International Journal of Nursing Studies Advances最新文献

Background

Objective

Design

Setting

Participants

Methods

Results

Conclusions

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

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.

Background

There is substantial evidence on the associations between a positive nurse practice environment and improved nurse and patient outcomes, as well as the factors that mediate these associations, in high-income countries and in hospital settings. The knowledge gaps in African and primary health care settings motivated this empirical study.

Objective

The objective of this study was to examine the impact of the dimensions of the nurse practice environment, specifically human resource management, foundations for nursing care, and participation in clinic affairs, on job outcomes and standards of care.

Design

A cross-sectional study was conducted between November 2021 and June 2022.

Setting

180 primary health care clinics in two South African provinces of Gauteng and North West.

Participants

665 nurses of all categories.

Methods

A causal model was developed with pathways between the nurse practice environment dimensions and the outcomes of job satisfaction, intention to leave, and standards of care. A set of standardised instruments was used to measure the study variables. Using structural equation modelling, workload and professional support were tested as potential mediators between the nurse practice environment and the outcome variables.

Results

The nurses scored the domain of foundations for nursing care 71.2 out of 100 on average, indicating high agreement, while the mean scores for nurses’ participation in clinic affairs and human resources management were lower at 68.0 and 61.7 respectively. Although nurses expressed moderate satisfaction with professional support (67.7), they were less satisfied with their workload (52.2). The mean score of overall job satisfaction was moderate (58.9), with 53.8 % of the nurses reporting that they intended leaving the clinic where they were working. Thirty-six percent intended leaving the nursing profession, indicating low intention to stay. The final mediation model was judged to fit the data adequately based on goodness-of-fit indices, confirming that workload and professional support had a mediating role between the nurse practice environment dimensions of interest and both nurses’ job outcomes and standards of care.

Conclusions

We have highlighted the value of supportive practice environments, effective workload management, and enhanced professional support in improving nurses’ job outcomes and satisfaction with standards of care. Improving nurses’ practice environments at primary health care level may have a wide-ranging impact on the performance of the health system. Therefore, primary health care facility managers should ensure that workload is distributed equitably, professional support for nurses is enhanced, and the overall work environment is improved.

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.

Background

Objectives

Design

Settings & participants

Methods

Results

Conclusions

Background

Chronic kidney disease is common, affecting up to 13 % of the global population, and is predicted to become the fifth leading cause of 'life years lost' by 2040. Individuals with end-stage kidney disease commonly develop complications such as protein-energy wasting and cachexia which further worsens their prognosis. The syndrome of ‘renal cachexia’ is poorly understood, under-diagnosed and even if recognised has limited treatment options.

Objective

To explore the lived experience of renal cachexia for individuals with end-stage kidney disease and the interrelated experiences of their carers.

Design

This interpretive phenomenological study was designed to facilitate an in-depth exploration of how patients and carers experience of renal cachexia. To improve and document the quality, transparency, and consistency of patient and public involvement in this study the Guidance for Reporting Involvement of Patients and the Public-Short Format was followed.

Setting

The study was conducted across two nephrology directorates, within two healthcare trusts in the United Kingdom.

Participants

Seven participants who met the inclusion criteria were recruited for this study, four patients (three female, one male) and three carers (two male, one female).

Methods

We employed a purposive sampling strategy. Data collection was conducted between July 2022 and December 2023. Interviews were semi-structured, audio-recorded, transcribed verbatim and analysed in six steps by two researchers using interpretive phenomenological analysis. Ethical approval was approved by the Office for Research Ethics Committees Northern Ireland (Reference: 22/NI/0107).

Results

Analysis generated six group experiential themes: the lived experience of appetite loss, functional decline and temporal coping, weight loss a visual metaphor of concern, social withdrawal and vulnerability, the emotional toll of eating challenges and psychological strain amidst a lack of information about cachexia.

Conclusion

This is the first qualitative study exploring the lived experience of renal cachexia for patients and carers. Our study highlights that psycho-social and educational support is urgently needed. Additionally, healthcare professionals need better information provision to help them to recognise and respond to the needs of this population. Further research is required to develop models of holistic support which could help patients and carers cope with the impact of renal cachexia and optimally manage this syndrome within the family unit.

Registration

N/A.

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.

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.

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.