SAGE Open Nursing最新文献

Introduction: Nurse practitioner-led clinics (NPLC) represent a model of care that has the potential to enhance primary healthcare delivery to community-dwelling adults who are living with chronic disease by providing greater access and continuity of care and reducing the burden on acute care settings. However, there is limited understanding of nurse practitioners' experiences and perspectives on supporting adults in chronic disease management within an NPLC model of care. Increased understanding would contribute to our ability to evaluate the effectiveness of the NPLC model of care for chronic disease management.

Objective: This study explored current chronic disease management practices implemented by nurse practitioners within NPLC throughout the Province of Ontario.

Methods: A qualitative study was implemented using interpretive description. In-depth interviews were conducted between January 2021 and May 2021 with nurse practitioners who were practicing within NPLCs across Ontario. Data was analyzed using thematic analysis.

Results: Eleven interviews were completed with nurse practitioners who provided care to community-dwelling adults who were managing chronic disease in a range of geographic settings. Resultant themes included: the nurse practitioner role in bridging access to patients who fall between the cracks, benefits of interprofessional care, meeting a patient where they are at, and addressing healthcare system burden.

Conclusion: Results suggest that NPLCs are well-positioned to support community-based patients living with chronic disease through provision of on-site interprofessional care, continuity in service provision and increased access to primary healthcare services. This article provides insights into the nurse practitioner led primary healthcare model and how it can facilitate access to services, foster patient self-management and provide a successful alternative model of care.

Background: Nurse educators must seek innovative frameworks for their curricula to prepare nursing students to meet evolving healthcare needs. The South African National Department of Health introduced the new nursing curriculum (R171) in 2013 with the aim of producing generalist nurses who can meet the health care needs of the patients and to align the nursing program with the relevant Higher Education Qualification Framework. R171 was implemented in the North-West Province in 2021.Therefore, the main purpose of this study was to explore and describe the experiences of nurse educators regarding the three-year R171 nursing curriculum in North-West Province, South Africa.

Methodology: The researcher used a descriptive phenomenology research design to achieve the aim and objectives. A nonprobability sampling approach was adopted for the study with use of a purposive sampling technique to select participants with insight and experience on the phenomenon in question. Semi-structured individual interviews, through Microsoft Teams, collected the data, with analysis using thematic analysis.

Results: Three themes emerged from the findings of this study, namely inadequate resources to implement the R171 nursing curriculum, teaching and learning challenges in implementing the R171 nursing curriculum, and the possible solutions for effective implementation of the R171 nursing curriculum.

Conclusion: To implement the R171 nursing curriculum effectively, it is necessary to include nurse educators in the development of the curriculum. There is also a need for comprehensive support that comprises all available essential resources.

Introduction: Novice nurses face many concerns at the beginning of their professional careers. The majority of novice nurses have been challenged with stress, inability to work autonomously, insecurity, inexperience, and unpreparedness to work in a clinical setting at the early of their work.

Objective: This study aims to explain novice nurses' experiences to understand their concerns. This was a qualitative study using conventional content analysis.

Methods: Unstructured in-depth open individual interviews were used for data collection. Sixteen nurses were selected by purposeful sampling. The data were analyzed using the Graneheim and Lundman content analysis approach. After data collection, all interviews were transcribed and reviewed, and categories were extracted.

Results: After analyzing the data obtained from the experiences of novice nurses, three major themes and 11 subthemes were identified. The major themes were initial uncertainty in the novice nurse, loneliness and helplessness alongside colleagues, and concerns about workplace discrimination by managers.

Conclusion: Since the results of this qualitative study showed that novice nurses have such important concerns as confusion, feelings of loneliness and helplessness, and feelings of worry about discrimination at the beginning of their work, so, it is necessary to pay attention to these issues in planning by providers to assist them transitioning in clinical settings.

Background: Alcohol use in early pregnancy increases the risk for Fetal Alcohol Spectrum Disorders. Women who engage in heavy drinking and become pregnant when they are not actively trying to conceive are at heightened risk for alcohol-exposed pregnancies. Identifying factors associated with greater risk for alcohol-exposed pregnancies is critical for prevention.

Objective: This study explored the odds of contraceptive nonuse and heavy drinking for women trying to conceive or ambivalent about pregnancy as compared to those trying to avoid pregnancy.

Methods: Logistic regression analysis was used to examine the role of pregnancy intentions, including ambivalence, on contraceptive nonuse and heavy drinking among a national sample of 583 sexually active heterosexual women of childbearing age conducted online in 2024.

Results: Results showed that women who are trying to conceive or are ambivalent about pregnancy have higher odds of contraceptive nonuse than women trying to avoid pregnancy (OR = 13.19, p < .01 and OR = 3.56, p < .001, respectively), but no significant differences in heavy alcohol use by pregnancy intention.

Conclusion: Pregnancy intentions are associated with contraceptive nonuse but not heavy alcohol use. Delayed pregnancy recognition among those not actively trying to conceive but also not consistently using an effective form of contraception might place women who are avoiding or ambivalent about pregnancy at heightened risk for an alcohol-exposed pregnancy.

Introduction: Nurses in intensive care units (ICUs) are vulnerable to sick building syndrome (SBS), which can affect their health, performance, and patient safety. Understanding SBS is crucial in healthcare to protect both staff and patients. However, many ICU nurses lack knowledge about this condition and the necessary detection tools.

Objectives: This study aimed to describe ICU nurses' knowledge about SBS and the need of an instrument to detect the signs and symptoms of SBS.

Methods: A cross-sectional study was conducted with a sample of 100 ICU nurses, recruited through simple random sampling from the Critical Care Indonesia Nurse Association. The study focused on nurses' knowledge of SBS and the need for an instrument to detect it. Research instruments included basic respondent characteristics, nurses' knowledge, and the need for an SBS detection tool. Data were analyzed using descriptive statistics.

Results: The majority of respondents exhibited a good level of knowledge (66%), yet many answered questions incorrectly regarding SBS etiology, symptoms, and effects. This was exemplified by incorrect responses attributing noise and chemicals as causes of SBS, overlooking fatigue as a symptom, and inaccurately assessing the physical effects of SBS. Notably, nurses demonstrated strong knowledge regarding SBS prevention (71%) and treatment (94%). Respondents unanimously supported the necessity of an instrument capable of detecting SBS among ICU nurses (71%), with an electronic instrument being the preferred option over other forms.

Conclusion: ICU nurses possess a good level of knowledge about SBS. It is recommended to develop and investigate an electronic-based instrument for detecting SBS. Additionally, implementing an e-learning educational program could further enhance the knowledge and management of SBS among healthcare professionals.

Introduction: Hypertensive patients may lack time to visit clinics and attend educational sessions, resulting in poor blood pressure control. Uncontrolled blood pressure in people with hypertension can increase the risk of heart disease and stroke.

Objective: The specific purpose of this study was to determine the effect of online group education on knowledge, motivation, self-efficacy, self-care behavior, and blood pressure control of hypertensive patients.

Method: The research method used a quasi-experiment method. The subjects were hypertensive patients in Indonesia. The sampling technique used was cluster random sampling. Total sampling consisted of 96 participants, consisting of 48 intervention groups and 48 control groups. The inclusion criteria in the study were patients with primary hypertension who were willing to become research respondents. The exclusion criteria in this study were respondents who were sick and unable to follow therapy, had hearing problems, and had complications of other diseases (kidney disease, heart disease, diabetes mellitus, and stroke). Data collection methods include observation. The instruments used were the HKLS, HBP-SCP questionnaire, and Sphygmomanometer digital.

Result: Data analysis using repeated ANOVA and Friedman tests. There was a significant decrease in systolic (p < .001) and diastolic (p = .001) blood pressure and an increase in knowledge (p < .001), motivation (p < .001), self-efficacy (p < .001), and self-care behavior (p < .001) in the intervention group.

Conclusion: Online group education effectively reduces blood pressure and increases self-care behaviors in hypertensive patients.

Background: Despite free maternal healthcare, about 50% of pregnant women in Ghana initiate their antenatal clinic (ANC) late.

Aim: This study aimed to identify the factors that contribute to the late initiation of ANC among pregnant women in the Jasikan District, Ghana.

Method: A cross-sectional study was conducted between December 2021 and May 2022 in multiple health facilities. Multistage sampling was employed to select 352 pregnant women attending ANC in selected health facilities. A structured questionnaire was used to collect the data. The data was analyzed using Stata version 14.0. Descriptive statistics was used to describe the study variables and multivariable logistic regression models were performed to determine the predictors of late ANC initiation at p < .05 and 95% confidence interval (CI).

Results: Approximately 45.7% of the participants initiated ANC late. Age less than 20 years, older age groups (40-49 [odds ratio (OR): 18.0, 95%CI: 3.68-88.0, p < .001]; 30-39 [OR: 6.4, 95%CI: 1.76-22.87, p = .005] and 20-29 [OR: 4.6, 95%CI: 1.30-15.98, p = .018]) were associated with late initiation of ANC. Having a higher number of children (4 [OR: 2.8, 95%CI: 1.36-5.79, p = .005] and 3 [OR: 2.5, 95%CI: 1.33-4.58, p = .004]) were predictors of late ANC initiation as compared to having one child. Women who sought for advice from women leaders (OR: 3.5, 95%CI: 1.18-10.12, p = .02) were about three (3) times more likely to initiate ANC late as compared to those who sought for advice from friends. Women who felt poorly received at ANC (OR: 7.7, 95%CI: 2.188-27.078, p = .001) were about eight (8) times more likely to initiate ANC late as compared to those who felt well received. Again, those who spent over six (6) hours during ANC visits (OR: 18.4, 95%CI: 4.246-79.734, p < .001) had an 18 times higher risk of initiating ANC late relative to those who spent less than 3 h.

Conclusion: The study findings highlight the need for interventions that addresses the social and cultural factors, negative perceptions of ANC, and long waiting times at health facilities to improve early initiation of ANC. Such interventions can assume health education and promotion to address the sociocultural and unfavorable perceptions toward ANC. The sector ministry and the health facilities may consider expanding ANC service centers to reduce long waiting times.

Introduction: Pre-hospital care personnel, including paramedics and emergency medical technicians (EMTs), are crucial frontline responders in emergency medical situations. They are critical in delivering timely medical assistance to individuals in emergencies. However, the demanding nature of their work can subject them to significant job stress, which may adversely affect their well-being and job performance.

Objectives: This study aimed to assess the levels of job stress and explore associated factors among pre-hospital care providers in Addis Ababa.

Methodology: A cross-sectional study was conducted at a healthcare facility, involving 134 ambulance healthcare providers. Participants were selected through a simple random sampling technique. Data collection employed pretested, self-administered questionnaires utilizing a nursing stress scale. Descriptive statistics were utilized to summarize the findings. Logistic regression analysis was employed to ascertain associations between variables while controlling for potential confounders. The strength of the association between dependent and independent variables was evaluated using odds ratios with a 95% confidence interval.

Result: Of the 134 study participants, 47% (95% CI: 38.2, 55.8) of them had job stress. Notably, several factors were significantly associated with job stress among pre-hospital healthcare providers working in ambulances. Conflict with leaders (AOR = 5.07; 95% CI: 2.98, 12.53), fear of mistakes (AOR = 8.22; 95% CI: 1.86, 36.34), lack of resources (AOR = 11.06; 95% CI: 5.19, 22.41), overloaded with ambulance care (AOR = 18.94; 95% CI: 4.33, 38.73) and inadequate information from dispatchers (AOR = 7.35; 95% CI: 3.32, 16.62) were identified as significant associated factors of job stress among these providers. These findings highlight the critical need to address leadership conflicts, fear of errors, and communication deficiencies to mitigate job stress among pre-hospital healthcare providers working in ambulances.

Conclusion: This study highlights the prevalence of job stress among pre-hospital healthcare providers working in ambulances, and found it as a significant problem. Notably, conflict with leaders, fear of mistakes, lack of resources, work overload and inadequate information from dispatchers emerged as significant associated factors contributing to job stress among pre-hospital health care providers. Efforts to foster better communication channels between providers and dispatchers, promote supportive leadership practices, and implement error-reduction strategies are essential. By addressing these challenges, healthcare organizations can create a more conducive work environment that supports the mental and emotional health of pre-hospital healthcare providers.

Background: Hemorrhagic stroke is a serious condition that leads to high morbidity and mortality rates, particularly within the first 30 days following the stroke. One serious complication is increased intracranial pressure (IICP), which worsens neurological symptoms and can result in death or disability.

Purposes: To develop and implement a clinical nursing practice guideline (CNPG) for prevention and management of IICP in hemorrhagic stroke patients.

Methods: This study had two phases: (1) Evidence trigger and support, identifying clinical problems and gathering empirical evidence, and (2) Evidence-observed, where a CNPG was developed and implemented. The CNPG was based on the Nursing Role Effectiveness Model and Soukup's Nursing Practice Development Model, covering preoperative and postoperative care and key nursing activities such as assessment, prevention, and management. The study assessed the CNPG's impact on nurses' knowledge, practices, and implementation feasibility. Nineteen registered nurses from the Surgical Intensive Care Unit were included and analyzed using descriptive statistics, interquartile range, and the Wilcoxon signed-rank test.

Results: The findings showed a significant improvement in nurses' mean knowledge scores after implementing the nursing guideline for preventing IICP in hemorrhagic stroke patients (p < 0.000). The overall mean knowledge score was high (X̄ = 23.11, SD = 2.54, Mdn = 23, IQR = 5). Additionally, the total mean nursing practice score (X̄ = 122.53, SD = 17.80) and overall mean perceived implementation feasibility score were both high (X̄ = 4.68, SD = .35).

Conclusions: The findings suggest that integrating nursing practice guidelines and providing training to enhance nurses' knowledge significantly contribute to positive outcomes in both structure and process. Regarding structure, nurses demonstrated increased knowledge and proficiency in nursing practices. Regarding process outcomes, evidence-based guidelines were effectively utilized, paving the way for practical application in future nursing practice.

Introduction: The administration of drugs is an important part of nurses' professional practice. A basic knowledge of pharmacological principles is required to make accurate decisions about drug management and conduct patient medication education. However, several studies have suggested that nurses have inadequate knowledge of pharmacology and medication management.

Objective: To explore the level of knowledge in pharmacology and medication management among nurses working in nursing homes (NHs).

Methods: We conducted a cross-sectional study at 24 NHs in Norway. The nurses took a multiple-choice test in pharmacology with 35 questions at their workplace. Each question had four alternative answers with one answer being correct. One point was awarded for a correct answer and zero for a wrong answer. The test included categories in general pharmacology, clinical pharmacology, and medication management.

Results: In total, 145 nurses completed the questionnaire. In the range of 0-35 correct responses, the mean score for the sum of all questions was 22.5, which equates to 66% of responses being correct. Linear multiple regression showed no association regarding gender, age distribution among the nurses, years since completing basic education in nursing, years of work experience in NHs, postgraduate education, and knowledge of pharmacology and medication management. Knowledge was better in the category medication management (p < 0.001) than in the category's general pharmacology and clinical pharmacology. When evaluating specific test questions, 38.9% of the nurses answered a question on opioids correct, 64.1% a question on anticoagulants correct, 33.5% knew the prerequisites for generic substitution, and 45.5% did not know the difference between agonists and antagonists.

Conclusion: Our results are in line with previous findings. The participating nurses working in the NHs have insufficient knowledge in pharmacology and medication management. This may cause harm and undermine patient safety.