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Sepsis arises when the body's response to an infection injures its own tissues and organs. Among children hospitalized with suspected sepsis in low-income country settings, mortality rates following discharge are high, similar to mortality rates in hospital. The Smart Discharges Program uses a mobile health (mHealth) platform to identify children at high risk of post-discharge mortality to receive enhanced post-discharge care. This study sought to explore the perceptions and experiences of the caregivers and nurses of children enrolled into the Smart Discharges Program and the program's effect on post-discharge care. We conducted an exploratory qualitative study, which included in-person focus group discussions (FGDs) with 30 caregivers of pediatric patients enrolled in the Smart Discharges Program and individual, semi-structured interviews with eight Smart Discharges Program nurses. The study was carried out at four hospitals in Uganda in 2019. Following thematic analysis, three key themes pertaining to the Smart Discharges program were identified: (1) Facilitators and barriers to follow-up care after discharge; (2) Changed caregiver behavior following discharge; and (3) Increased involvement of male caregivers. Facilitators included telephone/text message reminders, positive nurse-patient relationship, and the complementary aspects of the program. Barriers included resource constraints and negative experiences during post-discharge care seeking. With regards to behavior, when provided with relevant and well-timed information, caregivers reported increased knowledge about post-discharge care and improvements in their ability to care for their child. Enrolment in the Smart Discharges Program also increased male caregiver involvement, increased provision of resources and improved communication within the family and with the healthcare system. The Smart Discharges approach is an impactful strategy to improve pediatric post-discharge care, and similar approaches should be considered to improve the hospital to home transition in similar low-income country settings.
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Cuidadores , Enfermeiras e Enfermeiros , Alta do Paciente , Pesquisa Qualitativa , Sepse , Humanos , Cuidadores/psicologia , Uganda , Masculino , Feminino , Sepse/terapia , Sepse/psicologia , Criança , Enfermeiras e Enfermeiros/psicologia , Pré-Escolar , Adulto , Lactente , Telemedicina , Grupos Focais , PercepçãoRESUMO
To explore the perceptions and experiences of general practice nurses, general practitioners, and patients who participated in a nurse-led intervention to improve blood pressure control. Given the impact of hypertension on rates of premature death and disability, it is important that interventions be evaluated to reduce blood pressure. A key component of such evaluation is understanding the experiences of participants and clinicians. Understanding these experiences can provide insight into acceptability and feasibility that informs future research and implementation. Qualitative descriptive study within a mixed methods project. Semi-structured interviews were conducted post-intervention with six patients, five nurses, and three general practitioners. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. The COREQ checklist guided reporting. Three themes around the need for change, navigating change, and sustaining change were revealed. In highlighting the need for change, participants recognized that it was time to actively work toward improved blood pressure control. In navigating change, general practice nurses were perceived as ideally placed to communicate risks around uncontrolled blood pressure and support lifestyle change. The final theme, sustaining change revealed the feasibility of the intervention in practice, however, clinician participants identified that appropriate funding is required to ensure sustainability. Nurse-led intervention to improve blood pressure control in general practice is feasible in practice and acceptable to patients. This highlights an opportunity for nurses to play a more proactive role in hypertension management within general practice. To ensure sustainability, however, issues such as funding, teamwork, and collaboration need to be addressed. Trial Registration: Australian and New Zealand Clinical Trials Registry: ACTRN12618000169246.
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Hipertensão , Pesquisa Qualitativa , Humanos , Hipertensão/psicologia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Idoso , Clínicos Gerais/psicologia , Medicina Geral/métodos , Pacientes/psicologia , Pacientes/estatística & dados numéricos , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Entrevistas como Assunto/métodosRESUMO
BACKGROUND: New research is crucial in addressing the role of nurses in preventing pressure injuries (PIs) and remedying deficiencies in their self-efficacy in this area. PURPOSE: The aim of this study was to examine the self-efficacy perceptions of nurses in managing PIs within surgical services. METHODS: The study involved 186 nurses from surgical services. Data were collected using a self-efficacy scale and a personal information form designed to assess nurses' PI management skills. Analysis involved descriptive (number, percentile) and inferential statistics (ANOVA, t- s) in SPSS-24. RESULTS: Surgical nurses reported their self-efficacy in managing PIs with a mean score of 47.38 ± 21.87 on a self-efficacy scale, indicating a broad range of perceptions. Average scores were 43.55 ± 23.47 for evaluation, 48.39 ± 25.65 for planning, 43.68 ± 25.34 for surveillance, and 50.64 ± 22.23 for decision-making. Of note, nurses reported the lowest self-efficacy scores for evaluation. No significant differences were found based on employment duration, gender, or education. Significant differences were observed based on age, service level, and post-graduate education (P < .05). CONCLUSION: This study highlights the need for enhanced nurse self-efficacy in PI management in surgical services, emphasizing the role of education programs focused on evaluation skills.
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Úlcera por Pressão , Autoeficácia , Humanos , Feminino , Masculino , Úlcera por Pressão/enfermagem , Úlcera por Pressão/prevenção & controle , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Competência Clínica/estatística & dados numéricos , Competência Clínica/normasRESUMO
BACKGROUND: Professional nurses typically promote and advocate self-care practices to their patients to achieve better health outcomes, but rarely engage in these practices themselves. METHODS: A qualitative, descriptive phenomenological approach was used in this study. Ten professional nurses employed in different primary health care facilities were purposively sampled. Semi-structured interviews were conducted to collect data, which were analysed using Colaizzi's data analysis strategy, and data saturation was reached. RESULTS: Two themes were identified. Theme 1: the participants expressed that internal and external factors compromised self-care practices, such as subconscious self-neglect, insufficient resources, and a depressed economy, which encouraged them to work extended hours. Theme 2: participants' holistic well-being was compromised, as they neglected their mental well-being. CONCLUSION: Self-care practices among professional nurses seem unachievable. The extent of this population's self-care neglect was evident during the coronavirus disease 2019 (COVID-19) pandemic when professional nurses globally gave of themselves relentlessly.Contribution: This is the first study conducted on the topic in the City of Ekurhuleni, and the findings will provide relevant stakeholders with a directive on what strategies, policies, and guidelines to develop and implement to make self-care practices attainable for professional nurses.
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COVID-19 , Atenção Primária à Saúde , Pesquisa Qualitativa , Autocuidado , Humanos , Adulto , Feminino , COVID-19/epidemiologia , Masculino , SARS-CoV-2 , Enfermeiras e Enfermeiros/psicologia , Pessoa de Meia-Idade , Entrevistas como AssuntoRESUMO
BACKGROUND: Moral injury is prevalent among health care professionals, especially nurses. It can have negative personal consequences for clinicians, and indirectly impact the quality of patient care. Although nurses around the world experienced moral injury during the pandemic, it will continue to be a professional challenge. Thus, this study aimed to determine the psychometric properties of a scale measuring moral injury translated into Spanish. METHODS: A methodological study with a cross-sectional approach was conducted. After translating the Moral Injury Symptom Scale for Healthcare Professionals (MISS-HP) into Peruvian Spanish (MISS-HP-S) using International Test Commission methods, data were collected using online survey methods from a sample of 720 Peruvian nurses. Analytical methods included exploratory and confirmatory factor analysis, and invariance by age were examined. The corrected homogeneity index, ordinal alpha, and McDonald's omega allowed the evaluation of internal reliability. RESULTS: Findings from this sample of nurses who were mostly female (92%), from coastal Peru (57%), and averaged 39 (± 11) years of age, provided support for the validity and reliability of the MISS-HP-S. Structural validity was endorsed by findings indicating consistent factorial structure and adequate invariance among different age groups. In this study, three factors were observed: guilt/shame, condemnation, and spiritual strength. Internal consistency values included an ordinal alpha of 0.795 and McDonald's omega of 0.835. CONCLUSION: These findings differ from those reported from previous studies in other cultural contexts, suggesting the influence of cultural and sample-specific factors in the perception of moral injury among Peruvian nurses. Because this evidence supports the validity of the MISS-HP-S, it can be used in professional practice and in future research to identify and address situations that contribute to nurse moral injury.
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Psicometria , Humanos , Psicometria/instrumentação , Feminino , Adulto , Masculino , Estudos Transversais , Reprodutibilidade dos Testes , Pessoa de Meia-Idade , Peru , Princípios Morais , Inquéritos e Questionários/normas , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Pessoal de Saúde/psicologia , TraduçõesRESUMO
This study assessed the resilience of nurses in Saudi Arabia during the corona virus 2019 (COVID-19) pandemic and examined its influence on their quality of life (QOL). A sample of 356 nurses was surveyed in this quantitative, cross-sectional study using the Resilience Scale for Nurses and the World Health Organization Quality of Life (WHOQOL-BREF) from October 2020 to March 2021. The nurses reported the highest resilience score on "situational pattern", while the lowest score was on "relational pattern." The nurses had good perceptions on their overall QOL and health and rated their "social relationship" as having the highest quality, while their "environmental" domain as having the least quality. Gender, marital status, provision of direct nursing care to COVID-19 patients, "philosophical pattern", "situational pattern" and "dispositional pattern" had multivariate impacts on the QOL dimensions. The study concluded that being resilient can positively impact the nurses' QOL during stressful situations, such as the COVID-19 pandemic.
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COVID-19 , Enfermeiras e Enfermeiros , Qualidade de Vida , Resiliência Psicológica , Humanos , Arábia Saudita/epidemiologia , Feminino , COVID-19/psicologia , COVID-19/epidemiologia , Masculino , Adulto , Estudos Transversais , Enfermeiras e Enfermeiros/psicologia , SARS-CoV-2 , Pessoa de Meia-Idade , Inquéritos e Questionários , PandemiasRESUMO
A cross-sectional descriptive study was conducted to assess the level of caring behaviour among clinical nurses in Southern China and explore its influencing factors. The study was carried out in the Sixth Affiliated Hospital, South China University of Technology, Guangdong, China, from December 2022 to February 2023. A total of 537 nurses participated, and the mean scores for caring behaviour, responsibility perception, and inclusive leadership were examined. The mean score for caring behaviour among clinical nurses was 125.25 ± 18.31. The mean responsibility perception score was 21.38 ± 3.36, while the mean inclusive leadership score was 38.04 ± 6.56. Notably, the inclusive leadership questionnaire and responsibility perception showed significant positive correlations with caring behaviour (p <0.01). Furthermore, regression analysis indicated that inclusive leadership and responsibility perception exerted significant influences on nurses' caring behaviour (p <0.01). These findings underscore the importance of creating an inclusive leadership environment that enhances nurses' sense of responsibility perception in order to promote and improve nursing caring behaviour. Key Words: Caring behaviour, Inclusive leadership, Responsibility perception, Influence factor, Clinic nurses.
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Atitude do Pessoal de Saúde , Empatia , Liderança , Humanos , China , Estudos Transversais , Feminino , Masculino , Adulto , Inquéritos e Questionários , Recursos Humanos de Enfermagem Hospitalar/psicologia , Enfermeiras e Enfermeiros/psicologia , Pessoa de Meia-IdadeRESUMO
OBJECTIVES: The purpose of this analysis is to develop the concept of sense of belonging in nursing. The secondary purpose is to identify the antithesis or direct opposite beyond the negative consequences related to a lack of belonging in nursing. DESIGN: Rodgers' evolutionary method guided the analysis and advancement of sense of belonging in nursing. DATA SOURCES: Following PRISMA guidelines, peer-reviewed English articles and dissertations were reviewed from PubMed, ERIC, CINAHL, and PsychINFO. Forty-seven articles describing sense of belonging in the nursing profession, both academic and workforce, were included. REVIEW METHODS: Inductive thematic analysis was used to determine recurring themes of the antecedents, attributes, consequences, and antithesis of belonging in nursing. RESULTS: A welcoming, positive atmosphere encouraging a culture of mentorship is key to developing an environment of belonging. The attributes of belonging include being trusted, valued, and an accepted part of the team, and encouraging a connection to the community. Nurses and nursing students have improved confidence, self-esteem, and motivation to learn when a sense of belonging is present. They feel supported and respected in the environment. However, historically minoritized students and nurses report discrimination, bias, and condescension resulting in feeling invisible, isolated, excluded, and neglected. Nurses and nursing students feel invisible, isolated, excluded, and neglected without a sense of belonging. CONCLUSION: Developing a sense of belonging in nurses and nursing students is critical to our profession. Further research is essential to develop interventions and strategies for cultivating a sense of belonging in nursing.
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Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Autoimagem , Mentores , Formação de Conceito , Enfermeiras e Enfermeiros/psicologiaRESUMO
Objective: This study aims to examine the current status of turnover intention among female nurses with two children and explore the factors influencing their decision to resign, ultimately providing a basis for reducing nurses' turnover intention and stabilizing the nursing workforce. Methods: A convenience sampling method was used to select 1,370 in-service female nurses with two children from 65 Grade A tertiary public hospitals in Sichuan Province from September to December 2023. Data was collected through a general information questionnaire, work-family behavioral role conflict scale, regulatory emotional self-efficacy, and turnover intention scale. Results: This study revealed that the average score for turnover intention among female nurses with two children was (13.11 ± 3.93). There was a positive correlation between work-family behavioral role conflict and turnover intention (r = 0.485, p < 0.01), while regulatory emotional self-efficacy showed a negative correlation with turnover intention (r = -0.382, p < 0.01). The main influencing factors for resignation among these nurses included age, number of night shifts per month, average monthly income, primary caregiver for children, work-to-family conflict and family-to-work conflict, and the ability to express positive emotions (POS), the capacity to regulate negative emotions such as despondency/distress (DES), and the skill to manage anger/irritation (ANG). Collectively, these factors explained 29.5% of the total variance in turnover intention scores. Conclusion: Turnover intention among female nurses with two children is relatively high. To address this issue, hospital managers shall implement effective measures through various channels to settle work-family conflict, enhance nurses' regulatory emotional self-efficacy, and reduce turnover intention resulting from work-family conflict. Together, these efforts will reduce nurse turnover and foster a stable nursing workforce.
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Hospitais Públicos , Intenção , Reorganização de Recursos Humanos , Humanos , Feminino , Estudos Transversais , China , Reorganização de Recursos Humanos/estatística & dados numéricos , Adulto , Inquéritos e Questionários , Centros de Atenção Terciária , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Autoeficácia , Satisfação no Emprego , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricosRESUMO
INTRODUCTION: Nurses play a vital role in the provision of health care in rural, remote and isolated locations. Consequently, the current global nursing workforce shortage has significant and far-ranging implications for these communities where there are enduring issues with workforce maldistribution and shortage, instability, high staff turnover and health disparities. This article provides an analysis of existing literature on what rural, remote and isolated practising nurses view as important for the attraction and retention of this workforce in the Australian context. METHODS: A structured scoping review informed by Arksey and O'Malley's framework for conducting scoping studies was undertaken. Six electronic databases were searched in August 2022. Cosgrave's person-centred retention improvement framework (which includes attraction) for addressing health workforce challenges in rural contexts was used to guide the synthesis and interpretation of information from the included studies. Key themes were identified inductively, conceptualised within Cosgrave's framework and mapped to the overarching lifecycle stages of attraction, retention and resignation, also referred to as turnover or decision to leave. RESULTS: Twelve articles met the inclusion criteria for this review. Six themes related to attraction, retention and resignation were identified: (1) demanding role and scope of practice; (2) values divergence and professional opportunities; (3) continuing professional development and mentoring; (4) social, lifestyle and personal or family; (5) management and organisation; and (6) pay and incentives. The issues articulated within each of these themes overlapped, highlighting the complexities involved. CONCLUSION: Limited empirical research that combines a person-centred and whole-of-lifecycle approach to understanding the rural and remote nursing workforce was found. However, our analysis of existing evidence suggests that such approaches are required to appropriately plan for and target solutions that centre nurses' specific needs and experiences for the future nursing workforce. Relatedly, limited translational research on the nursing workforce that explicitly includes and engages with nurses was found. Such research is fundamentally needed to improve retention outcomes.
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Reorganização de Recursos Humanos , Serviços de Saúde Rural , Humanos , Serviços de Saúde Rural/organização & administração , Austrália , Enfermeiras e Enfermeiros/psicologia , Atitude do Pessoal de Saúde , Satisfação no EmpregoRESUMO
AIM: To explore the effects of demographic characteristics, mental workload, and Adversity quotient (AQ) on the job engagement of nurses in East China. DESIGN: A quantitative and cross-sectional study. METHOD: The survey collected questionnaire data on mental workload, adversity quotient, and job engagement from 473 nurses selected working in 12 Grade-A tertiary hospitals based on informed consent in East China between July 2020 and March 2021. RESULTS: The total score of mental workload was 78.24 ± 11.65, the adversity quotient score was 128.26 ± 15.84, job engagement score was 42.32 ± 7.79. Job engagement has a remarkable positive correlation with adversity quotient (r = 0.613, p<0.001), and a negative correlation with mental workload (r = -0.499, p<0.001). Mental workload has an apparent negative correlation with adversity quotient (r = -0.291, p<0.001). Labor-management relationship with current organization, department, study to get a degree or diploma in spare time, attitude towards a career in Nursing, attitude towards the current career position, satisfaction with marriage, social support, load feelings, self-assessment, control, and endurance could predict 70.9% of job engagement of nurses. CONCLUSIONS: The mental workload of nurses was higher, the AQ was at a medium level, and the job engagement of nurses was also slightly higher. Labor-management relationship with current organization, department, study to get a degree or diploma in spare time, attitude towards a career in Nursing, attitude towards the current career position, satisfaction with marriage, social support, load feelings, self-assessment, control, and endurance had predictive effects on nurses' job engagement. It is necessary to take a variety of measures according to the social-demographic characteristics, improve the adversity quotient, and evaluate the mental workload correctly, to improve the job engagement of nurses. IMPACT: The epidemic situation and other emergencies make the work pressure of nurses in Grade-A tertiary hospitals increase suddenly. It should pay attention to the influence of different demographic factors, and pay attention to the correct guidance of work demand-mental workload, as well as the cultivation, and improvement of job resource-AQ, which can improve the job engagement of nurses to some extent. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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Centros de Atenção Terciária , Engajamento no Trabalho , Carga de Trabalho , Humanos , Estudos Transversais , China , Feminino , Adulto , Masculino , Inquéritos e Questionários , Carga de Trabalho/psicologia , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Satisfação no Emprego , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Pessoa de Meia-IdadeRESUMO
BACKGROUND: In Jordan, nurses consider a primary providers of direct patient care, and play a multifaceted role in ensuring healthcare quality. The study aimed to examines the moderating effect of job satisfaction in the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality. METHODS: A cross-sectional research approach was adopted among 311 from Registered Nurses (RN) across Jordanian hospitals. Job satisfaction, workload scale and job burnout scale were shared between March and April 2023. RESULTS: The overall findings indicate that workload, job burnout, and turnover intention are negatively and significantly related to healthcare quality, and that job satisfaction moderates the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality. These findings have broad implications for healthcare organizations, emphasizing the pivotal role of job satisfaction in mitigating the negative effects of workload, burnout, and turnover intentions among nurses. CONSULSION: Strategies to enhance job satisfaction, such as reducing work-related stress and fostering supportive work environments, should be prioritized by healthcare policymakers and institutions to ensure the delivery of high-quality patient care.
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Esgotamento Profissional , Satisfação no Emprego , Reorganização de Recursos Humanos , Qualidade da Assistência à Saúde , Carga de Trabalho , Humanos , Esgotamento Profissional/psicologia , Reorganização de Recursos Humanos/estatística & dados numéricos , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos , Adulto , Feminino , Estudos Transversais , Masculino , Jordânia , Qualidade da Assistência à Saúde/estatística & dados numéricos , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Adulto JovemRESUMO
AIM: To explore internationally qualified nurses' perceptions regarding the facilitators and barriers to specialty skill transfer in Australia. DESIGN: The study utilised a descriptive research design with a cross-sectional survey. Data were collected from July to September 2022. METHODS: A self-designed survey was distributed through social media, snowballing and nursing professional organisations. The survey included six open-ended questions which were analysed using thematic content analysis. RESULTS: Sixty-three participants completed the open-ended questions in the survey. The findings identified a range of facilitators (support, previous experience, self-agency) and barriers (systems barriers, bias/discrimination, being undervalued, lack of trust) to skill transition. CONCLUSION: Recognising and addressing facilitators and barriers, coupled with creating customised pathways for specialty skill integration, are essential for optimising the utilisation of specialised skills in internationally qualified nurses. IMPACT: This study aims to explore the barriers and facilitators involved in maximising skill utilisation among internationally qualified nurses in Australia. Identifying these barriers and facilitators is essential for improving patient care, as it will guide the development of strategies for safe nursing service delivery and the optimisation of skill usage. These findings hold significant implications for policymakers, healthcare organisations and nurses, providing valuable insights into how to address these obstacles and capitalise on the factors that make skill transfer smoother and more effective. PATIENT OR PUBLIC CONTRIBUTION: Sixty-three internationally qualified nurses shared their experiences and opinions.
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Competência Clínica , Humanos , Estudos Transversais , Austrália , Feminino , Adulto , Inquéritos e Questionários , Masculino , Enfermeiros Internacionais/psicologia , Atitude do Pessoal de Saúde , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologiaRESUMO
AIM: Despite the serious consequences of exposure to high job demands for nursing staff, few studies have identified pathways that could reduce the influence of high job demands on burnout. The current study aimed to exaime whether a stress mindset mitigates the positive relationship between job demands and burnout. DESIGN: A cross-sectional survey was adopted and data were collected employing self-report questionnaires. METHODS: A convenience sample of 676 nurses recruited from six regional hospitals in China were invited to complete a demographic questionnaire, the Psychological Job Demand Scale, the Stress Mindset Scale and the Burnout Scale. Hierarchical multiple regression analysis and simple slope analysis were used to examine the moderating role of stress mindset. RESULTS: Higher job demands were positively linked to burnout, and stress mindset was negatively linked to burnout. Stress mindset moderated the positive relationship between job demands and burnout. Specifically, compared to nurses with a stress-is-debilitating mindset, the relationship will be smaller for nurses holding a stress-is-enhancing mindset. PATIENT OR PUBLIC CONTRIBUTIONS: Based on these findings, nursing leaders should foster nurses' stress-is-enhancing mindset, which can ameliorate the adverse effect of job demands.
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Esgotamento Profissional , Humanos , Esgotamento Profissional/psicologia , Feminino , Estudos Transversais , Masculino , Adulto , Inquéritos e Questionários , China , Estresse Psicológico/psicologia , Pessoa de Meia-Idade , Satisfação no Emprego , Carga de Trabalho/psicologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Autorrelato , Estresse Ocupacional/psicologia , Enfermeiras e Enfermeiros/psicologiaRESUMO
AIM: To develop a conceptual framework for nurses' protocol-based care decision-making. DESIGN: Miles & Huberman's bottom-up approach to developing conceptual frameworks was followed, using data collected from a multiple embedded case study examining protocol-based decision-making by nurses in three hospital wards within a university hospital in northern Spain. METHODS: The qualitative data from the case study, obtained through documentary analysis, observations, and interviews, underwent a secondary analysis consisting of four steps: data reduction, data display, comparison, and drawing conclusions. RESULTS: The framework for protocol-based care decision-making comprises four components: (1) protocol-based care, as a balance between standardisation and individualised care, (2) the process, (3) the context, and (4) the elements of protocol-based care decision-making. These components and their relationship as a context-dependent, linear, variable and multifactorial process, directly influenced by the perception of risk, are described and illustrated. CONCLUSIONS: This study provides a rigorous bottom-up framework for nurses' protocol-based care decision-making. The framework could be a valuable resource for managers, clinical nurses, educators, and researchers to guide and evaluate nurses' decision-making, leading to improved care quality and reduced variability in clinical practice. Furthermore, the framework lays a foundation for further research and practical applications. IMPACT: This study addressed the problem of understanding nurses' protocol-based care decision-making and the need for a specific conceptual framework. The main findings of the study contribute to the development of a rigorous bottom-up framework comprising four components of protocol-based care decision-making. The framework has the potential to improve care quality, reduce variability, enhance patient safety, and increase healthcare efficiency by guiding nurses' decision-making in various healthcare settings. NO PATIENT OR PUBLIC CONTRIBUTION: Patient or public contribution was not applicable since the study focused on nurses' decision making.
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Pesquisa Qualitativa , Humanos , Espanha , Tomada de Decisões , Enfermeiras e Enfermeiros/psicologia , Protocolos Clínicos , Adulto , Feminino , Recursos Humanos de Enfermagem Hospitalar/psicologia , Masculino , Tomada de Decisão Clínica/métodosRESUMO
BACKGROUND: Human activities have significantly contributed to a persistent climate change trend, posing substantial threats to human health. Nurses regularly interact with patients experiencing the consequences of climate change, making their engagement in addressing this issue crucial. Nonetheless, our understanding of nurses' viewpoints regarding climate change remains limited. AIM: This scoping review aims to identify practicing nurses' and nursing students' perceptions of climate change. DESIGN: To fulfil this objective, a documentary search strategy was developed using an iterative process. METHODS: The search strategy was tested in four bibliographic databases, as well as in the grey literature. A 2-stage selection process was conducted, and relevant data were extracted from selected articles for analysis. RESULTS: Twenty-two scientific articles and 11 documents from nursing associations were selected. The findings suggest that while many nurses and nursing students are concerned about climate change and its effects on their patients' health, their role in addressing the climate crisis is not well understood. Many barriers such as having a heavy workload and the lack of support hindered their ability to adjust their practice in response to the changing climate. Furthermore, many expressed a need for trainings on climate change issues. CONCLUSIONS: These results raise a great and urgent demand for these professionals to receive appropriate training to cope with climatic threats to health. Future research should focus on the development of nursing climate leadership, and healthcare organizations should support nursing initiatives and help raise nurses' awareness regarding climate change.
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Atitude do Pessoal de Saúde , Mudança Climática , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Percepção , Enfermeiras e Enfermeiros/psicologiaRESUMO
AIM: To explore the views of general practitioners (GPs) and nurses on type 2 diabetes (T2D) management, including the use of recently funded T2D medications in New Zealand (NZ) and their perceived barriers to providing optimal care. BACKGROUND: T2D is a significant health concern in NZ, particularly among Maori and Pacific adults. Characterised by prolonged hyperglycaemia, T2D is generally a progressive condition requiring long-term care. METHODS: Semi-structured interviews were conducted between July and December 2022 with 21 primary care clinicians (10 GPs and 11 nurses/nurse prescribers) from nine different general practice clinics across the Auckland and Waikato regions of NZ. Framework analysis was conducted to identify common themes in clinicians' perceptions and experiences with T2D management. FINDINGS: Three themes were identified: health-system factors, new medications, and solution-based approaches. Lack of clinician time, healthcare funding, staff shortages, and burn-out were identified as barriers to T2D management under health-system factors. The two newly funded medications, empagliflozin and dulaglutide, were deemed to be a positive change for T2D care in that they improved patient satisfaction and clinical outcomes, but several clinicians were hesitant to prescribe these medications. Participants suggested that additional education and specialist diabetes support would be helpful to inform optimal medication prescribing and that better use of a multi-disciplinary team (clinical and support staff) could support T2D care by reducing workload, addressing cultural gaps in healthcare delivery, and reducing burnout. An improved primary care work environment, including appropriate professional development to support prescribing of new medications and the value of collaboration with a non-regulated workforce, may be required to facilitate optimal T2D management in primary care. Future research should focus on interventions to increase support for both clinical teams and patients while adopting a culturally appropriate approach to increase patient satisfaction and improve health outcomes.
Assuntos
Diabetes Mellitus Tipo 2 , Inibidores do Transportador 2 de Sódio-Glicose , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atitude do Pessoal de Saúde , Diabetes Mellitus Tipo 2/tratamento farmacológico , Clínicos Gerais/psicologia , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Hipoglicemiantes/uso terapêutico , Entrevistas como Assunto , Nova Zelândia , Enfermeiras e Enfermeiros/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde , Pesquisa Qualitativa , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêuticoRESUMO
BACKGROUND: The increasing use of telemedicine (TM) represents a major shift for health workers and patients alike. Thus, there is a need for more knowledge on how these interventions work and are implemented. We conducted a qualitative process-evaluation alongside a larger randomized controlled trial designed to evaluate a telemedicine follow-up intervention for patients with a leg- or foot-ulcer, who either have or do not have diabetes. Accordingly, the aim of this study was to explore how both health care professionals and patients experienced the implementation of TM follow-up in primary care. METHODS: The intervention comprised an interactive TM platform facilitating guidance and counselling regarding wound care between nurses in primary care and nurses in specialist health care in Norway. Nurses and patients from seven clusters in the intervention arm were included in the study. We conducted 26 individual interviews (14 patients and 12 nurses) in primary care between December 2021 and March 2022. Thematic analyses were conducted. RESULTS: The analyses revealed the following themes: (1) enhancing professional self-efficacy for wound care, (2) a need to redesign the approach to implementing TM technology and (3) challenging to facilitate behavioral changes in relation to preventive care. As to patients' experiences with taking part in the intervention, we found the following three themes: (1) experience with TM promotes a feeling of security over time, (2) patients' preferences and individual needs on user participation in TM are not met, and (3) experiencing limited focus on prevention of re-ulceration. CONCLUSIONS: TM presents both opportunities and challenges. Future implementation should focus on providing nurses with improved technological equipment and work on how to facilitate the use of TM in regular practice in order to fully capitalize on this new technology. Future TM interventions need to tailor the level of information and integrate a more systematic approach for working with preventive strategies. CLINICAL TRIAL REGISTRATION: NCT01710774. Registration Date 2012-10-17.
Assuntos
Pesquisa Qualitativa , Telemedicina , Humanos , Feminino , Masculino , Noruega , Pessoa de Meia-Idade , Adulto , Atenção Primária à Saúde , Idoso , Entrevistas como Assunto , Enfermeiras e Enfermeiros/psicologiaRESUMO
The aims of the research were to investigate the mediating effect of emotional intelligence and the moderating effect of disgust sensitivity on the relationship between proactive personality and caring behavior among clinical nurses. A cross-sectional design while adhering to STROBE guidelines was used for this study. Three hundred ninety-three purposely selected nurses from three tertiary general hospitals completed an online survey. Measures included proactive personality, emotional intelligence, disgust sensitivity, and caring behavior. The findings showed that proactive personality positively predicted nurses' caring behavior, and that emotional intelligence played a mediating role in the relationship between proactive personality and caring behavior. Disgust sensitivity indirectly and negatively moderated the impact of proactive personality on nurses' caring behavior mainly in the second half of this moderated relationship. The findings underscore that the nursing managers may consider incorporating emotional intelligence topic in practical nursing skills training and improving nurses' ability to control their disgust sensitivity can improve their professional behavior, thus to provide patients with high-quality nursing services.
Assuntos
Asco , Inteligência Emocional , Personalidade , Humanos , Feminino , Estudos Transversais , Masculino , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Empatia , Atitude do Pessoal de Saúde , Análise de MediaçãoRESUMO
Even during the third wave of the COVID-19 pandemic health professionals were facing mental health challenges. The aim of this study was to examine the mental health of doctors, nurses and other professional groups in Europe and to identify differences between the professional groups. We conducted a cross-sectional online survey in 8 European countries. We asked for demographic data, whether the participants were exposed to COVID-19 at work, for main information sources about the pandemic, the Depression Anxiety Stress Scales (DASS-21), and major stressors. A MANCOVA was carried out to find predictors of mental health among health care professionals. The sample (N = 1398) consisted of 237 physicians, 459 nurses, and 351 other healthcare professionals and 351 non-medical professionals with no direct involvement in patient care. The mean mental health of all groups was affected to a mild degree. Major predictors for depression and anxiety were the profession group with higher scores especially in the group of the nurses and working directly with COVID-patients. In the third wave of the COVID-19 pandemic, the psychological burden on health professionals has remained high, with being nurse and working directly with COVID19 patients being particular risk factors for mental distress. We found as a main result that nurses scored significantly higher on depression and anxiety than practitioners.