A pilot study of the relation of dependency need expression to nurse-patient relations.

Thesis (M.S.)--Boston Universit

Implicación de la familia en el cuidado del paciente crítico

Treball Final de Grau en Infermeria. Codi: IN1138. Curs: 2018/2019Background: Patients who, due to the severity of their illness are hospitalized in an Intensive Care Unit (ICU), are in a stressful environment. Therefore, promote and facilitate the integration of family members in their care can produce benefits for both, the family and the patient. Aims: Identify the family's role in the caring of the critical patient in the ICU. Methods: Integrative review of the literature in these databases: Pubmed, Web of Science, ScienceDirect and Scopus. The search strategy was started by consulting the descriptors in Medical Subject Headings (MeSH), and these were combined with the Boolean operator "AND". In order to filter the documents found after the initial research, the filters used are "last 5 years", "English and Spanish" and "reviews and articles". Methodological quality was evaluated using the Spanish Critical Appraisal Skills Programme (CASPe). Results: At first, a total of 1702 documents were found. After applying the temporal, idiomatic and study type filters, 226 studies were obtained. Finally, the inclusion and exclusion criterions were applied, obtaining a final sample of n=9 documents to be studied. Conclusion: The role of accompaniment and participation in decision-making are those that most clearly identify the role of the family member. However, the literature doesn't describe an active role in terms of direct participation in the care of the critical patient. Research of higher methodological quality is needed.Introducción: Los pacientes que debido a la gravedad de su enfermedad ingresan en una Unidad de Cuidados Intensivos (UCI), se encuentran en un entorno estresante, por ello promover y facilitar la integración de los familiares en su cuidado puede producir beneficios tanto en la familia como en el propio paciente. Objetivos: Identificar el rol que realiza la familia en el cuidado del paciente crítico en UCI. Metodología: Revisión integradora de la literatura en las bases de datos: Pubmed, Web of Science, ScienceDirect y Scopus. La estrategia de búsqueda se inició consultado los descriptores en Medical Subject Headings (MeSH), estos se combinaron con el operador booleano “AND”. Para filtrar los documentos, tras la búsqueda inicial se aplicaron los filtros “últimos 5 años”, “inglés y español” y “revisiones y artículos”. Se realizó una evaluación de la calidad metodológica mediante la herramienta Critical Appraisal Skills Programme español (CASPe). Resultados: Inicialmente se encontraron un total de N=1702 documentos. Tras aplicar los filtros de tipo temporal, idiomático y tipo de estudio se obtuvieron 226 estudios. Finalmente, se aplicaron los criterios de inclusión y exclusión obteniendo una muestra final de n=9 documentos a estudio. Conclusiones: El rol de acompañamiento y la participación en la toma de decisiones son los que más claramente identifican el papel del familiar. Sin embargo, la literatura no describe un rol activo en lo que se refiere a la participación directa en el cuidado del paciente crítico. Se precisa investigación de mayor calidad metodológica

Development and reliability testing of the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes (SESPI) : an assessment instrument of mental health nursing documentation

Aim: To develop and test the reliability of the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes (SESPI). Therapeutic nurse–patient interactions are fundamental in mental health nursing. However, little is known about how these interactions are recorded in nursing documentation and there is no instrument available for collecting this type of information for quantitative analysis. Design: Instrument development and reliability testing. Methods: The development of the SESPI was based on qualitative analyses of progress notes retrieved from patient records in two mental health services. A self psychological attunement perspective guided the analyses. SESPI was tested for internal consistency and inter‐rater reliability after 22 nurses independently scored 10 progress notes. Results: Cronbach's alpha for the entire instrument was 0.977, indicating that the raters’ scores had very high internal consistency. ICC was 0.770. The alpha and ICC values for each step were high, varying between 0.970 and 0.992. Keywords: empathy, inpatients, instrument development, medical record, nurse–patient relations, nursing assessment, psychiatric nursingpublishedVersio

Communication interventions in adult and pediatric oncology: A scoping review and analysis of behavioral targets

BackgroundImproving communication requires that clinicians and patients change their behaviors. Interventions might be more successful if they incorporate principles from behavioral change theories. We aimed to determine which behavioral domains are targeted by communication interventions in oncology.MethodsSystematic search of literature indexed in Ovid Medline, Embase, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov (2000-October 2018) for intervention studies targeting communication behaviors of clinicians and/or patients in oncology. Two authors extracted the following information: population, number of participants, country, number of sites, intervention target, type and context, study design. All included studies were coded based on which behavioral domains were targeted, as defined by Theoretical Domains Framework.FindingsEighty-eight studies met inclusion criteria. Interventions varied widely in which behavioral domains were engaged. Knowledge and skills were engaged most frequently (85%, 75/88 and 73%, 64/88, respectively). Fewer than 5% of studies engaged social influences (3%, 3/88) or environmental context/resources (5%, 4/88). No studies engaged reinforcement. Overall, 7/12 behavioral domains were engaged by fewer than 30% of included studies. We identified methodological concerns in many studies. These 88 studies reported 188 different outcome measures, of which 156 measures were reported by individual studies.ConclusionsMost communication interventions target few behavioral domains. Increased engagement of behavioral domains in future studies could support communication needs in feasible, specific, and sustainable ways. This study is limited by only including interventions that directly facilitated communication interactions, which excluded stand-alone educational interventions and decision-aids. Also, we applied stringent coding criteria to allow for reproducible, consistent coding, potentially leading to underrepresentation of behavioral domains

Lääkehoidon puhelinneuvonta terveyskeskuksen päivystyksessä

Opinnäytetyö on osa Turun ammattikorkeakoulun Turvallinen lääkehoito- kehittämishanketta. Opinnäytetyön yhteistyökumppanina toimii Kaarinan kaupungin terveystoimi. Opinnäytetyö on tehty systemaattista kirjallisuuskatsausta mukaillen. Aineisto kerättiin käyttämällä Cinahl, Medic ja Medline -tietokantoja. Aineistoa saatiin eri hakusanayhdistelmiä hakukoneissa käyttämällä yhteensä 436 917 kappaletta. Näistä valittiin yhdeksän julkaisua, jotka analysoitiin. Opinnäytetyön tarkoituksena on kuvata lääkehoidon puhelinneuvontaa terveyskeskuksen päi-vystyksessä. Opinnäytetyössä esitetään tämän hetkisen puhelinneuvonnan ja lääkehoidon oh-jauksen tarve nykyisessä terveydenhuoltojärjestelmässä. Työssä otettiin selvää, mitkä ovat neuvonnan ja ohjauksen hyödyt ja haitat ja miten niitä voitaisiin kehittää. Työssä käsitellään myös millaista ammattitaitaitoa hoitohenkilökunta tarvitsee toteuttaakseen lääkehoidon ohjausta puhelimitse. Kehittämisen myötä annettaisiin potilaalle mahdollisuus saada laadukasta ja turval-lista puhelinneuvontaa sekä lääkehoidon ohjausta. Tulokset osoittavat, että lääkehoidon ohjauksen ja puhelinneuvonnan kysyntä on kasvanut. Puhelinneuvonnan myötä aikaisemmat ruuhkat päivystyksissä ja lääkärien vastaanotoilla ovat vähentyneet. Lääkehoidon ohjauksen tarve on lisääntynyt itsehoitolääkkeiden kysynnän vuoksi ja myös potilaiden epätietoisuus omista käyttämistään lääkkeistä on lisääntynyt. Vain terveydenhuollon ammattilainen voi antaa puhelinneuvontaa ja lääkehoidon ohjausta. Hoi-tajien tulisi hallita farmakologia sekä osata laskea hyvin lääkelaskuja. Osalla hoitajista on kui-tenkin puutteita näillä osa-alueilla. Terveydenhuollon ammattilaisia tulisi kouluttaa ja heidän taitojaan tulisi testata säännöllisesti. Näin potilas saisi mahdollisimman laadukasta puhelinneu-vontaa sekä lääkehoidon ohjausta.This thesis is part a of larger project conducted at the Turku University of Applied Sciences called Safe medication. This thesis was made in collaboration with the municipal health care of Kaarina. The method used for this thesis was systematic literature review. Material was ga-thered from Cinahl, Medic and Medline databases. There were 436 917 matches with varied search term compositions. Nine journals were chosen and analyzed. The goal of the study was to describe current need for telephone consultation and medication guidance in health care systems. This thesis presents the benefits and the disadvantages of telephone consultation and presents guidelines for improving the current situation. The study also discusses the types of professional expertice needed by nurses who are giving medicinal telephone consultation to patients. With the proposed guidelines patients could get safe, high quality telephone consultation. The results indicate that the need of medication guidance and telephone consultation have in-creased. Telephone consultation has helped to reduce rushes at emergency rooms and doctor’s receptions. The need for medication guidance has increased due to increasing demand of self medication and proliferating uncertainty of patients own medication. Only health care professionals can give telephone consultation and medication guidance. Ther-fore, nurses should master both pharmacology and medication calculations. The problem is that some nurses have shortcomings in these fields. There should be a system to educate and test health care professionals regularly. In this manner, the patients would get the best possible telephone consultation and medication guidance

The therapeutic relationship in inpatient psychiatric care: a narrative review of the perspective of nurses and patients

Purpose: to study the significance of 'therapeutic relationship' between nurses and patients within the context of a psychiatric hospital. Method: narrative literature review. Content analysis. Findings: the significance of the therapeutic relationship is quite similar for both nurses and patients in psychiatric hospital units. Nevertheless, several factors may separate the two positions: the time available for the relationship, the negative perceptions on the part of both parties, and the insecurity of the setting. Practice implications: increased knowledge and understanding of the significance of the therapeutic relationship from the perspective of nurses and patients would allow the strengthening of areas of mutual interest

Comment le processus de la relation interpersonnelle dans un contexte domiciliaire permet-il une intégration communautaire chez les adultes souffrant de psychose ?: travail de Bachelor

Dans un contexte domiciliaire l’infirmière est de plus en plus confrontée à des clients souffrant de troubles psychiatriques. La relation qu’elle établit avec le patient est au coeur de son intégration communautaire. Le but de ce travail est de définir comment le processus de la relation interpersonnelle dans un contexte domiciliaire permet-il une intégration communautaire chez les adultes souffrant de psychose ? Une revue de la littérature a été conduite sur les bases de données CINAHL, MEDLINE/PubMed et PsycINFO en utilisant diverses combinaisons de termes MeSH. La relation infirmière-client, à la suite des travaux de Peplau confirme son rôle d’outil thérapeutique. L’évolution du progrès de la relation peut être évaluée par l’échelle « Relationships form » proposée par Forchuk. Quant à la nature de la relation infirmière-client, elle peut être évaluée par la « Working Aliance Inventory » élaborée par Horvath et Greenberg. Lors de la transition de l’hôpital à la communauté, une période de chevauchement permet à l’infirmière domiciliaire de débuter la relation avec le client alors qu’il est encore hospitalisé. Cette approche permet une meilleure évolution et une prise de confiance dans la relation interpersonnelle. Les évaluations de l’évolution et de la nature de la relation établie avec le client permettent de mieux organiser le dispositif de soins à domicile où de multiples professionnels interviennent. Par conséquent, elles sont utiles pour l’élaboration des rôles propres de chaque intervenant

Nurses’ Experiences Empowering Hospitalized Patients

Four focus groups were conducted to explore acute care nurses’ experiences empowering patients and the facilitators and barriers they encountered during the process. Thirty-four nurses employed at four hospitals in the Midwestern United States participated in the study between February and April 2015. Facilitators of empowerment included establishing a therapeutic relationship, fostering communication, providing education, respecting patient autonomy, engaging support systems, and lifting spirit/giving hope. Barriers included conflicting information about plans of care, lack of time, fear and anxiety over unfamiliar environments and routines, ineffective or inadequate support systems, lack of/low accountability, and killing the soul. Nurses also described innovative strategies they used to overcome the barriers. The development of future inpatient empowerment interventions needs to focus on the innovative strategies nurses used to overcome barriers in addition to considering the facilitators and barriers to empowerment that nurses identified

Zarządzanie informacją w procesie pielęgnowania w oddziale neurologicznym

Introduction. The specific character of nervous system diseases requires repeated and long-lasting hospitalisations or stays in sanatorium. One of the most important tasks of a nurse is teaching a patient how to be more self-dependent and limiting the help and support received from others in everyday activities such as sanitary functions and hygiene. Nurses must help patients to gain knowledge, get involved in interrelationships, develop proper habits which will allow them to use their abilities and resources.Aim. Evaluation of information and knowledge flow management in nursing process, between nursing staff and patients of neurological ward.Material and Methods. Diagnostic survey was used as a method for the purpose of this work. The questionnaire-polling, used for the study, employed two standardised instruments (EUROPEP and NEWCASTLE). Thequestionnaire also included questions aimed at gaining demographic data. The obtained data was statistically analysed. The level of significance was set at p≤0.05. The study was conducted from April to July 2014. The studyincluded 120 patients hospitalised in the Department of Neurology, Independent Public Teaching Hospital No. 4 in Lublin, Neurology Ward, Provincial Special Hospital in Lublin, Department of Neurology with Stroke Unit, First Military Hospital in Lublin and Department of Neurology, Hospital of the Ministry of Interior and Administration in Lublin.Results. The average level of care provided in the evaluated departments of neurology was 78.40% (5.7 in the scale from 1 to 7; 1 — horrible care, 7 — excellent care). The nursing care provided at the Department of Neurology of the First Military Hospital was evaluated by patients as delivered in 83.33% (M=6.00; SD=0.45). In other evaluated units, the level of satisfaction was higher than 75% but lower than 80%. Patients’ expectations regarding the time devoted to them by nurses was met in 90.08%. The level of satisfaction from co-deciding about the nursing process was only 72.93%. The majority (89.2%) of subjects was satisfied with nursing advice they received. It was noted that the level of patients’ satisfaction concerning their knowledge of performed nursing procedures was very high (93.75%).Conclusions.1) The study showed a very high level (82.14%) of patients’ satisfaction from interpersonal relations with nurses at the department of neurology. 2) Time devoted to patients and nurse’s interest in patient’s problemsdo not always translate satisfactorily into nursing actions aimed at effective acquisition of information about their problems and involving patients’ families in planning the nursing process.3) The majority of patients was satisfied with the advice received from nurses. The preparation of patients for self-care was performed at a slightly lower level.4) Good relations with patients are a condition precedent for high level of work organisation at the department of neurology.5) Strong sense of security among patients indicates that there is efficient flow of information concerning patient’s functional capacity and that nurses possess broad knowledge of potential risks to patients hospitalised at the department of neurology. (JNNN 2015;4(4):162–169)Wstęp. Specyfika chorób układu nerwowego wiąże się z koniecznością częstych i długich pobytów w szpitalu lub w sanatorium. Do jednych z najważniejszych zadań pielęgniarki należy nauczenie pacjenta jak największej samodzielności i możliwie maksymalnego uniezależnienia się od potrzeby korzystania z pomocy drugiej osoby przy załatwianiu codziennych czynności fizjologicznych i higienicznych. Konieczne jest udzielanie pacjentom pomocy w zdobywaniu wiedzy, we włączaniu się w system wzajemnych powiązań, w rozwinięciu odpowiednich nawyków, które pozwolą im lepiej wykorzystać własne zdolności i zasoby.Cel. Celem pracy była ocena zarządzania obiegiem informacji i wiedzy w procesie pielęgnowania miedzy zespołem pielęgniarskim a pacjentami na oddziale neurologicznym.Materiał i metody. Na użytek niniejszej pracy wykorzystano metodę sondażu diagnostycznego. Badania przeprowadzono za pomocą kwestionariusza ankiety, w którym wykorzystano dwa standaryzowane narzędzia (EUROPEP i Newcastle). W ankiecie zawarto także pytania mające na celu pozyskanie danych demograficznych. Pozyskane danepoddano analizie statystycznej. Przyjęto poziom istotności p≤0,05. Badania przeprowadzono w okresie od kwietnia do lipca 2014 roku. Badaniami objęto 120 pacjentów hospitalizowanych w Klinice Neurologii SPSK nr 4 w Lublinie, w Oddziale Neurologii Wojewódzkiego Szpitala Specjalistycznego w Lublinie, w Oddziale Neurologii z OddziałemUdarowym I Szpitala Wojskowego w Lublinie oraz w Oddziale Neurologii Szpitala MSWiA w Lublinie.Wyniki. Średni poziom opieki świadczonej w badanych oddziałach neurologii wyniósł 78,40% (5,7 w skali od 1 do 7; 1 — opieka okropna, 7 — opieka wyśmienita). Opieka pielęgniarska w oddziale neurologii I Szpitala Wojskowego w świetle oceny chorych była realizowana w 83,33% (M=6,00; SD=0,45). W pozostałych badanych jednostkach poziom satysfakcji pacjentów był wyższy niż 75% lecz nie przekroczył 80%. Oczekiwania chorych aby pielęgniarki poświęciły im odpowiednią ilość czasu zostały spełnione w 90,08%. Poziom satysfakcji badanych z współdecydowania o procesie pielęgnowania wyniósł zaledwie 72,93%. Zdecydowana większość (89,2%) podopiecznych wyraziła zadowolenie z otrzymanych porad pielęgniarskich. Odnotowano bardzo wysoki (93,75%) pozom satysfakcji pacjentów z posiadanej wiedzy o wykonywanych czynnościach pielęgniarskich.Wnioski.1) Przeprowadzone badania wykazały wysoki poziom (82,14%) satysfakcji pacjentów z relacji interpersonalnych z pielęgniarkami na oddziale neurologii.2) Czas poświęcony choremu i interesowanie się jego problemaminie zawsze w dostatecznym stopniu przekłada się na działania pielęgniarki zmierzające do efektywnego pozyskiwania informacji o problemach pacjenta i włączenia go i jego rodziny w planowanie procesu pielęgnowania. 3) Zdecydowana większość podopiecznych wyraziła zadowolenie z otrzymanych porad pielęgniarskich. Na nieco niższympoziomie było realizowane przygotowanie chorych do samoopieki.4) Dobre relacje z pacjentami warunkują wysoki poziom organizacji pracy na oddziale neurologicznym.5) Wysokie poczucie bezpieczeństwa chorych wskazuje na sprawny obieg informacji na temat wydolności funkcjonalnej chorych oraz o dużej wiedzy pielęgniarek o potencjalnych zagrożeniach dla pacjenta jakie mogą się pojawić w trakcje hospitalizacji na oddziale neurologicznym. (PNN 2015;4(4):162–169

La intervención humor en la interacción enfermero-paciente

Objective: To describe the factors influencing the use of humor in nursing care, its applicability and benefits. Method: A scoping review was performed using the Arksey and O’Mally methodology. A search for articles published between 2008 and 2018 was performed using the platforms EBSCO Host, Virtual Health Library and Google Scholar. Results: From the initial 465 articles found, 17 were included for final revision. Data allowed to retrieve information on humor definition; its applicability as a nursing intervention; humor as a tool to improve nurse-patient communication and relationship; influence factors; type of humor interventions; humor benefits in health care context and; limitations and precautions of humor intervention. Conclusion: The use of humor promotes both communication and human interaction; it promotes well-being; helps deal/cope with difficult and unpleasant situations, reduces tension, discomfort and stress; and strengthens the immune system. This intervention should be used with caution