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Anteayer Journal of Advanced Nursing

Adherence in Patients With Heart Failure—Relationships to Symptom Burden and Hospitalisation Frequency: A Cross Sectional Survey Study

ABSTRACT

Aims

To investigate adherence and non-adherence to treatment regimens among heart failure patients and to explore relationships with symptom burden and hospitalisation frequency.

Design

The research employed a cross-sectional survey study design.

Methods

The online survey “Living with heart failure”, was conducted among patients attending the Cardiac outpatient clinic at a Swedish University Hospital over the course of a calendar year. Data analysis employed descriptive statistics using the statistical processing program SPSS.

Results

The survey was made accessible to 1395 respondents; 479 individuals participated. The response rate was 34.3%. 73.6% were classified as non-adherent and 26.4% as adherent. Among the non-adherent, a statistically significantly higher symptom burden was observed. Lower hospitalisation frequency was associated with higher adherence and lower symptom burden. Frequent hospitalisations correlated with lower adherence and more severe symptoms.

Conclusion/Implications

This study underscores the prevalence of non-adherence in the heart failure population and emphasises the importance of addressing this issue.

Impact

Non-adherence to treatment regimens remains a global challenge, historically underestimated and challenging to quantify. Non-adherence to medical treatment in the heart failure population is about 50%; non-adherence from a wider perspective implicates a gap of knowledge. The principal discoveries from this study underscore the extensive non-adherence and its exacerbating effects on symptom burden and hospitalisation. The primary significance of this research will manifest among caregivers in multidisciplinary teams providing support to the heart failure population.

Reporting Method

The Equator Guidelines Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) were adhered to.

Patient or Public Contribution

No patient or public contribution.

Pedagogical Strategies for Teaching Conceptual Models and Nursing Theories in Undergraduate Students: A Scoping Review

ABSTRACT

Background

Teaching nursing theories is essential to structure and guide clinical practice, yet their integration into initial training courses remains a challenge.

Aim

To map the educational practices used to teach nursing theories and conceptual models in initial nursing training programmes.

Design

A scoping review.

Methods

Is review was conducted following the guidelines of the Joanna Briggs Institute and the PRISMA-ScR. A comprehensive search of five databases and in the grey literature was conducted to find studies from the inception of the databases to January 2024. A total of 32 articles meeting the inclusion criteria were selected for analysis.

Results

The findings reveal a wide variety of educational techniques, ranging from traditional lectures to innovative Methods such as simulation and virtual games. The analysis also shows that these educational practices cover a broad Spectrum of theories, from well-established theories that have stood the test of time, such as watson's, to more recent Theories like the fundamentals of care.

Conclusion

While integrating nursing theories into initial training programmes is crucial, further research is needed to assess the effectiveness of the pedagogical strategies used to teach them. The mapping of educational practices carried out in this review serves as a valuable resource for educators, providing a structured basis to diversify and enrich the teaching of nursing theories.

Implications for Practice

This scoping review explores for the first time the range of pedagogical practices used in the teaching of nursing theories on an international scale. It provides a valuable resource for educators, allowing them to enrich their pedagogical approach. It offers a structured overview of the various possible methods, thus facilitating the adaptation of teaching strategies to different contexts. This methodological diversity can also serve as a source of inspiration for developing new concepts for teaching disciplinary fundamentals. The renewed interest in teaching disciplinary fundamentals underscores the relevance of this review in the current context.

Impact

Through this mapping of pedagogical strategies, this scoping review contributes to improving the quality of teaching nursing disciplinary fundamentals internationally. The results provide a foundation for developing specific courses on nursing conceptual models and theories, offering educators various possibilities to enrich their teaching methods while adapting to local contexts and student needs.

Patient or Public Contribution

No patient or public contribution. This is a scoping review.

Trial Registration

https://osf.io/gj35n

Competencies Required for Hospital‐Based Wound, Ostomy, and Continence Nurses to Provide PI Care in Home Care in Japan: A Mixed‐Methods Study

ABSTRACT

Aim

To identify the competencies required for hospital-based WOC nurses to provide direct pressure injury (PI) care in home care settings in Japan.

Design

Mixed methods convergent design.

Methods

The qualitative strand used a descriptive design to explore competencies for overcoming barriers faced by hospital-based WOC nurses when providing PI care at home. The quantitative strand used a cross-sectional design to assess competencies in organising the hospital PI management system.

Results

Six competencies were identified: (1) Establish relationships with home healthcare professionals; (2) Promote hospital-based WOC nurse's expertise to home healthcare professionals; (3) Collaborate with the regional medical liaison office in WOC nurse's hospital; (4) Involve hospital administrators in home PI management; (5) Utilise social media/Information and Communication Technology for patient or home-visiting nurse communication; and (6) Utilise public or academic support projects to facilitate home-based activities. The median scoring rate for each medical staff domain on the revised Collaboration Competency Scale for WOC Nurses ranged from 80% to 91%.

Conclusion

The results of this study can serve as a practical resource to help WOC nurses expand their activities into home-care settings.

Implications for the Profession

Their ability to coordinate with staff and manage PI care within hospitals supports active engagement in home care, improving continuity and quality.

Impact

This study addressed the issue that many hospital-based WOC nurses cannot visit patients at home. The competencies identified may enable these nurses to expand their role into home care.

Reporting Method

This study followed EQUATOR guidelines, with the STROBE Statement applied to the quantitative part and the COREQ checklist to the qualitative part.

Patient or Public Contribution

Patients or the public were not involved in the study's design, conduct, or reporting.

Tensive Adaption: A Grounded Theory on the Process of Nurses' Dealing With Workplace Violence

ABSTRACT

Aim

To explore the process of how nurses experience and deal with workplace violence based on nurses' perceptions and experiences in Iran.

Methods

An exploratory qualitative study was conducted using grounded theory approach. Participants included 17 nurses working in 4 hospitals in 2 urban areas in Iran with at least 1 year of clinical experience in emergency departments and intensive care units. Data were collected through in-depth, semi-structured individual interviews conducted between August 2024 and March 2025. The constant comparative analysis approach was used for data analysis. This research method was carried out in five stages: open coding to identify concepts; development of concepts in terms of their characteristics and dimensions; contextual analysis; integration of the process to data analysis; and final category integration.

Findings

The main concern of participants in dealing with workplace violence was a ‘multidimensional security threat’. ‘Perpetrator response to nursing care’ (at the individual level) and ‘organisational inefficiency’ (at the organisational level) provided the context for this threat. A general theme entitled ‘tensive adaptation’ was the core category in this research and included four main categories: ‘tolerant reactions’, ‘seeking help’, ‘passive reactions’ and ‘hostile reactions’. ‘Organisational damage’, ‘nurse damage’ and ‘patient damage’ were the outcomes.

Conclusion

The theoretical model of ‘tensive adaptation’ provides a new perspective on ‘what’ and ‘how’ nurses experience and manage workplace violence. Effective strategies for managing violence such as effective communication, empathy, providing appropriate care, anger management, self-care, effective teamwork and requesting support can be considered by nursing administrators and incorporated into training programmes for nurses and nursing students. The adverse consequences of nurses' exposure to workplace violence should receive greater attention, as the entire healthcare system is affected by this exposure.

Implications for the Profession and/or Patient Care

Workplace violence leads to physical and psychological problems, reduced job satisfaction, diminished performance, negative effects on personal and family life and decreased quality of patient care. The main concern of participants in dealing with workplace violence was ‘multidimensional security threat’. This concept includes three characteristics: ‘psychological health threats’, ‘physical health threats’ and ‘professional position threat’. ‘Perpetrator response to nursing care’ (individual level) and ‘organisational inefficiency’ (organisational level) served as contextual conditions that expose nurses to workplace violence. In ‘tensive adaptation’, nurses attempt to respond to workplace violence through strategies such as ‘tolerant reactions’, ‘seeking help’, ‘passive reactions’ and ‘hostile reactions’. ‘Organisational damage’, ‘nurse damage’ and ‘patient damage’ are the consequences of nurses' exposure to workplace violence.

Reporting Method

The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used to report this study.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.

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