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AnteayerJournal of Nursing Scholarship

Determining factors affecting job strain for nurse practitioners in acute care practice

Abstract

Purpose

To investigate nurse practitioners’ (NPs) experience of job strain in acute care settings, and to examine the factors that may affect job strain in that context.

Design

Descriptive design using a national survey was employed.

Methods

A total of 1396 NPs completed online surveys that recorded demographic characteristics and included a Job Content Questionnaire (JCQ), a Condition for Work Effectiveness Questionnaire (CWEQ), and the Dempster Practice Behavior Scale (DPBS). Multiple logistic regressions were conducted to explore the factors associated with job strain types.

Findings

NPs were classified into job strain categories of passive (24.4%), active (31.4%), low (19.2%), or high (24.9%). The passive job strain type was associated with overtime hours, organizational empowerment, and autonomy. The active job type was associated with higher organizational empowerment and autonomy. The high-strain and low-strain job types were both associated with overtime hours and autonomy.

Conclusion

Nearly 25% of acute care NPs are in a high job strain type. Organizational empowerment and autonomy were two major factors associated with the passive and active job strain types. Overtime hours and autonomy were both associated with the high-strain and low-strain job types.

Clinical relevance

Supportive hospital/nursing leadership should acknowledge the impact of NP practice as they can contribute to the operational efficacy of their organization. Hospital administrators should provide a supportive practice environment by empowering NPs, enhancing autonomy, and addressing working conditions for NPs to decrease the odds of having a passive or high-strain job type in practice.

Which factors influence the prevalence of institution‐acquired falls? Results from an international, multi‐center, cross‐sectional survey

Abstract

Purpose

Falls are a highly prevalent problem in hospitals and nursing homes with serious negative consequences such as injuries, increased care dependency, or even death. The aim of this study was to provide a comprehensive insight into institution-acquired fall (IAF) prevalence and risk factors for IAF in a large sample of hospital patients and nursing home residents among five different countries.

Design

This study reports the outcome of a secondary data analysis of cross-sectional data collected in Austria, Switzerland, the Netherlands, Turkey, and the United Kingdom in 2017 and 2018. These data include 58,319 datapoints from hospital patients and nursing home residents.

Methods

Descriptive statistics, statistical tests, logistic regression, and generalized estimating equation (GEE) models were used to analyze the data.

Findings

IAF prevalence in hospitals and nursing homes differed significantly between the countries. Turkey (7.7%) had the highest IAF prevalence rate for hospitals, and Switzerland (15.8%) had the highest IAF prevalence rate for nursing homes. In hospitals, our model revealed that IAF prevalence was associated with country, age, care dependency, number of medical diagnoses, surgery in the last two weeks, and fall history factors. In nursing homes, care dependency, diseases of the nervous system, and fall history were identified as significant risk factors for IAF prevalence.

Conclusions

This large-scale study reveals that the most important IAF risk factor is an existing history of falls, independent of the setting. Whether a previous fall has occurred within the last 12 months is a simple question that should be included on every (nursing) assessment at the time of patient or resident admission. Our results guide the development of tailored prevention programs for persons at risk of falling in hospitals and nursing homes.

Worldwide prevalence of inadequate work ability among hospital nursing personnel: A systematic review and meta‐analysis

Abstract

Purpose

To estimate the worldwide pooled prevalence of inadequate work ability among hospital nursing personnel using the Work Ability Index (WAI).

Design

Systematic review and meta-analysis.

Methods

A systematic search was conducted on Medline/PubMed, Scopus, Web of Science, Scielo, PsychInfo, CINAHL, Nursing and Allied Health, LILACS, and Google Scholar from inception to July 2021 to identify observational studies on work ability among hospital nursing personnel using the WAI. Two researchers independently completed the study selection, quality assessments, and data extraction on the prevalence of inadequate work ability that was pooled using the random effects model. Finally, subgroup analyses were performed to explore sources of heterogeneity.

Findings

A total of 42 studies were included, consisting of 24,728 subjects worldwide from 14 countries. Of these, 35 studies were included in the meta-analytical analyses. The worldwide pooled prevalence of inadequate work ability among hospital nursing personnel was 24.7% (95% CI = 20.2%–29.4%). High levels of heterogeneity were detected in all studies. Prevalence was higher in studies where samples were composed of nurses and nursing assistive personnel (26.8%; 95% CI = 22.4%–31.5%) than in those of nurses alone (22.2%; 95% CI = 13.1%–32.9%) and in studies where the sample was over 40 (28.1%; 95% CI = 19.5%–37.5%) than in those with a sample under that age (22.4%; 95% CI = 15.8%–29.7%).

Conclusions

Almost one in four members of hospital nursing staff in the world has inadequate work ability and therefore are at risk of several negative outcomes during their working life. These prevalence data correspond to the pre-pandemic period, so new studies should also be especially useful in quantifying the impact of the COVID-19 pandemic on work ability in the hospital nursing workforce.

Clinical relevance

The above findings justify the launch of initiatives that include annual assessment for the early identification of inadequate work ability, offering the possibility of anticipated corrective measures. Nursing workforce older than 40 years and those belonging to the professional category of nursing assistive personnel should be priority target groups for screening and intervention to improve work ability.

Developing a multicomponent implementation strategy for mental health interventions within the Nurse‐Family Partnership: An application of the EPIS framework

Abstract

Purpose

The purpose of this article is to describe the process used to create the Mental Health Innovation (MHI), a multicomponent implementation strategy that integrates evidence-based mental health interventions into the Nurse-Family Partnership (NFP), a national home visiting program delivered by nurses to low-income mothers.

Organizing construct

The Exploration, Preparation, Implementation, Sustainment (EPIS) framework outlines the multistep, stakeholder-engaged process used to develop the MHI.

Conclusion

Engaging stakeholders provided an in-depth understanding of NFP infrastructure and the needs of NFP nurses and their clients. This understanding was key to designing a multicomponent implementation strategy to integrate mental health interventions within national and local NFP infrastructure and existing care processes.

Clinical relevance

Application of implementation frameworks such as EPIS provides a guide to integrating evidence-based interventions in a systematic, intentional, and rigorous manner, which in turn may promote their wide scale use and long-term sustainability.

Effects of nurse‐led supportive‐expressive group intervention for post‐traumatic growth among breast cancer survivors: A randomized clinical trial

Abstract

Background

Post-traumatic growth induced from cancer diagnosis and treatment could benefit the prognosis of cancer survivors, but intervention based on self-disclosure in group is limited.

Objective

Aimed to examine the effectiveness of a supportive-expressive group intervention on post-traumatic growth. The impact of the intervention on anxiety and depression were also explored.

Design

This randomized clinical trial enrolled patients from June 2017 to September 2018 with a one-month follow-up. Data collectors were blinded to patient grouping.

Setting

A single center study in Chengdu, China.

Participants

One hundred sixty-eight participants who met the eligibility criteria were randomly assigned to the intervention group (n = 84) or control group (n = 84); 46 were excluded and 122 patients finished the one-month follow-up.

Methods

Participants in the intervention group received nurse-led support intervention focusing on topics such as “Being a Patient”, “Interpersonal Relationships”, “Journey for Recovery”, and “Planning the Future” while participants in the control group received health education, rehabilitation training etc. according to the nursing routine of breast cancer patients. The intervention was designed in accordance with the diagnosis and treatment process as well as patient needs. Participants in both groups were evaluated three times (T1-baseline before the intervention, T2-end of the intervention, and T3-1 month follow up). Post-traumatic growth, anxiety and depression were evaluated.

Results

Participants in the intervention group reported higher level of post-traumatic growth (< 0.01 or 0.05) and reduced anxiety and depression (p < 0.01 or 0.05 and p < 0.01 or 0.05). The multilevel model indicated that the intervention significantly promoted post-traumatic growth (β T3 = 7.87, p < 0.05) and dimensions of relating to others (β T3 = 4.26, < 0.001), personal strength (β T3 = 4.27, < 0.01), appreciation of life (β T3 = 8.69, < 0.001), and new possibilities (β T3 = 1.91, p < 0.05), anxiety (β T3 = −3.63, < 0.001), and depression (β T3 = −2.27, < 0.001), but had no effect on the dimension of spiritual change. In addition, the multi-level model showed that patients with younger ages (β = −0.05~−0.52, p < 0.05–0.001), with high school and above education levels (β = 1.53~9.29, p < 0.01) and accompanied by husbands(β = −1.48~−8.51, p < 0.05) had more effective intervention and patients with religious belief had a better spiritual change level (β = 1.86, < 0.001).

Conclusions

These findings provide evidence for the potential effectiveness of the nurse-led intervention on positive benefits of post-traumatic growth and relieved anxiety and depression for Chinese breast cancer survivors and will inform the design and development of a large randomized controlled trial.

Clinical relevance

The supportive-expression group intervention can be applied independently by nurses. The four themes of self-disclosure can help patients grow after trauma, and this method can be used as a psychological support technique for breast cancer patients during hospitalization.

Rethinking “zero tolerance”: A moderated mediation model of mental resilience and coping strategies in workplace violence and nurses’ mental health

Abstract

Aims

This study aimed to investigate whether the impact of workplace violence (WPV) on nurses’ mental health varies with mental resilience and coping strategies.

Background

Workplace violence is a serious threat to nurses’ mental health, and its impact on nurses’ mental health is influenced by many factors.

Method

A cross-sectional study involving 349 participants was conducted over 12 months. The data were analyzed using SPSS 25.0 and SPSS PROCESS macro.

Results

In total, 82.52% of nurses were exposed to WPV. WPV not only affects mental health directly but also indirectly through mental resilience. Coping strategies had a moderating effect among WPV, mental resilience and mental health. When nurses coped with psychological violence with intolerance, WPV had a stronger negative effect on their mental health. When nurses coped with psychological violence with tolerance but coped with physical violence with intolerance, mental resilience had a stronger positive effect on their mental health.

Conclusions

Good mental resilience and coping with psychological violence with tolerance while coping with physical violence with intolerance can help buffer WPV and promote mental health.

Clinical relevance

Employers who have a “zero tolerance” policy regarding WPV need to re-examine how they currently operate.

Diabetes nurse practitioners in the shadow of the COVID‐19 pandemic: Challenges, insights, and suggestions for improvement

Abstract

Purpose

The study examined the role of diabetes nurse practitioners (DiNPs) and their contribution to the quality of care of individuals with diabetes during the COVID-19 pandemic. Specifically, we examined the benefits and barriers of using telemedicine for managing diabetes.

Design

A descriptive qualitative research using content analysis of interviews.

Methods

Participants were invited through the National DiNPs’ Forum. Semi-structured interviews were conducted with 24 licensed DiNPs (age range, 37–58 years) who were involved in the clinical care of individuals with diabetes during the COVID-19 pandemic. The interviews were recorded and transcribed, and content analysis was then used for extracting themes and their related categories.

Findings

Content analysis revealed five themes: (a) Benefits and barriers of remote diabetes treatment; (b) Teamwork and its implications to DiNPs; (c) Technological challenges, resourcefulness, and creativity; (d) Changed perception of DiNP roles; and (e) Cultural diversity and improving communication skills. The benefits of telemedicine included improved control, efficiency, convenience and satisfaction, while the disadvantages of this method included the inability to provide optimal practical guidance on technical aspects of physical assessments and care. Sectors with limited digital literacy and language barriers had difficulties using telemedicine. Teamwork was reported as a facilitator to managing treatment. Telemedicine provided an opportunity for DiNPs to become more efficient and focused and to clearly define their role in the organization.

Conclusions

The COVID-19 pandemic has posed new challenges. Along with the need to adapt the therapeutic approach to remote care, DiNPs improved their professional status, acquired new skills, and were satisfied with their personal and professional growth.

Clinical relevance

Telemedicine should become an integral part of diabetes management to enable access to populations who cannot come to the clinic. Patients should be guided on using telemedicine platforms.

The effectiveness of acupressure for managing postoperative pain in patients with thoracoscopic surgery: A randomized control trail.

Abstract

Purpose

More than 86% patients experience moderate to severe pain after thoracoscopic surgery. A combination of diverse nonpharmacological pain relief methods is a developing trend for pain management. The purpose of this study was to explore the effect of acupressure in reducing pain after thoracoscopic surgery.

Design

A Randomized controlled study with purpose sampling was used for this study. Patients who underwent thoracoscopic surgery at a medical center in central Taiwan were enrolled. Study data was collected from September 2020 to April 2021 after the approval of the institutional review board. A total of 100 participants were randomized into two groups (49 and 51 in the experimental and control groups, respectively).

Methods

Participants in the experimental group received acupressure at the Neiguan (PC6) and Shenmen (HT7) acupoints thrice a day for 2 days, whereas those in the control group received routine treatment and did not receive acupressure. The measurement included questionnaires for the collection of general information, physiological information, and disease rating scale. The Visual Analogue Scale-Pain (VAS-P) was used to measure the severity of pain. SPSS statistical software was used for data analysis. Independent sample t-test and chi-squared test were used for descriptive statistics, and paired t-test and linear mixed model were used to examine the effect of acupressure in alleviating pain.

Findings

After acupressure intervention, the pain score of the experimental group was lower than that of the control group, and this difference was significant β = 17.76, p < 0.001 on day 1 after intervention; β = 19.80, p < 0.001 on day 2 after intervention. The postoperative pain score in the experimental group on day 2 after intervention was significantly lower than that in the control group (t = 2.039, p = 0.044). After the subjects received acupressure, pain index significantly decreased after considering the interaction between time and group (p < 0.001). Regardless of the type of surgery, there were significant differences in pain index when the interaction between time and group was considered (p < 0.001).

Conclusions

This study provided an experimental basis that acupressure can help in pain management in patients after thoracoscopic surgery, and the pain relief results become more significant as the duration of intervention increases.

Clinical relevance

Acupressure is effective in relieving postoperative pain in any type of thoracoscopic surgery. Nurses can use acupressure to help control pain in patients after thoracoscopic surgery.

Effects of nurse‐led nonpharmacological pain interventions for patients with cancer: A systematic review and meta‐analysis

Abstract

Purpose

The purposes of this study were to review the types of nurse-led nonpharmacological pain interventions (NPI) offered to cancer patients and/or family caregivers, and to determine a comprehensive and robust estimate of the effect size of nurse-led NPI for cancer patients on various pain-related outcomes.

Design

Systematic review and meta-analysis. Studies assessing nurse-led NPIs targeting cancer patients and published between January 2008 and December 2020 were identified by searching multiple literature databases, including MEDLINE®, EMBASE, Google Scholar, Cochrane Library, ProQuest Medical Library, and CINAHL®.

Methods

This review was conducted in accordance with the Preferred Reporting Item for Systematic Reviews and Meta-analyses guidelines. The selected randomized clinical trials were independently assessed for methodological quality. The effect sizes (ESs) of treatment were presented as standardized mean differences (Hedges’ g) and 95% confidence intervals (CIs).

Findings

A meta-analysis was performed to analyze data from 22 randomized clinical trials. Three types of nurse-led NPI were offered, mainly to cancer patients but also to some caregivers: music, physical, and psycho-educational interventions. The dose and duration of nonpharmacological interventions varied widely. The study participants ranged in age from 44.1 to 67.3 years. Meta-analysis indicated that, although these interventions had small effects in long-term (g = 0.24, 95% CI: 0.06–0.43, p = 0.011) to medium effects in short-term (g = 0.43, 95% CI: 0.32–0.53, p < 0.001), they significantly reduced patients’ pain, increased their knowledge of pain management, reduced barriers to pain management and pain coping, and improved other physical and emotional symptoms. The significance of the ES differed according to the type of intervention, with psycho-educational and physical NPIs having a significant but medium short-term ES, whereas music NPI had a significant but large short-term ES. Only psycho-educational NPIs had significant long-term effects.

Conclusion

The combined ES showed that these nurse-led NPIs were significantly effective in both the short and long-term. Types of intervention as a potential moderator were associated with short-term and long-term effects of nonpharmacological interventions on patient outcomes.

Clinical relevance

Research-tested interventions should be provided to help patients cope effectively with pain.

Transformational leadership as a mediator between work–family conflict, nurse‐reported patient safety outcomes, and job engagement

Abstract

Purpose

Work–family conflict (WFC) is an important issue in nursing administration and management that is associated with reduced work effectiveness and patient safety issues. To date, very few studies have attempted to explain the mechanisms underlying these relationships. The aim of this study was to determine the influence of work–family conflict (WFC) on patient safety outcomes and job engagement via the intermediary role of transformational leadership (TL).

Design

Cross-sectional study.

Methods

Seven hundred fifty-four nurses from 10 acute care hospitals in the Philippines were included in this cross-sectional study.

Findings

A higher perception of WFC was associated with increased adverse events, reduced quality of care and decreased job engagement. WFC was indirectly associated with quality of care, adverse events and job engagement through the intermediary of TL.

Conclusions

The results of this study underscore the important role of nurse managers’ TL in sustaining work–family balance and, in turn, improving patient safety outcomes and enhancing job engagement among nurses.

Clinical relevance

Institutional measures to foster patient safety outcomes and sustain the nursing workforce should involve enhancing nurse managers’ leadership behaviors through theory-driven interventions, periodic leadership assessment, and implementation of leadership development activities. WFC may be addressed by creating empowering work conditions, providing adequate coaching and mentorship to nurses, and implementing work–family friendly policies in the workplace.

The efficacy of psychological interventions for depressed primary caregivers of patients with Alzheimer's disease: A systematic review and meta‐analysis

Abstract

Objectives

To systematically evaluate the effectiveness of psychological intervention durations and different psychological interventions on treating depression in primary caregivers of Alzheimer's disease (AD) patients.

Methods

A computerized search of PubMed, Cochrane Library, Embase, Ebsco, Web of Science, CNKI, CSBD, and CSTJ databases on randomized controlled trials (RCTs) of psychological interventions for depressed primary caregivers of AD patients was performed. Depression scores were derived from the Self-rated Depression Scale (SDS) and the Centre for Epidemiological Studies Depression Scale (CES-D). The results were analyzed using Revman 5.3 utilizing Trial Sequential Analysis (TSA) software for data analysis.

Results

Eight RCTs involving 857 depressed primary caregivers of AD patients were included in the study. Of the four psychological interventions studied, only three (i.e., cognitive-behavioral psychological, integrated psychological, and psychological interview intervention) were shown to significantly reduce depression levels in primary caregivers of AD patients after 2-months, 10-weeks, and 6-months of treatment (p ≤ 0.05). It is uncertain that a supportive psychological intervention or a 3-months psychological intervention reduced the level of depression. Sequential and sensitivity analyses confirmed the reliability of the outcome measures.

Conclusion

Cognitive-behavioral psychological, integrated psychological, and psychological interview interventions were able to significantly reduce depression levels in primary caregivers of AD patients. These findings reveal that psychological interventions may be a promising means for depressed primary caregivers of patients with AD.

Clinical relevance

For the primary caregivers of AD patients, effective interventions can help reduce psycho-depressive symptoms and improve the quality of life for the caregivers and the patients. Medical staff may want to use this information to help to provide a more effective guide for primary caregivers in an effort to reduce possible levels of depression.

Experiences of accessing healthcare services by people with hearing loss/impairment (deaf) in sub‐Saharan Africa: An integrative review

Abstract

Purpose

The aim was to review published articles to identify experiences of people with hearing loss/impairment accessing healthcare services in sub-Saharan Africa.

Design and method

The study was guided by Cooper's integrative review methodology. Articles published between 2010 and 2020 were identified through electronic databases. The search included: Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, EBSCOHOST, MEDLINE, and Psyc INFO and using specific search terms. Ninety-one (91) articles were identified and screened for eligibility, and only seven articles were appraised using relevant tools for qualitative and quantitative designs.

Findings

The articles that met the inclusion criteria were from the following sub-Saharan countries: Ghana (n = 2) South Africa (n = 3) Uganda (n = 1) and Zimbabwe (n = 1). Review analysis revealed seven (7) major themes categorized as: communication, lack of knowledge, discrimination, financial problem, healthcare workers’ attitudes, and a lack of autonomy, security and privacy issues.

Conclusion

The review provides evidence that indicate the challenges faced by people with hearing loss/impairment in sub-Saharan Africa. Studies suggest that communication, lack of knowledge; financial problems, lack of autonomy and privacy, and a perception of being discriminated against were major impediments in accessing healthcare service. Undesirable attitudes were also a hindrance for healthcare access.

Clinical relevance

Communication is a major impediment in accessing healthcare for the hearing impaired people residing in sub-Saharan Africa.

Exploration of risk factors for high‐risk adverse events in elderly patients after discharge and comparison of discharge planning screening tools

Abstract

Objectives

Discharge planning is an effective strategy to prevent adverse health events and reduce medical expenditures. The high-risk target populations of discharged elderly patients and important predictors for the occurrence of adverse events are still not clear. Therefore, the purposes of this study were to examine the validity of discharge planning screening tools in sufficiently identifying high-risk adverse events to health after discharge and to compare two screening tools with our study model.

Design

We conducted a prospective study and recruited elderly patients who had had no hospitalization within 3 months before admission to 13 general wards of a medical center in northern Taiwan from November 2018 to May 2020.

Methods

Elderly patients were randomly selected during the study period. Within 24 h of admission, patients were asked to consent to join this study. After the patient was discharged, the patient's health and hospitalization for the next year were tracked by telephone interviews.

Results

In total, 300 participants were recruited for this study. Incidences of high-risk adverse events within 30 days, 60 days, and 12 months after discharge were 20.3%, 25.7%, and 48.7% respectively. A logistic regression showed that an increased age, physical or mental disabilities or a major illness, a low body-mass index, and having been hospitalized in the past year were significantly related to the occurrence of high-risk events among elderly discharge patients. The pooled sensitivity of the Pra was 52% and the specificity was 72%; the pooled sensitivity of the LACE index was 67% and the specificity was 36%. The predictive model of this study had a higher discriminatory power than the Pra and LACE index for high-risk events after discharge.

Conclusions

Elderly patients are more vulnerable to high-risk adverse events after discharge. Both the LACE index and Pra are useful discharge planning screening tools to screen for high-risk adverse events after discharge. Elderly patients need more-active and complete continuity of care plans and discharge planning services to ensure that the overall quality of patient care can be improved and readmissions and mortality reduced.

Clinical relevance

The findings of this study can provide information for discharge planning managers to identify high-risk elderly patients during hospitalization and promptly offer care education or resources to improve care management.

Predictors for psychological distress of young burn survivors across three years: A cohort study of a burn disaster in Taiwan

Abstract

Purpose

The study aims to investigate long-term psychological distress and its risk factors in the burn survivors.

Design

A longitudinal study with follow-up interviews was conducted from November 2015–June 2018. A post-burn baseline interview was conducted 6 months after the event, followed by annual surveys for three years.

Methods

The burn survivors received structured assessment through telephone in the four-wave interviews, including the five-item Brief Symptom Rating Scale (BSRS-5); two-item Patient Health Questionnaire (PHQ-2); four-item Startle, Physiological Arousal, Anger, and Numbness Scale (SPAN-4); and six-item Impact of Event Scale (IES-6) alongside demographic data and other health-related assessment.

Findings

A total of 180 respondents with the mean age of 23 years old completed the four waves of interview. Using the BSRS-5 as the outcome, each variable had different input in psychological distress during the follow-up years. The main finding was that the SPAN-4 score could predict more than 62% of psychological distress between 6 months and 3 years after the disaster. The generalized estimating equation demonstrated that SPAN-4, IES-6, family functioning impairment, hypnotics use, adaptation to the event, and PHQ-2 could predict psychological distress. However, the variable of follow-up year did not exemplify significant estimation in the model.

Conclusions

The results indicated that different factors had various influences on psychological distress across the four follow-up stages. PTSD-like symptoms, depression, and anxiety were the most common psychological problems experienced by the young burn cohort in the longitudinal post-traumatic period.

Clinical relevance

Healthcare providers should be aware of psychological consequences of traumatic events within up to a 3-year post-burn period, particularly post-traumatic stress, depression, and anxiety symptoms.

Ineffective health management: A systematic review and meta‐analysis of related factors

Abstract

Purpose

A standardized language system can support the elaboration of clinical guidelines by matching information from similar patterns of response to people. To identify the factors that are related to a higher likelihood of an ineffective health management nursing diagnosis.

Methods

We conduct a systematic review and meta-analysis. An electronic search was conducted in MEDLINE databases via PubMed, Web of Science, SciELO, CINAHL, SCOPUS, and Embase between October and November 2020. Descriptive data were extracted from each article. The odds ratios for each etiological factor related to ineffective health management were directly extracted from the articles or calculated from the data described in the articles. The analysis of the measurements of exposure and the magnitude of the effect was performed using the statistical software R, and a forest plot was constructed for each etiological factor.

Findings

Ten studies were included, and 15 related factors were recovered from the primary studies. The factors that significantly increased the likelihood of an ineffective health management nursing diagnosis were insufficient knowledge of the therapeutic regimen, perceived barriers, powerlessness, economic disadvantage, and difficulty managing complex treatment regimens. No effect was verified with the following factors: decision conflict, family pattern of healthcare, and inadequate number of cues to action.

Conclusion

Factors related to a higher likelihood of ineffective health management may be the focus of early and targeted nursing interventions, contributing to an improved quality of care.

Clinical relevance

Understanding exposure to these factors can improve diagnostic reasoning at different population levels.

Direct care nurses’ perceptions of their roles in clinical research: An integrated review of the literature

Abstract

Purpose

To review the extant literature relevant to perceptions by direct care nurses toward clinical research endeavors.

Design

An integrative review guided by the socioecological model was conducted.

Methods

Five databases were searched to identify relevant peer-reviewed articles; there was no limitation on publication date.

Findings

The final sample (N = 9) was systematically appraised. Numerous barriers to direct care nurses’ ability to perform study activities on clinical research trials were encountered at all levels: (1) personal—comprehension, education, and training; (2) interpersonal—communication issues within or from the study team, failure to advocate for the patient; (3) organizational—lack of leadership support, knowledge, and time; and (4) community—insufficient guidance and oversight by research-governing bodies.

Conclusions

Direct care nurses report numerous barriers to completing protocol-administered activities for their patients participating in clinical research. A dearth of robust research exists in describing the reasons for, or persistence of, barriers faced by direct care nurses to assisting with research, and there have been little to no interventions to address them.

Clinical relevance

As translational research evolves and becomes more complex, there is the need to ensure both the care of clinical research participants and the integrity of the research. Direct care nurses are critical to this endeavor, and potential barriers they face may have significant ramifications for the research enterprise. Recognition of these barriers and eventual interventions designed to address them are needed.

Suicide attempts among Taiwanese lesbian, gay, bisexual, and transgender adults during the 2018 Taiwan referendum on same‐sex issues

Abstract

Purpose

To examine suicide attempts and the influencing factors among Taiwanese lesbian, gay, bisexual, and transgender (LGBT) adults during the 2018 Taiwanese referendum on same-sex issues.

Research design and methods

The 2018 Taiwanese referendum was held on November 24. A cross-sectional online survey was conducted between October 2018 and February 2019. A total of 1012 self-identified LGBT adults were included in the final sample.

Results

Among the 1012 Taiwanese LGBT adults, the rates of suicide attempts ranged from 9.1% to 24.4%. A younger age, being a student, having low income, having mental health issues, and having a high level of depressive symptoms were associated with a significantly higher risk of suicide attempts in the participants. Conversely, having a postgraduate degree, having high self-esteem, and perceiving support from friends and family were associated with a lower risk of suicide attempts.

Conclusion

This is the first study to investigate suicide attempts among LGBT individuals and the influencing factors within the context of a same-sex marriage referendum in an Asian country. The results of this study demonstrate the importance of suicide prevention measures for the LGBT community, particularly during times of increased social stress and conflict between social groups with diverse sexual and gender identities.

Clinical relevance

The results of this study suggest that nurses’ and health-care providers’ sensitivity toward LGBT patients and their knowledge and skills in providing culturally competent care are key factors in suicide prevention for LGBT adults. Therefore, nurses and health-care providers must be provided with training courses on culturally competent care.

Nurse editors’ roles and practices

Abstract

Purpose

While nurse editors carry great responsibility for the scientific literature in the nursing profession, little has been published about this unique role. The purpose of this study was to examine contemporary nurse editors’ roles and practices.

Design

In early 2019, a sample of 129 nurse editors participated in a cross-sectional study using survey methods.

Methods

The online survey was based on an instrument used in a prior study and included 43 primarily multiple-choice questions. Findings were analyzed using descriptive statistics.

Findings

Beyond the expected roles of journal management, editorial decision making, leadership for the profession, and specific journal focus, some aspects of the nurse editor role have remained unchanged. The role continues to be learned mostly on the job and nurse editors still find satisfaction in helping other nurses publish and disseminate their work. Nurse editors are older and better educated. They also are receiving more manuscripts submitted to their journals and perceive this role as hard work but worth it. This is also the first study to report on the role of other levels of editors.

Conclusion

This study provides a description of the current roles and practices of nurse editors. Nurse editors can bring more attention to the role and encourage more nurses to consider this role as an attainable and a satisfying one.

Clinical relevance

Being a nurse editor is a leadership role and one that many nurses may not consider as a career goal. Nurse editors can increase the visibility of this role and engage, encourage, and support nurses who are interested in this role.

Predictors of nurses’ reporting for work at the time of epidemics and natural disasters; solutions for hospital surge capacity

Abstract

Purpose

To identify the predictors of nurses’ presence at hospitals at the time of three types of disasters.

Design

This cross-sectional study was performed using a researcher-generated questionnaire.

Methods

This study was performed on 350 nurses of five public hospitals. Data was collected using a questionnaire in which the respondents were asked about their decisions on reporting for work in the event of three scenarios: epidemic of an unknown contagious respiratory disease, earthquake, and flood. Multiple logistic regression was used to analyze the data.

Findings

The four predictors of nurses reporting for work include receiving trainings on disasters, and concerns on the non-compensation for providing services following the disaster, concerns about family safety and workplace safety.

Conclusion

Although slightly different factors affect the willingness of participants to report for work in each scenario, they can be put in two main categories; namely as personal and impersonal. Devising a family disaster plan and providing educational programs on self-care are two main strategies to increase the chances of presence at work following disasters.

Clinical relevance

The presence of more nurses in the hospital at the time of disasters can significantly improve the quality of care, and clinical outcomes of patients and disaster victims.

Effectiveness of eHealth interventions for cancer‐related pain, fatigue, and sleep disorders in cancer survivors: A systematic review and meta‐analysis of randomized controlled trials

Abstract

Purpose

To systematically evaluate the effects of Electronic health (eHealth) interventions on fatigue, pain, and sleep disorders in cancer survivors.

Design

A systematic review and meta-analysis was conducted.

Methods

Relevant studies were searched from five databases (MEDLINE, Embase, the Cochrane Central Register of Controlled trials, CINAHL, and PsycINFO). The comprehensive literature search was done in December 2020. Only randomized controlled trials (RCTs) that examined the effects of eHealth interventions among cancer survivors were included.

Findings

Twenty-five RCTs were included. The meta-analysis showed that eHealth interventions had a positive impact on pain interference (SMD = −0.37, 95% CI: −0.54 to −0.20, p = 0.0001) and sleep disorders (SMD = −0.43, 95% CI: −0.77 to −0.08, p = 0.02) but not on pain severity or fatigue in cancer survivors. The sensitivity and subgroup analyses indicated that the pooled results were robust and reliable.

Conclusion

eHealth interventions are effective in improving pain interference and sleep disorders in cancer survivors. Additional high-quality RCTs are needed to test the effectiveness of eHealth interventions on fatigue, pain, and sleep disorders in cancer survivors.

Clinical relevance

This systematic review and meta-analysis provides evidence to offer effective and sustainable eHealth care for symptom management among cancer survivors.

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