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1.
Nordisk Alkohol Nark ; 41(1): 97-110, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38356789

RESUMEN

Aim To report the development and validation of the Nurses' Skills to Care for Alcohol-Intoxicated Patients in Emergency Department instrument, shortened NSCAIP-ED. Methods: A mixed-methods design was used to develop the instrument. It was used to conduct a survey where ED nurses self-evaluated their skills to care for acutely ill alcohol-intoxicated patients (N = 1220, n = 252). The data were utilised to perform instrument validation using confirmatory factor analysis (CFA) and Cronbach's alpha. Results: The construct validity was tested statistically. The CFA model fit indicators showed mostly acceptable fit (chi-square test p < 0.001; RMSEA 0.079; CFI 0.923; TLI 0.918; SRMR 0.084) and instruments' scales had well acceptable Cronbach's alpha values (all alphas were in the range of 0.866-0.912). Conclusions: The NSCAIP-ED is a feasible and reliable instrument that can be used when measuring nurses' skills to care for alcohol-intoxicated patients in the ED. This instrument could be useful for nursing managers in EDs for evaluating their nursing staff's skills in the care area in question, but also for designing continuing education based on the results.

2.
BMC Nurs ; 22(1): 198, 2023 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-37303039

RESUMEN

BACKGROUND: Several nursing interventions for pressure injury prevention have been identified, including risk and skin status assessment. The aim of this study was to explore prevention of pressure injuries in Finnish acute inpatient care. The data were collected on pressure injury risk and skin status assessments, repositioning, the use of support surfaces, preventive skin care, malnutrition risk assessment, and nutritional care. METHODS: This multicentre, cross-sectional study was conducted in 16 acute care hospitals, excluding psychiatric care. Adult patients from inpatient care were recruited on the annual international Stop Pressure Ulcers Day in 2018 and 2019. Enrolment covered 6,160 participants in 503 units. Descriptive statistics were used to describe pressure injuries, risk assessments, and preventive nursing interventions. Cross tabulation, Pearson's chi-square and Fisher's exact tests were also used. Reporting follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. RESULTS: In all, 30% of the participants had their pressure injury risk assessed during the care, and for 19% within 8 h after admission. The same time limit in risk assessment was fulfilled for 16% of the participants with a pressure injury, and 22% of the participants using a wheelchair or being bedridden. A skin status assessment within 8 h after admission was conducted for 30% of all participants, and for 29% of the participants with a pre-existing pressure injury, and for 38% of the participants using a wheelchair or being bedridden. The risk of malnutrition was screened in 20% of the participants. Preventive interventions were targeted to participants with a pressure injury instead of patients with a high-pressure injury risk. CONCLUSION: This study adds evidence about pressure injury risk assessments and the implementation of preventive nursing interventions in Finnish acute care. Skin status and pressure injury risk assessments were irregularly conducted, and the outcome was not used by nurses to guide the implementation of preventive interventions. The results reveal the gaps in evidence-based nursing practice, which require further efforts to prevent pressure injuries. Improving the national focus on pressure injury prevention practice is critical for improving healthcare for our patients.

3.
J Nurs Adm ; 53(1): 19-26, 2023 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-36542440

RESUMEN

OBJECTIVE: To add to the body of evidence regarding nurse engagement and related factors from a non-US sample of nurses. BACKGROUND: Leadership has a positive impact on nurses' autonomy and engagement experiences. It is necessary to explore the factors that explain the relationships between leadership, autonomy, and engagement level. METHODS: Nurses (n = 4393) from 9 hospitals participated in a survey in March 2020. Multivariable logistic regression analysis was performed to identify engagement and autonomy predictors. RESULTS: Of the respondents, 9% were engaged, 28% content, 29% ambivalent, and 34% disengaged. Respondents' separate background variables were not significant predictors in multivariate models, whereas the leadership- and autonomy-related variables were. CONCLUSIONS: A manager's responsiveness, an organization's readiness to follow nurse suggestions for performance improvement, and receiving recognition and regular feedback promote engagement. Furthermore, engagement is enhanced when nurses have an active role in decision-making and their contributions are respected. Visible nurse managers and leaders who are effective advocates for nurses strengthen nurses' autonomy.


Asunto(s)
Enfermeras Administradoras , Enfermeras y Enfermeros , Humanos , Estados Unidos , Liderazgo , Estudios Transversales , Encuestas y Cuestionarios , Hospitales , Satisfacción en el Trabajo
4.
Int Wound J ; 20(6): 2037-2052, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36584884

RESUMEN

This study evaluates the effect of nursing staff's renewed consistent pressure ulcer (PU) prevention practice on PU prevalence and the PU prevention implemented for residents. A quasi-experimental intervention study was conducted. The data were collected from 232 residents (n = 115 in intervention and 117 in comparison group) in two public long-term older people care (LOPC) facilities in Finland using the Pressure Ulcer Patient instrument (PUP-Instrument). The facilities were chosen with convenience sampling, after which they were randomly allocated as either intervention or comparison facility. Based on international guidelines for PU prevention, the renewed, consistent PU prevention practice with six areas was developed and implemented using the operational model for evidence-based practices (OMEBP). After the intervention, a significant difference between the intervention and the comparison facility was seen in the prevalence of PUs and in the residents' highest stage of PUs in the sacrum, buttock and hip areas, and heels. Between the facilities, a significant difference was seen in the use of PU and nutrition risk assessment instruments and nutritional supplements, time used for repositioning in the daytime and at night-time, lifting belt use, and avoiding shearing or stretching residents' skin. The successful intervention improved skin integrity in LOPC facilities.


Asunto(s)
Úlcera por Presión , Anciano , Humanos , Cuidados a Largo Plazo , Úlcera por Presión/epidemiología , Úlcera por Presión/prevención & control , Prevalencia , Cuidados de la Piel , Supuración
5.
Int Wound J ; 19(4): 919-931, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34605185

RESUMEN

The aim of this national cross-sectional study was to explore the prevalence of pressure injuries and incidence of hospital-acquired pressure injuries, and the relating factors in somatic-specialised inpatient care in Finland. The study was conducted in 16 (out of 21) Finnish health care organisations offering specialised health care services. Data were collected in 2018 and 2019 from adult patients (N = 5902) in inpatient, emergency follow-up, and rehabilitation units. Pressure injury prevalence (all stages/categories) was 12.7%, and the incidence of hospital-acquired pressure injuries was 10%. Of the participants, 2.6% had at least one pressure injury at admission. The risk of hospital-acquired pressure injuries was increased for medical patients with a higher age, the inability to move independently, mode of arrival, being underweight, and the absence of a skin assessment or pressure injury risk assessment at admission. For surgical patients, the risk was associated with the inability to move independently, mode of arrival, and lack of skin assessment at admission, while being overweight protected the patients. Overall, medical patients were in greater risk of hospital-acquired pressure injuries than the surgical patients. An assessment of the pressure injury risk and skin status should be carried out more systematically in Finnish acute care hospitals.


Asunto(s)
Pacientes Internos , Úlcera por Presión , Adulto , Estudios Transversales , Humanos , Incidencia , Úlcera por Presión/epidemiología , Úlcera por Presión/etiología , Prevalencia , Factores de Riesgo
6.
J Clin Nurs ; 31(1-2): 275-282, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34114280

RESUMEN

AIM AND OBJECTIVE: The aim of the study was to investigate how the sleep improvement interventions developed for the wards were associated with patients' sleep. The objective was to promote patients' sleep. BACKGROUND: The quality of sleep is vital for patients' health and recovery from illness. However, patients generally sleep poorly during hospitalisation. Sleep-disturbing factors are connected to the hospital environment, patients' physical illness, emotional state and the activities of the staff. Many sleep-disturbing factors can be influenced by appropriate nursing interventions. DESIGN: A two-group intervention study including the development of nursing interventions aimed at supporting patients' sleep. One group received a sleep promotion intervention and the other received standard care. Both groups evaluated their sleep in the morning. METHODS: A survey of participants' sleep evaluations was collected with the five-item Richards-Campbell Sleep Questionnaire. The data were analysed statistically. The STROBE checklist was used to report the study. RESULTS: From the participants' perspective, sleep was better in the intervention group, even though statistically significantly only among men. The pain intensity correlated with sleep quality. The number of patients in the room or whether participants had had an operation had no effect on their sleep evaluations. CONCLUSIONS: Interventions targeted at supporting and promoting the sleep quality of hospital inpatients may be effective. They should be developed in collaboration with patients and nurses. Several nursing interventions can be proposed to promote better sleep among patients; however, more research is needed to confirm the results. Sleep promotion should include both standardised protocols and individualised sleep support. RELEVANCE TO CLINICAL PRACTICE: Investing in nursing interventions to promote patients' sleep is important. Patients' individual sleep-related needs should be part of their care plan. Training programmes that support nurses' knowledge and skills of patients' sleep promotion should be part of nursing education in healthcare organisations.


Asunto(s)
Enfermeras y Enfermeros , Competencia Clínica , Hospitales , Humanos , Masculino , Sueño
7.
Scand J Caring Sci ; 36(1): 150-161, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33694185

RESUMEN

BACKGROUND: Pressure ulcers cause economic burden, human suffering, pain and decreased health-related quality of life in patients. Pressure ulcers are preventable in most cases, and nursing staff knowledge is a key factor in successful pressure ulcer prevention. Further evidence is needed to better tailor pressure ulcer prevention training programmes to the nursing staff. AIM: To evaluate the level of nursing staff knowledge about evidence-based pressure ulcer prevention practices in both primary and specialised care, and to identify what factors determine nurses' knowledge levels. METHODS: A correlational, cross-sectional study was conducted from 2018 to 2019 in two hospital districts in Finland. The Pressure Ulcer Prevention Knowledge test was used to collect data, and the Attitude towards Pressure ulcer Prevention (APuP) instrument was used as a background variable. The data were statistically analysed with Wilcoxon and Kruskal-Wallis tests, Spearman correlations and multiple linear regression. RESULTS: The pressure ulcer prevention knowledge of the participating registered nurses, practical nurses and ward managers (N = 554) was on average 24.40 (max. 35.00). There was no difference in the participants' knowledge based on the type of unit in which they were working (primary or specialised care). The participants' attitudes (p < 0.0001), current position (p = 0.0042), frequency of taking care of patients with pressure ulcers (p = 0.0001) and self-evaluated training needs (p < 0.0001) independently explained the variation in the knowledge scores. CONCLUSIONS: Special attention needs to be paid to the knowledge of those nurses working in positions that require lower levels of education and those who rarely take care of patients with pressure ulcers. Supporting nurses' positive attitudes towards pressure ulcer prevention should be an essential part of pressure ulcer prevention training. Nurses' self-evaluations of their training needs can be used to target training. The limitations of the study should be considered when generalising the results.


Asunto(s)
Enfermeras y Enfermeros , Úlcera por Presión , Competencia Clínica , Estudios Transversales , Finlandia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Úlcera por Presión/prevención & control , Calidad de Vida , Encuestas y Cuestionarios
8.
Scand J Caring Sci ; 35(4): 1342-1351, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33394504

RESUMEN

OBJECTIVES: Hospitalised patients are at risk of temporary or permanent loss of functioning which impacts their future independence. Implementation of a rehabilitative approach in everyday nursing in the acute care setting may produce good therapeutic results and promote independent daily living of patients. Thus, the aim of the study was to explore and understand the patterns of a rehabilitative approach in acute hospital wards from the perspective of interdisciplinary team members. Specifically, our aim was to identify the factors promoting and preventing a rehabilitative approach. METHOD: We conducted four focus group interviews with 21 participants, including multidisciplinary team members from acute hospital wards. Data were analysed with conventional inductive content analysis. RESULTS: The findings highlighted that the rehabilitative approach, as a personal way of working and personal working attitude, was a part of comprehensive nursing. The main goals of the rehabilitative approach were to support the physical functioning of the patients and their independent initiative and individuality during clinical care in hospital ward. The promoting and preventing factors that influenced the development of the rehabilitative approach consisted of personal factors, organisational factors and the physical settings of the hospital wards. CONCLUSION: The findings of this study indicate that the rehabilitative approach in nursing focused on supporting the physical functioning, independence and self-confidence of the patient. The staff highlighted that interdisciplinary teamwork was one feature of the rehabilitative approach. The rehabilitative approach in nursing should be established as a part of everyday activity in clinical practice.


Asunto(s)
Actividades Cotidianas , Grupos Focales , Humanos , Investigación Cualitativa
9.
Scand J Caring Sci ; 35(1): 115-122, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32037636

RESUMEN

BACKGROUND: Healthcare professionals have a key role in detecting health risks from alcohol use. The earlier the alcohol misuse is identified and addressed, the lower the risk of harm and the need for actual drug treatment. Positive attitudes and high motivation on the part of nurses are needed for achieving success in the care of intoxicated patients. AIM: The aim of the study was to describe nurses' skills to care for and attitudes towards the care of patients with alcohol intoxication in emergency departments (EDs). METHOD: The data were collected from nursing staff who participated in online training related to the care of alcohol-intoxicated patients in the EDs (N = 20, n = 17). As part of the training, nurses wrote two essays. The essays made up the data of this study which were analysed using inductive content analysis. RESULTS: Three main categories emerged from the nurses' descriptions of their skills in caring for and attitudes towards the care of patients with alcohol intoxication: nurse's lack of commitment to intoxicated patient care; nurse's commitment to intoxicated patient care; and nurse's skills in intervention methods. CONCLUSION: Many different factors influence nurses' commitment or lack of commitment in the care of intoxicated patients. Nurses' attitudes and skills are linked to the success of care of intoxicated patients in ED. IMPLICATIONS FOR NURSING OF ALCOHOL-INTOXICATED PATIENTS: Increasing awareness of alcohol-related issues seems to help nurses to understand better the situation of a patient with alcohol intoxication, make their attitudes more positive and help them to use the intervention methods.


Asunto(s)
Intoxicación Alcohólica , Enfermería de Urgencia , Enfermeras y Enfermeros , Personal de Enfermería en Hospital , Actitud del Personal de Salud , Servicio de Urgencia en Hospital , Conocimientos, Actitudes y Práctica en Salud , Humanos , Rol de la Enfermera
10.
J Addict Nurs ; 31(3): 146-152, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32868607

RESUMEN

AIM: The aim of the study was to describe nurses' skills, knowledge of care, and attitudes toward the care of patients with alcohol intoxication in the emergency department. METHOD: The data were collected using theme interviews in 2016. The study participants were nurses working in the emergency department (n = 6) that has a sobering unit. The data were analyzed using inductive content analysis. RESULTS: On the basis of the interviewees' descriptions, five main categories were formed: the skills to discuss the use of alcohol on arrival, safety skills, teamwork skills, the skills to organize follow-up care, and nurses' attitudes and ethics in patients' care. Asking about the use of alcohol as well as the use of a screening tool varied. The interviewees emphasized the skills to anticipate the risk of violence as well as ensuring the safety of the working environment. Nurses' attitudes were seen as the ability to regulate negative emotions raised by the patient. Factors related to nurses' attitudes emerged in patients' behavioral disorders and commitment to treatment. Despite some negative feelings toward patients, nurses thought that it is important to ensure ethicality in patients' care. CONCLUSIONS: The nurses' skills and knowledge of care and attitudes toward patients with alcohol intoxication varied. There is a need for additional training on issues relating to the treatment of patients with alcohol intoxication.


Asunto(s)
Intoxicación Alcohólica/terapia , Actitud del Personal de Salud , Servicio de Urgencia en Hospital , Conocimientos, Actitudes y Práctica en Salud , Personal de Enfermería en Hospital/educación , Adulto , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad
11.
J Wound Care ; 27(Sup2): S4-S10, 2018 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-29419369

RESUMEN

OBJECTIVE: To quantify pressure ulcer (PU) prevalence and to describe and identify the PU risk factors in acute hospital wards. METHOD: A descriptive quantitative study was performed in 13 wards in a central hospital in Finland. The study included PU risk evaluation using the Braden risk assessment method, and full skin and medical assessment of consenting adult patients. Patients in paediatric, maternity and psychiatric wards, and in the intensive care unit were excluded. Patient's PUs were examined on the ward, and evaluated and classified using the international European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel (EPUAP/NPUAP) Pressure Ulcer Classification System. Demographic data, the Braden risk assessment scale, skin assessment, and the location and severity of PUs were also recorded. RESULTS: A sample of 229 inpatients was examined for signs of PUs on one day in 2013. The overall PU prevalence was 8.7% (20 patients). Of those assessed as 'at risk of developing PUs', four patients (1.7%) were considered at 'very high risk', 39 patients (17.0%) at 'high risk', and 60 patients (26.2%) with a 'moderate risk'. The patient's age and length of treatment period were associated with PU risk, while only length of treatment period was associated with PU prevalence. Older patients had a higher risk of PUs than younger ones. The longer the hospital stay, the higher the PU risk was. In addition, patients with a long hospital stay more often had a PU. CONCLUSION: According to the study, PUs occur with significant frequency in acute hospital wards. It is important to carry out PU prevention actions among all patient groups, but risk increases among older patients and those who, for any reason, stay in hospital for a longer period of time.


Asunto(s)
Pacientes Internos , Úlcera por Presión/epidemiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Finlandia/epidemiología , Unidades Hospitalarias , Humanos , Masculino , Persona de Mediana Edad , Úlcera por Presión/etiología , Úlcera por Presión/enfermería , Prevalencia , Factores de Riesgo
12.
Inform Health Soc Care ; 43(3): 234-247, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28139155

RESUMEN

BACKGROUND: Internet-based applications are potentially useful and effective interventions to reach and support adolescents with mental health problems. Adolescents' commitment to the use of a new Internet-based intervention is closely related to the support they receive from healthcare professionals. This study describes nurses' experiences of the use of an Internet-based support system for adolescents with depressive disorders. METHOD: Qualitative descriptive study design including individual interviews with nine nurses at two psychiatric outpatient clinics. The Technology Acceptance Model (TAM) was used as the theoretical background of the study. RESULTS: Nurses described several benefits of using the Internet-based support system in the care of adolescents with depressive disorders if the nurses integrate it into daily nursing practices. As perceived disadvantages the nurses thought that an adolescent's mental status might be a barrier to working with the support system. Perceived enablers could be organizational support, nurses' attitudes, and technology-related factors. Nurses' attitudes were identified as a barrier to supporting adolescents' use of the Internet-based support system. CONCLUSION: The findings suggest that the implementation plan and support from the organization, including that from nurse managers, are crucial in the process of implementing a technology-based support system.


Asunto(s)
Actitud del Personal de Salud , Trastorno Depresivo , Internet , Enfermeras y Enfermeros , Apoyo Social , Adolescente , Adulto , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Investigación Cualitativa
13.
Scand J Caring Sci ; 32(1): 24-44, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28771752

RESUMEN

The aim of the study was to synthesise the best available research evidence on nursing professionals' experiences of the facilitators and barriers to the use of online telehealth services in nursing practice. Telehealth is used to deliver healthcare services and health-related information by means of information and communication technology (ICT). The systematic review of qualitative studies was conducted using thematic synthesis of previous studies. International electronic databases PubMed, CINAHL, Eric, Web of Science/Web of Knowledge and Scopus, and Finnish databases Medic and Ohtanen were searched in spring 2013. In addition, the search was complemented in fall 2015. Following critical appraisal, 25 studies from 1998 to fall 2015 were reviewed and the findings were synthesised. Both facilitators and barriers were grouped into five main categories which were related to nurses' skills and attitudes, nurses' work and operations, organisational factors, patients and technology. The highest number of facilitators and barriers was found in the category focusing on nurses' work and operations. Based on the findings, nurses' skills and attitudes are preventing factors in the implementation of telehealth. There is also a need to focus on patients' role in telehealth usage although the findings support positive adoption of ICT tools among patients. The findings call for further development of technological tools used in nursing practice and healthcare services. The change from traditional face-to-face nursing to the use of telehealth calls for local agreements and further discussions among professionals on how this change will be accepted and implemented into practice. In addition, organisations need to make sure that nurses have enough resources and support for telehealth use.


Asunto(s)
Actitud hacia los Computadores , Comunicación , Internet/estadística & datos numéricos , Personal de Enfermería/psicología , Telemedicina/métodos , Teleenfermería/métodos , Teléfono/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa
14.
Neuropsychiatr Dis Treat ; 13: 1201-1209, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28490882

RESUMEN

PURPOSE: Information and communication technologies have been developed for a variety of health care applications and user groups in the field of health care. This study examined the connectivity to computers and the Internet among patients with schizophrenia spectrum disorders (SSDs). PATIENTS AND METHODS: A cross-sectional survey design was used to study 311 adults with SSDs from the inpatient units of two psychiatric hospitals in Finland. The data collection lasted for 20 months and was done through patients' medical records and a self-reported, structured questionnaire. Data analysis included descriptive statistics. RESULTS: In total, 297 patients were included in this study (response rate =96%). More than half of them (n=156; 55%) had a computer and less than half of them (n=127; 44%) had the Internet at home. Of those who generally had access to computers and the Internet, more than one-fourth (n=85; 29%) used computers daily, and >30% (n=96; 33%) never accessed the Internet. In total, approximately one-fourth of them (n=134; 25%) learned to use computers, and less than one-third of them (n=143; 31%) were known to use the Internet by themselves. Older people (aged 45-65 years) and those with less years of education (primary school) tended not to use the computers and the Internet at all (P<0.001), and younger people and those with higher education were associated with more active use. CONCLUSION: Patients had quite good access to use computers and the Internet, and they mainly used the Internet to seek information. Social, occupational, and psychological functioning (which were evaluated with Global Assessment of Functioning) were not associated with access to and frequency of computer and the Internet use. The results support the use of computers and the Internet as part of clinical work in mental health care.

15.
J Med Internet Res ; 19(2): e46, 2017 02 21.
Artículo en Inglés | MEDLINE | ID: mdl-28223262

RESUMEN

BACKGROUND: Clinical trials are the gold standard of evidence-based practice. Still many papers inadequately report methodology in randomized controlled trials (RCTs), particularly for mHealth interventions for people with serious mental health problems. To ensure robust enough evidence, it is important to understand which study phases are the most vulnerable in the field of mental health care. OBJECTIVE: We mapped the recruitment and the trial follow-up periods of participants to provide a picture of the dropout predictors from a mHealth-based trial. As an example, we used a mHealth-based multicenter RCT, titled "Mobile.Net," targeted at people with serious mental health problems. METHODS: Recruitment and follow-up processes of the Mobile.Net trial were monitored and analyzed. Recruitment outcomes were recorded as screened, eligible, consent not asked, refused, and enrolled. Patient engagement was recorded as follow-up outcomes: (1) attrition during short message service (SMS) text message intervention and (2) attrition during the 12-month follow-up period. Multiple regression analysis was used to identify which demographic factors were related to recruitment and retention. RESULTS: We recruited 1139 patients during a 15-month period. Of 11,530 people screened, 36.31% (n=4186) were eligible. This eligible group tended to be significantly younger (mean 39.2, SD 13.2 years, P<.001) and more often women (2103/4181, 50.30%) than those who were not eligible (age: mean 43.7, SD 14.6 years; women: 3633/6514, 55.78%). At the point when potential participants were asked to give consent, a further 2278 refused. Those who refused were a little older (mean 40.2, SD 13.9 years) than those who agreed to participate (mean 38.3, SD 12.5 years; t1842=3.2, P<.001). We measured the outcomes after 12 months of the SMS text message intervention. Attrition from the SMS text message intervention was 4.8% (27/563). The patient dropout rate after 12 months was 0.36% (4/1123), as discovered from the register data. In all, 3.12% (35/1123) of the participants withdrew from the trial. However, dropout rates from the patient survey (either by paper or telephone interview) were 52.45% (589/1123) and 27.8% (155/558), respectively. Almost all participants (536/563, 95.2%) tolerated the intervention, but those who discontinued were more often women (21/27, 78%; P=.009). Finally, participants' age (P<.001), gender (P<.001), vocational education (P=.04), and employment status (P<.001) seemed to predict their risk of dropping out from the postal survey. CONCLUSIONS: Patient recruitment and engagement in the 12-month follow-up conducted with a postal survey were the most vulnerable phases in the SMS text message-based trial. People with serious mental health problems may need extra support during the recruitment process and in engaging them in SMS text message-based trials to ensure robust enough evidence for mental health care. CLINICALTRIAL: International Standard Randomized Controlled Trial Number (ISRCTN): 27704027; http://www.isrctn.com/ISRCTN27704027 (Archived by WebCite at http://www.webcitation.org/6oHcU2SFp).


Asunto(s)
Trastornos Mentales/tratamiento farmacológico , Trastornos Mentales/psicología , Pacientes Desistentes del Tratamiento/psicología , Telemedicina/métodos , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Cumplimiento de la Medicación/psicología , Persona de Mediana Edad , Selección de Paciente , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Encuestas y Cuestionarios , Envío de Mensajes de Texto/estadística & datos numéricos
16.
Int Emerg Nurs ; 31: 22-29, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27363921

RESUMEN

OBJECTIVES: To evaluate impacts of brief intervention on patients' alcohol risk drinking, quality of life and health state after treatment at the Sobering Unit in the emergency department at three months, six months, and one year follow-up. METHODS: This was a quasi-experimental study without control group (one-year follow-up). Alcohol use of patients in emergency department (Sobering Unit) in specialized care in Finland (AUDIT-test), quality of life (EQ-5D-3L) and health state (EQ VAS) at baseline, three months, six months and one year following the brief intervention were analyzed with Wilcoxon Signed-Rank test. RESULTS: The patients' alcohol risk use decreased statistically significantly after the treatment period at the Sobering Unit. The patients' health-related quality of life did not change statistically significantly during three months following the treatment period, whereas a statistically significant increase took place after six months. Self-perceived health status improved statistically significantly between the treatment period and three- and six-month follow up time points. CONCLUSIONS: The study gave some suggestive evidence that a brief intervention could be effective for harmful drinkers or alcohol-dependent patients when used in an emergency department. The Sobering Unit in the emergency department is one solution to encourage patients to pay attention to their alcohol risk drinking.


Asunto(s)
Alcoholismo/psicología , Estado de Salud , Calidad de Vida/psicología , Asunción de Riesgos , Adolescente , Adulto , Anciano , Alcoholismo/complicaciones , Servicio de Urgencia en Hospital/organización & administración , Femenino , Finlandia , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad
17.
Stud Health Technol Inform ; 245: 1304, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29295387

RESUMEN

A significant part of the patients treated in an emergency department are under the influence of alcohol or drugs. It is important to identify individuals of patient groups who might benefit from an intervention to reduce drug use. The aim of the study was to develop an evidence-based web-education program aimed at enhancing nurses' knowledge and skills in the care, assessment, and management of substance-related disorders among acutely ill patients in emergency departments.


Asunto(s)
Actitud del Personal de Salud , Educación a Distancia , Servicio de Urgencia en Hospital , Atención de Enfermería , Trastornos Relacionados con Sustancias/diagnóstico , Humanos , Internet , Aprendizaje
18.
Stud Health Technol Inform ; 225: 946-7, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27332423

RESUMEN

This presentation describes the preliminary results of the facilitators of the use of telehealth applications from nurses' point of view based on a qualitative systematic literature review synthetizing 25 previously published papers. The study brought out two main categories that facilitate the use of telehealth among nurses: 1) Nurses' skills and attitudes, and 3) Changes in nurses' work and operations.


Asunto(s)
Enfermeras y Enfermeros , Telemedicina/estadística & datos numéricos , Actitud hacia los Computadores , Humanos , Competencia Profesional , Rol Profesional
19.
BMJ Open ; 5(11): e008574, 2015 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-26553830

RESUMEN

OBJECTIVES: To explore feedback on tailored SMS reminders to encourage medication adherence and outpatient treatment among patients taking antipsychotic medication, and associations related to the feedback. DESIGN: A cross-sectional survey nested within a nationwide randomised clinical trial ("Mobile.Net" ISRCTN27704027). SETTING: Psychiatric outpatient care in Finland. PARTICIPANTS: Between September 2012 and December 2013, 403 of 558 adults with antipsychotic medication responded after 12 months of SMS intervention. MAIN OUTCOME MEASURE: Feedback was gathered with a structured questionnaire based on Technology Acceptance Model theory. Data were analysed by Pearson's χ(2) test, binary logistic regression and stepwise multiple regression analyses. RESULTS: Almost all participants (98%) found the SMS reminders easy to use and 87% felt that the SMS did not cause harm. About three-quarters (72%) were satisfied with the SMS received, and 61% found it useful. Divorced people were particularly prone to find SMS reminders useful (χ(2)=13.17, df=6, p=0.04), and people seeking employment were more often 'fully satisfied' with the SMS compared with other groups (χ(2)=10.82, df=4, p=0.029). People who were older at first contact with psychiatric services were more often 'fully satisfied' than younger groups (OR=1.02, 95% CI 1.01 to 1.04, p=0.007). CONCLUSIONS: The feedback of patients taking antipsychotic medication on SMS services was generally positive. Overall, people were quite satisfied despite considerable variation in their sociodemographic background and illness history. Our results endorse that the use of simple easy-to-use existing technology, such as mobile phones and SMS, is acceptable in psychiatric outpatient services. Moreover, people using psychiatric outpatient services are able to use this technology. This acceptable and accessible technology can be easily tailored to each patient's needs and could be customised to the needs of the isolated or jobless. This is an area in which much careful evaluation is needed.


Asunto(s)
Teléfono Celular , Cumplimiento de la Medicación , Sistemas Recordatorios , Envío de Mensajes de Texto , Adolescente , Adulto , Anciano , Antipsicóticos/uso terapéutico , Estudios Transversales , Femenino , Finlandia , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Satisfacción del Paciente , Encuestas y Cuestionarios , Adulto Joven
20.
Inform Health Soc Care ; 40(1): 79-90, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24393065

RESUMEN

Objectives: To describe the association of team climate with attitudes toward information and communication technology among nursing staff working on acute psychiatric wards. Background: Implementation of ICT applications in nursing practice brings new operating models to work environments, which may affect experienced team climate on hospital wards. Method: Descriptive survey was used as a study design. Team climate was measured by the Finnish modification of the Team Climate Inventory, and attitudes toward ICT by Burkes' questionnaire. The nursing staff (N = 181, n = 146) on nine acute psychiatric wards participated in the study. Results: It is not self-evident that experienced team climate associates with attitudes toward ICT, but there are some positive relationships between perceived team climate and ICT attitudes. The study showed that nurses' motivation to use ICT had statistically significant connections with experienced team climate, participative safety (p = 0.021), support for innovation (p = 0.042) and task orientation (p = 0.042). Conclusion: The results suggest that asserting team climate and supporting innovative operations may lead to more positive attitudes toward ICT. It is, in particular, possible to influence nurses' motivation to use ICT. More attention should be paid to psychosocial factors such as group education and co-operation at work when ICT applications are implemented in nursing.

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