FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

An integrative review of community nurse‐led interventions to identify and respond to domestic abuse in the postnatal period

Abstract

Aim

To critically review community nurse-led domestic abuse interventions aimed at identifying and responding to domestic abuse in the postnatal period.

Background

Domestic abuse is a global problem resulting in dire consequences for women and children. Public Health Nurses (PHNs) are ideally placed to give women the opportunity to disclose in a safe and confidential manner; however, community settings present complex challenges.

Design

An integrative review and narrative summary.

Data Sources

Five electronic databases: CINAHL, MEDLINE, PsycINFO, EMBASE and Scopus, and peer-reviewed journals were searched for research papers published between 01 January 2005 and 01 March 2019. Fifteen papers met the inclusion criteria.

Review Methods

An integrative review where qualitative and quantitative data were extracted. Following quality appraisal, data were collated, analysed and themes were identified.

Results

Quantitative outcomes from short-term interventions include an increase in routine enquiry, documentation of alone status and safety planning, however, referrals remained low. There was a reduction in victimization seen in intensive home visiting interventions. One study reported potential harm to mothers experiencing domestic abuse prior to the intervention. Thematic analysis generated three themes: (1) benefits to women and nurses, (2) approaches to domestic abuse identification and response and (3) implementation of community nurse-led interventions.

Conclusion

Community nurse-led domestic abuse interventions have shown to have positive outcomes for women, provided the appropriate supports are in place such as: interagency training; guidelines, referral pathways and safety protocols; collaborative working with domestic abuse services and organizational support.

Impact

Professionals such as PHNs are challenged to respond appropriately and compassionately to domestic abuse disclosures, while ensuring the safety of women and children is central to service delivery. This integrative review will inform further development, implementation and the sustainability of community nurse-led domestic abuse initiatives worldwide.

Sacrifice and solidarity: a qualitative study of family experiences of death and bereavement in critical care settings during the pandemic

Por: Dennis · B. · Vanstone · M. · Swinton · M. · Brandt Vegas · D. · Dionne · J. C. · Cheung · A. · Clarke · F. J. · Hoad · N. · Boyle · A. · Huynh · J. · Toledo · F. · Soth · M. · Neville · T. H. · Fiest · K. · Cook · D. J.
Background

Pandemic-related restrictions are expected to continue to shape end-of-life care and impact the experiences of dying hospitalised patients and their families.

Objective

To understand families’ experiences of loss and bereavement during and after the death of their loved one amidst the SARS-CoV-2 (COVID-19) pandemic.

Design

Qualitative descriptive study.

Setting

Three acute care units in a Canadian tertiary care hospital.

Participants

Family members of 28 hospitalised patients who died from March–July 2020.

Main outcome measures

Qualitative semistructured interviews conducted 6–16 months after patient death inquired about family experiences before and beyond the death of their loved one and garnered suggestions to improve end-of-life care.

Results

Pandemic restrictions had consequences for families of dying hospitalised patients. Most family members described an attitude of acquiescence, some framing their experience as a sacrifice made for the public good. Families appreciated how clinicians engendered trust in the name of social solidarity while trying to mitigate the negative impact of family separation. However, fears about the patient’s experience of isolation and changes to postmortem rituals also created despair and contributed to long-lasting grief.

Conclusion

Profound loss and enduring grief were described by family members whose final connections to their loved one were constrained by pandemic circumstances. Families observed solidarity among clinical staff and experienced a sense of unity with staff, which alleviated some distress. Their suggestions to improve end-of-life care given pandemic restrictions included frequent, flexible communication, exceptions for family presence when safe, and targeted efforts to connect patients whose isolation is intensified by functional impairment or limited technological access.

Trial registration number

NCT04602520; Results.

Attitudes towards vaccines and intention to vaccinate against COVID-19: a cross-sectional analysis--implications for public health communications in Australia

Por: Enticott · J. · Gill · J. S. · Bacon · S. L. · Lavoie · K. L. · Epstein · D. S. · Dawadi · S. · Teede · H. J. · Boyle · J. · for the iCARE Study Team · Vally · Losada · Shawon · Kautzky-Willer · Dash · Cornelio · Matte · Abou-Setta · Aaron · Alberga · Barnett · Barone · Belanger-Gra
Objective

To examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults as part of the iCARE Study.

Design and setting

Cross-sectional online survey conducted when free COVID-19 vaccinations first became available in Australia in February 2021.

Participants

Total of 1166 Australians from general population aged 18–90 years (mean 52, SD of 19).

Main outcome measures

Primary outcome: responses to question ‘If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated?’.

Secondary outcome: analyses of putative drivers of uptake, including vaccine confidence, socioeconomic status and sources of trust, derived from multiple survey questions.

Results

Seventy-eight per cent reported being likely to receive a SARS-CoV-2 vaccine. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 2.01 (95% CI 1.77 to 2.77)), being male (1.37 (95% CI 1.08 to 1.72)), residing in least disadvantaged area quintile (2.27 (95% CI 1.53 to 3.37)) and a self-perceived high risk of getting COVID-19 (1.52 (95% CI 1.08 to 2.14)). However, 72% did not believe they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level and rurality. Knowing that the vaccine is safe and effective and that getting vaccinated will protect others, trusting the company that made it and vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight per cent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing, etc) postvaccine.

Conclusions

Most Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified (eg, knowing vaccine is safe and effective, and doctor’s recommendation to get vaccinated) can inform public health messaging to enhance vaccination rates.

Study protocol for a randomised controlled trial of enhanced informed consent compared to standard informed consent to improve patient understanding of early phase oncology clinical trials (CONSENT)

Por: Pal · A. · Stapleton · S. · Yap · C. · Lai-Kwon · J. · Daly · R. · Magkos · D. · Baikady · B. R. · Minchom · A. · Banerji · U. · De Bono · J. · Karikios · D. · Boyle · F. · Lopez · J.
Introduction

Early phase cancer clinical trials have become increasingly complicated in terms of patient selection and trial procedures—this is reflected in the increasing length of participant information sheets (PIS). Informed consent for early phase clinical trials has been contentious due to the potential ethical issues associated with performing experimental research on a terminally ill population which has exhausted standard treatment options. Empirical studies have demonstrated significant gaps in patient understanding regarding the nature and intent of these trials. This study aims to test whether enhanced informed consent for patient education can improve patient scores on a validated questionnaire testing clinical trial comprehension.

Methods and analysis

This is a randomised controlled trial that will allocate patients who are eligible to participate in one of four investigator-initiated clinical trials at the Royal Marsden Drug Development Unit to either a standard arm or an experimental arm, stratified by age and educational level. The standard arm will involve the full length trial PIS, followed by electronic or paper administration of the Quality of Informed Consent Questionnaire Parts A and B (QuIC-A and QuIC-B). The experimental arm will involve the full length trial PIS, exposure to a two-page study aid and 10 online educational videos, followed by administration of the QuIC-A and QuIC-B. The primary endpoint will be the difference (using a one-sided two-sample t-test) in the QuIC-A score, which measures objective understanding, between the standard and experimental arm. Accrual target is at least 17 patients per arm to detect an 8 point difference (80% power, alpha 0.05).

Ethics and dissemination

Ethics approval was granted by the National Health Service Health Research Authority on 15 June 2020—IRAS Project ID 277065, Protocol Number CCR5165, REC Reference 20/EE/0155. Results will be disseminated via publication in a relevant journal.

Trial registration number

NCT04407676; Pre-results.

Integrative Review of Dietary Choice Revealed by fMRI: Considerations for Obesity Prevention and Weight‐Loss Education

Abstract

Background

Emerging findings from neuroimaging studies investigating brain activity associated with dietary behavior are illuminating the interaction of biological and behavioral mechanisms that have implications for obesity prevention. Globally, A total of 1.9 billion adults are overweight, and 650 million are obese. Obesity and being overweight are major risk factors for chronic illness and death. Behaviorally based health interventions have had limited success in curbing the obesity epidemic. Greater understanding of brain responses to food cues will contribute to new knowledge and shape public health efforts in obesity prevention. However, an integration of this knowledge for obesity prevention education has not been published.

Aims

This study links evidence generated from brain activation studies generated in response to diet and food images and highlights educational recommendations for nurses engaged in obesity prevention and weight‐loss education.

Methods

An integrative review of the literature was conducted using the MeSH keywords “magnetic resonance imaging,” “diet,” and “food images” in PubMed, MEDLINE Complete, CINAHL, and Cochrane databases from their first appearance in 2006 through March 2018. Studies published in English and using functional magnetic resonance imaging to measure brain response to diet, and food images were initially identified. Animal models, those whose primary focus was a specific disease, and intervention studies were excluded.

Results

Of 159 studies identified, 26 met inclusion criteria. Findings from neuroimaging studies may help explain the relationship between brain mechanisms and behavioral aspects of dietary choice and inform patient education in obesity prevention. Awareness of this evidence is applicable to nursing education efforts. This review contributes several recommendations that should be considered by nurses providing individualized weight‐loss education.

Linking Evidence to Action

Nurses engaged in patient education for obesity prevention should consider personalized interventions that cultivate internal awareness for dietary adherence, self‐care, exercise, hydration, and mood state; avoid using caloric deprivation approaches, such as skipping breakfast, for weight‐loss interventions; and note the importance of individualized obesity prevention and weight‐loss education.

❌