Nursing Reports最新文献

Background/Objectives Leadership is central to the development of effective workplace cultures and as such should be viewed as a practice that is relational, exercised through a process of mutual and reciprocal influence. Person-centred leadership is an approach to leadership that supports a way of being that is authentic, prioritising values lived out in action. However, there is an increasing recognition that leadership development has not been impactful in relation to workplace culture. This paper reports on the ongoing evaluation of an innovative development programme (Queen's Nurse Development Programme), the overall aim of which was to illuminate the participants' experiences of engaging in transformative learning and development and identify the technical and transformative outcomes arising. The programme focused on developing leadership capacity for societal change and maximising the health impact of community nursing leaders. Methods The methodological framework for evaluation was underpinned by a Collaborative Critical Creative Inquiry. Twenty community nurses were selected to undertake the programme during 2020. The collection and analysis of data was consistent with the Collaborative Critical Creative Inquiry and was conducted as a one-day workshop, with participants engaged in a cycle of creative hermeneutic analysis. Results A total of seven themes were identified, including: sense of belonging; personal growth; developing new skills; finding voice; importance of self-care; and creating a safe place. This illuminated how the transformative learning and development processes within this programme were experienced and how these enabled participants to explore how they influence their practice and workplace. It is the journey with self that generates a sense of belonging and enables personal growth and the ability to care for self and others. Conclusions The key learning from this innovative development programme is the importance of focusing on the attributes of practitioners and the key building blocks for knowing, being, and becoming a person-centred practitioner.

Background: The increasing number of institutionalized older individuals worldwide stresses the need to evaluate the association between the functional profile of institutionalized older adults and their quality of life (QoL), depressive symptoms and feelings of loneliness.

Methods: A cross-sectional study was conducted in 19 residential facilities in Alentejo, Portugal. Between March and September 2023, all individuals aged ≥65 years were invited to complete a structured questionnaire (n = 1303). Sociodemographic and clinical data were collected, and validated scales for the Portuguese older population were used. Linear regression and unconditional binary logistic models were computed.

Results: The highest level of dependence was observed in the self-care dimension (mean (SD) = 2.93 (1.21)), with 40% of participants exhibiting levels of dependence requiring daily care or total replacement. QoL was inversely associated with functionality in all dimensions, as well as with severe or complete dependence, even after adjusting for sex, age and education. Participants with depressive symptoms and feelings of loneliness were, respectively, three and two times more likely to be dependent on care (adjusted OR = 3.69, 95% CI: 1.80-7.52; adjusted OR = 2.04, 95% CI: 1.07-3.87).

Conclusions: Public policies and interventions should include social and emotional support strategies alongside traditional medical interventions.

COVID-19 affects the respiratory system, reducing the oxygen saturation level, leading to hypoxemia and increasing the metabolic oxygenation need.

Objective: To describe the nursing interventions related to the need for oxygenation in hospitalized adults with severe COVID-19 disease in the Intensive Care Unit.

Method: This was an observational, retrospective and descriptive study in a population of 2205 patients with a convenience sample of n = 430 and based on the North American Nursing Diagnosis Association (NANDA), the Nursing Interventions Classification (NIC) and the Nursing Outcomes Classification (NOC). The analysis was performed with a non-parametric test to determine the association between the nursing interventions and the need for oxygenation.

Results: The findings are aimed at improving nursing interventions with statistical associations as follow: oxygen therapy (p < 0.000), airway suctioning (p < 0.000), airway management (p = 0.029), invasive mechanical ventilation (p < 0.000) and non-invasive mechanical ventilation (p = 0.022). NOC taxonomy expected outcomes in ventilation, 34% (146), alteration in gas exchange, 33.7% (145), and respiratory status, 558.9% (253), were severely compromised.

Conclusions: The nursing interventions to maintain the respiratory status are focused on airway care and oxygen therapy in order to increase the oxygen saturation level and decrease the severity of the need for oxygenation.

Background/Objectives: Hospitalization can be stressful for children due to the influence of unfamiliar environments, separation from family, and interactions with healthcare professionals. This study aimed to explore children's hospitalization experiences from a child-centered care perspective to develop interventions that better meet their emotional and psychological needs. Methods: This qualitative study employed Husserl's descriptive phenomenology to explore hospitalization experiences among children aged 9-13 years. Conducted at a primary health center in Spain from October 2022 to June 2023, the study used purposive sampling to select participants hospitalized within the past six months. Data were collected through in-depth interviews and children's self-created drawings, analyzed using thematic analysis with ATLAS.ti software. Results: A total of 10 school-age children (five boys and five girls) were interviewed. Three main themes emerged: (1) Emotions and Feelings-children described fear, anxiety, and loneliness during their hospital stay; (2) Experiences of Pain and Discomfort-participants reported physical pain and discomfort; (3) Interactions with Medical Staff-children expressed a need for more detailed explanations and clearer communication. Conclusions: The findings highlight the importance of family-centered care and improved communication between healthcare providers and children. Strategies like art therapy and flexible visiting hours could provide better emotional support. Tailored communication to children's developmental levels is crucial. Integrating these strategies into clinical practice could enhance the well-being of hospitalized children. Future research should focus on evaluating these interventions to improve pediatric care.

Background/objectives: Overweight and obesity are growing concerns that also affect nursing staff, healthcare professionals that play a critical role in public health awareness and intervention. This study aimed to define the health parameters associated with body weight, analyze if there is an erroneous self-perception of overweight/obesity through the distortion of body weight perception, and determine the predictive factors of body weight distortion.

Methods: A cross-sectional study of 224 nursing students gathered anthropometric and demographic data. Self-perceived body weight was assessed using Stunkard and Stellar's scale. Descriptive statistics and multinomial logistic regression identified significant predictors of weight distortion.

Results: The analysis found that men reported greater weight discrepancies than women. Specifically, 57% of the men (28 of 49 participants) underestimated their real BMI, while only 23% of the women (40 of 175 participants) did so. Age, sex, and weight classification emerged as significant explanatory variables for the distortion of body weight perception.

Conclusions: The findings indicate a significant vulnerability among nursing students to the misperception of their own body weight status, highlighting the need for targeted training strategies. These strategies should focus on correcting misperceptions of obesity among health professionals throughout their working life to improve future obesity prevention efforts for society.

Background/objectives: Rehabilitation helps reduce disability in dementia. The Australian National Dementia Action Plan identifies a gap in clear treatment pathways post-diagnosis, affecting the quality of life for those with dementia. This study assessed the impact of a one-day dementia training course and follow-up on GPs' and practice nurses' knowledge, attitudes, and confidence regarding dementia rehabilitation.

Methods: The training, led by two experienced GPs and an academic physiotherapist, covered dementia diagnosis, allied health roles, care planning, and referrals. The follow-up involved applying the learnt material and completing a reflective task. Three longitudinal surveys (Dementia Knowledge Assessment Scale-DKAS, General Practitioners' Attitudes and Confidence towards Dementia Survey-GPACS-D, and Dementia Rehabilitation Scale) and Likert-scale statements were conducted pre-course, post-course, and at four-month follow-up, alongside a focus group. Descriptive and regression analyses were applied to survey data, and content analysis was used for focus group data.

Results: Seventeen participants (14 GPs, 3 nurses) completed the pre-post-course survey, with eight (6 GPs, 2 nurses) participating in follow-up and focus group discussions. Post-course, DKAS scores increased by 12.1%, GPACS-D by 10.1%, and the dementia rehabilitation scale by 9.4%. Likert-scale statements improved by 8-79%. At the four-month follow-up, there was a slight, non-significant decline in most measures. Focus groups highlighted the training's impacts, useful components, barriers, and suggestions for improvement.

Conclusion: Training GPs and practice nurses in dementia rehabilitation enhances knowledge, awareness, and confidence. Ongoing efforts are needed to sustain benefits and address referral barriers for better access to dementia rehabilitation services.

Background and objectives: Despite the robustness of evidence-based practice in increasing efficiency in nursing care and improving patient safety, using evidence in practice is still rare in mental health nursing. This correlational descriptive research aimed to explore the factors and examine the relationship between attitudes, knowledge/skills, organizational culture, mentorship, and demographic factors to evidence-based practices among mental health nurses working in psychiatric hospitals in Thailand.

Methods: The sample consisted of 255 nurses working in psychiatric hospitals under the Thai Department of Mental Health, located in service units across the country's four regions. The data collection tools included (1) a demographic questionnaire, (2) the Evidence-Based Practice Questionnaire: EBPQ, (3) Organizational Culture & Readiness for System-wide Integration of Evidence-Based Practice: OCRSIEP, and (4) the Evidence-Based Practice Mentorship Scale. Descriptive statistics and Spearman's correlation coefficient were used for data analysis.

Results: The findings revealed that the factors positively correlated with evidence-based practice among mental health nurses in Thailand were attitude with a mean score of 4.90 (r = 0.39, p-value < 0.001), knowledge/skills with a mean score of 4.69 (r = 0.61, p-value < 0.001), organizational culture with a mean score of 3.94 (r = 0.26, p-value < 0.001), and mentorship with a mean score of 2.77 (r = 0.16, p-value = 0.011). Demographic factors such as educational level (r = 0.21, p-value < 0.001) and work experience in psychiatric and mental health nursing (r = 0.14, p-value = 0.031) were also positively correlated.

Conclusions: This research revealed that EBP knowledge and skills are the most significant factors related to evidence-based practice among Thai mental health nurses. Therefore, EBP knowledge and skills should be enhanced in the curriculum during the nursing study and through continuing education once nurses graduate. Organizational culture and mentorship also need to be promoted to strengthen the use of EBP in Thailand.

(1) Background: Pain is a common symptom in patients with Amyotrophic Lateral Sclerosis (ALS). There are no evidence-based pharmacological treatments for pain in ALS; recommendations are based on guidelines for chronic non-oncological pain and clinical experience. The aim is to map the literature on how people with ALS experience pain, and how this affects their daily activities and social relationships. (2) Methods: This scoping review included studies concerning patients with spinal/bulbar ALS aged ≥ 18 years who experience pain, focusing on perception, characteristics, treatment, and impact on quality of life. Temporal and linguistic criteria were applied when searching the MEDLINE, CINAHL, and SCOPUS databases. (3) Results: The management of pain in these patients is complex and involves the use of anti-inflammatory drugs, analgesics, and opioids. Pain is associated with other conditions such as depression and anxiety, which contribute to a deterioration in the quality of life. Moreover, pain may also negatively influence patient compliance with prescribed treatment regimens and the quality of care they perceive themselves to be receiving. (4) Conclusions: It is of the most importance to identify effective ways to assess and treat this issue, with health care professionals taking an active role in this process.

Background: In the transition to a professional learning environment, healthcare professionals in their first year of specialized postgraduate clinical training (known as residents in Spain) are suddenly required to handle confidential information with little or no prior training in the safe and appropriate use of digital media with respect to confidentiality issues. The aims of this study were: (1) to explore the usefulness of an advanced clinical simulation program for educating residents from different healthcare disciplines about confidentiality and the dissemination of clinical data or patient images; (2) to explore the use of social networks in healthcare settings; and (3) to explore participants' knowledge and attitudes on current regulations regarding confidentiality, image dissemination, and the use of social networks; Methods: This was a cross-sectional study. Data were collected from all 49 first-year residents of different health professions at a Spanish hospital between June and August 2022. High-fidelity clinical simulation sessions designed to address confidentiality and health information dissemination issues in hospital settings, including the use of social networks, were developed and implemented. Data were assessed using a 12-item ad hoc questionnaire on confidentiality and the use of social media in the healthcare setting. Descriptive of general data and chi-square test or Fisher's exact test were performed using the SPSS 25.0 software; Results: All the participants reported using the messaging application WhatsApp regularly during their working day. A total of 20.4% of the participants stated that they had taken photos of clinical data (radiographs, analyses, etc.) without permission, with 40.8% claiming that they were unaware of the legal consequences of improper access to clinical records. After the course, the participants reported intending to modify their behavior when sharing patient data without their consent and with respect to how patients are informed; Conclusions: The use of advanced simulation in the training of interprofessional teams of residents is as an effective tool for initiating attitudinal change and increasing knowledge related to patient privacy and confidentiality. Further follow-up studies are needed to see how these attitudes are incorporated into clinical practice.

Patient safety is fundamental to healthcare. Adverse events, particularly medication errors, cause harm to patients, especially the paediatric population in the emergency department.

Aim: To explore paediatric emergency nurses' perceptions of medication administration errors.

Method: A qualitative, ethnomethodological, descriptive study. The participants were nurses working in the paediatric emergency department. Data were collected through in-depth individual interviews with paediatric emergency nurses. The study excluded nurses employed for less than six months. Ten individual interviews were carried out. All interviews were face-to-face and audio-recorded with the participant's consent. Interviews took between 52 min and 1 h 25 min. A questions guide was followed during the interviews. The analysis of the data was carried out according to the scheme proposed by Taylor and Bogdan.

Results: The participants' discourse revealed three main categories: Safety culture, transmitted by supervisors and safety groups. Teamwork, with good communication and a positive relationship. Error management, the lack of formal support and negative feelings despite an understanding of the multifactorial nature of errors. The study identifies several challenges in the healthcare system. Emphasis was placed on the perception of errors in terms of patient harm, while near misses or dose delays or omissions are not treated as errors.

Conclusions: Although institutions have implemented safety culture strategies, nurses have not fully embraced them. There is a need to promote a positive safety culture and a safe working environment that encourages communication within the team. The hospital should provide training in safe management and patient safety and develop effective protocols. This study was not registered.