Journal of Research in Nursing最新文献

Background: Although cognitive behavioural therapy (CBT) is recommended for managing individuals with schizophrenia, it has been underutilised in clinical practice. Low-intensity CBT (fewer sessions provided by non-specialists) is expected to offer a partial solution; however, its implementation within community-based care settings remains limited.

Aims: To explore the difficulties and barriers faced by home-visiting nurses when providing low-intensity CBT to individuals with schizophrenia.

Methods: A qualitative descriptive study was conducted through semi-structured interviews with six nurses in Japan who had experience in delivering low-intensity CBT, including CBTs for psychosis (CBt-p) and individualised metacognitive training for psychosis (MCT+). Data were analysed using a qualitative descriptive method.

Results: Three main categories of difficulties/barriers were identified: 'Difficulties in learning low-intensity CBT', 'Difficulties in applying low-intensity CBT to individual clients' and 'Difficulties in providing low-intensity CBT due to the unique structures and functions of home-visiting nursing'.

Conclusions: The findings suggest the need for refining the implementation manuals with simplified terminology and familiar examples; creating a work environment that allows continuous consultation with supervisors and mutual learning; revising reimbursement systems under the national health insurance scheme to allow for longer visit times; and training non-specialist nurses as co-therapists to ensure the continuity of care.

Background: In Sweden, providing a free-of-charge national child vaccination programme is part of national public health work to promote health and prevent illness. Yet Sweden is no exception when it comes to systematic societal inequality. Research worldwide has shown that childhood vaccination coverage is lower among refugee and migrant children than among non-migrant children.

Aim: The aim of this study is to explore how school nurses working in one of Sweden's largest regions reflect on their strategies and experiences of including children with refugee or migrant backgrounds in the school-based extended HPV vaccination programme.

Methods: The study draws from semi-structured individual interviews with 21 school nurses. Analysis drew on Braun et al's (2011) four contextual dimensions: 1) the situated context; 2) the professional context; 3) material contexts; 4) external contexts. Thematic analysis was undertaken (Braun and Clarke, 2006; Clarke and Braun, 2013).

Results: Three themes were identified: 1) social and economic deprivation; 2) ways of communicating; 3) gratitude. According to the school nurses, mapping the families' social situation and building trusting relationships are essential. Providing written information about the vaccination in diverse languages and/or involving an interpreter are also important strategies to reach refugee and migrant parents. Despite the families' often marginalised position, the children and their parents favour the HPV vaccination, which could be interpreted as vaccine confidence.

Conclusions: Meeting the needs of children and families with refugee or migrant backgrounds requires that school nursing practice take a holistic perspective. The study contributes new insights regarding these issues.

Background/aim: Chronic obstructive pulmonary disease (COPD) is progressive and persistent airway obstruction, leading to deteriorated health status and decreased quality of life. Many patients cannot manage their condition due to lack of self-efficacy. This study assessed the effect of a telenursing distance empowering programme on self-efficacy and health status in COPD patients.

Methods: An experimental study with baseline and three follow-up measurements was conducted. Participants (N = 108) were randomised into experimental and control groups. As a pre-test, patients' self-efficacy and health status in both groups were assessed. Both groups received routine pre-discharge education. In the intervention group, 14 sessions of mobile phone-based education and counselling were provided over 7 weeks after discharge. The effect of the intervention was examined with multilevel analyses.

Results: There was no statistically significant difference between two groups in the demographic variables, self-efficacy and health status before the intervention (p > 0.05). After the intervention, a statistically significant difference in the mean self-efficacy scale scores and health status scores between the two groups at the immediately after intervention, 1-month, and 3-month follow-up period were seen (p < 0.001).

Conclusion: Empowerment through telenursing can enhance self-efficacy and health status in patients with COPD.

Practice implications: Using telenursing customised to the patient's conditions and needs over time can lead to better access to educational and counselling services, improved empowerment, self-efficacy and disease management, ultimately resulting in better health status.

Background: Nasogastric feeding tube (NGT) management is generally undertaken by nurses. There is substantial data linking inadequate management with patient safety risks; however, evidence on nursing competence with this skill is scant.

Objective: To evaluate the published and grey literature for adult nurses' acquisition and retention of competency for NGT management in the hospital setting.

Design: Integrative review.

Method: The following databases were searched: CINAHL Plus, MEDLINE and ERIC. In addition, the British Library, national and international healthcare and nutrition organisations were also searched. Titles and abstracts were reviewed for relevance.

Results: Seventeen international studies were identified, the findings demonstrated nurses do not routinely review or update their skills regarding NGT management. Those that did utilised resources of poor evidence-based quality. Self-reporting tools identified poor adherence to organisational guidelines and unsafe practices. Education and training interventions had favourable results. However, follow-up assessments were at short post-intervention interval(s), and therefore were of doubtful reliability.

Conclusion: The evidence for adult nurses to acquire and retain competency in NGT management in hospital settings is fragmented and not generalisable, calling for further research.