Current Issue : April - June Volume : 2016 Issue Number : 2 Articles : 7 Articles
Background: In order to manage the acute and long-term effects of living with a chronic disease such as diabetes,\nboth medical treatment and good psychosocial support are needed. In this study, we wish to examine whether a\npsychological group intervention targeting people with poorly controlled type 1 diabetes can be helpful in augmenting\nquality of life while also lowering participantsââ?¬â?¢ HbA1c level. The group intervention will consist of a brief treatment\ndeveloped from a branch of cognitive behavioural therapy called acceptance and commitment therapy, which is part\nof the so-called third wave of cognitive behavioural therapy. Common for these third-wave therapies, the focus is less\non the content and restructuring of thoughts and more on the function of behaviour. Here, we describe the protocol\nand plans for study enrolment.\nMethods/Design: This on-going study is designed as a randomised wait-list controlled trial. Eighty patients aged 26ââ?¬â??55\nyears and with an HbA1c level >70 mmol/mol at the time of enrolment will be included.\nDiscussion: In this study, we will assess the effect of starting acceptance and commitment therapy group treatment for\npatients with type 1 diabetes and its effect on glycaemic control and well-being....
Background The Institute of Medicine�s Future of Nursing report identifies the clinical nurse\nleader as an innovative new role for meeting higher health-care quality standards. However,\nspecific clinical nurse leader practices influencing documented quality outcomes remain unclear.\nLack of practice clarity limits the ability to articulate, implement and measure clinical nurse\nleader-specific practice and quality outcomes.\nPurpose and methods Interpretive synthesis design and grounded theory analysis were used to\ndevelop a theoretical understanding of clinical nurse leader practice that can facilitate systematic\nand replicable implementation across health-care settings.\nResults The core phenomenon of clinical nurse leader practice is continuous clinical leadership,\nwhich involves four fundamental activities: facilitating effective ongoing communication;\nstrengthening intra and interprofessional relationships; building and sustaining teams; and\nsupporting staff engagement.\nConclusion Clinical nurse leaders continuously communicate and develop relationships within\nand across professions to promote and sustain information exchange, engagement, teamwork and\neffective care processes at the microsystem level.\nImplication for nursing management Clinical nurse leader-integrated care delivery systems\nhighlight the benefits of nurse-led models of care for transforming healthcare quality. Managers\ncan use this study�s findings to frame an implementation strategy that addresses theoretical\ndomains of clinical nurse leader practice to help ensure practice success....
Background: Mechanical ventilation (MV) is one of the most utilised techniques in the intensive care unit (ICU),\nbut it can cause sequelae that can negatively influence the patient�s health-related quality of life (HRQL). Nursingsensitive\noutcomes (NSOs) can also influence the HRQL. Assessing the HRQL of mechanically ventilated patients\nadmitted to an ICU and its relation to nurse-sensitive outcomes will give healthcare professionals with valuable\ninformation to improve patient care.\nMethods: Prospective longitudinal cohort study in which all patients admitted to the ICU at Hospital Universitari Vall\nd�Hebron who undergo MV for more than 48 h will be included. The study will last 12 consecutive months. HRQL\nwill be assessed by the completion of the SF-36 and the Saint Georges Respiratory Questionnaire. Pre-admission\nHRQL assessment will be performed by the main caregiver, and after ICU discharge, the assessment will be\nperformed by the patient him/herself. The same questionnaires will also be completed one year after ICU discharge.\nOther variables (sociodemographic and those related to reason for ICU admission, ICU length of stay, MV, ICU\nstressors and NSO) will be included in a multiple regression model to assess their relation to the patient�s HRQL.\nDiscussion: This study will show the relationship between the HRQL perceived by patients and their main caregiver,\nwhat the HRQL is one year after discharge from ICU, and what the impact of MV, NSO and ICU stressors and other\nclinical outcomes on the patient�s HRQL is. Determining mechanically ventilated patients� HRQL and its relation to NSO\nand ICU stressors as well as other clinical variables will enable early nursing interventions to try to minimise possible\nsequelae and improve the patient�s welfare....
Aim: The aim of this study was to evaluate the effectiveness of a nursing intervention protocol targeting the knowledge and\npractice of adult patients experiencing low back pain. Design: A quasi-experimental research design. Methods: Pre-post\nassessment of outcome was used in this study. The study was conducted in the outpatient clinic of the physical therapy\ndepartment at Zagazig University Hospital and Beni-Suef University Hospital, Egypt. Sample: 40 participants diagnosed with\nchronic low back pain (lasting for longer than six months). Seven of the 40 dropped out during the follow-up phase for\npersonal or logistical reasons. Tools included sections for demographic characteristics, knowledge and practice assessment; in\naddition to the Oswestry Disability Index, and Visual Analogue Scale (VAS). Results: The application of an instruction\nprotocol intervention for low back pain was effective in improving patient knowledge and practice, with associated\namelioration of the severity of pain and disability among them. The effect was still apparent at the three-month follow-up.\nConclusion: It is recommended that the study be replicated using a more robust randomized clinical trial design. Nonetheless,\nthe instruction protocol with the designed booklet may be adopted as an element of the care services offered to patients\nsuffering LBP, given the clear positive effects on patient knowledge, which would undoubtedly help them decide on the most\npreferential management approach....
Background: Nurses� clinical competence is vital to ensure safe and high quality care, and the continuous\nassessment of nurses� clinical competence is of major concern. A validated instrument for the self-assessment of\nnurses� clinical competence at different educational levels across specialties and countries is lacking. The aim of this\nstudy was to test the reliability and construct validity of the new Professional Nurse Self-Assessment Scale\n(ProffNurse SAS) questionnaire in long term and home care contexts in Norway. The questionnaire is based on the\nNordic Advanced Practice Nursing model, in which the nurse-patient relationship is central.\nMethods: The study has a cross-sectional survey design. A purposive sample of 357 registered nurses who worked\nin long term and home care contexts in two geographical regions encompassing eight municipalities and three\ncounties was included. The respondents completed the 74-item ProffNurse SAS questionnaire and demographic\nbackground data was collected. Data collection was conducted in two phases: first region autumn 2011 and\nsecond region spring 2012.\nExploratory factor analyses (EFA) were used to test the psychometric properties of the questionnaire and included\nthe following steps: assessment of the factorality of the data, factor extraction by Principal Component Analysis\n(PCA), oblimin (oblique) factor rotation, and interpretation. Cronbach�s alpha was used to estimate the internal\nconsistency.\nResults: The PCA revealed a six-component structure, reducing the number of items in the questionnaire from 74\nto 51. Based on the content of the highest-loading items, the six components were named: Direct Clinical Practice,\nProfessional Development, Ethical Decision-Making, Clinical Leadership, Cooperation and Consultation, and Critical\nThinking. The Cronbach�s alpha values ranged from 0.940 (highest; Direct Clinical Practice) to 0.737 (lowest; Critical\nThinking), leading to the estimation that the ProffNurse SAS is reliable.\nConclusions: The six components support the study�s theoretical framework. The ProffNurse SAS showed\nacceptable reliability and construct validity and may therefore be a promising instrument for the assessment of\npracticing nurses� clinical competence. However, we recommend further psychometric testing in other countries\nand contexts and the inclusion of larger samples of nurses at various levels of education, particularly master�s level\nAPNs....
INTRODUCTION AND OBJECTIVE:\nThe correctness of the blood test is closely related to the sample.\nAccording to the recent reported data, 80 percentage\nunsatisfactory results of the clinical test are due to the poor\nquality of sample, especially the blood sample. Clinical practice\nguide (CPG) is directly to instruct the clinical nursing practice.\nAnd the recommendations in the clinical practice guide are\nbased on the best available study evidences. There is lack of CPG\nabout blood sample specimen collection, preservation and\ndelivery (BSCPD) in China. Additionally, related published\nclinical studies are accumulated in a great deal. Therefore,\nestablishing a CPG is necessarily and practicable. The detailed\nobjectives are: 1) to describe and analyze the research status of\nBSCPD in China; 2) to describe and analyze the practice status\nof BSCPD in China; 3) to systematic appraise the available\nevidences of BSCPD; 4) to establish the clinical practice guide of\nBSCPD; 5) to judge the clinical practice guide of BSCPD.\nMETHODS:\nObjective 1): Bibliometric analysis is applied, the database\ninclude China National Knowledge Infrastructure Database\n(CNKI) and Sino-med and the research period is from the year\nof 2003 to 2013; Objective 2): Questionnaire survey for all the\nregistered clinical nurses in a grade three hospital; objective 3):\nSystematic review according to Cochrane collaboration\nhandbook 5.1.0 is applied which includes assessment of risk of\nbias, data extraction, data analysis; Objective 4) and 5): Using\nthe appraising guidelines research and evaluation (AGREE) to\nevaluate of the draft of CPG of BSCPD.\nRESULTS:\nBibliometric analysis started in 2013, and search strategies have\nbeen established. Questionnaire survey setting and depth\ninterviewees have been identified and communicated.\nCONCLUSIONS:\nThe CPG of BSCPD will serve as an important resource in\ninstructing and modifying clinical nursing practice. Given this\nCPG of BSCPD will be a draft version, the applicability and\nsuitability of it will need a further evaluated in the real clinical\nnursing world....
Background: Career planning in nursing is often haphazard, with many studies showing that nurses need personal\nmotivation, education, and the support of workplaces, which are often dominated by political and fiscal agendas.\nNurses often need institutional and personal support to plan their careers and make decisions regarding their\ncareer aspirations.\nMethod: A descriptive qualitative design was used. Data were gathered using semi-structured digitally recorded\ninterviews and analysed for common categories. Twenty seven (n = 27) participants were interviewed.\nResults: There were four categories revealed by the participants who described their career progression\nexperiences: moving up the ladder, changing jobs for career progression, self-driven and the effects of institutional\nenvironments.\nConclusion: Many of the participants� careers had been shaped serendipitously. Similar to other studies, these\nnurses felt political, institutional and financial factors impacted on their career opportunities. There are implications\nfor nursing managers with more support required for nurses to plan their career trajectories. In addition to an\norganisation centred approach to career planning, nurse leaders and managers must take into account the personal\nand professional requirements of their nurses. Nurses themselves also need to take personal responsibility for career\ndevelopment. Greater support for nurses� career planning and personal drive will help organisations to plan their\nfuture workforce needs....
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