International Journal of Nursing Studies Advances最新文献

Development and psychometric evaluation of the self-care of informal caregivers inventory

IF 3.1 Q1 NURSING

International Journal of Nursing Studies Advances

Pub Date : 2024-09-12 DOI: 10.1016/j.ijnsa.2024.100237

Background

In recent years, a growing body of literature on informal caregivers’ health and well-being has emerged, highlighting the need for a tool to measure their self-care practices.

Objective

The aim of the study was to develop a theory-based instrument measuring the self-care behaviors of informal caregivers and test its psychometric properties.

Design

The initial phase of instrument development entailed a detailed, six-step process (conceptualization, theoretical adaptation, back-translation and cultural adaptation, cognitive interviewing, item enhancement, and content validity), followed by formal psychometric testing (participant engagement, validity, internal consistency reliability, test-retest reliability).

Setting

Study conducted at a hospital located in Tehran, Iran.

Participants

A sample of 234 informal caregivers of cancer outpatients receiving treatment in oncology wards was enrolled. Caregivers had to be 18 years or older, recognized as the primary caregiver by the patient, and willing to provide informed consent.

Methods

The Self-Care of Informal Caregivers Inventory items comprise three dimensions: self-care maintenance (11 items), self-care monitoring (7 items), and self-care management (9 items), which achieved a content validity index rating of 100 % in a panel of experts. Data were collected from caregivers during routine clinic visits. Construct validity was verified through exploratory structural equation modelling and reliability was verified using Cronbach's α and multidimensional model-based reliability. Test-retest reliability was evaluated using the Intraclass Correlation Coefficient.

Results

All three dimensions showed good model fit indices (self-care maintenance: Comparative Fit Index = 1.00, Tucker-Lewis Index = 0.99, Root Mean Square Error of Approximation = 0.044; self-care monitoring: Comparative Fit Index = 1.00, Tucker-Lewis Index = 1.00, Root Mean Square Error of Approximation = 0.027; self-care management: Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99, Root Mean Square Error of Approximation = 0.048) and Cronbach's α of 0.88, 0.88, and 0.91, respectively. The overall multidimensional model-based reliability was 0.93. The Intraclass Correlation Coefficient values for the three dimensions were 0.94, 0.60, and 0.51, respectively.

Conclusion

Preliminary testing provides support for use of the Self-Care of Informal Caregivers Inventory in research. Using this theory-based instrument to assess the self-care practices of informal caregivers can assist in identifying topics to discuss and opportunities for guidance.

Tweetable Abstract

The Self-Care of Informal Caregivers Inventory: A validated tool for informal caregivers is useful for research. #Informalcaregivers #SelfCare

背景近年来，有关非正规护理人员的健康和福祉的文献越来越多，这凸显了人们对衡量其自我护理行为的工具的需求。目的本研究旨在开发一种基于理论的工具，用于衡量非正规护理人员的自我护理行为，并测试其心理测量特性。设计工具开发的初始阶段需要经过详细的六步流程（概念化、理论调整、回译和文化调整、认知访谈、项目增强和内容效度），然后进行正式的心理测试（参与者参与、有效性、内部一致性可靠性、测试重复可靠性）。方法非正规护理人员自我护理量表的项目包括三个方面：自我护理维护（11 个项目）、自我护理监测（7 个项目）和自我护理管理（9 个项目）。数据是在常规门诊就诊时从护理人员处收集的。通过探索性结构方程模型验证了结构效度，并使用克朗巴赫α和基于多维模型的信度验证了信度。结果所有三个维度均显示出良好的模型拟合指数（自我保健维护：比较拟合指数 = 1.0）：比较拟合指数 = 1.00，Tucker-Lewis 指数 = 0.99，近似均方根误差 = 0.044；自我护理监测：比较拟合指数 = 1.00，Tucker-Lewis 指数 = 0.99，近似均方根误差 = 0.044：比较拟合指数 = 1.00，塔克-刘易斯指数 = 1.00，近似均方根误差 = 0.027；自我护理管理：比较拟合指数 = 0.99，塔克-刘易斯指数 = 0.99，近似均方根误差 = 0.048）和克朗巴赫α分别为 0.88、0.88 和 0.91。基于多维模型的总体信度为 0.93。三个维度的类内相关系数分别为 0.94、0.60 和 0.51。使用这一基于理论的工具来评估非正规护理人员的自我护理实践，有助于确定讨论主题和指导机会：非正式照顾者自我照顾量表：非正式照顾者的有效工具有助于研究。#非正式照顾者 #自我照顾

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引用次数: 0

Practice of blood pressure self-monitoring and associated factors among hypertensive patients on follow-up visits at hospitals, West Shoa Zone, Oromia, Ethiopia, 2022…An institution-based cross-sectional study

IF 3.1 Q1 NURSING

International Journal of Nursing Studies Advances

Pub Date : 2024-09-10 DOI: 10.1016/j.ijnsa.2024.100236

Introduction

Blood pressure self-monitoring is patients' regular use of personal blood pressure measurement equipment to measure their blood pressure outside of a clinical environment. Inadequate blood pressure self-monitoring remains a significant problem faced by healthcare providers and populations in the prevention of Hypertension. This study is to assess the practice of blood pressure self-monitoring and associated factors among hypertensive patients on follow-up visits at Hospitals, West Shoa zone, Oromia, Ethiopia, 2022.

Methods

An institution-based cross-sectional quantitative study supported by a qualitative study was carried out on 412 hypertensive patients from September 01–30/09/2022. An interviewer-administered questionnaire was used to collect data, and a simple random sampling technique was employed to select the study participants. Data were entered into a computer using the Kobo toolbox and exported to Statical package of social science Version 26 for analysis. Binary logistic regression analysis was run to assess the association between the dependent and independent variables and Variables with P- value < 0.25 were entered into a multivariate logistic regression to control the effects of potential confounding factors. P-value of <0.05 was taken as a cutoff point to declare a statistically significant association between independent and dependent variables.

Result

The proportion of blood pressure self-monitoring practice among hypertensive patients on follow-up visits at hospitals in the West Shoa zone was 19.6 %. Educational level [AOR=7.49, 95 %CI (3.00, 8.67)], income [AOR=3.14, 95 %CI (1.21, 8.13)], co-morbidities [AOR=5.55, 95 %CI (2.74, 11.24)], recommendation toward self-monitoring [AOR=2.40, 95 %CI (1.15, 5.03)] and awareness of self-monitoring [AOR=8.54, 95 %CI (3.54, 10.60)] were factors significantly associated with blood pressure self-monitoring practice.

Conclusion and Recommendation

The proportion of blood pressure self-monitoring among hypertensive patients on follow-up visits at hospitals in the West Shoa zone was low. The practice of blood pressure self-monitoring needs to be deliberated by health education programs and recommended to minimize hypertension complications.

导言自我血压监测是指患者在临床环境之外定期使用个人血压测量设备测量血压。自我血压监测不足仍然是医疗服务提供者和人群在预防高血压方面面临的一个重要问题。本研究旨在评估 2022 年埃塞俄比亚奥罗米亚州西肖亚区医院随访的高血压患者进行血压自我监测的情况及相关因素。方法：2022 年 9 月 1 日至 30 日，对 412 名高血压患者进行了一项以机构为基础的横断面定量研究，并辅以一项定性研究。研究采用访谈员发放问卷的方式收集数据，并采用简单随机抽样技术选取研究对象。数据使用 Kobo 工具箱输入计算机，并导出到社会科学统计软件包 26 版进行分析。二元逻辑回归分析用于评估因变量和自变量之间的关联，P 值为 < 0.25 的变量被输入到多元逻辑回归中，以控制潜在混杂因素的影响。P值为0.05时，自变量与因变量之间的联系具有统计学意义。结果在西肖亚区医院随访的高血压患者中，有自我监测血压习惯的比例为19.6%。教育水平[AOR=7.49，95 %CI (3.00，8.67)]、收入[AOR=3.14，95 %CI (1.21，8.13)]、合并疾病[AOR=5.55，95 %CI (2.74，11.24)]、对自我监测的建议[AOR=2.40，95 %CI (1.15，5.03)]和对自我监测的认识[AOR=8.54，95 %CI (3.54，10.60)]均与自变量有显著相关性。结论和建议在西肖亚区医院随访的高血压患者中，自我监测血压的比例较低。自我监测血压的做法需要在健康教育计划中加以考虑和推荐，以最大限度地减少高血压并发症。

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引用次数: 0

Understanding frailty and its opposites from community-dwelling older peoples’ perspectives: A phenomenological qualitative study 从社区老年人的角度理解虚弱及其对立面：现象学定性研究

IF 3.1 Q1 NURSING

International Journal of Nursing Studies Advances

Pub Date : 2024-09-06 DOI: 10.1016/j.ijnsa.2024.100238

Background

the global population is ageing. As older people become more susceptible to frailty, an increase in frailty prevalence is also expected. Although frailty has been defined before in research, older peoples’ perceptions of frailty do not always coincide with those used in research or medical settings. Further exploring community-dwelling older people's viewpoints regarding frailty is essential for tailored care and policy.

Aim

the aim of this study was to explore the perspectives of Dutch community-dwelling older people regarding frailty and its opposing concepts.

Methods

a phenomenological qualitative study was conducted for which we carried out semi-structured interviews with independently living older people aged ≥65. Following the interviews, the participants filled out the Tilburg Frailty Indicator.

Results

the different domains of frailty: ‘physical’, ‘psychological’, and ‘social’, were recognized by participants. In addition, other aspects, such as financial capacity and digital functioning, have been identified. Four aspects of the meaning of frailty were identified in the category of other frailty definitions: ‘dependency’, ‘frailty as getting hurt’, ‘frailty as prone to deterioration’, and ‘frailty as experiences of loss and sacrifice’. Participants also described the opposites of frailty, which could also be distinguished according to the ‘physical’, ‘psychological’, and ‘social’ domains. In addition, participants mentioned the following concepts as opposing frailty: ‘vitality’, ‘resilience’, ‘independence’, ‘autonomy’, and ‘ambition’.

Conclusion

we found that frailty and its opposites share similar aspects, including physical, psychological, and social dimensions. Additionally, older people perceived cognition as an essential aspect of frailty. The psychological dimension seemed more dominant in concepts opposed to frailty, which raises opportunities to focus on the positive aspects and build on older people's (psychological) capabilities in managing frailty and its consequences. Based on these findings, policymakers and care professionals should consider the perspectives of older people regarding frailty and its opposing concepts.

背景全球人口正在老龄化。随着老年人越来越容易体弱，预计体弱的发生率也会增加。虽然研究中已经对虚弱进行了定义，但老年人对虚弱的看法并不总是与研究或医疗环境中使用的看法一致。本研究旨在探讨荷兰社区老年人对虚弱及其对立概念的看法。研究方法我们对年龄≥65 岁、独立生活的老年人进行了半结构化访谈，开展了一项现象学定性研究。结果参与者认识到虚弱的不同领域："身体"、"心理 "和 "社会"。此外，经济能力和数字功能等其他方面也得到了确认。在其他虚弱定义类别中，确定了虚弱含义的四个方面：依赖性"、"虚弱是受伤"、"虚弱是容易恶化 "以及 "虚弱是失去和牺牲的经历"。与会者还描述了虚弱的对立面，这些对立面也可以按照 "生理"、"心理 "和 "社会 "领域加以区分。此外，参与者还提到了以下与虚弱相对的概念："活力"、"韧性"、"独立"、"自主 "和 "雄心"。此外，老年人认为认知是体弱的一个重要方面。在与体弱相对的概念中，心理层面似乎更占主导地位，这就为我们提供了关注积极方面的机会，并利用老年人的（心理）能力来管理体弱及其后果。基于这些发现，决策者和护理专业人员应考虑老年人对虚弱及其对立概念的看法。

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引用次数: 0

Self-management in the post-hair transplantation recovery period among patients with androgenetic alopecia: A qualitative study 雄激素性脱发患者在植发后恢复期的自我管理：定性研究

IF 3.1 Q1 NURSING

International Journal of Nursing Studies Advances

Pub Date : 2024-08-19 DOI: 10.1016/j.ijnsa.2024.100234

Background

The success of hair transplantation surgeries for androgenetic alopecia is evaluated by postoperative long-term outcomes. Patients' self-management during the long recovery period affects this outcome.

Objective

This study aimed to explore patients' self-management status, facilitators, and impediments in the postoperative period and to provide a reference for developing a postoperative self-management intervention program.

Methods

Patients who underwent hair transplantation for androgenetic alopecia were selected using purposive sampling. They were interviewed using one-to-one semi-structured interviews at a general tertiary hospital in Hangzhou from March to April 2022. Qualitative research analysis software Nvivo 12.0 was used to analyze the collected data.

Results

The self-management of postoperative patients with androgenetic alopecia during the recovery period encompasses six areas: more problems with postoperative medication (e.g., not being able to take medication on time) and wound care (e.g., not daring to shampoo, etc.), not being able to review their postoperative condition on time (due to busy schedules at work and at home), more hindrances to the establishment of good living habits (affected by overtime work, socialising, and bad habits of the people around them), and seeking positive ways of relieving bad emotions (stress, anxiety, depression, etc.), worrying about one's image during recovery and taking the initiative to obtain and use resources to promote recovery (through the Internet, books, etc.)

Conclusions

Various factors impact the postoperative self-management abilities of patients, including medication, shampooing, and emotions. It is essential to design support programs to enhance these abilities and improve long-term hair transplantation outcomes.

背景雄激素性脱发的植发手术成功与否，要通过术后的长期疗效来评价。本研究旨在探讨患者在术后的自我管理状况、促进因素和阻碍因素，为制定术后自我管理干预方案提供参考。2022年3月至4月，在杭州市一家综合性三级甲等医院对他们进行了一对一半结构式访谈。结果雄激素性脱发术后患者在恢复期的自我管理包括六个方面：术后用药（如不能按时服药）和伤口护理（如不敢洗头等）问题较多、不敢洗头等）、不能及时复查术后情况（由于工作和家庭的繁忙）、建立良好生活习惯的障碍增多（受加班、应酬、周围人不良习惯的影响）、寻求缓解不良情绪的积极方法（压力、焦虑、抑郁等。结论影响患者术后自我管理能力的因素很多，包括用药、洗发和情绪等。设计支持计划以提高这些能力并改善长期植发效果至关重要。

{"title":"Self-management in the post-hair transplantation recovery period among patients with androgenetic alopecia: A qualitative study","authors":"","doi":"10.1016/j.ijnsa.2024.100234","DOIUrl":"10.1016/j.ijnsa.2024.100234","url":null,"abstract":"<div><h3>Background</h3><p>The success of hair transplantation surgeries for androgenetic alopecia is evaluated by postoperative long-term outcomes. Patients' self-management during the long recovery period affects this outcome.</p></div><div><h3>Objective</h3><p>This study aimed to explore patients' self-management status, facilitators, and impediments in the postoperative period and to provide a reference for developing a postoperative self-management intervention program.</p></div><div><h3>Methods</h3><p>Patients who underwent hair transplantation for androgenetic alopecia were selected using purposive sampling. They were interviewed using one-to-one semi-structured interviews at a general tertiary hospital in Hangzhou from March to April 2022. Qualitative research analysis software Nvivo 12.0 was used to analyze the collected data.</p></div><div><h3>Results</h3><p>The self-management of postoperative patients with androgenetic alopecia during the recovery period encompasses six areas: more problems with postoperative medication (e.g., not being able to take medication on time) and wound care (e.g., not daring to shampoo, etc.), not being able to review their postoperative condition on time (due to busy schedules at work and at home), more hindrances to the establishment of good living habits (affected by overtime work, socialising, and bad habits of the people around them), and seeking positive ways of relieving bad emotions (stress, anxiety, depression, etc.), worrying about one's image during recovery and taking the initiative to obtain and use resources to promote recovery (through the Internet, books, etc.)</p></div><div><h3>Conclusions</h3><p>Various factors impact the postoperative self-management abilities of patients, including medication, shampooing, and emotions. It is essential to design support programs to enhance these abilities and improve long-term hair transplantation outcomes.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000614/pdfft?md5=8af42989f33b1735ea2ebe669bceda3b&pid=1-s2.0-S2666142X24000614-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring the reasons behind nurses' intentions to leave their hospital or profession: A cross-sectional survey 探索护士打算离开医院或职业的原因：横断面调查

IF 3.1 Q1 NURSING

International Journal of Nursing Studies Advances

Pub Date : 2024-08-10 DOI: 10.1016/j.ijnsa.2024.100232

Background

Multiple factors can fuel nurses’ intention to leave their employing hospital or their profession. Job dissatisfaction and burnout are contributors to this decision. Sociodemographic and work context factors can also play a role in explaining nurses’ intention to leave.

Objective

To investigate the role of sociodemographic and work context factors, including job resources, job demands, job dissatisfaction, depersonalization, and emotional exhaustion, on nurses’ intention to leave their hospital or their profession.

Design

Multicentre cross-sectional study.

Setting(s)

Eight European hospitals, two per each country, including Belgium, the Netherlands, Italy, and Poland.

Participants

From May 16 to September 30, 2022, we collected 1,350 complete responses from nurses working at the selected hospitals (13 % response rate).

Methods

The intention to leave was assessed through two 5-Likert scale outcomes, agreeing with the intention to leave the profession and the intention to leave the hospital. Logistic regression models were used for statistical analysis.

Results

At the multivariable analysis, a higher intention to leave the hospital was observed for: younger age, having served on the frontline against COVID-19, lack of quipment, living in the Netherlands, emotional exhaustion, dissatisfaction with work prospects, and dissatisfaction with the use of professional abilities. There was a higher intention to leave the profession for: younger age, living in the Netherlands, having work-related health problems, depersonalization, emotional exhaustion, low possibilities of professional development, dissatisfaction with work prospects, lack of use of professional abilities, overall ob issatisfaction, and dissatisfaction with salary. Nurses living in Italy expressed the lowest intention to leave.

Conclusion

While confirming the role of job dissatisfaction and burnout, we found higher intention to leave for young nurses, nurses with work-related health problems, and caregivers during the COVID-19 pandemic. Dissatisfaction with work prospects, professional development, and salary also increased the intention to leave. We call for educators, managers, and policymakers to address these factors to retain at-risk nursing categories, implementing strategies to mitigate intentions to leave.

背景多种因素会促使护士有意离开其聘用医院或其职业。工作不满和职业倦怠是导致护士做出离职决定的原因。调查社会人口和工作环境因素（包括工作资源、工作要求、工作不满、人格解体和情感衰竭）对护士离开医院或其职业的意向的影响。参与者2022年5月16日至9月30日，我们收集了1350名在选定医院工作的护士的完整回复（回复率为13%）。方法通过两个5-Likert量表结果评估离职意向，即同意离职意向和离职意向。结果在多变量分析中，下列因素的离职意愿较高：年龄较小、曾在前线抗击 COVID-19、缺乏设备、居住在荷兰、情绪疲惫、对工作前景不满意以及对专业能力的使用不满意。年龄较小、居住在荷兰、有与工作相关的健康问题、人格解体、情感衰竭、专业发展可能性低、对工作前景不满意、专业能力得不到发挥、总体不满意和对薪酬不满意的护士离职意愿较高。结论在证实工作不满和职业倦怠的作用的同时，我们发现在 COVID-19 大流行期间，年轻护士、有工作相关健康问题的护士和护理人员的离职意愿较高。对工作前景、职业发展和薪酬的不满也会增加离职意向。我们呼吁教育者、管理者和政策制定者解决这些因素，以留住处于风险中的护士类别，实施减少离职意向的策略。

{"title":"Exploring the reasons behind nurses' intentions to leave their hospital or profession: A cross-sectional survey","authors":"","doi":"10.1016/j.ijnsa.2024.100232","DOIUrl":"10.1016/j.ijnsa.2024.100232","url":null,"abstract":"<div><h3>Background</h3><p>Multiple factors can fuel nurses’ intention to leave their employing hospital or their profession. Job dissatisfaction and burnout are contributors to this decision. Sociodemographic and work context factors can also play a role in explaining nurses’ intention to leave.</p></div><div><h3>Objective</h3><p>To investigate the role of sociodemographic and work context factors, including job resources, job demands, job dissatisfaction, depersonalization, and emotional exhaustion, on nurses’ intention to leave their hospital or their profession.</p></div><div><h3>Design</h3><p>Multicentre cross-sectional study.</p></div><div><h3>Setting(s)</h3><p>Eight European hospitals, two per each country, including Belgium, the Netherlands, Italy, and Poland.</p></div><div><h3>Participants</h3><p>From May 16 to September 30, 2022, we collected 1,350 complete responses from nurses working at the selected hospitals (13 % response rate).</p></div><div><h3>Methods</h3><p>The intention to leave was assessed through two 5-Likert scale outcomes, agreeing with the intention to leave the profession and the intention to leave the hospital. Logistic regression models were used for statistical analysis.</p></div><div><h3>Results</h3><p>At the multivariable analysis, a higher intention to leave the hospital was observed for: younger age, having served on the frontline against COVID-19, lack of quipment, living in the Netherlands, emotional exhaustion, dissatisfaction with work prospects, and dissatisfaction with the use of professional abilities. There was a higher intention to leave the profession for: younger age, living in the Netherlands, having work-related health problems, depersonalization, emotional exhaustion, low possibilities of professional development, dissatisfaction with work prospects, lack of use of professional abilities, overall ob issatisfaction, and dissatisfaction with salary. Nurses living in Italy expressed the lowest intention to leave.</p></div><div><h3>Conclusion</h3><p>While confirming the role of job dissatisfaction and burnout, we found higher intention to leave for young nurses, nurses with work-related health problems, and caregivers during the COVID-19 pandemic. Dissatisfaction with work prospects, professional development, and salary also increased the intention to leave. We call for educators, managers, and policymakers to address these factors to retain at-risk nursing categories, implementing strategies to mitigate intentions to leave.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000596/pdfft?md5=5786b4fcfb295a5ce60831d93399fa16&pid=1-s2.0-S2666142X24000596-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141978864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Describing the status quo of person-centred dementia care in different types of care units in German nursing homes: A convergent mixed methods study 描述德国养老院不同类型护理单元以人为本的痴呆症护理现状：聚合混合方法研究

IF 3.1 Q1 NURSING

International Journal of Nursing Studies Advances

Pub Date : 2024-08-10 DOI: 10.1016/j.ijnsa.2024.100233

Background

The policies and mission statements of nursing homes support the implementation of person-centred dementia care. The Dementia Policy Questionnaire assesses the content of person-centred dementia care in policies. To date, it is unknown whether these policies exist exclusively in dementia care units and whether the policies are consistent with the mission statements of nursing homes.

Objective

We aimed to (1) investigate nursing home care unit types regarding the existence of policies measured by the Dementia Policy Questionnaire, (2) explore whether these policies are addressed in the mission statements of the nursing homes, and (3) integrate both results.

Design

This is a convergent mixed methods study performed with a quantitative and qualitative dataset that was collected in the BeStaDem survey (2020).

Setting

The BeStaDem survey included licensed nursing homes in Germany.

Participants

A total of 134 nursing home administrators provided informed consent to participate in the BeStaDem survey.

Methods

For quantitative data, we performed Fisher's exact test to identify differences in the Dementia Policy Questionnaire item distribution of several types of care units (aim 1). To support the results of Fisher's exact test, we additionally applied logistic regression analysis. For qualitative data, we analyzed the mission statements deductively with the qualitative content analysis method (aim 2). For integration, we used a convergent triangulation approach (aim 3).

Results

The quantitative data collected from 134 German nursing homes show significant associations among person-centred dementia care policies, such as behavior assessment, and nursing homes with dementia care units. Regarding the qualitative data, of the 60 mission statements in total, eight mission statements of nursing homes with dementia care units exclusively address aspects such as dementia-specific interventions. The convergent triangulation approach shows that the answers given by the nursing homes in the quantitative survey are not always consistent with what they address in their mission statements.

Conclusions

Nursing homes with dementia care units provide more person-centred dementia care policies than other care unit types do but mostly do not address these aspects in their mission statements. The implementation of person-centredness benefits from the existence of policies and mission statements if nursing homes clearly address what is meant by person-centred dementia care in their nursing home.

背景疗养院的政策和使命宣言有助于实施以人为本的痴呆症护理。痴呆症政策问卷调查评估了政策中以人为中心的痴呆症护理内容。迄今为止，这些政策是否只存在于痴呆症护理单元，以及这些政策是否与疗养院的使命宣言相一致，尚不得而知。我们的目的是：（1）调查疗养院护理单元类型，了解是否存在以痴呆症政策问卷为衡量标准的政策；（2）探讨这些政策是否在疗养院的使命宣言中有所涉及；（3）整合这两项结果。设计这是一项收敛性混合方法研究，使用的定量和定性数据集是在 BeStaDem 调查（2020 年）中收集的。为了支持费雪精确检验的结果，我们还进行了逻辑回归分析。对于定性数据，我们采用定性内容分析法对使命陈述进行了演绎分析（目的 2）。结果从 134 家德国养老院收集的定量数据显示，以人为本的痴呆症护理政策（如行为评估）与设有痴呆症护理单元的养老院之间存在显著关联。在定性数据方面，在总共 60 份使命陈述中，有 8 家设有痴呆症护理单元的养老院的使命陈述专门涉及痴呆症特定干预等方面。收敛三角测量法显示，养老院在定量调查中给出的答案与他们在使命宣言中涉及的内容并不总是一致的。结论与其他护理单元类型相比，设有痴呆症护理单元的养老院提供了更多以人为本的痴呆症护理政策，但在他们的使命宣言中大多没有涉及这些方面。如果养老院能明确说明以人为本的失智症护理在其养老院中的含义，那么以人为本的理念就能从政策和使命宣言的存在中受益。

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引用次数: 0

Feasibility and acceptability of the ShareD dEciSIon making for patients with kidney failuRE to improve end-of-life care intervention: A pilot multicentre randomised controlled trial 肾衰竭患者 "ShareD dEciSIon "改善临终关怀干预的可行性和可接受性：多中心随机对照试验

IF 3.1 Q1 NURSING

International Journal of Nursing Studies Advances

Pub Date : 2024-08-05 DOI: 10.1016/j.ijnsa.2024.100231

Background

Kidney failure is associated with a high disease burden and high mortality rates. National and international guidelines recommend health professionals involve patients with kidney failure in making decisions about end-of-life care, but implementation of these conversations within kidney services varies. We developed the DESIRE (ShareD dEciSIon-making for patients with kidney failuRE to improve end-of-life care) intervention from our studies investigating multiple decision maker needs and experiences of end-of-life care in kidney services. The DESIRE intervention's three components are a training programme for health professionals, a patient decision aid, and a kidney service consultation held to facilitate shared decision-making conversations about planning end-of-life care.

Objectives

To assess the feasibility and acceptability of integrating the DESIRE intervention within kidney services.

Design

A pilot study using a multicentre randomised controlled design.

Setting

Four Danish nephrology departments.

Participants

Patients with kidney failure who were 75 years of age or above, their relatives, and health professionals.

Methods

Patients were randomised to either the intervention or usual care. Feasibility data regarding delivering the intervention, the trial design, and outcome measures were collected through questionnaires and audio recordings at four points in time: before, during, post, and 3 months after the intervention. Acceptability data were collected through semi-structured interviews with patients and relatives, as well as a focus group with health professionals post the intervention.

Results

Twenty-seven patients out of the 32 planned were randomised either to the intervention (n= 14) or usual care (n= 13). In addition, four relatives and 12 health professionals participated. Follow-up was completed by 81 % (n= 22) of patient participants. We found that both feasibility and acceptability data suggested health professionals improved their decision support and shared decision-making skills via the training. Patient and relative participants experienced the intervention as supporting a shared decision-making process; from audio recordings, we showed health professionals were able to support proactively decision-making about end-of-life care within these consultations. All stakeholders perceived the intervention to be effective in promoting shared decision-making and relevant for supporting end-of-life care planning.

Conclusions

Participant feedback indicated that the DESIRE intervention can be integrated into practice to support patients, relatives, and health professionals in planning end-of-life care alongside the management of worsening kidney failure. Minimising exhaustion and enhancing engagement with the in

背景肾衰竭与高疾病负担和高死亡率有关。国家和国际指南建议医护人员让肾衰竭患者参与生命末期护理决策，但在肾脏服务机构中，这些对话的实施情况各不相同。我们在调查肾脏服务中多个决策者的需求和临终关怀经验的基础上，开发了 DESIRE（肾衰竭患者分享决策以改善临终关怀）干预措施。目标评估将 DESIRE 干预纳入肾脏服务的可行性和可接受性。设计采用多中心随机对照设计进行试点研究。在干预前、干预中、干预后和干预后 3 个月的四个时间点，通过问卷和录音收集有关实施干预、试验设计和结果测量的可行性数据。通过对患者和亲属进行半结构化访谈，以及在干预后与医护人员进行焦点小组讨论，收集了可接受性数据。结果在计划的 32 名患者中，有 27 名被随机分配到干预（14 人）或常规护理（13 人）中。此外，还有 4 名亲属和 12 名医疗专业人员参与。81%（22 人）的患者完成了随访。我们发现，可行性和可接受性数据都表明，医护人员通过培训提高了决策支持和共同决策技能。患者和亲属参与者认为干预措施支持了共同决策过程；通过录音，我们发现医护人员能够在这些咨询中积极主动地支持临终关怀决策。结论参与者的反馈意见表明，DESIRE 干预措施可与实践相结合，在治疗肾衰竭恶化的同时，支持患者、亲属和医疗专业人员规划临终关怀。最大限度地减少干预过程中的疲惫感和提高参与度应成为后续改进干预的重点。注册该研究已在ClinicalTrials.gov上注册，标识符为NCT05842772：NCT05842772。首次招募日期：2023 年 3 月 20 日：首次招募日期：2023 年 3 月 20 日。

{"title":"Feasibility and acceptability of the ShareD dEciSIon making for patients with kidney failuRE to improve end-of-life care intervention: A pilot multicentre randomised controlled trial","authors":"","doi":"10.1016/j.ijnsa.2024.100231","DOIUrl":"10.1016/j.ijnsa.2024.100231","url":null,"abstract":"<div><h3>Background</h3><p>Kidney failure is associated with a high disease burden and high mortality rates. National and international guidelines recommend health professionals involve patients with kidney failure in making decisions about end-of-life care, but implementation of these conversations within kidney services varies. We developed the DESIRE (ShareD dEciSIon-making for patients with kidney failuRE to improve end-of-life care) intervention from our studies investigating multiple decision maker needs and experiences of end-of-life care in kidney services. The DESIRE intervention's three components are a training programme for health professionals, a patient decision aid, and a kidney service consultation held to facilitate shared decision-making conversations about planning end-of-life care.</p></div><div><h3>Objectives</h3><p>To assess the feasibility and acceptability of integrating the DESIRE intervention within kidney services.</p></div><div><h3>Design</h3><p>A pilot study using a multicentre randomised controlled design.</p></div><div><h3>Setting</h3><p>Four Danish nephrology departments.</p></div><div><h3>Participants</h3><p>Patients with kidney failure who were 75 years of age or above, their relatives, and health professionals.</p></div><div><h3>Methods</h3><p>Patients were randomised to either the intervention or usual care. Feasibility data regarding delivering the intervention, the trial design, and outcome measures were collected through questionnaires and audio recordings at four points in time: before, during, post, and 3 months after the intervention. Acceptability data were collected through semi-structured interviews with patients and relatives, as well as a focus group with health professionals post the intervention.</p></div><div><h3>Results</h3><p>Twenty-seven patients out of the 32 planned were randomised either to the intervention (<em>n</em>= 14) or usual care (<em>n</em>= 13). In addition, four relatives and 12 health professionals participated. Follow-up was completed by 81 % (<em>n</em>= 22) of patient participants. We found that both feasibility and acceptability data suggested health professionals improved their decision support and shared decision-making skills via the training. Patient and relative participants experienced the intervention as supporting a shared decision-making process; from audio recordings, we showed health professionals were able to support proactively decision-making about end-of-life care within these consultations. All stakeholders perceived the intervention to be effective in promoting shared decision-making and relevant for supporting end-of-life care planning.</p></div><div><h3>Conclusions</h3><p>Participant feedback indicated that the DESIRE intervention can be integrated into practice to support patients, relatives, and health professionals in planning end-of-life care alongside the management of worsening kidney failure. Minimising exhaustion and enhancing engagement with the in","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000584/pdfft?md5=298dc81b7c55b102912551e388ef2639&pid=1-s2.0-S2666142X24000584-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acceptability and usability of a nurse-assisted remote patient monitoring intervention for the post-hospital follow-up of patients with long-term illness: A qualitative study 针对长期病患者住院后随访的护士辅助远程患者监测干预措施的可接受性和可用性：定性研究

IF 3.1 Q1 NURSING

International Journal of Nursing Studies Advances

Pub Date : 2024-07-27 DOI: 10.1016/j.ijnsa.2024.100229

Background

Patients living with long-term chronic illnesses often need ongoing medical attention, lifestyle adjustments, and psychosocial support beyond the initial diagnosis and treatment phases. Many experience illness deterioration and subsequently require hospitalisation, especially in the transition period after hospital discharge. A promising strategy for managing long-term conditions is promoting self-management. eHealth interventions involving remote patient monitoring have the potential to promote self-management and offer a more seamless bridge between the hospital and the patient´s home environment. However, such interventions can only significantly impact health and health care if they are effective, accepted and adopted by users, normalised into routine practice and everyday life, and able to be widely implemented. Feasibility studies are used to determine whether an intervention is suitable for the target population and effective in achieving its intended goal. They may also provide critical information about an intervention´s acceptability and usability.

Objectives

We aimed to evaluate the acceptability and usability of a nurse-assisted remote patient monitoring intervention for the post-hospital follow-up of patients with long-term illnesses by use of the core constructs of normalisation process theory.

Design

A descriptive and explanatory qualitative approach was used, with patients observed during training and semi-structured interviews conducted with patients and nurses after study completion.

Settings

Participants were recruited from two university hospitals in Norway between December 2021 and February 2023.

Participants

Ten patients were observed during training, and 27 patients and eight nurses were interviewed after study completion.

Methods

Structured and overt observations were made while the patients received training to operate the remote patient monitoring service, guided by an observation guide. Semi-structured interviews were conducted with patients and nurse navigators about their experiences of remote follow-up care, guided by open ended questions. Data analysis followed a stepwise deductive inductive method.

Results

`Achieving acceptance and usability through digital social interaction´ emerged as a unifying theme that bridged the experiences of patients with long-term illnesses and the nurse navigators. This overarching theme was illustrated by four sub-themes, which all reflected the usability and acceptability of the nurse-assisted remote patient monitoring service in various ways.

Conclusion

Acceptability and usability are critical factors to consider when evaluating remote patient monitoring interventions. In this study, the most important feature for promoting acceptability and usability was the interaction between patie

背景长期慢性病患者在最初的诊断和治疗阶段之后，往往需要持续的医疗护理、生活方式调整和社会心理支持。许多患者病情恶化，需要住院治疗，尤其是在出院后的过渡时期。涉及远程患者监测的电子健康干预措施有可能促进患者的自我管理，并在医院和患者的家庭环境之间架起一座更无缝的桥梁。然而，此类干预措施只有在有效、被用户接受和采用、在日常实践和日常生活中常态化并能够广泛实施的情况下，才能对健康和医疗保健产生重大影响。可行性研究用于确定干预措施是否适合目标人群，是否能有效实现预期目标。我们的目的是通过使用正常化过程理论的核心结构来评估护士辅助远程患者监护干预措施的可接受性和可用性，该干预措施用于对长期病患者进行院后随访。方法在患者接受远程患者监护服务操作培训时，在观察指南的指导下进行结构化和公开观察。在开放式问题的指导下，对患者和护士导航员进行了半结构化访谈，了解他们对远程随访护理的体验。结果 "通过数字社交互动实现接受性和可用性 "成为一个统一的主题，将长期病患者和护士导航员的经历联系在一起。这一总主题由四个子主题组成，它们都以不同的方式反映了护士协助的远程患者监护服务的可用性和可接受性。结论可接受性和可用性是评估远程患者监护干预措施时需要考虑的关键因素。在本研究中，促进可接受性和可用性的最重要特征是患者与护士导航员之间的互动。因此，干预措施的可行性和实施潜力取决于提供者和接受者之间的关系。

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引用次数: 0

Health economic evaluations of programs reducing preterm birth: A scoping review 减少早产计划的卫生经济评估：范围界定审查

IF 3.1 Q1 NURSING

International Journal of Nursing Studies Advances

Pub Date : 2024-07-25 DOI: 10.1016/j.ijnsa.2024.100228

Background

Preterm birth has lifelong implications, placing a burden on individuals, families, communities and the health system. While several interventions to reduce preterm birth have been economically evaluated, no scoping review has been undertaken.

Objective

To conduct a scoping review of economic evaluations of interventions that have reduced preterm birth, identify gaps in the literature and inform future health care providers and researchers on the economic value of preterm birth reduction interventions.

Methods

Databases such as PubMed, Cumulative Index to Nursing and Allied Health Literature, EBSCO, Medline (OVID), EMBASE, NHS Health Technology Assessment, the Cost-Effectiveness Analysis Registry, and the NHS Economic Evaluation Database and grey literature were comprehensively searched for economic evaluations of interventions that reduced preterm birth conducted since 2000. Items included: preterm birth reduction, intervention, method of economic evaluation, time-horizon of analysis, study population, perspective of evaluation, effectiveness, and costs. Review processes were undertaken by two reviewers, and disagreements were resolved by the larger team.

Results

Fifteen publications met the inclusion criteria, including pharmacological interventions (5), telemedicine (1), diagnostic procedures (2), public and community health (2), prenatal care and nutrition (2), father's involvement (1), doula care (1) and a comprehensive maternity service redesign (1). Variations were observed in study design, time-horizon, study population and method of evaluation. Most studies (n = 13) adopted either a healthcare payer, provider, or system perspective. Shorter timehorizons for analysis were adopted in all studies, except one that conducted a lifetime economic evaluation. All included interventions, except one, were found to be costeffective, cost-beneficial or led to cost-savings.

Conclusion

Despite preterm birth placing a high economic burden on health systems and society, we found a dearth of long-term economic evaluations of prevention and reduction initiatives. Future research on preterm birth reduction initiatives should include economic evaluations.

背景早产会影响一生，给个人、家庭、社区和医疗系统带来负担。目的对减少早产的干预措施的经济评价进行范围界定，找出文献中的不足，并向未来的医疗保健提供者和研究人员介绍减少早产干预措施的经济价值。方法在 PubMed、Cumulative Index to Nursing and Allied Health Literature、EBSCO、Medline (OVID)、EMBASE、NHS Health Technology Assessment、Cost-Effectiveness Analysis Registry 和 NHS Economic Evaluation Database 等数据库以及灰色文献中全面检索 2000 年以来对减少早产干预措施的经济评估。项目包括：减少早产、干预措施、经济评估方法、分析时间范围、研究人群、评估角度、效果和成本。结果15篇出版物符合纳入标准，包括药物干预（5）、远程医疗（1）、诊断程序（2）、公共和社区卫生（2）、产前护理和营养（2）、父亲参与（1）、朵拉护理（1）和综合产科服务重新设计（1）。在研究设计、时间跨度、研究人群和评估方法方面存在差异。大多数研究（n = 13）采用了医疗支付方、提供方或系统的视角。除一项研究进行了终生经济评估外，其他所有研究都采用了较短的时间跨度进行分析。结论尽管早产给医疗系统和社会带来了沉重的经济负担，但我们发现对预防和减少早产措施进行长期经济评估的研究并不多。未来对减少早产措施的研究应包括经济评估。

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引用次数: 0

The development of nursing-sensitive indicators: A critical discussion 制定护理敏感指标：批判性讨论。

IF 3.1 Q1 NURSING

International Journal of Nursing Studies Advances

Pub Date : 2024-07-24 DOI: 10.1016/j.ijnsa.2024.100227

Discussion arguments

In a science-based profession, nurses must continuously monitor and evaluate the effectiveness of their care. However, data on what constitutes nursing care in practice and the delivery process is lacking. Insufficient evidence on how nurses contribute to patient care hampers the evaluation of nursing practice.

We discuss nursing-sensitive indicators, their origins, current applications, and challenges related to their use in evaluating the quality of nursing care. We analyse nursing-sensitive indicators in the context of criticisms levelled at the profession related to the lack of evidence to support their value in the larger healthcare environment.

Conclusions

We have a disjointed approach to evaluating nursing care. Current systems designed to monitor nursing care, such as metrics and data sets, are not adequate or effective for comprehensively evaluating nursing care, considering the fundamentals and values of the nursing profession.

讨论论点作为一个以科学为基础的职业，护士必须不断监测和评估其护理工作的成效。然而，有关护理实践和实施过程的数据却十分匮乏。我们讨论了护理敏感指标、其起源、当前应用以及在评估护理质量时面临的挑战。我们分析了护理敏感性指标在医疗保健大环境中的价值，并结合对护理专业的批评，指出这些指标缺乏支持其价值的证据。考虑到护理专业的基本原理和价值，目前为监测护理而设计的系统（如度量标准和数据集）不足以或不能有效地全面评估护理。

引用次数: 0

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