Enfermeria Clinica最新文献

Objective

To review and synthesize the scientific production of educational interventions for the prevention and control of dengue in adults.

Method

Integrative literature review, protocol registered in INPLASY (202170038). The search was performed in MEDLINE, LILACS, Web of Science and EMBASE, with no start date until March 31, 2021. Intervention studies were included: randomized clinical trials, cluster and quasi-experimental studies. The outcome evaluated was dengue prevention and control. The evaluation of the methodological quality and the level of evidence of the included studies was carried out.

Results

Ten studies were included with levels of evidence between 1c and 2dm, corresponding to low- and middle-income countries in Asia and America. The use of didactic aids was evidenced against educational processes, digital tools, and a field of action by nursing was observed, from health education.

Conclusions

Health education in scenarios other than clinical ones can favor empowerment by the population to improve health behaviors. On the other hand, the use of electronic tools is of great help in evaluating the effect of an intervention.

Objectives

Maternal mortality continues to pose a critical challenge in obstetric practice, with postpartum haemorrhage as one of the major causes. This study aimed to explore the lived experiences of midwives regarding the management of postpartum hemorrhage (PPH).

Methods

The study employed a qualitative phenomenological approach. Participants were selected using purposive sampling technique, and 15 participants were recruited for the study. Data collection was done using a semi-structured interview guide for in-depth interviews. The interviews were audio-recorded, and data analysis was done using thematic analysis.

Results

Two themes emerged from the analysis, including 1) management practices adopted against PPH and 2) hospital protocol for the management of PPH. The major management practices adopted by the midwives were using uterotonics, especially oxytocin, and other management practices such as anti-shock garments, stimulation of contractions by rubbing the uterus, and assessment of the cause of bleeding and suturing of lacerations. It was also deduced that different healthcare facilities had policies for managing postpartum hemorrhage. Barriers affecting the effective management of PPH were understaffing, unavailability of suitable facilities and equipment, restrictions on nurses/midwives in managing PPH, unfavourable hospital policy and lack of communication among the healthcare team.

Conclusion

The participants’ experiences suggest they are somewhat satisfied with PPH management in their facilities. However, barriers such as understaffing, unavailability of equipment, poor communication among healthcare teams and restrictions on nurses in PPH management should be addressed to improve midwives’ experiences in PPH management.

Introduction

Palliative care competence is one of the competencies that must be possessed by generalist nurses. For this reason, strategies for developing palliative care learning models need to be carried out to ensure nursing students have palliative care competencies. Therefore, this study was structured to develop a transformation theory-based palliative care learning model that prioritizes the active participation of students to deal with palliative care in future practice.

Methods

This study was a cross-sectional study involving 189 nursing students as participants. The proposed model involves six variables, namely student characteristics, educator characteristics, learning media, palliative care competencies, transformative learning theory (TLT)-based palliative learning, and competency achievement. Data were collected using a questionnaire that was tested using the Structural Equation Modeling (SEM) technique.

Results

SEM analysis showed that the R² value of TLT-based palliative care learning was 0.707 or 70.7%. These results indicate that the diversity of TLT-based palliative care learning variables can be explained by the variables of students, educators, palliative competencies, and learning media by 70.7%. Each construct has a value of Q2 > 0, which means the model is satisfactory. The path coefficient value of 0.627 indicates that the characteristics of educators have the most significant contribution to the TLT-based palliative care learning model.

Conclusion

It can be concluded that the teaching-learning process based on TLT is a promising strategy to support nursing students to achieve palliative care competence.

Aim

The number of unintended pregnancies and the decreasing use of contraceptives during the COVID-19 pandemic are of particular concern to the national population and family planning program. The successful implementation of the family planning program cannot be carried out by the government alone. Still, it requires strong synergy with stakeholders. The difference in perceptions among stakeholders, acceptors, and the community about family planning is crucial, so qualitative research is needed to identify this matter. This study explores stakeholders’ perceptions of post-partum family planning programs and their barriers during the COVID-19 pandemic.

Method

This research uses a descriptive qualitative method, with participants consisting of family planning officers, cadres of family planning units, and the head of the family planning program. The data were collected through in-depth interviews and examined using content analysis.

Results

The results show that health workers and community leaders cooperated at the village and sub-district levels in realising the family planning programs. During the COVID-19 pandemic, services were stopped at the public health centre, especially long-term contraceptive method services. Stakeholders believe that barriers to the program's success include education level, negative perceptions, lack of training, and low trust in partners.

Conclusion

Cross-sectoral engagement is essential in increasing participation in family planning programs. Other critical success factors are support from husbands, community leaders, and local government.

Aim

This study aims to identify breastfeeding traditions in Balinese society.

Method

This study uses a qualitative method with purposive and snowball sampling techniques. In-depth interviews were conducted face-to-face at the participants’ homes. The participants were 22 mothers with babies in the North Badung area, Bali. All interviews were recorded, transcribed verbatim, and analyzed using a content analysis approach.

Result

Five major themes were identified: (1) postnatal traditions; (2) support for breastfeeding mothers; (3) infant feeding; (4) breastfeeding problems; and (5) efforts to promote breastfeeding.

Conclusion

Postnatal traditions, support for breastfeeding mothers, exclusive breastfeeding, and efforts to promote breastfeeding are cultures in society that can support exclusive breastfeeding. While feeding a baby other than breast milk and breastfeeding problems hinder exclusive breastfeeding. Families, traditional/religious leaders, and health workers must always collaborate to maximize exclusive breastfeeding.

Aims

Developed in 2020, the breasts examination for cancer awareness (BECA) mobile application is an Android-based application aiming to support healthcare by providing information related to breast neoplasms, breast self-examination (BSE), and early detection. The app also has an adjustable reminder system. This study aims to analyse the determinants of BECA mobile application adoption among women of childbearing age.

Methods

This research is quantitative with a descriptive analysis design. The population consisted of 81 women aged 15–49 selected using the total population sampling method. The data were collected in Indonesia between August and September 2021 using questionnaires through the application system. The data were processed using univariate, bivariate, and multivariate analyses.

Results

The majority of the respondents were 21–30 years old (39.5%), were students (53.1%), lived in the Special Region of Yogyakarta (DIY) (53.1%), graduated from senior high school (51.9%), had menarche in early adolescent age (98.8%), and were married (59.3%). Three external determinants of using BECA application for BSE were the support from healthcare providers (p = 0.024), community leaders (p = 0.006), and spiritual leaders (p = 0.038). Meanwhile, all internal factors drive the use of BECA application in BSE practice (p < 0.05). Among the seven domains, the benefit is the most significant factor influencing BSE practice among respondents (p = 0.016).

Conclusion

There are seven determinants of using the BECA application for BSE among women of childbearing age, including support from health workers, community leaders, and spiritual leaders, as well as the system's quality, information, service, and benefits. From all of these factors, the benefits are the strongest determinant of using the BECA mobile application for BSE among women of childbearing age.

Aims

The COVID-19 pandemic has accelerated the adoption of telemedicine in the healthcare sector. It provides remote health services from professionals, including diagnoses, treatments, disease preventions, and evaluations, through information and communication technology. For healthcare providers, telemedicine can assist with the improvement of individual and community health qualities. Therefore, nurses need to enhance their knowledge and confidence and maintain a positive attitude toward telemedicine. Research has shown that 70% of telemedicine implementation failures are attributable to medical personnel's inability to utilise technology. This study aimed to determine the knowledge, self-confidence, and attitudes in using telemedicine according to nurses’ perceptions in a private hospital in Indonesia.

Method

The study is descriptive-quantitative with a cross-sectional approach. The population was nurses working in an outpatient department of a private hospital in western Indonesia. A total of 52 samples were selected using a purposive sampling technique. The instrument used was the Indonesian version of the telemedicine objective structured clinical exam (TeleOSCE) questionnaire, consisting of 22 questions to measure self-reported knowledge, confidence, and attitudes. The data were collected in February 2022 and analysed using univariate descriptive statistics.

Results

The result indicated that 40 (76%) nurses perceived that they had a moderate level of knowledge of telemedicine operations, 32 (61.5%) perceived they had an average level of self-confidence, and 29 (55.8%) claimed a neutral attitude toward telemedicine.

Conclusion

The moderate perceived knowledge, self-confidence, and attitudes indicate the need for improvement through education, training, and work experience. Training programs on telemedicine are expected to enhance nurses’ knowledge and confidence in using telemedicine, creating a positive attitude toward the concept.

We present the clinical case report of a 33-year-old woman who, after a perinatal death, presents a complicated grieving process.

The aim is to apply an individualized care plan that allows a reestablishment of the balance of the woman and her environment after an experience of perinatal death.

During the first visit to her midwife, the Athens Insomnia, Continuituing Bonds and Goldberg Anxiety and Depression scales were applied. Focused assessment was made using the Gordon patterns and based on the nursing approach described in Dysfunctional Grief Theory.

Six International NANDA diagnostic labels were identified (maladaptative grieving, insomnia, hopelessness, ineffective motherhood process, moral distress and anxiety), and they were prioritized using clinical network reasoning using the Outcome Present State (OPT) model, observing the relationships between the labels, diagnoses and identifying how they affected the rest.

For each International NANDA diagnostic labels, the nursing outcomes were planned nursing interventions. The expected results included the description of the evaluation indicators using the Likert scales. Both results and interventions were agreed between the professional and the woman.

The care plan raises the difficulty that nursing professionals pose in assisting in situations of complicated grief, and specifically, associated with perinatal death. This situation makes key competencies necessary in training as well as the need to know new nursing approaches.

Aims

To evaluate the effect of educational intervention program to improve the knowledge of nurses and midwives on discharge planning.

Method

The study employed a quasi-experimental pre-post design without control group. Total of 165 nurses and midwives working on general and critical care wards were included in the study. The researchers created a questionnaire based on the discharge planning form from the hospital's Quality and Risk Management team. To assess the respondent's knowledge of discharge planning. The questionnaire's validity and reliability were established using a biserial point validity test (>0.20) and a reliability test using the KR 20 formula (0.865). The study collected data before and after the program. Both univariate and bivariate analyses were used to analyze the data. The educational intervention took place between 31 January and 9 February 2022 and consisted of 11 sessions lasting between 60 and 120 min each. The researchers implemented the educational program with the assistance of materials provided by the hospital's Quality and Risk Management team.

Results

The study enrolled a total of 161 individuals (97% response rate). This study revealed that there were differences in nurses’ and midwives’ knowledge levels before and after the educational intervention (p value 0.001). However, there was no difference in the level of knowledge between in-charge and clinicals prior to and following the educational intervention (p value > 0.05). In addition, most of respondents (>90%) reported that the educational intervention program was very good. The respondents also suggested that the educational program on discharge planning should be conducted periodically.

Conclusions

The educational intervention program was successful in terms of increasing the knowledge of nurses and midwives. Monitoring and evaluating the knowledge of nurses and midwives regarding discharge planning is also essential for conducting periodic discharge planning training. In addition, a discharge planning module must be regularly reevaluated to ensure that discharge planning education meets the needs of patients and hospitals.

Aims

Diabetes mellitus (DM) is an incurable chronic disease that can be controlled by self-care management. Health education assisted by technology can improve self-care management. This pilot study aims to: (a) identify the concerns, issues, and challenges faced by type 2 diabetes mellitus (T2DM) patients and healthcare providers, especially during the COVID-19 pandemic; (b) develop a Self-care Management Health Education e-Learning Program (ScMHEeLP); and (c) pilot whether ScMHEeLP can improve knowledge, self-care management, and glycemic controls of T2DM patients.

Method

This pilot study uses a multiphase mixed-methods design. Twenty-three participants were involved in in-depth interviews as the basis for developing ScMHEeLP, and thirty-seven voluntary participants were recruited for the evaluation phase. The ScMHEeLP was piloted for 3 months to test its effectiveness in improving the knowledge, self-care management, and glycemic controls of T2DM patients. Thematic analysis was used to examine the qualitative data, and the Wilcoxon test was used for quantitative data.

Results

In the development phase revealed patients’ and healthcare providers’ concerns, issues, and challenges regarding diabetic care, especially during the COVID-19 pandemic. Based on these findings, the ScMHEeLP was developed in the form of web-based. ScMHEeLP consists of seven animatic videos, completed with a feature to evaluate patients’ understanding of the disease and treatments. ScMHEeLP was downloadable and accessible anywhere and anytime (online–offline). In the evaluation phase showed a significant difference in the levels of knowledge (Z = −5.306, p = 0.000), levels of self-care activities (Z = −5.139, p = 0.000), and level of fasting blood sugar (Z = −4.282, p = 0.000), before and after the implementation of ScMHEeLP.

Conclusions

ScMHEeLP was able to improve knowledge and self-care activities and able to lower fasting blood sugar levels. ScMHEeLP still needs continuous improvement and further testing for better outcome.