Current Issue : October - December Volume : 2016 Issue Number : 4 Articles : 6 Articles
Background.The aim of the study was to evaluate the prevalence and extent of burnout among nurses in Singapore and investigate\nthe influence of demographic factors and personal characteristics on the burnout syndrome. Methods. A cross-sectional survey\ndesign was adopted. All registered nurses working in Singapore General Hospital were approached to participate. A questionnaire\neliciting data on demographics, burnout (measured using theMaslach Burnout Inventory, MBI), and personality profile (measured\nusing the NEO Five-Factor Inventory, NEO-FFI) was used. Results. 1830 nurses out of 3588 responded (response rate: 51%). Results\nfrom 1826 respondents were available for analysis. The MBI identified 39% to have high emotional exhaustion (EE, cut-off score\nof >27), 40% having high depersonalization (DP, cut-off score of >10), and 59% having low personal accomplishment (PA, cut-off\nscore of <33). Inmultivariable analysis, age, job grade, and neuroticism were significantly associated with each of the 3 components\nof theMBI. Staff nurses less than 30 years with high to very high neuroticism were more likely to experience high EE, high DP, and\nlow PA. Conclusion. Younger nurses in Singapore are at increased risk of burnout. Personality traits also played a significant role in\nthe experience of burnout....
Background: Self-care practices in heart failure (HF) contribute to quality of life, symptom stabilization, and extended\nlife expectancy. However, adherence to practices such as liquid and salt restriction or symptom monitoring require\nhigh motivation on a daily basis. The aim was to assess the feasibility, acceptability, and potential effectiveness of a\nnursing intervention with family caregivers, aimed at improving self-care practice of HF patients.\nMethods: This pilot study involved 32 HF patient-caregiver dyads (16/group) randomized to an experimental (EG) or\ncontrol group (CG). The intervention, based on the Self-Determination Theory, was designed to enhance patientsââ?¬â?¢\nautonomy and motivation in self-care practices, by involving their caregiversââ?¬â?¢ support. Five encounters were planned\nwith the EG dyadsââ?¬â?two face-to-face during hospitalization and three by telephone after discharge. The feasibility of\ndelivering the protocol was evaluated as well as the acceptability of the intervention. The potential effectiveness of the\nintervention was assessed based on patient outcomes, including general self-care management and self-care specific\nto HF, perceived competence to manage HF, autonomous motivation (A-motivation, external extrinsic motivation,\ninternal extrinsic motivation, and intrinsic motivation), and perceived support from the caregiver. Caregiver outcomes\nincluded level of support provided to the patient.\nResults: Despite recruitment challenges, the intervention was feasible, with 12 of the 16 dyads receiving all 5\nencounters delivered per protocol. The 4 other dyads received the two hospital encounters, but at least 1 of\nthe 3 post-discharge planned telephone encounters was not feasible because the patients had been re-hospitalized\nor was deceased. Participantââ?¬â?¢s satisfaction with the intervention was high. Outcomes favoring the EG include self-care\nspecific to HF, internal extrinsic motivation, intrinsic motivation, and caregiverââ?¬â?¢s feeling that they provide a higher\nlevel of support.\nConclusions: Caregiver involvement was found to be both a feasible and acceptable means of supporting\nself-care practice in HF patients. This approach presents a potential avenue for enhancing patientsââ?¬â?¢ efforts in\nthis regard. However, this pilot study offers preliminary findings only, which need to be replicated in a phase\n3 clinical trial....
Background. Significant facilitators and barriers to organ donation and transplantation remain in the general public and even in\nhealth professionals. Negative attitudes of HPs have been identified as the most significant barrier to actual ODT. The purpose of\nthis paper was hence to investigate to what extent HPs (physicians and nurses) experience such facilitators and barriers in ODT\nand to what extent they are intercorrelated. We thus combined single causes to circumscribed factors of respective barriers and\nfacilitators and analyzed them for differences regarding profession, gender, spiritual/religious self-categorization, and self-estimated\nknowledge of ODT and their mutual interaction. Methods. By the use of questionnaires we investigated intricate facilitators and\nbarriers to organ donation experienced byHPs (n = 175; 73% nurses, 27%physicians) in around tenwards at theUniversityHospital\nof Munich. Results. Our study confirms a general high agreement with the importance of ODT. Nevertheless, we identified both\nfacilitators and barriers in the following fields: (1) knowledge of ODT and willingness to donate own organs, (2) ethical delicacies\nin ODT, (3) stressors to handle ODT in the hospital, and (4) individual beliefs and self-estimated religion/spirituality. Conclusion.\nAttention to the intricacy of stressors and barriers in HPs continues to be a high priority focus for the availability of donor organs....
Background: The introduction of care pathway plans for end-of-life cares such as the Liverpool\nCare Pathway (LCP) reveals a unique possibility for inter professional collaboration. Knowledge of\nsymptom relief and how to meet the patients� needs at the last stage of the palliative phase are essential\nfor the nurses� approach and care actions, but the documentation of such implementations\nis still rare and sometimes criticized. Aim: To explore and describe nurses� experiences of using\nthe LCP plan with patients hospitalized with heart failure at the end-of-life stage. An explorative\ndesign was applied, using qualitative content analysis of 20 interviews with nurses practicing the\nLCP plan in two district hospitals in Norway. Results: The nurses found the LCP plan as quality assurance\nfor treatment and care in patients with heart failure in the last hours and days of life. The\nuse of the LCP plan implied: 1) individualized adjustment, 2) symptom relief and 3) a holistic approach.\nConclusion: Nurses experienced that using the LCP plan as a comprehensive action plan\ncontributed in the decision making process and improved inter professional communication. Using\nthe LCP plan should be seen as a tool to practice individualized and holistic nursing to patients\nat the end-of-life and their families, as well as a purposeful relief of symptoms associated with\nheart failure....
The study identified priorities of the Patient Assessment Data (PAD) using the Japanese Psychiatric\nNursing Assessment Classification System (PsyNACSÃ?©) derived from 644 psychiatric nursesââ?¬â?¢\nresponses who were practicing in specific units: Acute Care Units (ACU), General Care Units (GCU),\nLong-term Care Units (LCU), physically Complicated Disease Care Units (CDCU), and Dementia Care\nUnits (DCU). Secondary analysis of the PsyNACSÃ?© on-line survey data using four levels of ââ?¬Å?importanceââ?¬Â\nwas used to determine the priorities: 1) unnecessary; 2) quite important; 3) important and\n4) very important. The Mean Factor Points (MFP) and the Welchââ?¬â?¢s ANOVA were calculated. Psy-\nNACSÃ?© score of 3 or higher indicates the PAD as priority. The results showed that in the ACU PAD1,\nââ?¬Å?Psychological symptomââ?¬Â, ââ?¬Å?Stress copingââ?¬Â, and ââ?¬Å?Mood disorder and aggressionââ?¬Â, and PAD2 ââ?¬Å?Information\nof adherenceââ?¬Â, and ââ?¬Å?Information of the psychiatry rehabilitationââ?¬Â, and PAD7 ââ?¬Å?Situation of\nthe family and social lifeââ?¬Â, ââ?¬Å?Relationship to the health care providersââ?¬Â, and ââ?¬Å?Relationships with\nothersââ?¬Â are high priority (high importance). Other PADs showed results below PsyNACSÃ?© score of\n3. The GCU had PAD 3 ââ?¬Å?Balance of waterââ?¬Â, the LCU had PAD 4 ââ?¬Å?Intention/Point of viewââ?¬Â, and\nââ?¬Å?Thoughts of the patientââ?¬Â and PAD 7 ââ?¬Å?Disease and familyââ?¬Â. The CDCU showed PAD 2 ââ?¬Å?Blood testââ?¬Â,\nPAD 3 ââ?¬Å?Excretion situationââ?¬Â, and PAD 5 ââ?¬Å?General health conditionââ?¬Â, ââ?¬Å?Respiratory and chest symp-tomââ?¬Â, and ââ?¬Å?Vital signsââ?¬Â, and the DCU had PAD 1 ââ?¬Å?Cognition functionââ?¬Â, and ââ?¬Å?Delirium and derangement\ncapacity to register failureââ?¬Â, PAD 3 ââ?¬Å?Function of eatingââ?¬Â, PAD 6 ââ?¬Å?Egestion and cleanlinessââ?¬Â and\nPAD 8 ââ?¬Å?Activity and sleepingââ?¬Â, and ââ?¬Å?Mobility capabilityââ?¬Â. These classifications indicated levels of\nimportance in the CAD comprising the PAD below the score of ââ?¬Å?2ââ?¬Â. Japanese psychiatric hospitals\nspecify assessments according to functional areas. By prioritizing the CAD for each PAD, more effective\nand efficient assessments can be performed according to practice unit....
Background: Diabetic kidney disease, a global health issue, remains associated with high morbidity and mortality.\nPrevious research has shown that multidisciplinary management of chronic disease can improve patient outcomes.\nThe effect of multidisciplinary self-care management on quality of life and renal function of patients with diabetic\nkidney disease has not yet been well established.\nMethod/Design: The aim of this study is to evaluate the impact of a multidisciplinary self-care management program\non quality of life, self-care behavior, adherence to anti-hypertensive treatment, glycemic control, and renal function of\nadults with diabetic kidney disease. A uniform balanced cross-over design is used, with the objective to recruit 40 adult\nparticipants with diabetic kidney disease, from public and private out-patient settings in French speaking Switzerland.\nParticipants are randomized in equal number into four study arms. Each participant receives usual care alternating with\nthe multidisciplinary self- care management program. Each treatment period lasts three months and is repeated twice at\ndifferent time intervals over 12 months depending on the cross-over arm. The multidisciplinary self-care management\nprogram is led by an advanced practice nurse and adds nursing and dietary consultations and follow-ups, to the habitual\nmanagement provided by the general practitioner, the nephrologist and the diabetologist. Data is collected\nevery three months for 12 months. Quality of life is measured using the Audit of Diabetes-Dependent Quality of\nLife scale, patient self-care behavior is assessed using the Revised Summary of Diabetes Self-Care Activities, and\nadherence to anti-hypertensive therapy is evaluated using the Medication Events Monitoring System. Blood\nglucose control is measured by the glycated hemoglobin levels and renal function by serum creatinine, estimated\nglomerular filtration rate and urinary albumin/creatinine ratio. Data will be analyzed using STATA version 14.Discussion: The cross-over design will elucidate the responses of individual participant to each treatment, and will\nallow us to better evaluate the use of such a design in clinical settings and behavioral studies. This study also explores\nthe impact of a theory-based nursing practice and its implementation into a multidisciplinary context....
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