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Making kindness our hallmark 让善良成为我们的标志
IF 2.2 4区 医学 Q2 Nursing Pub Date : 2024-01-09 DOI: 10.1111/opn.12597
Sarah H. Kagan PhD, RN

Those who correspond with me directly may notice a few quotes beneath my contact details in my email signature. The words I took time to include there mean a great deal to me. Ralph Waldo Emerson and Dorothy Day are among those represented. The quotations from their works talk about kindness, time, and being. Their words are among those by which I strive to act each day. As this New Year 2024 stretches before us, I'd like to share their words with you as I reflect on how fundamental kindness is to what we aim to achieve as nurses, scholars, and most importantly—human beings.

Emerson and Day are individuals separated by time whose words are complementary to one another in important respects. Emerson was a 19th century essayist, poet, and philosopher (https://plato.stanford.edu/entries/emerson/). He said, “You cannot do kindness too soon, for you never know how soon it will be too late.” Day was a 20th century journalist and activist (https://catholicworker.org/life-and-spirituality-dorothy-day/). She wrote “We are communities in time and in a place, I know, but we are communities of faith as well—and sometimes time can stop shadowing us. Our lives are touched by those who lived centuries ago, and we hope our lives will mean something to people who won't be alive until centuries from now. It's a “great chain of being” … I think our job is to do the best we can to hold up our small segment of the chain, doing our best to keep that chain connected, unbroken.” I sometimes pause amid a workday just to take in the signification of Emerson's and Day's words today.

Read together, Emerson's and Day's words speak to me as a person and as a nurse. They say to me that kindness allows us to transcend the travails of daily life. That transcendence comes in remembering that, in our fleetingly short lives, other people matter most. Kindness recalls us to our precious shared humanity, despite trying circumstances. In any given moment, being kind reinforces the value of our personhood within that shared humanity. We are each individual people in our own right and universally human at the same time. Every one of us needs and craves kindness. We recoil when kindness is absent and are too often surprised when we encounter it. One of my fondest hopes is that kindness becomes so commonplace that we revel in it surrounding us instead of being surprised by it.

Kindness is many things, things that surpass our many differences. Kindness is gratitude, thanks, and simple communion with another human being. Kindness is honesty, offered with empathy and consideration for the other. My experience shows me that kindness commonly means most in small gestures. The pace of our lives as people, professionals, and scholars typically presses us to forgo the small gesture. Think of how often you leave an encounter without ever hearing “how are you?” or receive email messages devoid of a salutation, a farewell, or both. Conversely, consider the last time a genuine co

与我直接通信的人可能会注意到,在我的电子邮件签名中,我的联系方式下面有几句话。我花时间写在这里的话对我意义重大。拉尔夫-瓦尔多-爱默生(Ralph Waldo Emerson)和多萝西-戴(Dorothy Day)就是其中的代表。他们作品中的引文谈到了仁慈、时间和存在。我每天都在努力践行他们的话。在 2024 年新年即将到来之际,我想与大家分享他们的话语,同时反思作为护士、学者以及最重要的人类,仁慈对于我们的目标是多么重要。爱默生是 19 世纪的散文家、诗人和哲学家(https://plato.stanford.edu/entries/emerson/)。他说:"你不能过早地行善,因为你永远不知道多久之后就会为时已晚"。戴伊是 20 世纪的记者和活动家 (https://catholicworker.org/life-and-spirituality-dorothy-day/)。她写道:"我知道,我们是时间和地点的共同体,但我们也是信仰的共同体,有时时间会停止对我们的影响。我们的生活被几个世纪前的人所触动,我们希望我们的生活对几个世纪后才出生的人有意义。这是一条 "伟大的存在之链"......我认为,我们的工作就是尽我们所能,支撑起我们在这条链条中的一小段,尽我们所能让这条链条保持连接,不被打断。今天,我有时会在工作之余停下来,细细品味爱默生和戴伊的这番话。它们告诉我,仁慈使我们能够超越日常生活的苦难。这种超越来自于记住,在我们转瞬即逝的短暂生命中,他人是最重要的。尽管环境艰难,但善良让我们忆起宝贵的共同人性。在任何特定的时刻,善意都会强化我们在共同人性中的人格价值。我们每个人都是独立的个体,同时又是普遍的人类。我们每个人都需要并渴望善意。当善良缺失时,我们会退缩,而当我们遇到善良时,我们往往会感到惊讶。我最殷切的希望之一是,善良变得如此普遍,以至于我们陶醉于善良的包围,而不是对善良感到惊讶。善良是感激、感谢,是与他人简单的交流。善良是真诚,是对他人的同情和体贴。我的经验告诉我,善意通常在细微的举动中体现得淋漓尽致。作为普通人、专业人士和学者,我们的生活节奏通常迫使我们放弃细微的举动。想一想,你经常在没有听到 "你好吗?"的情况下就离开,或者在收到电子邮件时没有致意、道别,或者两者兼而有之。反之,想想上一次真诚的赞美或询问你的近况是什么时候让你从工作压力带来的泥潭中惊醒。由此而产生的温暖感觉或转瞬即逝的微笑所代表的意义远比我们用言语表达的要多。我知道,说到这里,你可能会想,莎拉,善良与护理和老年护理研究期刊有什么关系?人性和人格在我们的学科、职业和专业中广泛而持久地存在。仁慈是对人性和人格的认可,体现了我们的普遍性和多样性,并能增进我们的福祉。作为护士,我们的目标是支持健康,我还要补充一点,支持老年人的功能和福祉,关注他们的日常生活。在这一目标中,我们重新定义了环境,强调与其他生命和物体的互动。我们固有的关系学和互动论方法强调,无论我们以何种身份--临床医生、教育工作者、研究人员、政策制定者、管理者、活动家等--表达善意,善意都是护理工作不可或缺的一部分。当善意被忽视或否定时,无论选择什么,其背后的情感都可能会伤害到那些只是希望得到善意和答案的人。我们在临床实践中都见过这种情况。当一个人被善意而诚实地告知诊断或预后的真相时,尽管真相中蕴含着 "坏消息 "的概念,他的脸上还是写满了欣慰。当我们回忆起安慰他们的情景时,他们因这种善意而感到的自相矛盾的宽慰会留在我们每个人的心中。作为护士学者和科学家,我们每个人都会与其他学科的同行一起,曾经并将再次面对我们称之为 "坏消息 "的事情。即使这仅仅是对我们提交的手稿或基金申请不满意的答复,这样的消息也会在我们的职业生涯和生活中一次又一次地出现。
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引用次数: 0
Practicalities of promoting practice-based learning in end of life care for care home staff: Lessons from “online” supportive conversations and reflection sessions 促进疗养院工作人员在临终关怀方面开展基于实践的学习的实用性:从 "在线 "支持性对话和反思会议中汲取的经验教训
IF 2.2 4区 医学 Q2 Nursing Pub Date : 2024-01-07 DOI: 10.1111/opn.12598
Jo Hockley RN PhD, Julie Watson RN PhD, Lucy Johnston MSc, Susan D. Shenkin MD

Introduction

Deaths in care homes and “at home” are anticipated to account for a third of UK deaths by 2040. Currently, palliative and end of life care are not part of statutory training in care homes. Reflective practice is a tool that can facilitate practice-based learning and support. Following a feasibly study to test “online” supportive conversations and reflection sessions (OSCaRS) to support care home staff in relation to death/dying during the first months of the COVID pandemic, a one-year practice development follow-up project was undertaken with the aim to create a team of NHS/specialist palliative care (SPC)-based facilitators to lead and support OSCaRS provision in up to 50 care homes in one region in Scotland—the focus of this paper.

Methods

Forty care home managers attended an on-line session explaining the project, with a similar session held for 19 NHS/SPC-based nurses external to care homes. Those interested in facilitating OSCaRS then attended three education sessions. Data collected: records of all activities; reflective notes on OSCaRS organised/delivered; a summary of each OSCaRS reflection/learning points; final interviews with NHS/SPC trainee facilitators.

Results

A total of 19 NHS/SPC facilitators delivered one or more OSCaRS in 22 participating care homes. However, as of January 2022 only six trained facilitators remained active. Out of the 158 OSCaRS arranged, 96 took place with a total of 262 staff attending. There were three important aspects that emerged: the role, remit, and resources of NHS/SPC supporting OSCaRS; requirements within care homes for establishing OSCaRS; and, the practice-based learning topics discussed at each OSCaRS.

Conclusion

Attempts to establish a team of NHS/SPC facilitators to lead OSCaRS highlights that end of life care education in care homes does not clearly fall within the contractual remit of either group or risks being missed due to more pressing priorities.

预计到 2040 年,在护理院和 "家中 "死亡的人数将占英国死亡人数的三分之一。目前,姑息治疗和临终关怀还不是护理院法定培训的一部分。反思性实践是一种可以促进基于实践的学习和支持的工具。在 COVID 大流行的头几个月,我们进行了一项可行性研究,测试 "在线 "支持性对话和反思课程(OSCaRS),以支持护理院员工应对死亡/临终关怀,之后我们又开展了一项为期一年的实践发展后续项目,旨在建立一支由国家医疗服务体系(NHS)/姑息关怀专家(SPC)组成的促进者团队,领导并支持苏格兰一个地区多达 50 家护理院提供 OSCaRS(本文的重点)。
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引用次数: 0
Psychometric properties of a Turkish version of the social activities scale for community-dwelling older people requiring support 土耳其版社交活动量表的心理计量特性,适用于需要支持的社区居住老年人
IF 2.2 4区 医学 Q2 Nursing Pub Date : 2023-12-29 DOI: 10.1111/opn.12593
Sevinc Tastan RN, PhD, Hatice Bebis RN, PhD

Background

Social activities decelerate the deterioration of mental capacity in older people and improve their physical and psychosocial health. Valid and reliable measurement tools are needed to determine the social activity status of older people and plan health services to protect their mental health.

Objective

This study aimed to adapt the Social Activities Scale for Community-Dwelling Older People Requiring Support (SASOS) into Turkish.

Methods

This methodological study was conducted in Northern Cyprus between January and June 2022. Convenience sampling was used to recruit 155 community-dwelling older people who needed support. Expert opinion, item-content validity index, and scale-content validity index were used to evaluate content validity. Internal consistency and test–retest reliability tests were used to evaluate reliability. Exploratory factor analysis was used to evaluate construct validity. The Loneliness Scale for Elderly was used to evaluate concurrent validity.

Results

The Cronbach's alpha of SASOS was 0.90. Additionally, correlation coefficients of all items ranged between 0.61 and 0.79. Exploratory factor analysis revealed a three-factor structure. ‘Interactions with friends and neighbors’ was the factor that explained the highest variance (46%). There was a negative, weak, and statistically significant relationship between the scores obtained from the social loneliness subscale of LSE and all three subscales of SASOS.

Conclusions

The Turkish version of SASOS is a valid, reliable instrument to evaluate social activities in community-dwelling older people who needed support.

Implications for practice

The SASOS has been identified as a valuable measure for assessing the social support needs of older individuals. It serves as a guide for both planning and evaluating interventions to enhance their health.

社交活动可以减缓老年人心智能力的衰退,改善他们的身体和心理健康。需要有效可靠的测量工具来确定老年人的社交活动状况,并规划保健服务以保护他们的心理健康。
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引用次数: 0
Spanish version of the Maastricht Personal Autonomy Questionnaire: A validation study among community-dwelling older adults with chronic multimorbidity 西班牙文版马斯特里赫特个人自主性问卷:对居住在社区的慢性多病老年人的验证研究
IF 2.2 4区 医学 Q2 Nursing Pub Date : 2023-12-15 DOI: 10.1111/opn.12595
José Manuel Hernández-Padilla RN, MSc, PhD, Iria Dobarrio-Sanz RN, MSc, PhD, Matías Correa-Casado RN, MSc, PhD, María del Mar Jiménez-Lasserrotte RN, MSc, PhD, Cayetano Fernández-Sola RN, MA, PhD, María Dolores Ruiz-Fernández RN, MSc, PhD

Background

Loss of personal autonomy in older adults with chronic multimorbidity is associated with worsened biopsychosocial health. In order to facilitate the standardised assessment of personal autonomy in older adults with chronic conditions, nurses could use the Maastricht Personal Autonomy Questionnaire (MPAQ).

Objective

To translate, culturally adapt and psychometrically assess the Spanish version of the MPAQ in community-dwelling older adults with chronic multimorbidity (MPAQ-Sp).

Methods

Observational cross-sectional study. A convenience sample of 884 community-dwelling older adults was recruited from 10 community centres in five health districts in southeastern Spain. Data were collected between January 2021 and September 2022. The study was completed in four phases. Phase 1: The MPAQ was translated into Spanish. Phase 2: A pilot test of reliability and content validity was conducted. Phase 3: To test the dimensionality of the tool, an exploratory factor analysis (EFA) was conducted. Phase 4: a final validation study was conducted which included a confirmatory factor analysis (CFA) and assessed the validity (content, criterion and construct), reliability and readability of the MPAQ-Sp.

Results

The average age of the sample was 75.89 years (SD = ±8.04). Their mean number of chronic conditions was 4.84 (SD = ±2.19) and 67% were women. The MPAQ-Sp is comprised of 16 items distributed in four subscales: [1] the ‘Degree of autonomy’ scale, [2] the ‘Working on autonomy’ scale, [3] the ‘Dilemmas: health over preferences’ scale and [4] the ‘Dilemmas: preferences over health’ scale.

Conclusions

The Spanish version of the MPAQ-Sp is a valid and reliable instrument to assess personal autonomy in Spanish-speaking, community-dwelling older adults with chronic multimorbidity.

Implications for Practice

The use of the MPAQ-Sp would allow researchers and healthcare professionals to identify a loss of personal autonomy among Spanish-speaking community-dwelling older adults with chronic multimorbidity.

患有慢性多病的老年人丧失个人自主权与生物-心理-社会健康状况恶化有关。为了便于对患有慢性疾病的老年人的个人自主性进行标准化评估,护士可以使用马斯特里赫特个人自主性问卷(MPAQ)。
{"title":"Spanish version of the Maastricht Personal Autonomy Questionnaire: A validation study among community-dwelling older adults with chronic multimorbidity","authors":"José Manuel Hernández-Padilla RN, MSc, PhD,&nbsp;Iria Dobarrio-Sanz RN, MSc, PhD,&nbsp;Matías Correa-Casado RN, MSc, PhD,&nbsp;María del Mar Jiménez-Lasserrotte RN, MSc, PhD,&nbsp;Cayetano Fernández-Sola RN, MA, PhD,&nbsp;María Dolores Ruiz-Fernández RN, MSc, PhD","doi":"10.1111/opn.12595","DOIUrl":"10.1111/opn.12595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Loss of personal autonomy in older adults with chronic multimorbidity is associated with worsened biopsychosocial health. In order to facilitate the standardised assessment of personal autonomy in older adults with chronic conditions, nurses could use the Maastricht Personal Autonomy Questionnaire (MPAQ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To translate, culturally adapt and psychometrically assess the Spanish version of the MPAQ in community-dwelling older adults with chronic multimorbidity (MPAQ-Sp).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Observational cross-sectional study. A convenience sample of 884 community-dwelling older adults was recruited from 10 community centres in five health districts in southeastern Spain. Data were collected between January 2021 and September 2022. The study was completed in four phases. Phase 1: The MPAQ was translated into Spanish. Phase 2: A pilot test of reliability and content validity was conducted. Phase 3: To test the dimensionality of the tool, an exploratory factor analysis (EFA) was conducted. Phase 4: a final validation study was conducted which included a confirmatory factor analysis (CFA) and assessed the validity (content, criterion and construct), reliability and readability of the MPAQ-Sp.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average age of the sample was 75.89 years (SD = ±8.04). Their mean number of chronic conditions was 4.84 (SD = ±2.19) and 67% were women. The MPAQ-Sp is comprised of 16 items distributed in four subscales: [1] the ‘Degree of autonomy’ scale, [2] the ‘Working on autonomy’ scale, [3] the ‘Dilemmas: health over preferences’ scale and [4] the ‘Dilemmas: preferences over health’ scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Spanish version of the MPAQ-Sp is a valid and reliable instrument to assess personal autonomy in Spanish-speaking, community-dwelling older adults with chronic multimorbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Practice</h3>\u0000 \u0000 <p>The use of the MPAQ-Sp would allow researchers and healthcare professionals to identify a loss of personal autonomy among Spanish-speaking community-dwelling older adults with chronic multimorbidity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.12595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138714658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gauging the stress of long-term care nursing assistants using ecological momentary assessment, wearable sensors and end of day reconstruction 利用生态瞬间评估、可穿戴传感器和日终重建测量长期护理护理助理的压力
IF 2.2 4区 医学 Q2 Nursing Pub Date : 2023-12-14 DOI: 10.1111/opn.12592
Kelly Doran PhD, RN, FAAN, Susanna Witmer BSN, RN, PCCN, K. Lira Yoon PhD, Ethan Ray Fischer BS, Abaneh Ebangwese BSN, RN, Shifali Sharma MS, G. S. Charan Duggirala BS, Lujie Karen Chen MS, PhD

Background

Nursing assistants working in long-term care (LTC) often report that their job is stressful. To reduce their work stress, a better understanding of their stress profile is needed.

Objective

We aimed to pilot test methods to identify and understand stressors that LTC nursing assistants experience.

Methods

We asked each participant to provide wearable sensor/watch data, ecological momentary assessment (EMA) surveys and end of day review data over two eight-hour working shifts.

Results

Eight nursing assistants participated. All participants worked in a common continuing care retirement community in Maryland, United States of America. Our stress assessment method revealed 83 stressful events that were classified under 10 categories. Most of the reported events were rated as having a mild to low-moderate intensity. The three most common causes of stress were work demands and pressure (28.35%), heavy workload and staffing (19.69%), and safety issues and COVID-19 concerns (17.32%). We also explored the difference between stress events and intensity among different shifts. Disrespect from residents (22.73%) was the most commonly reported stressor during day shifts. Feeling rushed was the most commonly reported stressor during the evening (22.47%) and the night (38.46%) shifts.

Conclusions

We found stress was commonly reported. Stress intensity conflicted with prior literature, and we explored possible explanations.

Implications for practice

We discuss potential implications for these findings, modification of our methods to increase feasibility, the utility of these data collection methods for future work and suggest next steps.

在长期护理(LTC)机构工作的护理助理经常表示他们的工作压力很大。为了减轻他们的工作压力,需要更好地了解他们的压力状况。
{"title":"Gauging the stress of long-term care nursing assistants using ecological momentary assessment, wearable sensors and end of day reconstruction","authors":"Kelly Doran PhD, RN, FAAN,&nbsp;Susanna Witmer BSN, RN, PCCN,&nbsp;K. Lira Yoon PhD,&nbsp;Ethan Ray Fischer BS,&nbsp;Abaneh Ebangwese BSN, RN,&nbsp;Shifali Sharma MS,&nbsp;G. S. Charan Duggirala BS,&nbsp;Lujie Karen Chen MS, PhD","doi":"10.1111/opn.12592","DOIUrl":"10.1111/opn.12592","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nursing assistants working in long-term care (LTC) often report that their job is stressful. To reduce their work stress, a better understanding of their stress profile is needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to pilot test methods to identify and understand stressors that LTC nursing assistants experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We asked each participant to provide wearable sensor/watch data, ecological momentary assessment (EMA) surveys and end of day review data over two eight-hour working shifts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight nursing assistants participated. All participants worked in a common continuing care retirement community in Maryland, United States of America. Our stress assessment method revealed 83 stressful events that were classified under 10 categories. Most of the reported events were rated as having a mild to low-moderate intensity. The three most common causes of stress were work demands and pressure (28.35%), heavy workload and staffing (19.69%), and safety issues and COVID-19 concerns (17.32%). We also explored the difference between stress events and intensity among different shifts. Disrespect from residents (22.73%) was the most commonly reported stressor during day shifts. Feeling rushed was the most commonly reported stressor during the evening (22.47%) and the night (38.46%) shifts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found stress was commonly reported. Stress intensity conflicted with prior literature, and we explored possible explanations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for practice</h3>\u0000 \u0000 <p>We discuss potential implications for these findings, modification of our methods to increase feasibility, the utility of these data collection methods for future work and suggest next steps.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138714656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Methods and approaches to facilitate inclusion of the views, perspectives and preferences of people with moderate-to-severe dementia in research: A narrative systematic review 促进将中重度痴呆症患者的意见、观点和偏好纳入研究的方法和途径:叙述式系统综述
IF 2.2 4区 医学 Q2 Nursing Pub Date : 2023-12-11 DOI: 10.1111/opn.12594
Rachel Collins PhD, Anthony Martyr PhD, Anna Hunt MSc, Catherine Quinn PhD, Claire Pentecost PhD, Julian C. Hughes PhD, Linda Clare ScD

Background

The perspectives of people with moderate-to-severe dementia are rarely directly elicited in research studies.

Objectives

This systematic review will explore methods and approaches for including the perspectives and preferences of people with moderate-to-severe dementia in research.

Methods

AgeLine, CINAHL, Embase, PsycINFO, PubMed, Social Policy and Practice and Web of Science were searched until June 16 2022. Study quality was assessed using the 16-item Quality Assessment Tool. We described specific communication tools, reviewed the evidence for their effectiveness and considered their strengths and limitations. We examined the more general communication skills and techniques applied to support the use of these tools using thematic synthesis. The review protocol was registered with PROSPERO CRD42019130386 and the review was conducted and reported according to PRISMA guidelines.

Results

Seven studies reported in 11 publications were included. In these studies five specific communication tools were used: Talking Mats, Augmentative and Alternative Communication Flexiboard, generic photographs in combination with a preference placement board, consultation ballot and personalised communication prescriptions. Each tool identified had advantages and disadvantages depending on dementia severity, verbal or physical ability, expense, researcher training requirements and ease of use. Thematic synthesis identified five general approaches to optimising communication that were employed to support use of the tools: ensuring conversations are individual and person-centred, managing external influences, engaging others, creating structure and facilitation skills.

Conclusion

All tools had some utility and there was no clear evidence to support the recommendation of any one specific tool; therefore, researchers are advised to select the tool most appropriate to their context.

Implications for Practice

The findings offer general guidance for researchers and practitioners on how to facilitate communication with people with moderate-to-severe dementia.

在研究中,中重度痴呆症患者的观点很少被直接引用。
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引用次数: 0
Development and initial validation of the staff perception of residential care environments (SPORE) instrument 工作人员对住宿护理环境(SPORE)感知工具的开发和初步验证
IF 2.2 4区 医学 Q2 Nursing Pub Date : 2023-12-10 DOI: 10.1111/opn.12596
Susanna Nordin PhD, Marie Elf PhD, Kevin McKee PhD

Background

The impact of the physical environment on healthcare staff well-being and work performance is well recognised, yet there is a lack of instruments assessing environmental features from the perspective of staff working in residential care facilities (RCFs) for older people.

Objectives

To develop and provide initial validation of the instrument Staff Perceptions Of Residential care facility Environments (SPORE).

Design

An instrument development and psychometric evaluation study.

Methods

Based on material from a British project, items were translated and adapted for Swedish residential care facilities as SPORE. Care staff (N = 200), recruited from 20 Swedish RCFs, completed a questionnaire-based survey containing the SPORE instrument and two other instruments selected as suitable for use in the validation. In addition, an environmental assessment instrument was used for further validation. Analyses were performed at individual (staff) level and home (RCF) level.

Results

The SPORE subscales demonstrated good internal consistency reliability and were moderately to strongly correlated at the individual level with the subscales of measures of person-centred care, and strongly correlated with the same measures at the home level. The SPORE subscales were also highly correlated with the total score of the instrument used to assess the quality of the physical environment.

Conclusion

The initial validation indicates that the SPORE instrument is promising for measuring care staff perceptions of environmental features in care facilities for older people. SPORE can be a valuable instrument for use in research and in practice to evaluate the environment as part of working towards high-quality care.

Implications for Practice

The design of the physical environment within RCFs can affect the staff's health and work performance. The instrument is useful for evaluating the environment and informing decisions about design solutions that support staff in their important work.

物理环境对医护人员身心健康和工作表现的影响已得到广泛认可,但目前还缺乏从老年人住宿护理设施(RCF)工作人员的角度对环境特征进行评估的工具。
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引用次数: 0
Caregiving for frail home-dwelling older people: A qualitative study of family caregivers' experiences 体弱居家长者的照护:家庭照护者经验的质性研究。
IF 2.2 4区 医学 Q2 Nursing Pub Date : 2023-11-27 DOI: 10.1111/opn.12586
Bente Egge Søvde MNSc, RN, PhD, Anne Marie Sandvoll PhD, RN, Eli Natvik PhD, PT, Jorunn Drageset PhD, MNSc, RN

Background

The increasing frailty of home-dwelling older people can lead to rising expectations from their family caregivers due to various demographic developments and political guidelines. European data show that 60% of home-dwelling older people receive informal care. Frailty among older people is a state of vulnerability, increasing the risk of adverse health outcomes, declining daily activities and needing long-term care.

Aim

To explore family caregivers' lived experiences with caring for frail, home-dwelling older people.

Methods

We conducted a phenomenological study to obtain in-depth descriptions of the phenomenon. We interviewed nine family caregivers, five men and four women between 52 and 90 years old, in-depth in their homes. We used a hermeneutical phenomenological approach described by van Manen and followed the COREQ checklist.

Results

The phenomenon's essential meaning is described as striving to adapt throughout the caring relationship. The interrelated themes describe different caring relationships, caring for a family member and letting go of the primary caring responsibility.

Conclusions

Family caregivers describe care as meaningful yet demanding. In our study, the varying condition of frailty was an additional challenge in care. By addressing these challenges, healthcare providers can better support and help family caregivers to withstand their caring relationships. The Norwegian Centre for Research Data approved the study (Ref.61202).

背景:由于各种人口发展和政治指导方针,居家老年人的日益虚弱可能导致其家庭照顾者的期望不断提高。欧洲的数据显示,60%的居家老人接受非正式护理。老年人的虚弱是一种易受伤害的状态,会增加不良健康结果的风险,减少日常活动,需要长期护理。目的:探讨家庭照顾者照顾体弱居家老人的生活经验。方法:采用现象学方法对该现象进行深入描述。我们深入采访了9位家庭照顾者,5男4女,年龄在52岁到90岁之间。我们使用van Manen描述的解释学现象学方法,并遵循COREQ检查表。结果:该现象的本质含义被描述为在整个关爱关系中努力适应。相关的主题描述了不同的照顾关系,照顾家庭成员和放弃主要的照顾责任。结论:家庭照顾者认为护理是有意义的,但也是有要求的。在我们的研究中,不同的虚弱状况是护理的另一个挑战。通过应对这些挑战,医疗保健提供者可以更好地支持和帮助家庭照顾者承受他们的照顾关系。挪威研究数据中心批准了这项研究(参考文献61202)。
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引用次数: 0
Improving nutrition care and diet intake for hospitalised older people at risk of malnutrition through a nurse-driven mealtime assistance bundle 通过护士主导的用餐时间援助套餐,改善有营养不良风险的住院老年人的营养护理和饮食摄入。
IF 2.2 4区 医学 Q2 Nursing Pub Date : 2023-11-21 DOI: 10.1111/opn.12590
Di Zhang DNP, APN, Laura Bee Gek Tay FRCP, Su Fee Lim PHD, APN, Joyce Yee Hui Ang BSN, RN, Cherie Chung Yan Tong MSc, CNSC, RD, Clarissa Yoke Leng Tang APD, Jill Brennan-Cook DNP, RN, GERO-BC

Background

Poor dietary intake is common in hospitalised older people. A targeted mealtime intervention is needed to improve nutrition care and dietary intake, especially for those at risk of malnutrition.

Objectives

This quality improvement project designed, implemented and evaluated a mealtime assistance bundle consisting of care measures driven by the hospital nursing team. The aims were to improve the mealtime care process to promote dietary intake of the hospitalised older people and to improve nursing staff's knowledge, attitude and practice in malnutrition.

Methods

This project adopted a pre–post design, targeting older people aged 65 years and above, who were admitted to a general medical unit in a regional hospital in Singapore. A mealtime assistance bundle consisting of seven care measures, using the acronym CANFEED, was implemented for older adults at risk of malnutrition. Outcome measures on the amount of dietary intake during meals through chart reviews and surveys of nursing staff using Malnutrition Knowledge, Attitudes and perceived Practices (M-KAP) questionnaire were performed before and after implementation.

Results

There were fewer older adults with poor intake in the post-implementation group than the pre-implementation group. Among those at risk of malnutrition, older adults in the post-implementation group had higher average intake of all provided meals as well as the protein-dense main dish. Significant improvements were noted in the total scores rated by the nursing staff in both the Knowledge-Attitude subscale and Practice subscale of the M-KAP questionnaire.

Conclusions

Integrating a nurse-driven mealtime assistance bundle into usual care may have positive outcomes on nutritional intake of hospitalised older people at risk of malnutrition, and on knowledge, attitude and practice of hospital nurses in nutrition care.

Implications for Practice

Nurses play a critical role in nutrition care for hospitalised older people. Continuing efforts to improve nutritional intake of hospitalised older people should focus on staff education, building a multidisciplinary food-promoting culture and patient, family and community empowerment. More efficient clinical processes incorporating information technology with the EMR to support better nutritio

背景:饮食摄入不良在住院老年人中很常见。需要有针对性的用餐时间干预,以改善营养护理和饮食摄入,特别是对那些有营养不良风险的人。目的:本质量改进项目设计、实施并评估了由医院护理团队推动的由护理措施组成的用餐时间援助包。其目的是改善用餐时护理过程,促进住院老年人的饮食摄入,并改善护理人员在营养不良方面的知识、态度和做法。方法:本项目采用岗前设计,研究对象为新加坡某地区医院普通内科收治的65岁及以上老年人。针对有营养不良风险的老年人,实施了一项由七项护理措施组成的用餐时间援助包,简称CANFEED。实施前后分别采用营养不良知识、态度和认知行为问卷(M-KAP)对护理人员进行问卷调查,通过图表审查和调查,对膳食摄入量进行结果测量。结果:与实施前相比,实施后组老年人饮食不良的人数较少。在那些有营养不良风险的老年人中,实施后组的老年人对所有提供的膳食以及蛋白质密集的主菜的平均摄入量更高。护理人员在M-KAP问卷的知识态度子量表和实践子量表上的总得分均有显著提高。结论:将护士主导的用餐时间援助整合到日常护理中,可能会对有营养不良风险的住院老年人的营养摄入以及医院护士在营养护理方面的知识、态度和实践产生积极的影响。对实践的启示:护士在住院老年人的营养护理中发挥着关键作用。继续努力改善住院老年人的营养摄入,重点应放在工作人员教育、建立多学科的促进饮食文化以及增强患者、家庭和社区的权能。需要更有效的临床程序,将信息技术与电子病历结合起来,以支持住院老年人更好的营养护理。
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引用次数: 0
Urban–rural differences in associations among perceived stress, resilience and self-care in Chinese older adults with multiple chronic conditions 中国老年多重慢性病患者压力感知、心理弹性和自我护理的城乡差异
IF 2.2 4区 医学 Q2 Nursing Pub Date : 2023-11-20 DOI: 10.1111/opn.12591
Yuanyuan Jin PhD, MSN, RN, Roger Brown PhD, Muna Bhattarai PhD, RN, Junyang Song MSN, RN

Background

Social determinants of health (SDH) are mainly comprised of structural and intermediary domains. Emerging evidence suggests that the burden of multiple chronic conditions (MCCs) in older adults is exacerbated by structural determinants (e.g. low income and low education). However, less attention was paid to the intermediary determinants (i.e. material circumstances, psychosocial factors and behavioural factors) of MCCs.

Objectives

To investigate the associations among perceived stress, resilience and self-care in Chinese older adults with MCCs by comparing urban and rural groups.

Methods

A convenience sample (125 and 115 participants from urban and rural settings, respectively) of Chinese older adults with MCCs was enrolled between January and April 2022. Hierarchical multiple regression analyses and propensity score weights were used to determine the associations among perceived stress, resilience and self-care.

Results

Hypothesis 1 regarding the negative associations between perceived stress and self-care was fully supported in the rural group. However, for the urban group, the negative association was only supported for the relationship between MCCs-related perceived stress and self-care maintenance. Hypothesis 2 was fully supported regarding the positive associations between resilience and the three components of self-care in both groups, although the relationship between resilience and self-care monitoring was marginally significant in the urban group. Hypothesis 3 regarding the moderating effect of resilience was only supported in the relationship between general perceived stress and self-care monitoring in the rural group. After adding the propensity score weights, the moderating effect was no longer statistically significant in the rural group.

Conclusions

The urban–rural disparities in the Chinese context might largely be attributed to the complex interactions of the structural determinants and intermediary determinants. Findings can inform the development of culturally tailored interventions to promote self-care and reduce urban–rural disparities for Chinese older adults with MCCs.

Implications for practice

With

背景:健康的社会决定因素(SDH)主要由结构域和中间域组成。新出现的证据表明,结构性决定因素(如低收入和低教育程度)加重了老年人多重慢性疾病的负担。然而,对mcc的中间决定因素(即物质环境、社会心理因素和行为因素)的关注较少。目的:通过对城市和农村人群的比较,探讨中国老年mcc患者感知压力、心理弹性和自我护理之间的关系。方法:在2022年1月至4月期间招募了中国老年mcc患者(分别来自城市和农村地区的125名和115名参与者)。采用分层多元回归分析和倾向得分权重来确定感知压力、心理弹性和自我照顾之间的关系。结果:关于压力感知与自我照顾负相关的假设1在农村群体中得到完全支持。然而,对于城市组而言,仅在mcs相关的感知压力与自我护理维持之间存在负相关。假设2完全支持弹性和自我照顾三个组成部分之间的正相关,尽管弹性和自我照顾监测之间的关系在城市组中是边际显著的。关于弹性调节作用的假设3仅在农村群体的一般感知压力与自我保健监测之间的关系中得到支持。在增加倾向得分权重后,农村组的调节效应不再具有统计学意义。结论:中国城乡差异的主要原因可能是结构决定因素和中介决定因素之间复杂的相互作用。研究结果可以为制定适合中国文化的干预措施提供信息,以促进中国老年mcc患者的自我护理,减少城乡差异。实践意义:随着中国患有多种慢性疾病的老年人数量的增加,以及对改善其健康结果的有效干预措施的呼吁,当前的研究结果可以为制定和实施护士主导的文化定制干预措施提供信息,以促进中国mcc老年人的自我护理,并减少城乡差距。
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引用次数: 0
期刊
International Journal of Older People Nursing
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