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To explore how public health nurses at child and family health clinics work to prevent maltreatment and the experiences of public health nurses in the maltreatment prevention efforts.
Child maltreatment is a serious societal issue with major consequences. Preventive efforts are increasing and have broad political support. A key objective of the child and family health clinic services is to prevent, identify, and stop maltreatment, abuse, and neglect. National clinical guidelines outline, in general terms, how such work should be conducted. However, limited research exists on how public health nurses prevent maltreatment and the effectiveness of their methods.
A qualitative and explorative design was used, based on semi-structured interviews with 14 public health nurses conducted as part of the project ‘Public Health Nurses in Child and Family Clinics' Role in Preventing and Detecting Child Maltreatment’ at Oslo Metropolitan University. The interviews were carried out between August and November 2021. We used qualitative content analysis with an inductive approach to analyse the data.
Three main categories were developed: 1. Structure and system: weaving prevention into daily practice; 2. To dare and endure: a negotiation of courage and understanding, and 3. To empower and uphold: the goal of strengthening and supporting parents. The results show the importance of early intervention, barriers to discussing maltreatment with parents, and the importance of building trust and empowering parents.
Preventing maltreatment is a key part of public health nurses' clinical work, focusing on early risk identification and parental guidance. While building trust with families is prioritised, structural, resource, and guideline-related challenges persist.
This study provides knowledge about Norwegian public health nurses clinical work with child maltreatment at the child and family health clinics, which can serve as a valuable foundation for further research as well as for collaborating services.
EQUATOR guidelines were followed, using the COREQ checklist.
No patient or public contribution.
To extract and interpret quantitative data exploring the effectiveness of family health conversations (FHCs) on family functioning, perceived support, health-related quality of life, caregiver burden and family health in families living with critical or chronic health conditions.
Addressing the health of families affected by critical or chronic illnesses requires focused attention. The effective integration of FHCs is hampered by a scarcity of rigorous quantitative studies that provide solid evidence on best practices and outcomes.
A systematic review following the Joanna Briggs Institute guidelines.
The review is reported according to the PRISMA 2020 checklist. Appropriate studies were searched in PubMed, CINAHL, PsycINFO, Scopus and Cochrane Databases. Results of the search were imported into the Covidence web-based program. Included were studies with a quantitative research design, delivered to families with critical or chronic health conditions, describing FHCs based on the Calgary Family Assessment Model and/or the Calgary Family Intervention Model, and/or the Illness Beliefs Model, using reliable and validated instruments, published between 2008 and 2023, and written in English.
In total, 24 papers met the inclusion criteria. Sixteen papers used a quasi-experimental design, eight of which included a control group. Two papers used a mixed methods design, and six papers were randomised controlled trials (RCTs). A statistically significant effect of FHCs on family functioning was reported in two RCTs and three quasi-experimental papers. We also found that a statistically significant effect of FHCs was reported on perceived support in 9 of 15 papers, quality of life in 4 of 11 papers and caregiver burden in 1 of 3 papers.
The interventions reviewed revealed variability and partial results concerning the effectiveness of FHCs on family functioning. More rigorous research about short-term, intermediate- and long-term effectiveness is needed before conclusions can be drawn.
The study is reported according to the PRISMA 2020 (Preferred Reporting Items for Systematic reviews and Meta-Analyses) (File S1).
No patient or public contribution. Data were gathered from previously published studies.
To evaluate the quality of care from the patients' perspective after receiving either person-centred, nurse-led follow-up or standard care after surgical treatment of intermittent claudication.
Secondary analysis of a randomised controlled trial.
Patients at two centres for vascular surgery in Stockholm, Sweden were randomised to either a person-centred, nurse-led follow-up programme (intervention group) or a standard follow-up programme with surgeons. During their visits at 4 to 8 weeks and 1 year after surgery, they received the questionnaire Quality from patients' perspective with 28 items. The patients responded to each item from two aspects: (1) how they perceived the quality of received care and (2) subjective importance (how important the care was for them).
A total of 104 of 138 patients at 4–8 weeks and 159 of 193 patients at 1 year after surgery completed the questionnaire. At 4–8 weeks, the intervention group scored significantly higher perceived quality of care regarding five items: receiving useful information about “How I should take care of myself” and “Which nurse were responsible for my care”, “Nurses were respectful towards me”, “Nurses showed commitment/cared about me” and “Easy to get in contact with the clinic through telephone”. At 1 year, the intervention group scored higher regarding two items: “Which nurses were responsible for my care” and “Next of kin treated well”.
Person-centred, nurse-led follow-up as implemented in this study has been shown to lead to a higher perception of quality of care regarding information about self-care, the experience of being respected, and knowing the care provider responsible for their care. Thus, it could contribute towards improved patient satisfaction without compromising the perception of quality of care regarding other factors such as receiving the best medical care or timeliness.
This study addresses how patients with intermittent claudication, who underwent revascularisation, perceive a follow-up care that is person-centred and nurse-led compared to standard care delivered by surgeons. The results indicate that patients find the person-centred and nurse-led follow-up programme satisfactory, with equal or higher quality of care and that follow-up can be delivered by nurses with retained patient safety. Thus, vascular units may consider transitioning follow-up care from surgeons to nurses while maintaining positive patient's perception of quality of care, patient satisfaction and safety.
Reporting of the work was made using the Consolidated Standards of Reporting Trials (CONSORT) statement.
No patient or public contribution.
Study Details | Person-centred Follow-up and Health Promotion Programme After Revascularization for Intermittent Claudication | ClinicalTrials.gov: NCT03283358
To evaluate the impact of a multilevel intervention in a surgical department on the segregation of non-hazardous healthcare waste (plastic and paper) during the perioperative period as well as its effect on the carbon footprint of the healthcare organisation.
A prospective before–after interventional study without a control group was carried out in the operating room of the Universitary Hospital Mútua Terrassa in Catalonia (Spain). A multilevel programme to improve the segregation process during the surgical interventions was implemented in several phases from May 2023 to December 2024. Data collection was conducted in each phase of the study through questionnaires addressed to the professionals along with calculations of the carbon footprint and the volume of waste segregation. The study is framed within the socio-ecological model and employs a collaborative design. The study population included all professionals working in the operating room (n = 320).
A multidisciplinary team was formed with consideration for all stakeholders. The project phases were implemented consecutively. A total of 141 professionals (44.4%) completed the baseline questionnaire. As a result of the project's development, the carbon footprint has been reduced to 79.1 kg CO2 eq/week, representing an 85% reduction in emissions.
The implementation of the recycling project has led to significant reductions in the amount of waste generated and it has been positively evaluated by the professionals.
The benefits of fostering a behavioural change among the professionals, coupled with the implementation of a well-designed segregation and recycling system, lead to significant benefits for the institution in carbon footprint.
Nurses can lead this type of project with a clear impact on both the institution and the environment.
Reduction of the carbon footprint in the operating room increased satisfaction among professionals for contributing to environmental improvement.
The reporting of intervention evaluation studies using nonrandomized designs: the TREND statement Des Jarlais et al. (2004) was used to evaluate the quality of the study.
N/A. Only professionals are involved in this study.
Despite a variety of literature reviews, there is limited understanding of the learning strategies healthcare professionals use to help patients adopt and maintain effective foot care practices.
To explore learning processes and educational strategies for persons with diabetes focusing on foot care and examine how different learning processes influence these strategies.
The scoping review followed the methodological framework established by Arksey and O'Malley and refined by Levac et al. Additionally, the PRISMA-ScR checklist was followed. A literature search was conducted in the PubMed, CINAHL, MEDLINE and Academic Search Premier databases, using specific search terms related to diabetic foot care and learning strategies. The selection process involved screening 906 articles based on inclusion criteria such as relevance to diabetic foot care, learning processes, and educational strategies, and excluded studies that were not written in English. The data were charted and quantitative and qualitative data were synthesised and thematically analysed to identify key learning strategies.
The analysis identified two main themes: learning insights for comprehensive understanding and self-efficacy, and increased practical knowledge leads to improved footcare. Subthemes included integrative and reflective learning, motivational and collaborative learning, task-oriented and procedural learning, and feedback and reinforcement-based learning.
Effective diabetic foot care education should be multifaceted, incorporating deep learning, practical skills, and motivational elements. Early learning plays a central role in this process. Tailoring educational interventions to personal learning styles and providing continuous support can significantly improve patients' foot care outcomes. A framework for understanding the progressive stages of patient learning and self-management is presented as a starting point. Future research should focus on developing and evaluating educational models that address diverse learning needs, ultimately contributing to better management and prevention of diabetic foot complications.
(1) To codesign a health literacy intervention within a specialist healthcare setting to help the parents of children with epilepsy access, comprehend, use and communicate information and (2) to assess the intervention's feasibility by exploring stakeholders' perspectives on its usefulness, ease of use of trial methods and contextual factors impacting its execution.
A codesign participatory approach followed by a feasibility approach inspired by the OPtimising HEalth LIteracy and Access to Health Services (Ophelia) process for health literacy intervention development.
(1) The codesign approach included workshops with (a) multidisciplinary personnel (n = 9) and (b) parents (n = 12), along with (c) an interview with one regional epilepsy specialist nurse (n = 1). The participants discussed parents' health literacy needs on the basis of vignettes and brainstormed service improvements. A three-step intervention was subsequently designed. (2) The intervention's feasibility was assessed via interviews with six parents (n = 6), a focus group interview with study nurses, a short doctors survey and a log of time spent testing the intervention.
(1) The parents of first-time admitted children to a specialist epilepsy hospital were targeted for the intervention. Nurse–parent consultations were central to the intervention, activating parents in codeveloping and executing a tailored education plan. (2) Feasibility: parents (n = 6) experienced consultations and education plans that were beneficial for enhancing their self-efficacy in managing the child's condition. The study nurses (n = 3) acknowledged positive outcomes in streamlining patient education but felt that their training on the intervention methods was insufficient. Both parents and nurses identified limited personnel resources as a significant barrier to executing the intervention.
The codesigned intervention engaged nurses and parents in HL development despite system barriers. The parents experience enhanced self-efficacy in managing their child's condition. However, needs refinements and further feasibility tests are needed before future implementation.
The Consort Statement 2010 extension for reporting non-randomised pilot and feasibility studies was used to ensure the methodological quality of the study. A Consort Statement 2010 checklist is provided as an additional file.
The collaboration of parents within the target group, the providers involved and the project's steering committee was crucial in codesigning and evaluating this three-step intervention. Parents and multidisciplinary providers actively contributed through workshops, interviews and in discussion meetings. The study nurses testing the intervention played a key role in defining the documentation process for the codeveloped education plan.
This three-step health literacy intervention can positively impact parents' self-efficacy in managing their child's condition. Enhancing nurses' communication skills is essential for improving parents' health literacy, making it crucial to allocate resources for such training. The intervention content and strategies to meet parents' health literacy needs require refinement, with more provider involvement to better adapt it to the context. Future studies should focus on further feasibility testing by considering a more flexible time frame.
Open Science Framework: https://osf.io/fg9c7/
To explore the meaning of adaptation after visceral transplantation in terms of patient experiences, symptoms, self-efficacy, transplant-specific and mental well-being.
A convergent parallel mixed-methods study, consisting of interviews and generic as well as transplant-specific questionnaires. Results were integrated using meta-inference.
The study comprises a population of 17 visceral transplant recipients in Scandinavia, 12 women and 5 men with a mean age of 40.6 years (range 19–63 years) and an average follow-up of 9.4 years (range 0–25 years). Data were collected between May 2023 and January 2024 through open-ended in-depth interviews with 12 participants and analysed in accordance with phenomenological hermeneutics. Questionnaires from all 17 participants were analysed to measure transplant-specific well-being, symptoms, self-efficacy as well as anxiety and depressive symptoms.
Being a visceral transplant recipient is a dynamic and life-long adaptation process that comprises two distinct yet interconnected trajectories: coherence and endurance. Coherence involves the person's ability to make sense of their situation and find meaning despite the challenges and adversity of the chronic condition. In contrast, endurance involves a person's capacity to withstand hardship and endure unpleasant or difficult experiences. Both trajectories interact dynamically, influencing and reinforcing each other. Resilience based on coherence enabled acceptance and adjustment. Conversely, uncertainty, resignation and feeling unsupported resulted in a lack of acceptance, manifested as resistance. The challenge involved in adaptation was demonstrated by 47% showing borderline elevated or elevated levels of anxiety and 18% reporting symptoms of depression. Self-efficacy varied considerably.
The meaning of adaptation after visceral transplantation in terms of experiences, symptoms, transplant-specific and mental well-being is balancing between coherence and endurance facilitated by acceptance and hampered by resistance. The uncertainty inherent in being a visceral transplant recipient may lead to heightened self-rated anxiety symptoms and diminished self-efficacy.
What problem did the study adress?
This study adresses the challenges involved in being a visceral transplant recipient and adapting to life after a visceral transplantation.
What were the main findings?
COREQ checklist (consolidated criteria for reporting qualitative research).
No Patient or Public Contribution was organised.
To cross-culturally adapt a framework for person-centred leadership in residential care for older people in Sweden.
This study has an exploratory and descriptive design.
The translation procedure followed a cyclic process of translation into Swedish and back-translation into English by two independent bilingual linguists. An evaluation of conceptual and semantic equivalence and comprehensiveness between the original English version and the translated Swedish version was performed by an expert committee. The translated version of the framework was validated by leaders (n = 34) in residential care, who assessed its relevance through a web form. The adaptation of the framework followed recommended guidelines for cross-cultural adaptation.
The translation procedure resulted in two minor changes related to the wording in two descriptors. The results of the validation procedure showed that the framework is relevant for leaders in Swedish residential care for older people.
The cross-culturally adapted framework is useful and suitable for leaders in Swedish residential care for older people. The framework clarifies the leader's role and identifies leadership attributes and requirements for person-centred leadership in residential care, thereby providing support to leaders by framing person-centred leadership.
The framework can be used as a guide for leadership training and/or development initiatives in residential care. It can be further extended to nursing curriculums, leadership development programs, and organisational performance and development processes. It may also provide a foundation for policy and guidelines by establishing the activities required for leaders to promote person-centredness in the care of older people.
This study followed the STROBE checklist for cross-sectional studies.
There was no patient or public contribution.
To describe nurses' perceptions of sexual healthcare for people with physical and/or intellectual disabilities.
Nurses are responsible for meeting the fundamental needs of people with physical and/or intellectual disabilities, yet there are still issues when it comes to their sexuality. Sexual assistants can help people with physical and/or intellectual disabilities to meet their sexual needs, but little is known about these invisible, unregulated care providers.
Qualitative descriptive study.
The study was conducted in a region of southern Spain. Convenience sampling was used to recruit 22 nurses aged 23–41 years, who had provided care to people with physical and/or intellectual disabilities. The participants' experiences were explored through semi-structured interviews conducted between November 2022 and May 2023.
Three main themes were extracted from the data analysis: (1) the need to increase the visibility of people with physical and/or intellectual disabilities sexuality, (2) sexual assistance: a conspiracy of silence and (3) defining the role of sexual assistants.
According to the nurses, sexual assistants are still unregulated care providers who carry out their work in anonymity. Sexual assistants support people with physical and/or intellectual disabilities in the whole spectrum of their sexuality; in addition to sexual pleasure, they provide opportunities for bonding, affection, physical contact, stimulation or caressing. Nurses are committed to normalising the role of sexual assistants and regulating their services within a sound legal framework. Health professionals need to include specific training on sexual assistance in their training programmes.
Understanding how nurses perceive the sexual needs of people with physical and/or intellectual disabilities, as well as the role of sexual assistants, who could improve this group of people's quality of life by providing them care in different healthcare settings.
No Patient or Public Contribution.
To understand, from a nursing perspective, factors affecting the use of prophylactic dressings to prevent pressure injuries in acute hospitalised adults.
Pressure injury causes harm to patients and incurs significant costs to health services. Significant emphasis is placed on their prevention. Relatively recently, prophylactic dressings have been promoted to reduce pressure injury development. However, in the acute care setting, information about the clinical use of these dressing is lacking.
Qualitative, descriptive.
Nineteen medical and surgical nurses participated. Semi-structured interviews were conducted and transcribed verbatim. Thematic analysis was performed using an inductive approach using NVivo software.
Three themes were identified, reflecting factors that influenced and perpetuated indiscriminate use of prophylactic dressings: False sense of security; Convenience and task prioritisation; and Navigating challenges in evidence-based pressure injury prevention.
The findings indicate inconsistent prevention practices, with prophylactic dressings often applied without justification or referral to research-based evidence to guide clinical decision-making. There was a prevailing attitude of ‘job done’ when a prophylactic dressing was applied.
This study has identified several factors that perpetuate the inappropriate use of prophylactic dressings for pressure injury prevention that may be amenable to organisational change. The findings indicate that nurses often rely on these dressings as a shortcut due to time constraints, which led to missed skin assessments and low-value care. The research can be used to inform the development of clear guidelines on dressings within hospital settings which encourage assessment-based selection for their use, and process-based guidance for their application, skin surveillance, dressing inspection and removal.
The Consolidated Criteria for Reporting Qualitative Research (COREQ) reporting guideline was followed.
Neither patients nor the public were directly involved in this study.
The study aimed to examine factors associated with the perceived feeling of safety and postoperative recovery in patients who have undergone orthopaedic day surgery under regional anaesthesia.
The design was quantitative, descriptive, and cross-sectional. The study participants comprised a consecutive sample (n = 209) of patients who underwent orthopaedic day surgery under regional anaesthesia.
A questionnaire was sent to the home addresses of the study population approximately 3 weeks postoperatively. The questionnaire included the Feeling Safe During Surgery Scale (FSS), the Swedish version of the post-discharge surgical recovery scale (S-PSR), and questions concerning background variables. Multivariate regression models were used to examine the association of different variables with both feeling safe and postoperative recovery.
The only factor associated with the feeling of safety was preoperative anxiety; higher levels of preoperative anxiety were associated with lower levels of perceived safety during surgery. The factors associated with postoperative recovery were the recovery process itself and the patient's feeling of safety. Higher levels of postoperative anxiety were associated with a lower level of postoperative recovery. Higher levels of perceived safety during surgery were associated with higher postoperative recovery.
The perceived feeling of safety in the perioperative period could not be explained by factors such as age, gender, or level of education. Based on the results of this study, postoperative recovery was associated with the perceived feeling of safety in the perioperative period. Anxiety in the perioperative period was associated with patients' perceived feeling of safety and their postoperative recovery. Thus, this study's results emphasise the importance of ensuring that people undergoing surgery feel safe to promote their recovery. Based on previous research, the nurse–patient relationship seems to be an important part of making patients feel safe, which ultimately affects their recovery.
This study examines the association between perceived feeling of safety in the perioperative period and patients' postoperative recovery after undergoing orthopaedic day surgery under regional anaesthesia. Previous research has shown that the nurse–patient relationship and patients' possibilities to participate in their care are important for them to feel safe. This study further emphasises the importance of fostering relationships in the perioperative period and making patients an active part in decision-making, as it may positively impact their recovery. Creating a feeling of safety for the patient should be prioritised, as it benefits their perioperative experience and postoperative recovery.
This research is reported in accordance with the STROBE guidelines.
No patient or public contribution.
To examine parents' perceptions of care quality at child health centres. Specific objectives were to examine parents' perceptions of the care received and the subjective importance of such care. Furthermore, to examine the relationship between parents' sociodemographic characteristics and the perceptions of care quality.
A cross-sectional study.
A random sample of parents of children born in Sweden in 2021 participated. Data were collected by the QPP-CHC questionnaire and analysed using descriptive and analytical statistics.
The response rate was 19.4%. The targeted sample size of 210 participants was reached as 584 parents responded to the questionnaire. Parents' overall ratings of care quality at child health centres indicated optimal quality with mean values >3. However, various potential improvements areas were identified as needing additional information. These included dental care (m = 2.82), allergy prevention (m = 2.25), breastfeeding (m = 2.97), sleep (m = 2.83), the child's behaviour (m = 2.47) and the child's crying (m = 2.47). Also, parents rated suboptimal quality regarding that the care was based on healthcare routines rather than parental preferences and needs (m = 2.86). Parents born outside of the Nordic countries rated higher care quality than those born in the Nordic countries, as well as parents with a non-academic education.
Parents want information based on their preferences and needs. Parent's perceptions of areas for improvement are new and important knowledge for registered nurses at child health centres.
The findings indicate that parents feel that insufficient attention is given to areas of care that they perceive as important. Parents' perspectives on the care quality at child health centres is an important component of quality work and might lead to improvements in the care quality at child health centres.
The Strengthening the Reporting of Observational Studies (STROBE) checklist for cross-sectional studies was used to guide reporting.
The findings of this study suggests that parents feel that insufficient attention is given to areas of care that they perceive as important. Parents' perspectives on the care quality at child health centres provides important knowledge which can guide further development of care quality at child health centres. The findings indicate that a family-centred approach that integrates relational and routine-oriented nursing can be a way to ensure that the care is based on parents' preferences and needs.
No patient or public contribution.
To explore how chronic illness transforms the self when living with and managing chronic illness and what this means for their self and identity. We also discuss how people with chronic conditions could be supported by healthcare professionals to manage illness in daily life.
Self-management recommendations from health care are commonly based on a biomedical understanding of the disease. People's experiences of how a condition affects them and adequate support are crucial for their outcomes in daily self-management.
A narrative review.
A systematic search was undertaken during January 2021 across the databases MEDLINE, CINAHL, PsycINFO, Soc INDEX and Philosopher's Index. A quality appraisal of articles was performed. Our analysis was inspired by qualitative content analysis. The PRISMA Checklist 2020/EQUATOR guidelines was used to report the study.
Twenty-eight peer-reviewed qualitative empirical articles focusing on self in a variety of chronic illnesses with relevance to nursing published from January 2010 to December 2020 were included. The main theme, Developing from an uncertain existence to meaning and wholeness, was built up by the five themes: Walking on an unstable ground; Being stalemated; Being involved with others for better or worse; Searching for meaning; and lastly, Modifying self and integrating a new way of living.
The results illuminate experiences that seldom are prioritized but need to be addressed by health professionals. Such experiences are oriented more towards the existential self rather than medical issues, why it is important to go beyond the medical lens.
This is important knowledge for nurses aiming to support people with chronic illnesses. Nurses supporting people in self-management need to be aware that by teaching and encouraging people to revise their daily habits, they also work on the boundaries of their self-concept.
No patient or public contribution.
To identify and examine the explanatory variables associated with clinical competence among registered nurses (RNs) and practical nurses (PNs) working in long-term care facilities (LTCF) for older adults.
This was a cross-sectional study. The competence test, ‘the Ms. Olsen test’, was used for data collection. A convenience sample of 337 nursing staff working in LTCFs for older adults was selected between December 2020 and January 2021. A quantitative, non-experimental approach with multiple linear regression analysis examined the explanatory variables associated with clinical competence and the outcome variables.
The main findings of the linear regression analysis show that the nursing staff's increasing age, use of Swedish as a working language and use of the Finnish nursing practice standards had statistically significant relationships with clinical competence among the participating nursing staff.
This is the first knowledge test that has been developed to test nursing staff's clinical competence in elderly care. In this study in Finland, the highest clinical competence was among the nursing staff who were Swedish-speaking RNs working in institutional care homes caring for patients according to national practice standards.
These results may be useful to nursing staff and managers working in elderly care to understand the explanatory variables associated with clinical competence in elderly care in Finland and in bilingual settings. The study highlights the importance of using national nursing standards in elderly nursing care. Knowing the explanatory variables associated with clinical competence can provide guidance for the further education of nursing staff in these settings.
Caring according to national practice standards and caring for severely ill patients are associated with clinical competence.
The authors adhered to the EQUATOR network guidelines Appendix S1 STROBE to report observational cross-sectional studies.
Registered and PNs completed a questionnaire for the data collection.
To explore and describe older persons' unique experiences of care encounters with home care nurses in a real-life context.
The increasing number of older persons in society contributes to increases in age-related impairments compromising their quality of life. Future care consists of “hospitals at home” where care encounters occur in a person's private domain, partly becoming a clinical workplace. Scant research has focused on how older persons experience care encounters with home care nurses and needs to be highlighted.
Multiple-case study.
The cases relied on replication logic and five purposive sampled older persons were interviewed. Data were analysed using qualitative content analysis and differences within and between cases were explored and findings across the cases were replicated.
The cross-analysis emerged in three categories: “Nursing routine rules the care encounters”, “Lack of knowledge and information” and “Dependency on support from others”.
Our research has found that older persons face challenges while receiving home care, including limited engagement in their care and the need for enhanced support. Implementing person-centred care in homes poses ethical challenges that require careful consideration. Home care nurses should prioritise understanding each patient individually, recognising them beyond their patient role, which necessitates more thorough and time-sensitive care encounters.
Findings were reported using COREQ guidelines.
Patients were interviewed and contributed with data for this study.
This study emphasises the need to prioritise individualised care in home settings and listen to the voices of older individuals to enhance quality.
To determine the prevalence and clustering of NANDA-International nursing diagnoses in patients assisted by pre-hospital emergency teams.
Retrospective descriptive study of electronic record review.
Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two-step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020.
Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six-cluster solution (n = 26.788) was found. Five clusters had a single high-prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co-occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051).
Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre-hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases.
Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre-hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre-hospital clinical setting.
What problem did the study address? There are different models of pre-hospital emergency care services. The use of standardized nursing languages in the pre-hospital setting is not homogeneous. Studies on NANDA-I nursing diagnoses in the pre-hospital context are scarce, and those available are conducted on small samples.
What were the main findings? This paper reports the study with the largest sample among the few published on NANDA-I nursing diagnoses in the pre-hospital care setting. Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients' safety/protection and coping/stress tolerance. Patients attended by pre-hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers.
Where and on whom will the research have an impact?
Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre-hospital setting, increasing the evidence of individualized and standardized care plans for pre-hospital care.
STROBE checklist has been used as a reporting method.
Only patients' records were reviewed without further involvement.
To explore how the Cognitive Continuum Theory has been used in qualitative nursing research and to what extent it has been integrated in the research process using the Qualitative Network for Theory Use and Methodology (QUANTUM).
Theory, research and nursing are intrinsically linked, as are decision-making and nursing practice. With increasing pressure on nurses to improve patient outcomes, systematic knowledge regarding decision-making is critical and urgent.
A meta-aggregative systematic review.
CINAHL, Medline, PsycINFO, Embase and PubMed were searched from inception until May 2022 for peer-reviewed research published in English.
Seven studies were included and assessed for methodological quality using the Joanna Briggs Institute checklist for qualitative research. A meta-aggregative synthesis was conducted using Joanna Briggs methodology. The QUANTUM typology was used to evaluate the visibility of the Cognitive Continuum Theory in the research process.
The review identified five synthesised findings, namely: 1. the decision-making capacity of the individual nurse, 2. nurses’ level of experience, 3. availability of decision support tools, 4. the availability of resources and 5. access to senior staff and peers. Only two of seven studies rigorously applied the theory. The included studies were mainly descriptive-exploratory in nature.
The transferability of the Cognitive Continuum Theory was demonstrated; however, evolution or critique was absent. A gap in the provision of a patient-centric approach to decision-making was identified. Education, support and research is needed to assist decision-making.
A new Person-Centred Nursing Model of the Cognitive Continuum Theory has been proposed to guide future research in clinical decision-making.
Nurses make numerous decisions every day that directly impact patient care, therefore development and testing of new theories, modification and revision of older theories to reflect advances in knowledge and technology in contemporary health care are essential.
To explore emotional, mental health and physical symptoms up to 3 months after discharge for adults hospitalized with COVID-19.
10%–30% of adults with COVID-19 experience physical and psychological symptoms 3 months or more following infection. Knowing symptoms can help direct early intervention.
A longitudinal descriptive design to study COVID-related symptoms 2 weeks, 6 weeks and 3 months after hospitalization.
Sixty-six patients were recruited from a hospital system in Midwestern US (October 2020–May 2021). Participants self-reported demographics, hospital and post discharge symptoms, PROMIS measures (depression, anxiety, fatigue, cognitive function, satisfaction social roles, sleep disturbance) and Impact of Event Scale-Revised (IES-R). Hospital length of stay, comorbidities, lowest oxygen saturation, respiratory support and resources used were collected. Descriptive and nonparametric statistics described the sample and identified correlations between variables. The STROBE checklist was used.
Data from 1 (T1) and 3 months (T2) post discharge were analysed (N = 52). A majority were female, white and married; 96% experienced ≥1 COVID-related symptoms at T1; 85% at T2. Fatigue was most prevalent, followed by shortness of breath, muscle weakness and foggy thinking. More physical symptoms during hospitalization correlated positively with number of symptoms at T1 and T2; a majority stated these impacted their normal routine ‘somewhat’ or ‘a lot’. T1 depression highly correlated with all T2 PROMIS and IES-R scores and number of physical symptoms. More symptoms at T1 were associated with worse fatigue, lower cognitive function and lower satisfaction with social roles at T2.
This study adds to the growing knowledge of mental, physical and emotional symptoms and relationships between these early after hospitalization with COVID-19.
Findings can help identify holistic nursing interventions to improve health and mitigate symptoms for people with long COVID.
Patients contributed via study participation.
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