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Anteayer Journal of Advanced Nursing

Healthcare providers’ perspectives on the relevance and utility of recommended sex trafficking indicators: A qualitative study

Abstract

Aims

The aims of this study were to (1) explore the barriers and challenges of sex trafficking identification and (2) understand how sex trafficking indicators are perceived (i.e. relevance and utility) by healthcare providers at five sites of a large sexual health care organization in a Midwestern state within the United States.

Design

A qualitative, collective case study was conducted.

Method

In-depth, semi-structured interviews were conducted with 23 healthcare staff (e.g. medical assistants, nurse practitioners) who provided sexual and reproductive healthcare between fall 2018 and spring 2020.

Results

Findings suggest that providers perceived behavioural and verbal sex trafficking indicators (e.g. patients appearing nervous or being unable to answer questions) as relevant, particularly with a female patient accompanied by a ‘controlling’ male. Medical and physical indicators (e.g. repeat STIs, bruises and tattoos) were perceived as generally lacking clinical utility or irrelevant. Some indicators were only perceived as relevant when combined or only later, upon reflection (e.g. older, female adult accompanying one or more female patients).

Conclusion

Healthcare providers may be aware of sex trafficking indicators conducive to identifying female patients, in relationships with older men, who are at risk of sex trafficking. Our study finds that healthcare providers may not be aware of all recommended sex trafficking indicators and the nuances of how patients present.

Impact

Provider trainings on sex trafficking dynamics and nuanced clinical presentations should include observing ST indicators in simulated interviews, assessing and safety planning (including using harm reduction strategies) with seemingly ambiguous cases. In addition, we recommend that trainings emphasize the relationship between the continuum of agency and victimization in sex trafficking and patient presentations.

Characteristics of dyadic care types among patients living with multiple chronic conditions and their informal caregivers

Abstract

Aims

To examine the distribution of dyadic care types in multiple chronic conditions, compare self-care and caregiver contributions to patients' self-care in each care type and identify the patient and caregiver characteristics associated with each care type.

Design

Secondary analysis of a multicentre, cross-sectional study.

Methods

Patient-caregiver dyads were enrolled from outpatient clinics and community settings. The Dyadic Symptom Management Type Scale was used to categorize dyads by type. Self-care, self-efficacy, comorbidities and cognitive impairment were measured in patients, whereas caregiver contributions to patient self-care, self-efficacy, caregiver burden and hours of caregiving were measured in caregivers. Sociodemographic characteristics perceived social support and mutuality were measured in both patients and caregivers. Univariate and multivariate analyses were performed.

Results

A sample of 541 patient-caregiver dyads was examined. The most frequent dyadic care type was the collaborative-oriented (63%). In the patient-oriented type, patients scored higher on self-care compared with caregivers; in the caregiver-oriented and collaborative types, caregivers scored higher than patients supporting the typology. The patient-oriented type was associated with younger, healthier male patients with better cognitive status, who scored higher for mutuality and whose caregivers scored lower for burden. The caregiver-oriented type was associated with older, less educated patients, with caregivers experiencing higher burden and unemployment. The collaborative type was associated with sicker patients, with the caregiver more probably to be female and employed, with higher perceived social support, mutuality and burden. The incongruent dyadic care type was associated with lower caregiver mutuality.

Impact

In the context of multiple chronic conditions, clinicians should consider targeting any educational interventions aimed at improving patient self-care and caregiver contributions to self-care by dyadic care types.

Barriers to healthy eating among nurses working in hospitals: A meta‐synthesis

Abstract

Aim

To explore the barriers to healthy eating among nurses working in hospitals.

Design

Meta-synthesis.

Data sources

Published and unpublished papers were identified through electronic searches on PubMed, CINAHL, PsycINFO, Embase, Scopus, COCHRANE Library, Food Science and Technology Abstract, ProQuest Dissertations and Theses and OpenGrey from inception until 6 September 2020. English-language primary qualitative or mixed-method studies on barriers to healthy eating among hospital nurses were included. Mixed-method studies were eligible if their qualitative data were distinguishable. Studies on nursing assistants, enrolled nurses, nursing students, and patient-care assistants were excluded, as well as studies without full-texts, correlational studies, quantitative surveys, exploratory studies, conference abstracts and reviews.

Methods

The studies were appraised using Critical Appraisal Skills Programme checklist. Qualitative data were extracted using Joanna Briggs Institute Qualitative Data Extraction Tool. Data synthesis followed two stages, meta-summary and meta-synthesis, proposed by Sandelowski & Barroso.

Results

Twelve studies published from 2008 to 2020 involving 618 hospital nurses were included. The meta-summary generated 10 themes, which were meta-synthesized into three interrelated themes: personal barriers (e.g. nonchalance towards unhealthy eating), interprofessional and patient-related barriers (e.g. sharing unhealthy food), and organizational barriers (e.g. overwhelming work demands).

Conclusion

Insufficient self-control and self-confidence, nonchalance and negligence towards healthy eating and cultural beliefs that oppose the practice of healthy eating (personal barriers), exposure of unhealthy food practices in wards (interprofessional and patient-related barriers) and hospital cafeterias, overwhelming work exigencies and institutional constraints (organizational barriers) hindered nurses to achieve wholesome healthy eating.

Impact

Many hospital nurses’ encountered challenges in healthy eating, thereby potentially jeopardizing their health and work performance. The findings emphasized the need of a joint effort by hospital nurses, families and colleagues, and hospital institutions to overcome the barriers to healthy eating faced by the hospital nurses.

Evidence‐informed implementation of nurse prescribing under supervision: An integrative review

Abstract

Aim

To explore evidence reporting facilitators and barriers to implementation of nurse prescribing and provide practical recommendations for evidence-informed implementation and adoption of nurse prescribing under a supervision model.

Background

As demand for access to quality health care services increases, health professional roles are expanding to meet population needs. Nurse prescribing has been effective in some countries and is being considered globally to address growing health care demand. Successful implementation of health service models requires careful planning and consideration. No existing reviews have examined implementation factors in the literature.

Design

Integrative review.

Data sources

CINAHL, MEDLINE, PubMed and EMBASE databases were searched from inception to 15 April 2020.

Review methods

This integrative review is guided by Whittemore and Knafl and adheres to PRISMA reporting guidelines. The sustainability of innovation framework was used to synthesize data concerning implementation and sustainability factors (i.e. innovation, organizational, political, workforce and financial) for nurse prescribing.

Results

A total of 39 articles were reviewed with literature predominantly reporting findings related to non-medical and nurse prescribing under various models. Variable evidence was found to inform nurse prescribing across five implementation and sustainability factors identifying several areas that require in-depth consideration. Very little evidence is available on nurse prescribing under supervision.

Conclusion

Introduction of service reform is often costly. This review highlights gaps in the literature and raises areas for consideration prior to implementation of this new service delivery model. The introduction of nurse prescribing must be planned and informed by available evidence to support effective adoption, practice and patient outcomes.

Impact

There are significant gaps in evidence related to nurse prescribing under a supervision model. Based on the evidence synthesized in this review, this paper provides practical recommendations for health service providers, managers, clinicians, educators and researchers to support implementation and adoption of nurse prescribing.

Factors influencing community‐dwelling older adults’ readiness to adopt smart home technology: A qualitative exploratory study

Abstract

Aims

Ageing-in-place for older people could be more feasible with the support of smart home technology. Ageing in-place may maximize the independence of older adults and enhance their well-being and quality of life, while decreasing the financial burden of residential care costs, and addressing workforce shortages. However, the uptake of smart home technology is very low among older adults. Accordingly, the aim of this study was to explore factors influencing community-dwelling older adults’ readiness to adopt smart home technology.

Design

A qualitative exploratory study design was utilized.

Methods

Descriptive data were collected between 2019 and 2020 to provide context of sample characteristics for community-dwelling older adults aged ≥65 years. Qualitative data were collected via semi-structured interviews and focus groups, to generate an understanding of older adult's perspectives. Thematic analysis of interviews and focus group transcripts was completed. The Elderadopt model was the conceptual framework used in the analysis of the findings.

Results

Several factors influenced community-dwelling older adults’ (N = 19) readiness to adopt smart home technology. Five qualitative themes were identified: knowledge, health and safety, independence, security and cost.

Conclusion

Community-dwelling older adults were open to adopting smart home technology to support independence despite some concerns about security and loss of privacy. Opportunities to share information about smart home technology need to be increased to promote awareness and discussion.

Impact

Wider adoption of smart home technology globally into the model of aged care can have positive impacts on caregiver burden, clinical workforce, health care utilization and health care economics. Nurses, as the main providers of healthcare in this sector need to be knowledgeable about the options available and be able to provide information and respond to questions know about ageing-in-place technologies to best support older adults and their families.

Bibliometric analysis of the Doctor of Nursing Practice dissertations in the ProQuest Dissertations and Theses database

Abstract

Aims

To examine the distributed characteristics and explore the research themes of Doctor of Nursing Practice (DNP) dissertations during the past two decades.

Design

A descriptive statistical and visualization bibliometric analysis was conducted.

Methods

Doctor of Nursing Practice dissertations submitted between January 2005 and June 2021 were collected from the ProQuest Dissertations and Theses database. A descriptive statistical analysis was conducted to calculate the distribution of the DNP dissertations by granting institution and the published year of publications. The VOSviewer 1.6.13 was used to explore the bibliometric networks and research priorities of the DNP dissertations.

Results

A total of 4989 DNP dissertations from 90 universities were included in this study, all from the United States. The number of DNP dissertations showed an upward trend, with steady growth from 2005 to 2014 and rapid growth after 2015. The DNP studies focused on five areas: health care management in clinical nursing, advanced practice in nursing education and health education, public health problems, mental health care for adolescents and nurses and the older people care and long-term care.

Conclusion

Parallel to the numerical increase in DNP dissertations is a steady expansion in the range of research topics and scopes, which is aligned with specific specializations of the DNP. Many are interdisciplinary and employ techniques imported from the fields of public health, psychology and social sciences, resulting in nursing educators and practitioners continually broaden their subject perspectives.

Impact

Knowing where, when and why DNP research trends developed will help nursing educators to further develop DNP education and optimize DNP programs in the future, such as paying more attention to the nursing practice. Moreover, this study will inspire DNP students and researchers to expand their subject perspectives and broaden the research scope to solve nursing practice problems based on interdisciplinary theories and methods.

Towards remote leadership in health care: Lessons learned from an integrative review

Abstract

Aim

To gather and synthesize current empirical evidence on remote leadership and to provide knowledge that can be used to develop successful remote leadership in health care.

Design

A integrative literature review with an integrated mixed methods design.

Data Sources

The literature search was carried out between February and March 2019 in the CINAHL, Medline (Ovid), PsycInfo, Scopus, SocIndex, Web of Science and Business Source Elite (EBSCO) databases.

Review Methods

An integrative review was conducted to identify relevant studies published from 2010 to 2019. Of the 88 eligible studies, 21 studies met the inclusion criteria and were selected for the final review. The included studies were analysed using mixed methods synthesis, more specifically, data-based convergent synthesis.

Results

The performed analysis identified three main themes: characteristics of successful remote leadership; enhancing the leader-member relationship; and challenges in remote leadership. The first theme included the following sub-themes: remote leader characteristics; trust; communication; and leading the team culture. The second theme covered the importance of organizing regular face-to-face meetings, clear communication policies and the connection between positive team spirit and good remote leader-member relationship, while the third theme emphasized leader- and member-related challenges for remote work.

Conclusions

As none of the identified studies had been conducted in a health care setting, future remote leadership research must also specifically consider the health care context. This will be pivotal to exploring how remote work can foster a safe workplace culture, empower health care workers, increase job satisfaction and improve patient outcomes.

Impact

Remote leadership has rarely been studied in the health care context. Trust, communication, team spirit and a leader's characteristics are central to remote leadership, a finding which is useful for re-evaluating and improving the current culture at health care organizations.

Dehydration in the nursing home: Recognition and interventions taken by Dutch nursing staff

Abstract

Aims

To examine which signs/symptoms registered nurses (RNs) and certified nurse assistants (CNAs) (nursing staff) in Dutch nursing homes associate with dehydration, if they observe these signs/symptoms themselves and what they do after observing them.

Design

A cross-sectional study.

Methods

In February 2020, using an online questionnaire based on a diagnostic strategy to diagnose dehydration, nursing staff was asked: (1) which signs/symptoms they associate with dehydration; (2) if they observe these signs/symptoms themselves; and (3) which actions they take after observing these signs/symptoms in a resident. Descriptive statistics and Chi-square statistics were used to describe the answers and explore significant differences between groups.

Results

In total, 250 RNs and 226 CNAs participated. Among RNs, 67%–99% associated the signs/symptoms of the strategy to dehydration compared with 45%–98% of the CNAs. RNs and CNAs often indicated to observe signs/symptoms from the strategy themselves (80.1% and 92.6%), but they also often relied on information given by other care professionals and the informal caregiver. Interventions taken were mainly focused on communicating findings to colleagues.

Conclusion

Many signs/symptoms from the diagnostic strategy trigger nursing staff to think of dehydration. Results also show that a variety of formal and informal caregivers are involved in dehydration care. As RNs and CNAs did often not receive dehydration training after entering workforce, this could have limited their ability to recognize signs/symptoms related to dehydration. To ensure timely recognition of dehydration, a clear description of roles and responsibilities about dehydration care in, and between, formal and informal caregivers is essential with structurally embedded dehydration training in the nursing home.

Impact

Tackling dehydration in the nursing home requires interdisciplinary collaboration and communication with family members. Without clear roles and responsibilities, a risk of dehydration can be left unattended.

Nurse anesthetist attitudes towards parental presence during anesthesia induction‐ a nationwide survey

Abstract

Aims

To describe nurse anesthetists’ attitudes towards the importance of parental presence during their child's anaesthesia induction and to explore associating factors.

Design

A cross-sectional design.

Methods

Nurse anesthetists from 55 Swedish hospitals were asked to participate (n = 1,285). A total of 809 completed the questionnaire, Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) during 2018. Data were analysed by descriptive statistics and multiple linear regression analysis.

Results

Nurse anesthetists generally had a positive attitude towards the importance of parental presence. They reported a more positive attitude in family as a resource in nursing care (median = 40) followed by family as a conversational partner (median = 25), family not as a burden (median = 17) and family as its own resource (median = 13). Multiple linear regression analyses showed that working in a district hospital, working only with children, having routines/memorandum about parental presence, being a woman, allowing both parents to be present in their child's anaesthesia and greater experience of children's anesthesia, were associated with a more positive attitude.

Conclusion

This nationwide survey contributes important knowledge for understanding nurse anesthetists' attitudes and the result shows that nurse anesthetists generally have a positive attitude towards the importance of parents. Areas of improvement were, however, identified; the nurses tend to not value family as its own resource and family as a conversational partner highly.

Impact

Nurse anesthetists have a crucial role in children's anesthesia care since the quality of parental presence experience depends on a positive attitude from the nurses. Parental involvement is important to establish a child-centered anaesthesia care, which should be highlighted in the education of nurse anesthetists. Parental involvement should also be addressed in healthcare policies and routines should be established.

Illustrating a novel methodology and paradigm applied to Emergency Department research

Abstract

Aim

To provide a practical example of how a novel methodology and paradigm was applied to a mixed methods study exploring the healthcare experiences of Australian adults who frequently use emergency department services.

Design

Discussion Paper.

Data sources

We explored published literature discussing philosophical and methodological issues related to mixed methods research. Literature searches were performed between July 2019 and February 2021.

Implications for nursing

Phenomenology is a powerful methodology to explore the lived experience of research participants, but it is not without limitations. Mixed methods phenomenology allows nurse researchers to bring further clarity to their research phenomena, however, including phenomenology in mixed methods studies may be seen to be philosophically incompatible. The philosophical metaparadigm of dialectical pluralism provides nurse researchers with a new coherent methodological and philosophical framework for combining participants’ descriptions of lived experience with a variety of data collection methods. It is effective when working with transdisciplinary research teams, and stakeholders representing diverse values and disciplines.

Conclusion

Complex healthcare environments require sophisticated, flexible research approaches. This paper presents mixed methods phenomenological research combined with the metaparadigm of dialectical pluralism providing a methodological framework that can support multifaceted nursing research.

Impact

The combination of mixed methods phenomenology and dialectical pluralism represents a novel solution for nurse researchers to articulate a research methodology and philosophical paradigm reflecting the complexity embedded in everyday nursing practice. This methodology offers a unique approach to exploration of challenging clinical and patient scenarios with multifaceted elements, and overcomes theories of philosophical incompatibilities between divergent methods.

Mediating role of career self‐efficacy between clinical learning environment and professional identity in nursing students

Abstract

Aims

To explore whether the clinical learning environment (CLE) has an indirect effect on professional identity through the mediation of career self-efficacy (CSE) in nursing students.

Background

The shortage of nurses has become a universal problem worldwide. Improving nurses' professional identity is considered an effective way to reduce the turnover rate of nurses. However, little is known about the relationship between the CLE, CSE and professional identity.

Design

An observational, questionnaire-based, cross-sectional study.

Methods

A web-based survey was completed by 212 undergraduate nursing students from June to August 2018. Measures included Chinese translations of the CLE, the Career Self-Efficacy Scale, and the Professional Identity Scale.

Results

Both the CLE (r = 0.552, p < 0.01) and CSE (r = 0.868, p < 0.01) correlated positively with professional identity. The indirect effect of the CLE on professional identity through CSE was positive (β = 0.342, p < 0.05) and the effect was 77.2%.

Conclusions

A better CLE and higher scores in CSE were associated with professional identity in nursing students, and a better CLE had an indirect effect on the professional identity of students through CSE.

Patient‐reported experiences of consultation with an advanced nurse practitioner: Factor structure and reliability analysis of the patient enablement and satisfaction survey

Abstract

Aim

The aim was to analyse the psychometric properties of a patient-reported-experience measure, the Patient Enablement and Satisfaction Survey (PESS), when used to evaluate the care provided by Advanced Nurse Practitioners (ANPs) in terms of factor structure and internal consistency. The PESS is a 20-item, patient-completed data collection tool that was originally developed to measure patient experience and enablement following consultation with nurses in general practice.

Design

Cross-sectional survey; validity and reliability analysis.

Methods

The sample in this study consisted of 178 patients who consulted with 26 ANPs working in four different specialities. Data were collected between June and December 2019. An exploratory factor analysis of the PESS was conducted to determine convergent validity which was supported by parallel analysis and the traditional Kaiser criterion. The internal consistency of individual PESS items was determined via Cronbach's alpha, McDonald's omega, the Average Variance Extracted tests and item-subscale/total score correlations.

Results

A three-factor structure (PESS-ANP) was found through exploratory factor analysis and this was supported by parallel analysis, the traditional Kaiser criterion and the percentage of variance explained criterion. A high degree of internal consistency was reported across all factors. One question was omitted from the analysis (‘Overall Satisfaction’) following the identification of problematic cross-loadings. The three factor solution was identified as: patient satisfaction, quality of care provision and patient enablement.

Conclusion

The findings of this study propose a three-factor model that is sufficiently reliable for analysing the experience and enablement of patients following consultation with an ANP.

Impact

Increasingly, patient-reported experience measures are being used to evaluate patients’ experience of receiving care from a healthcare professional. The PESS was identified to be reliable in evaluating the experience of patients who receive care from an ANP while a three-factor structure was proposed that can capture specific attributes of this care.

Cross‐cultural differences in nurse burnout and the relationship with patient safety: An East‐West comparative study

Abstract

Aims

To compare levels of nurse burnout across eastern and western cultures, as well as examine the influence of burnout on patient safety cross-culturally.

Design

Comparative cross-sectional study.

Methods

Survey data were collected from nurses between August and October 2017 in Australia (n = 730) and between April and October 2019 in China (n = 1107). Variables included burnout (emotional exhaustion, depersonalization, personal accomplishment), nurse leadership and support, staffing and resource adequacy, and perceived patient safety. Data were analysed separately for each jurisdiction using bootstrapped hierarchical regressions, which tested the relationships between burnout indicators and patient safety, controlling for support resources.

Results

Emotional exhaustion and depersonalization scores were significantly higher in the Australian sample compared with the Chinese sample. Australian participants reported significantly lower patient safety grades than Chinese participants and were less likely to agree that support resources were present in their current job. Separate regressions indicated that patient safety was significantly associated with staffing and resource adequacy, nurse leadership and support, and depersonalization among Australian participants (30% of variance explained in the final regression model), while staffing and resource adequacy, nurse leadership and support, personal accomplishment and emotional exhaustion predicted patient safety for Chinese participants (22% of variance explained in the final model).

Conclusion

Australian nurses are at greater risk of burnout than Chinese nurses. Burnout dimensions are differentially associated with patient safety across cultures. Culturally relevant interventions may be more optimal than universal approaches for improving burnout and patient safety in nursing.

Impact

This study increased understanding of cross-cultural differences in nurse burnout and the relationship with patient safety. Australian nurses were at greater risk of burnout than Chinese nurses. Emotional exhaustion, depersonalization and personal accomplishment influenced patient safety distinctively across the countries. These findings inform interventions designed to reduce nurse burnout and improve patient safety internationally.

Experiences of weight stigma in adolescents with severe obesity and their families

Abstract

Aim

To describe the experiences of weight stigma in adolescents with severe obesity and their parents.

Design

Qualitative descriptive secondary analysis.

Methods

A secondary analysis on 31 transcripts from a larger study of 46 transcripts conducted between February 2019 and June 2020. Semi-structured interviews were conducted with 19 parents (n = 17 mothers, n = 2 fathers) and 12 adolescents (n = 7 male, n = 5 female). Interviews were digitally audio recorded, transcribed and analysed using conventional content analysis.

Results

Four common themes were identified reflecting experiences of weight stigma: weight-based teasing and bullying, interactions with healthcare providers (HCPs), family interactions and blame. Subthemes were fairness and impact on mental health.

Conclusion

This secondary analysis adds to the sparse literature documenting the experiences of weight stigma from adolescents with severe obesity and their families. It is important to understand the experiences of weight stigma from the adolescent and parent perspective as it can inform healthcare, education and policies across communities and facilitate holistic health for this vulnerable population.

Impact

The need for research to better understand how experiences of weight stigma correlate with physiological and psychological outcomes and inform innovative interventions are critical to improve treatment of severe obesity. Healthcare providers across disciplines are in a strategic position to change the paradigm through which we provide care to youth with severe obesity and guide families in supporting their children's weight management efforts without contributing to weight stigma.

Strategies to manage cognitive dissonance when experiencing resistiveness to care in people living with dementia: A qualitative study

Abstract

Aims

To explore the experiences of healthcare personnel when they face resistiveness to care in people living with dementia in nursing homes.

Design

The study has a qualitative explorative design.

Methods

Three focus group interviews were conducted in June 2019. A total of 16 nurses and other healthcare personnel employed in three different nursing homes participated. A semi-structured interview guide was used during the focus group interviews. Data were transcribed verbatim and analysed using an inductive qualitative content analysis.

Results

The analysis generated one overarching category—‘Tension when facing resistiveness to care’, which describes the discomfort healthcare personnel experienced when confronted with resistiveness to care in people with dementia—and two other categories: ‘Attitude change’ and ‘Changing behaviour’, which describes their strategies to reduce and/or manage the discomfort. Four subcategories—‘Changing the mindset’, Conceptual shift’, Stepping back’ and ‘Not giving up’—described the actions taken by healthcare personnel to manage or reduce their cognitive dissonance.

Conclusion

The strategies used to manage or reduce cognitive dissonance provide a new understanding of how healthcare personnel choose to approach resistiveness to care in people living with dementia.

Impact

This study addresses cognitive dissonance, a discomfort experienced by healthcare personnel when facing resistiveness to care from people living with dementia. To reduce their dissonance, the participants employed several strategies, including coercive measures, when providing care. The theory of cognitive dissonance may help explain why healthcare personnel sometimes choose to employ coercive measures while providing care.

The Ms. Olsen test: Measurement properties of a short test of nursing staffs’ competence in clinical decision‐making

Abstract

Aims

To assess the measurement properties of the Ms. Olsen test for registered nurses and assistant nurses, respectively, and suggest cut-off points between competence levels.

Design

Cross-sectional study. The results were analysed by implementing the Rasch Measurement Theory.

Methods

Nursing staff working in various health care settings participated (n = 757). To measure the competence of nursing staff in clinical decision-making, a 19-item scale from the Nursing Older People-Competence Evaluation Tool—the ‘Ms. Olsen test’—was used. Data were collected in October 2017, 2018 and 2019.

Results

The Ms. Olsen test showed reasonably good measurement properties for registered nurses and assistant nurses respectively. Results show slightly better measurement properties for registered nurses than for assistant nurses. The cut-off for registered nurses, 0.62, corresponds to managing approximately two-thirds of the items while, for assistant nurses, the cut-off of 0.01 corresponds to managing approximately half of the items.

Conclusion

The Ms. Olsen test is a short (7- to 10-min) test measuring competence in clinical decision-making among nursing staff working in older people nursing. Despite reasonably good measurement properties, this should be considered an initial validation in the development of a short test for assessing clinical decision-making among nursing staff in various health care setting.

Impact

Several scales aiming to measure nursing competence have been developed over the last decade, but measurement properties (beyond classical test theory) are seldom evaluated, few scales concern other staff groups than registered nurses and few scales have proposed or established cut-offs for safe practice. The Ms. Olsen test is a short test of clinical decision-making that demonstrates reasonably good measurement properties. Cut-off points for registered nurses and assistant nurses were established. The Ms. Olsen test may be used to measure and evaluate competence in clinical decision-making among nursing staff working in older people nursing and educational settings.

A comparative study of the opinions, experiences and individual innovativeness characteristics of operating room nurses on robotic surgery

Abstract

Aim

To compare and evaluate operating room nurses’ opinions about robotic surgery with their individual innovativeness metric scores. The aim was also to identify the experiences, adaptation processes and influencing factors of operating room nurses working in robotic surgery rooms in Turkey.

Design

This was a comparative descriptive study.

Methods

The sample included 114 operating room nurses working in 12 institutions that performed robotic surgery in Turkey. Data were collected between January 2018 and September 2019 using the Demographic Characteristics of Nurses and Robotic Surgery Evaluation Form and the Individual Innovativeness Scale, and were analysed using a quantitative statistical approach (independent samples t-test, one-way analysis of variance and Kruskal–Wallis H test). The data obtained from the Robotic Surgery Evaluation section, which consisted of open-ended and closed-ended questions, were analysed with appropriate steps. In particular, answers to open-ended questions were grouped and coded according to their content.

Results

Operating room nurses held positive opinions about robotic surgery. Only 35.8% of the nurses had received training before joining the robotic team, while 55.2% had individually searched for information. Operating room nurses with robotic surgery experience had significantly higher (p < .001) individual innovativeness scores. Over 85% of nurses who received training adapted to robotic surgery in 3 months or less, while nurses with higher individual innovativeness scores adapted in a statistically significantly (p < .05) shorter period. Training, teamwork, and practical experience were mentioned as facilitating factors; inadequate training and technical problems were reported as obstructing factors.

Conclusion

Operating room nurses hold positive opinions about robotic surgery; nurses with robotic surgery experience have higher levels of individual innovativeness; and nurses who have received training are significantly better adapted.

Impact

What problem did the study address? This study addresses the need for a better understanding of operating room nurses’ opinions and experiences about robotic surgery and the influencing factors of adapting to it. This study also offers an evaluation and comparison of the nurses’ individual innovativeness characteristics and the correlation with their adaptation processes to the new role.

What were the main findings? The main findings show a correlation between specific education/training and nurses’ adaptation to the new role of robotic surgery, the individual innovativeness characteristics metric of nurses with or without robotic surgery experience and the time frame of their adaptation.

Where and on whom will the research have an impact? This research traces the profile of current operating room nurses working in the robotic surgery field and the factors influencing their experience. These findings and conclusions have a much broader impact than in Turkey alone. The findings raise awareness of the importance of educating and preparing operating room nurses before introducing them to the new roles and responsibilities inherent to robotic surgery.

Implementation of an intersectoral outreach and community nursing care intervention with refugees in Quebec: A protocol study

Abstract

Aim

To establish and assess an intersectoral local network focused on the roles of registered nurses and primary healthcare nurse practitioners to ensure the continuity of care and service pathways for refugees in Quebec.

Design

Developmental evaluation with a mixed methodology.

Methods

The qualitative component will include: (1) a document review; (2) observations of participants during meetings of different governance structures; (3) semi-structured interviews with key actors (n = 40; 20/neighbourhood interventions); and (4) focus groups with end users of the services (refugees) (n = 4; 6 to 8 participants per group). The quantitative component will be based on: (1) a data sheet on health and social interventions for refugees users filled in by registered nurses, primary healthcare nurse practitioners and physicians and (2) data analysis of the clinical-administrative database since 2012. This study received funding in June 2019 and Research Ethics Committee approval was granted in July 2020.

Discussion

In Quebec, refugee vulnerability is exacerbated by the lack of integration of existing resources and the lack of access to care and continuity of services. To address these issues, an integrated local network for refugees must be developed. Additionally, we will explore the role of registered nurses and their collaboration with primary healthcare nurse practitioners.

Impact

This study will provide recommendations on how to optimize the scopes of practice of registered nurses and primary healthcare nurse practitioners, adapt care and services and develop a local intersectoral network to better meet the complex needs of refugees. It will evaluate the use and the appreciation of new services for targeted populations (neighbourhoods and refugees) and aim to improve the accessibility, continuity and user experience of all health services for those populations.

Quality of life in cancer patients with different preferences for nurse spiritual therapeutics: The role of psychological capital

Abstract

Aim

To explore the status of quality of life and psychological capital and analyse the different effects of psychological capital on the quality of life of cancer patients with different preferences for nurse spiritual therapeutics.

Design

A cross-sectional survey was used.

Methods

Two hundred and eight cancer patients were recruited using convenience sampling from a tertiary Chinese hospital, between March and July 2019. Data on preferences for nurse spiritual therapeutics (PNST), psychological capital (PsyCap) and quality of life (QoL) were collected using paper questionnaires. Hierarchical multiple regression was employed to investigate the different influences of PsyCap on QoL of cancer patients with various levels of PNST.

Results

Compared with patients having high PNST, patients with mild-moderate PNST experienced lower self-efficacy, hope, optimism, PsyCap and social/family well-being. PsyCap significantly explained the variance on QoL of patients with various levels of PNST. Age, gender, presence of caregiver were significant factors influencing physical, social/family and emotional well-being of patients with high PNST.

Conclusion

The present study demonstrates disparities in PsyCap and QoL between cancer patients with mild-moderate and high PNST. It is essential to be aware of the positive influences of PsyCap on QoL and develop effective interventions for patients to improve their QoL, especially for those with mild-moderate PNST.

Impact

It is necessary to realize the benefits of PsyCap on QoL of cancer patients with various levels of PNST. Appropriate training for nurses needs to be developed to promote their spiritual care competencies. Moreover, supportive interventions should be developed for cancer patients to improve their PsyCap and QoL.

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