Replication with large, diverse samples is crucial to validate the findings and investigate intragroup variances.

Single-Case Experimental Designs (SCEDs), or N-of-1 trials, are commonly used to estimate intervention effects in many disciplines including in the treatment of youth mental health problems. SCEDs consist of repeated measurements of an outcome over time for a single case (e.g., student or patient) throughout one or more baseline phases and throughout one or more intervention phases. The manipulation of the baseline and intervention phase make the SCED a type of interrupted time series design, which is considered one of the most effective experimental designs for causal inference. An important step towards understanding why interventions are effective at producing a change in the outcome is through the investigation of mediating mechanisms. Hypotheses of mediating mechanisms involve an intervention variable which is hypothesized to affect an outcome through its effect on a mediating variable. Little work has attempted to combine mediation analysis and ABAB reversal designs. Therefore, the goals of this paper are to define, estimate, and interpret mediation effects for ABAB reversal designs. An empirical example is used to demonstrate how to estimate and interpret the mediation effects. R code is provided for researchers interested in estimating mediation effects in single-case reversal designs.

Although the prevalence of symptoms of post-traumatic stress disorder (PTSD) in infants and young children is similar as in older age groups, and PTSD intervention is as important in this age group, research on PTSD-treatment in infants is very scarce. Eye Movement Desensitization and Reprocessing (EMDR) Storytelling is a trauma-focused treatment that is being used by clinicians for infants with PTSD-symptoms. The aim was to assess the feasibility, acceptability and initial indications of effectiveness of EMDR Storytelling for infants aged 3-24 months with PTSD-symptoms after medical procedures. We included 6 infants and administered personalized items to assess PTSD-symptoms during the baseline, intervention and follow-up phase on a day-to-day basis. Furthermore, we measured PTSD-classification and symptoms at three and four measurement points, respectively. The data was analysed visually and quantitatively. EMDR Storytelling was shown to be feasible and acceptable for all participating families. Parent- and therapist-report showed that four out of the six infants included in the current study showed a clear reduction over time in PTSD-classification, -symptoms, and daily measured PTSD-symptoms. The results concerning the other two infants were mixed. Attention should be paid to cognitive (language) as well as interactional (infant-parent) mechanisms potentially underlying the benefits of EMDR Storytelling.

This study evaluated LLInC (Leerkracht-Leerling Interactie Coaching in Dutch, or Teacher Student Interaction Coaching), an intervention targeted at teachers' mental representations to improve dyadic teacher-child relationship quality. Four teachers and eight children from Dutch elementary schools participated in this single case study. Teachers themselves selected two children with whom they experienced a difficult relationship. The results indicated that teachers' global judgments of relationship quality improved from pretest to posttest for almost all teacher-child dyads. Day-to-day perceptions of conflict, closeness, and self-efficacy improved for a few teacher-child dyads, and especially for teacher-child dyads of the second targeted child. This implies that LLInC is especially helpful when carried out for at least two teacher-child dyads. The results of this study suggest that LLInC is promising, especially with regard to teachers' global relationship perceptions. However, LLInC should be further evaluated using a larger, representative sample, especially with regard to day-to-day perceptions of relationship quality.

Existing research has shown that parental behavior can influence the onset and persistence of adolescent depression; however, the initial treatment guidelines do not include parental involvement, and there is no established protocol for engaging parents. For this study, the Doepressie parent training protocol was designed to teach parents ways to help their child cope with depression, and this study sought to evaluate the feasibility and changes in parenting of combining individual cognitive behavioral therapy (CBT) for adolescents with parent training. Because of the heterogeneity observed in adolescents with depression, a single-case design study with daily diaries for parents was conducted. Adolescents (N = 9; mean age = 15.9, SD = 1.05) with major depressive disorder and their parents participated in this study. Parents reported that the parent training was feasible. After treatment, two-thirds of the adolescents no longer met the criteria for major depressive disorder. Most of the parents reported positive effects on their child's mood and activity level, problem-solving skills with their child, and parental responsiveness and competence. Four parents demonstrated medium positive change. Involving parents in the treatment of adolescent depression has significant clinical benefits. Because of the heterogeneity of adolescent depression, the impact of parental involvement varies.

In the United States, only approximately one-third of students read at or above proficiency level. Moreover, the difference in reading proficiency of students is severely disproportionate for students with disabilities compared to students without disabilities. Reading fluency is a precursor for academic success and one of the six aspects of reading that contributes to effective reading skills. Many studies have examined the effectiveness of repeated reading to improve reading fluency. However, existing literature has mixed evaluations of whether repeated reading can be considered evidence-based reading intervention practice for students with disabilities. The current study examined the effects of a repeated reading intervention on reading fluency for three middle school students with learning disabilities. To address limitations of traditional single-case experimental design analytical methods such as visual analysis and nonoverlap indices, our study provided empirical researchers with a step-by-step procedure of using an advanced statistical method for single-case experimental designs, namely, generalized linear mixed models (GLMM) to analyze data. The results presented by GLMMs showed that repeated reading intervention can significantly improve reading fluency for some students with learning disabilities. Implications, limitations, and future directions from both empirical and methodological perspectives were also discussed.

Transitioning to motherhood comes with new and intensive tasks that may cause parental stress, low parental self-efficacy, and internalizing problems. This can in turn negatively affect the mother-child relationship. Mindful with your Baby/Toddler (MwyB/T) is a mindfulness-based intervention for parents of young children experiencing parental stress and internalizing problems. Previous evaluative studies showed promising results, but methodology of these studies was limited. The current study used a single case design, including a baseline, intervention, posttest, and follow-up phase, to evaluate the effectiveness of MwyB/T. Ten participants were included and completed daily administered personalized items and validated questionnaires measuring mindfulness, mindful parenting, parental self-efficacy, internalizing problems, and parental stress, for 10 participants. Personalized items were first coded into themes and then assessed using visual analysis and descriptive effect size measures. Reliable change indices were computed for the questionnaires. All mothers improved on personalized items, with most improving on most (or all) of their items. On the questionnaires the majority of mothers improved. Results indicate that MwyB/T could benefit mothers with various intervention goals. More research is needed on the role of personalized items, both as a research measure and an as a possible additional element of interventions.