Nursing Reports最新文献

Adequate coordination between healthcare levels has been proven to improve clinical indicators, care costs, and user satisfaction. This is more relevant to complex or vulnerable patients, who often require increased care. This study aims to evaluate the differences between hospital discharge follow-up indicators, including number of general practitioners' (GPs) and community nurses' (CNs) consultations, presentiality of consultations, type of first post-discharge consultation, and time between hospital discharge and first consultation. Vulnerable and non-vulnerable patients were compared. A longitudinal retrospective study was carried out in the north of Tenerife on the post-discharge care of patients discharged from the Canary Islands University Hospital (Spanish acronym HUC) between 1 January 2018 and 31 December 2022. The results obtained show deficiencies in the care provided to patients by primary care (PC) after being discharged from the hospital, including delayed first visits, low presentiality of those visits that were less frequent even with increased patient complexity, scarce first home visits to functionally impaired patients and delays in such visits, and a lack of priority visits to patients with increased follow-up needs. Addressing these deficiencies could help those most in need of care to receive PC, thus reducing inequalities and granting equal access to healthcare services in Spain.

Background: Palliative care provides holistic support, addressing physical, psychological, social, emotional, and spiritual dimensions of suffering, known as "total pain", to improve patients' quality of life. Patients often rely on healthcare professionals, particularly nurses, for support. This study aimed to develop and validate questionnaires assessing nurses' perceptions of psychological, social, and spiritual issues in palliative care and their effectiveness in managing them.

Methods: Two self-rated questionnaires were created: the Psychological, Social, and Spiritual Problems of Palliative Patients' Questionnaire and the Effectiveness in Coping with the Psychological, Social, and Spiritual Challenges of Palliative Care Patients. The study surveyed 237 nurses caring for palliative patients in Split Dalmatian County, Croatia.

Results: The questionnaires demonstrated high reliability with Cronbach's α values of 0.98 and 0.99. Factor analysis revealed four factors for the first questionnaire and three for the second. Nurses primarily perceived patients as experiencing fear and emotional/spiritual suffering, with the greatest difficulty coping with the fear of the disease outcomes. Nurses acknowledged the need for improvement in addressing patient challenges, highlighting gaps in the Croatian system.

Conclusions: Ongoing efforts are crucial to prioritize palliative care globally, with nursing professionals playing a vital role in symptom management.

The healthcare environment faced by nurses is complex, with high workloads and situations of high comorbidity. The integration of nurses into the work environment is a cause for concern, and improvements are sought for their incorporation into the workforce. The benefits of mentoring programs are described not only for nurses but also for patients with safer practices and benefits for the institution due to the increased commitment of its professionals. A methodological article that illustrates the complete process to design and implement a tutoring program for new nurses in an emergency department is presented. The competency profile required for the figure of tutor was developed, including the steps followed for the development of the program and the structure and phases of which it is composed, as well as the validation of the evaluation instruments of the process. A strength was the participation of experts during the in-depth analysis of the competency profile, as well as in the adaptation of the evaluation items, which endorses the pertinence, relevance, usefulness, and clarity of the content of this program. The transparency in this methodology makes it possible to follow the steps for its reproduction and applicability in other hospitals.

Grief is a natural and self-limited adaptation process to a new reality that emerges after a significant loss (whether real or perceived), with a broad variety of manifestations that exert an impact on a grieving person's health. The study aim was to synthesize the evidence available about the interventions carried out by Primary Health Care nurses, by means of an individual approach to reduce maladaptive grief or maladaptive grief risk. A scoping review was conducted (November and December 2023) through searches in Medline, Cinahl, Web of Science, ProQuest and Scopus using MeSH terms combined with Booleans. Primary research of any design in adult people undergoing grief situations and receiving professional assistance by nurses in the primary, home and community care contexts published after 2009 in English, Spanish or Portuguese languages were included. Excluded publications were those conducted in in-hospital clinical settings and which did not correspond to research designs or the gray literature. The screening process was carried out by two reviewers using the appropriate JBI critical appraisal tools for each design and discrepancies were resolved by a third reviewer. A total of n = 10 studies were included (n = 4 qualitative, n = 2 RCTs, n = 1 quasi-experimental, n = 2 cross-sectional observational, and n = 2 mixed methods). The qualitative studies identified topics and subtopics of professionals' and families' experiences of grief. The observational studies analyzed symptoms and factors associated with the grieving process. Interventions consisted of cognitive-behavioral therapies delivered by psychological specialists who assessed the severity of grief in a range of cultural contexts using different instruments. The evidence retrieved from the studies that address the reduction in maladaptive grief or maladaptive grief risk is not conclusive. There is a need to increase both the number and the methodological quality of studies assessing the effectiveness of Nursing care in Primary Health Care for individuals experiencing maladaptive grief or maladaptive grief risk. Further research should focus on experimental studies, developing specific interventions conducted by nurses to address individual's grief and prevent maladaptive grief.

Comprehending the significance of legacy in end-of-life (EoL) situations helps palliative care professionals enhance person-centered outcomes for those with a life-threatening illness and their families. Our purpose was to conduct a concept analysis of legacy in EoL care. By employing Walker and Avant's approach, we identified the concept's defining characteristics. Subsequently, we established the antecedents, consequences, and empirical referents. After conducting a thorough review of titles and abstracts, a total of 30 publications were analyzed. These articles were sourced from three databases (CINAHL, Medline via PubMed, and Scopus) from 2002 to 2023. Our analysis identified several core attributes of legacy: (a) leave behind something of value that transcends death; (b) determine how people want to be remembered; (c) build and bestow across generations; (d) integrate advance care planning through EoL conversations and shared decision-making; and (e) develop strategies of dignity-conserving care. The consequences are related to improvements in spiritual and subjective well-being; coping with inevitable EoL existential issues; decreases in EoL suffering; engendering self-awareness, hope, gratitude, and peace; achieving and maintaining dignity; creating good memories; promoting mutually constructive and transformative relationships; and fostering the adjustment of bereaved people. Nevertheless, further effort is required to implement the key attributes of legacy that form the basis for creating legacy-oriented interventions near the EoL.

Background: Collaborative Online International Learning (COIL) involves international online activities that allow the support of transversal competencies in diverse and multicultural environments without moving from home. This paper presents the learning experiences and satisfaction of undergraduate nursing students at the University of Girona (Spain) from a COIL activity involving clinical simulation in collaboration with the University of Coventry (United Kingdom).

Methods: Qualitative study of content analysis. Twelve students from each of the two universities participated in the data collection process using reflective diaries.

Results: The data analysis highlighted five topics related to the COIL activity involving clinical simulation: (a) initial attitudes towards the COIL activity; (b) main learning through the COIL activity; (c) positive aspects of the COIL activity; (d) weaknesses of the COIL activity and proposals for improvement; and (e) overall evaluation of the COIL activity.

Conclusions: The main learning outcomes referred to by students were the relationships between transversal competencies and the skills for life, language skills, cultural skills, and more specific skills related to clinical standards. The students were most satisfied with the teaching activities and specified positive aspects and weaknesses that will add value to future versions of the activities.

The evaluation of the competencies corresponding to the different professional profiles of future nursing graduates is fundamental to their training. In this regard, students' self-evaluation must be part of their training. This study aimed to develop and psychometrically test the Perceived Self-Efficacy in Nursing Competencies (PSENC) Scale. This study was conducted in two phases: selecting and adjusting items and assessing the instrument's psychometric properties. A sample of 1416 students completed the scale online. Exploratory factor and confirmatory factor analyses were conducted. Inferential analysis was carried out. The exploratory factor analysis of the PSENC scale with 20 items resulted in five factors (76.3% of variance). All factors showed Cronbach's alpha coefficients > 0.70. The confirmatory factor analysis measurement model showed satisfactory and adequate goodness-of-fit indices. The developed scale showed the psychometric adequacy and usefulness to the self-assessment of nursing students regarding their self-efficacy expectations in competencies during their clinical practicum. This study was not registered.

Our study aims to estimate the prevalence of depressive symptomatology among older adults and to assess their association with loneliness and quality of life according to institutionalisation status in a Portuguese sample.

Background: The World Health Organisation estimates that by 2050, the world's population over 60 will number two billion people, which poses complex challenges in terms of maintaining the mental health of older adults. The COVID-19 pandemic has increased the prevalence of depressive symptoms in this population, but the post-pandemic phase has not yet been studied much.

Methods: A cross-sectional survey was carried out in 2023 among institutionalised and non-institutionalised older adults (total n = 525; institutionalised = 458; non-institutionalised = 67) who were selected by convenience sampling. The Patient Health Questionnaire (PHQ-9) was used to assess the presence of depressive symptoms, the WHOQOL-BREF to assess perceived quality of life and the Loneliness Scale (UCLA) to assess negative feelings of loneliness. Unconditional logistic regression models were fitted to compute crude adjusted odds ratios (ORs) and the respective 95% confidence intervals (95%CIs) for the association between sociodemographic, clinical and psychosocial characteristics and depressive symptomatology, according to institutionalisation status. The final model was adjusted for sex, age, QoL and feelings of loneliness.

Results: Of the 525 participants, 74.6% of the non-institutionalised participants had no or minimal depressive symptoms, while 55.4% of the institutionalised participants fell into this category. Mild to moderately severe depressive symptoms were present in 25.4% of the non-institutionalised participants. 26.9% of the institutionalised participants had mild symptoms, 11.8% had moderate symptoms, 3.9% had moderately severe symptoms, and 2.0% had severe depressive symptoms. Overall, a higher quality of life was associated with lower levels of depressive symptoms. Participants describing feelings of loneliness were more likely also to present depressive symptoms (OR = 78.10; 95%CI 2.90-2106.08 and OR = 3.53; 95%CI 1.72-6.91 for non-institutionalised and institutionalised older adults, respectively), independently of institutionalisation status.

Conclusions: The prevalence of depressive symptoms is high in older adults, which means that it has not decreased after the increase seen due to the COVID-19 pandemic. A lower perception of quality of life and the presence of negative feelings of loneliness are associated with the presence of depressive symptoms. These conclusions suggest that plans should be developed to intervene in the dimensions of depressive symptoms, perceived quality of life and negative feelings of loneliness.

In recent years, there has been an increase in the practice of chemsex, which is becoming an increasingly serious public health problem. The complex interaction between chemsex and mental health underscores the need to understand the psychological, social, and environmental factors that influence this practice.

Methods: A qualitative descriptive phenomenological study was conducted in the community of Madrid, Spain to explore the depth of the chemsex phenomenon through a thematic analysis. Between April and June 2024, interviews were conducted with 15 MSM (gay, bisexual, and other men who have sex with men) who participate in these practices, using purposive and snowball sampling.

Results: three main themes were identified, namely, (T1) contextualization of the practice, (T2) factors associated with chemsex, and (T3) strategies and interventions for risk and harm reduction.

Conclusion: Chemsex is a phenomenon that combines sexual practices with substance use in complex social environments, presenting significant risks to physical, mental, and sexual health. It is necessary to implement public health interventions to mitigate these risks.

Understanding and addressing dehumanization in healthcare is crucial due to its profound impact on patient care, ethical implications on patient dignity and autonomy, and its potential to affect the psychological well-being of healthcare professionals. The primary aim of this study was to establish reliable and valid instruments measuring two different types of dehumanization, namely animalistic dehumanization (i.e., stripping one of their uniquely human characteristics) and mechanistic dehumanization (i.e., stripping one of their human nature characteristics) among healthcare professionals. In this cross-sectional validation study among healthcare professionals, we tested measures of both animalistic and mechanistic dehumanization, focusing on the dehumanization of patients (hetero-dehumanization) and oneself (self-dehumanization), respectively. All measures were developed and validated based on a concept analysis, a literature review, and an appraisal of pre-existing scales. The research was conducted among 400 nurses and medical doctors employed in Greek public hospitals. Coefficient validity ratio results showed that 100% of items were acceptable for both measures. The newly established and validated hetero-dehumanization scale encompassed two factors (factor 1: animalistic dehumanization, factor 2: mechanistic dehumanization; Cronbach's alpha was equal to 0.86 for each measure). The self-dehumanization scale was a mono-factorial measure of mechanistic dehumanization (Cronbach's alpha = 0.97). Two validated measures of (self- and hetero-) animalistic and mechanistic dehumanization measures were developed for the assessment of dehumanization among health professionals, which will form the basis for future research in this important scientific field.