Current Issue : October - December Volume : 2016 Issue Number : 4 Articles : 6 Articles
Background: Professional midwives have an important role to play in midwifery training to\nproduce a competent midwife. According to the social learning theory, professional midwives\nact as role models for students. When allocated for clinical learning experiences in the training\nhospitals, students will have the opportunity to observe the well-trained, skilled, and\nexperienced professional midwives. The whole process will enable students to integrate theory\nwith practice and they will become competent.\nAim: The aim of this study was to determine the factors affecting integration of midwifery\nnursing science theory with clinical practice as perceived by midwives.\nSetting: The study was conducted at the training hospitals in Vhembe district of the Limpopo\nProvince, South Africa. These hospitals were: Donald Fraser, Siloam, and Tshidzini.\nMethods: A qualitative explorative, descriptive and contextual design was used. A Nonprobability,\nconvenient sampling method was used to select 11 midwives from the following\nhospitals: Donald Fraser, Siloam, and Tshidzini, in Vhembe district. In-depth individual\ninterviews were conducted. Data were analysed through open coding method.\nResult: One theme and five sub-themes emerged from the analysed data, namely: shortage of\nmidwives, attitudes towards student midwives, reluctance to perform teaching functions,\nlanguage barriers, and declining midwifery practice standards.\nConclusion: Shortage of midwives in the clinical areas led to fewer numbers of mentors whom\nthe students could observe and imitate to acquire clinical skills. Some of the midwives were\nreluctant to teach students. Recommendations were made for both training institutions and\nhospitals to employ preceptors for students in the clinical practical....
Background: In adults with intellectual disability (ID) and epilepsy there are suggestions that improvements in\nmanagement may follow introduction of epilepsy nurse-led care. However, this has not been tested in a definitive\nclinical trial and results cannot be generalised from general population studies as epilepsy tends to be more severe\nand to involve additional clinical comorbidities in adults with ID. This trial investigates whether nurses with\nexpertise in epilepsy and ID, working proactively to a clinically defined role, can improve clinical and quality of life\noutcomes in the management of epilepsy within this population, compared to treatment as usual. The trial also\naims to establish whether any perceived benefits represent good value for money.\nMethods/design: The EpAID clinical trial is a two-arm cluster randomised controlled trial of nurse-led epilepsy\nmanagement versus treatment as usual. This trial aims to obtain follow-up data from 320 participants with ID and\ndrug-resistant epilepsy. Participants are randomly assigned either to a ââ?¬Ë?treatment as usualââ?¬â?¢ control or a ââ?¬Ë?defined\nepilepsy nurse roleââ?¬â?¢ active arm, according to the cluster site at which they are treated. The active intervention\nutilises the recently developed Learning Disability Epilepsy Specialist Nurse Competency Framework for adults with\nID. Participants undergo 4 weeks of baseline data collection, followed by a minimum of 20 weeks intervention\n(novel treatment or treatment as usual), followed by 4 weeks of follow-up data collection. The primary outcome is\nseizure severity, including associated injuries and the level of distress manifest by the patient in the preceding\n4 weeks. Secondary outcomes include cost-utility analysis, carer strain, seizure frequency and side effects.\nDescriptive measures include demographic and clinical descriptors of participants and clinical services in which they\nreceive their epilepsy management. Qualitative study of clinical interactions and semi-structured interviews with\nclinicians and participantsââ?¬â?¢ carers are also undertaken Discussion: The EpAID clinical trial is the first cluster randomised controlled trial to test possible benefits of a\nnurse-led intervention in adults with epilepsy and ID. This research will have important implications for ID and\nepilepsy services. The challenges of undertaking such a trial in this population, and the approaches to meeting\nthese are discussed....
Background: The acquisition of quality clinical experience within a supportive and pedagogically adjusted clinical\nlearning environment is a significant concern for educational institutions. The quality of clinical learning usually\nreflects the quality of the curriculum structure. The assessment of the clinical settings as learning environment is a\nsignificant concern within the contemporary nursing education. The nursing students� satisfaction is considered as\nan important factor of such assessment, contributing to any potential reforms in order to optimize the learning\nactivities and achievements within clinical settings.\nThe aim of the study was to investigate nursing students� satisfaction of the clinical settings as learning\nenvironments.\nMethod: A quantitative descriptive, correlational design was used. A sample of 463 undergraduate nursing students\nfrom the three universities in Cyprus were participated. Data were collected using the Clinical Learning\nEnvironment, Supervision and Nurse Teacher (CLES + T).\nResults: Nursing students were highly satisfied with the clinical learning environment and their satisfaction has\nbeen positively related to all clinical learning environment constructs namely the pedagogical atmosphere, the\nWard Manager�s leadership style, the premises of Nursing in the ward, the supervisory relationship (mentor) and\nthe role of the Nurse Teacher (p < 0.001). Students who had a named mentor reported more satisfied with the\nsupervisory relationship. The frequency of meetings among the students and the mentors increased the students�\nsatisfaction with the clinical learning environment. It was also revealed that 1st year students were found to be\nmore satisfied than the students in other years.\nConclusion: The supervisory relationship was evaluated by the students as the most influential factor in\ntheir satisfaction with the clinical learning environment. Student�s acceptance within the nursing team and a\nwell-documented individual nursing care is also related with students� satisfaction. The pedagogical atmosphere\nis considered pivotal, with reference to students� learning activities and competent development within the\nclinical setting. Therefore, satisfaction could be used as an important contributing factor towards the development\nof clinical learning environments in order to satisfy the needs and expectations of students. The value of the\ndevelopment of an organized mentorship system is illustrated in the study....
Background: Persistently variable success has been experienced in locally translating even well-grounded national\nclinical practice guidelines, including in the perioperative setting. We have sought greater applicability and acceptance\nof clinical practice guidelines and protocols with our novel Perioperative Risk Optimization and Management Planning\nTool (PROMPTââ??¢). This study was undertaken to survey our institutional perioperative clinicians regarding (a) their\nqualitative recommendations for (b) their quantitative perceptions of the relative importance of a series of clinical\nissues and patient medical conditions as potential topics for creating a PROMPTââ??¢.\nMethods: We applied a mixed methods research design that involved collecting, analyzing, and ââ?¬Å?mixingââ?¬Â both qualitative\nand quantitative methods and data in a single study to answer a research question. Survey One was qualitative in nature\nand asked the study participants to list as free text up to 12 patient medical conditions or clinical issues that they\nperceived to be high priority topics for development of a PROMPTââ??¢. Survey Two was quantitative in nature and\nasked the study participants to rate each of these 57 specific, pre-selected clinical issues and patient medical\nconditions on an 11-point Likert scale of perceived importance as a potential topic for a PROMPTââ??¢. The two electronic,\nonline surveys were completed by participants who were recruited from the faculty in our Department of Anesthesiology\nand Perioperative Medicine and Department of Surgery, and the cohort of hospital-employed certified registered nurse\nanesthetists.\nResults: A total of 57 possible topics for a PROMPTââ??¢ was created and prioritized by our stakeholders. A strong correlation\n(r = 0.82, 95 % CI: 0.71, 0.89, P < 0.001) was observed between the quantitative clinician survey rating scores reported by\nthe anesthesiologists/certified registered nurse anesthetists versus the surgeons. The quantitative survey displayed strong\ninter-rater reliability (ICC = 0.92, P < 0.001).\nConclusions: Our qualitative clinician stakeholder survey generated a comprehensive roster of clinical issues and patient\nmedical conditions. Our subsequent quantitative clinician stakeholder survey indicated that there is generally\nstrong agreement among anesthesiologists/certified registered nurse anesthetists and surgeons about the relative\nimportance of these clinical issues and patient medical conditions as potential topics for perioperative optimization\nand risk management....
Introduction: In the last few years, there has been a growth in the number of cases of people with\nHIV/AIDS aged 50 years and older. This is explained by the inclusion of antiretroviral therapy, increased\nsurvival of patients as well as by the growth in the number of infected people in this age\ngroup. Objective: To analyze the association between sociodemographic and clinical characteristics\nwith the QOL of people aged 50 years or older living with HIV/AIDS. Methods: Quantitative,\ncross-sectional study conducted in the outpatient clinic of a reference hospital in Natal, Brazil. The\nsample consisted of 50 subjects, aged over 50, seropositive for HIV and with cognitive conditions\nto answer the interview. Authors used sociodemographic and clinical evaluation tools and the\nWHOQOL-HIV BREF scale. Results: Sociodemographic: respondents� average age was 57.32 years,\n58% male, 38% brown, 26% incomplete primary education, 46% single, 56% retired, 70% with a\nmonthly income of 1 to 2 minimum wages and 70% Catholic. Clinical: 60% have a partner without\nthe diagnosis of HIV/AIDS; 62% had not been hospitalized previously; 66% did not have opportunistic\ninfections; 40% indicated that there was a change in the physiological sexual function after\nthe onset of the disease. Quality of life: people living with HIV/AIDS had low scores in QOL domains.\nWhen associating sociodemographic and clinical aspects, it was observed that they had associations\nwith QOL, especially in regard to education, income, religion, change in sexual function\nand feelings. Conclusion: The spiritual domain was highlighted with the best performance, collaborating\nto facing, hope and resilience of HIV/AIDS....
Background: Increasing the number of patients participating in research studies is a current priority in the National\nHealth Service (NHS) in the United Kingdom. The role of specialist nurses in inviting patients to participate is\nimportant, yet little is known about their experiences of doing so. The aim of this study was to explore the\nperceptions of barriers and facilitators held by specialist nurses with experience of inviting adult NHS patients to a\nwide variety of research studies.\nMethods: A cross-sectional qualitative descriptive study was conducted between March and July 2015. Participants\nwere 12 specialist nurses representing 7 different clinical specialties and 7 different NHS Trusts. We collected data\nusing individual semi-structured interviews, and analysed transcripts using the Framework method to inductively\ngain a descriptive overview of barriers and facilitators.\nResults: Barriers and facilitators were complex and interdependent. Perceptions varied among individuals, however\nbarriers and facilitators centred on five main themes: i) assessing patient suitability, ii) teamwork, iii) valuing\nresearch, iv) the invitation process and v) understanding the study. Facilitators to inviting patients to participate in\nresearch often stemmed from specialist nurses� attitudes, skills and experience. Positive research cultures, effective\nteamwork and strong relationships between research and clinical teams at the local clinical team level were\nsimilarly important. Barriers were reported when specialist nurses felt they were providing patients with insufficient\ninformation during the invitation process, and when specialist nurses felt they did not understand studies to their\nsatisfaction.\nConclusion: Our study offers several new insights regarding the role of specialist nurses in recruiting patients for\nresearch. It shows that strong local research culture and teamwork overcome some wider organisational and\nworkload barriers reported in previous studies. In addition, and in contrast to common practice, our findings\nsuggest research teams may benefit from individualising study training and invitation procedures to specialist\nnurses� preferences and requirements. Findings provide a basis for reflection on practice for specialist nurses,\nresearch teams, policymakers, and all with an interest in increasing patient participation in research....
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