Current Issue : July-September Volume : 2023 Issue Number : 3 Articles : 5 Articles
Background Approximately 6.5 million adults have chronic heart failure (HF), the number one cause of 30-day hospital readmission. Managing HF and its symptoms is critical for patients. Hospitalization may impact patients’ perceptions of illness control, which can affect illness management. However, how hospital readmissions are perceived as related to one’s ability to control their HF and its symptoms has not been examined. Objective The purpose was to explore the experiences of people with HF in managing their illness (i.e., illness control), understand their perceptions of illness control after recent hospital readmission, and clarify the concept of illness control in people with chronic HF. Methods A qualitative approach, applied thematic analysis was employed. Purposive sampling was used to identify participants. Semi-structured interviews were conducted in 10 participants’ homes. Ongoing, concurrent, and comparative data analysis was used with ATLASti© data management software. Results Two themes were identified, strategies to control HF and barriers to controlling HF. Strategies to control HF included four subthemes: managing dietary intake and medications; self- advocacy; monitoring symptoms; and support. Barriers to control also had four subthemes: healthcare systems issues; health care professional relationships and interactions; personal characteristics; and knowledge deficits. Conclusion People use many different strategies to control HF. Control comes from both within and outside of the individual. The desire to control HF and its symptoms was evident, but implementing strategies is challenging and takes time, experience, and trial and error. Individuals did not view readmission negatively but as necessary to help them control their symptoms....
Background Worldwide people are living longer. The need for healthcare for older adults is increasing. The trend is towards advanced home healthcare, where registered nurses are key figures. This implies challenges for municipal home healthcare, as well as for registered nurses’ leadership. The aim is to explore registered nurses’ perceptions of challenges and suggestions for improvements in their leadership close to older adults in municipal home healthcare. Methods The present study is part of a larger web-based questionnaire survey with a cross-sectional design. The design is inductive, analysing data using qualitative content analysis and descriptive statistics. A questionnaire with open-ended and closed-ended questions was used. A total of n = 70 registered nurses leading close to older adults participated in seven municipalities in two geographic areas in Sweden. Results The results show registered nurses’ perceptions of challenges as leaders close to older adults in terms of 11 categories. The categories are motivating for care, adjusting and coordinating nursing care to the older adult, relating to next of kin, managing communication difficulties, relating to social situations in the home, managing demands, working alone, having lack of time, collaborating with physicians, and care staff having low competence. The registered nurses suggested improvements for their leadership close to older adults in terms of nine categories. The categories are adjusting the work to the older adult, clarifying registered nurses’ responsibility, balancing demands and resources, setting time aside, improving staffs’ competence, ensuring staff’s competence development, improving the work environment, and cooperation between professions in the municipality, as well as between healthcare organizations. Conclusion The results show that registered nurses’ leadership in municipal home healthcare implies a wide range of challenges. There is a need for strategies to improve the organizational preconditions to reduce challenges in registered nurses’ leadership in order to promote positive patient outcomes for safe and quality care....
Background Diabetic retinopathy (DR) is one of the major blinding eye diseases worldwide. Psychological, emotional and social problems of DR patients are prominent. The aim of this study is to explore the experiences of patients with different phases of DR from hospital to home based on the “Timing It Right” framework, and to provide a reference for formulating corresponding intervention strategies. Methods The phenomenological method and semi-structured interviews were used in this study. A total of 40 patients with DR in different phases were recruited from a tertiary eye hospital between April and August 2022. Colaizzi’s analysis method was used to analyse the interview data. Results Based on the “Timing It Right” framework, different experiences in five phases of DR before and after Pars Plana Vitrectomy (PPV) were extracted. The patients experienced complicated emotional reactions and inadequate coping skills during the pre-surgery phase, increased uncertainty during the post-surgery phase, insufficient confidence and the decision to change during the discharge preparation phase, eagerness for professional support and moving forward in exploration during the discharge adjustment phase, and courageous acceptance and positive integration during the discharge adaptation phase. Conclusion The experiences of DR patients with vitrectomy in different phases of disease are ever-changing, and medical staff should provide personalized support and guidance to help DR patients get through the hard times smoothly and enhance the quality of hospital-family holistic care....
Background and aim Effective support given by a midwife during labor and childbirth is associated with numerous positive outcomes. Yet the delivery of such support can be hindered by negative workplace cultures. The purpose of the current study was to examine the relationship between attitude and self-efficacy of labor support and labor supportive behaviors from the perspectives of midwives working in Iran. Methods Midwives (n = 213) employed in the labor wards of selected hospitals in an urban area of Iran participated in this cross-sectional study. Participants were recruited via convenience sampling from December 2016 to September 2017. The data were collected using a personal characteristics tool, the Labor Support Questionnaire, the Selfefficacy Labor Support Scale, and attitudes toward the Labor Support Questionnaire. Descriptive statistics along with multiple linear regression was used for data analysis. Results Participants had a supportive behavior score of 74.98 for mean (SD ± 13.39). The informational support dimension had the highest reported score of the supportive behaviors, whereas the tangible support dimension had the lowest score. The mean scores of attitude and self-efficacy toward labor support were 24.79 (SD ± 4.14) and 79.83 (SD ± 13.82). There were also statistically significant correlations between attitude and self-efficacy, and labor support behaviors and its dimensions. Multiple linear regression analysis results indicated that interests in occupation, attitude, and self-efficacy were predictors of labor supportive behaviors. Conclusion Midwives’ level of interest in the profession, attitude, and self-efficacy of labor support were significantly associated with labor support behaviors. Thus midwives’ interest in their profession, along with their attitudes and selfefficacy could usefully be developed to enhance their supportive behaviors during labor....
Background Waiting time for kidney transplants (KT) is an important health determinant for patients with chronic kidney disease (CKD). During this time, ongoing evaluation and participation is necessary in order to guarantee the quality and suitability of the proposed treatment. There is no existing literature on the potential impact of inclusion of an Advanced Practice Nurse (APN) role in the hospital setting on care for CKD patients who are candidates for KT. The main objectives of this protocol are: to analyse outpatient nursing activity in the care of individuals with KT in Spain; to identify the needs of individuals who are KT candidates; and to measure the impact of the APN role through patient outcomes and experiences. These objectives are fulfilled through 5 specific related substudies. Methods A convergent parallel mixed methods approach will be conducted between July 2021 and April 2024. Quantitative and qualitative data will be collected and analysed separately to ascertain whether the findings confirm or contradict one another. Each of the 5 substudies of the project require a specific design, sampling method, and data collection procedure in order to meet the overall objectives for the project. Discussion The results of the project are expected to inform the design of future nursing roles and contribute to future improvements in the quality of care provided. The data that may be obtained from this protocol are limited to the specific context of the study facility and may be extrapolated but not compared to other settings due to the variability of care pathways for KT candidates internationally. Trial registration This project was approved by the Clinical Research Ethics Committee (no.2020/9418/I). The study was supported by the “Strategic Plan for Health Research and Innovation” from the Generalitat de Catalunya, registration number SLT017/20/000001, with a contribution of 57,239 euros....
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