Adaptacja skali Caring Nurse-Patient Interaction (CNPI-70) do warunków polskich na podstawie badań samooceny kompetencji opiekuńczych studentów kierunku pielęgniarstwo

The aim of the study and the undertaken research is to adapt the CNPI-70tool to Polish conditions and then to use this scale for the evaluation of nursing students competencies.Material and methods. A CNPI -70scale survey was conducted among486nursing students analyzing their self-assessment of caring competencies at various levels of university.Results. The reliability of the scale is very high (Cronbach’s α is O,97), analyzing the70questions of the scale it can be concluded that all, except questions no5 and21,have an average or above average correlation with the result of the overall tool. The analysis also indicates that the removal of a single question from the tool does not affect its overall high reliability.The results of the self-assessment of caring competencies among nursing students show an increase in competence at the successive levels of the university course. The level of competence is also influenced by the experience of part time students.Conclusions. The Polish version of the CNPI-70scale, assessing the caring competence of nurses, takes into account the wide range of professional roles of nurses. Research confirms the high reliability of the scale thus recommending its use in research in nursing and education.  Celem pracy i podjętych badań jest adaptacja narzędzia CNPI-70 do warunków polskich i zastosowanie skali do ewaluacji kompetencji studentów kierunku pielęgniarstwo.Materiał i metoda. Badania skalą CNPI -70 przeprowadzono wśród 486 studentów kierunku pielęgniarstwo analizując samoocenę poczucia kompetencji opiekuńczych na różnym etapie studiówWyniki. Rzetelność skali jest bardzo wysoka (α Cronbacha wynosi O,97) Analizując 70 pytań skali można stwierdzić, że wszystkie – z wyjątkiem pytania 5 i 21 – korelują przeciętnie albo ponad przeciętnie z wynikiem ogólnym narzędzia. Analiza wskazuje również, że usunięcie pojedynczego pytania z narzędzia nie wpłynie na jego ogólną wysoką rzetelność.Wyniki samooceny kompetencji opiekuńczych wśród studentów pielęgniarska wskazują na wzrost kompetencji na poszczególnych etapach studiów. Na poziom kompetencji ma wpływ również doświadczenie zawodowe studentów studiów niestacjonarnych.Wnioski. Polskojęzyczna skala CNPI-70 do badania kompetencji opiekuńczych pielęgniarek uwzględnia szeroki przekrój ról zawodowych pielęgniarki. Przeprowadzone badania potwierdziły wysoką rzetelność skali rekomendując jej stosowanie w badaniach naukowych w pielęgniarstwie i w edukacji

The adaptation of the Caring Nurse-Patient Interaction scale (CNPI-70) to polish conditions on the basis of nursing students self-assessment of their caring competencies

The aim of the study and the undertaken research is to adapt the CNPI-70tool to Polish conditions and then to use this scale for the evaluation of nursing students competencies. Material and methods. A CNPI -70scale survey was conducted among486nursing students analyzing their self-assessment of caring competencies at various levels of university. Results. The reliability of the scale is very high (Cronbach’s α is O,97), analyzing the70questions of the scale it can be concluded that all, except questions no5 and21,have an average or above average correlation with the result of the overall tool. The analysis also indicates that the removal of a single question from the tool does not affect its overall high reliability. The results of the self-assessment of caring competencies among nursing students show an increase in competence at the successive levels of the university course. The level of competence is also influenced by the experience of part time students. Conclusions. The Polish version of the CNPI-70scale, assessing the caring competence of nurses, takes into account the wide range of professional roles of nurses. Research confirms the high reliability of the scale thus recommending its use in research in nursing and education.    Celem pracy i podjętych badań jest adaptacja narzędzia CNPI-70 do warunków polskich i zastosowanie skali do ewaluacji kompetencji studentów kierunku pielęgniarstwo. Materiał i metoda. Badania skalą CNPI -70 przeprowadzono wśród 486 studentów kierunku pielęgniarstwo analizując samoocenę poczucia kompetencji opiekuńczych na różnym etapie studiów Wyniki. Rzetelność skali jest bardzo wysoka (α Cronbacha wynosi O,97) Analizując 70 pytań skali można stwierdzić, że wszystkie – z wyjątkiem pytania 5 i 21 – korelują przeciętnie albo ponad przeciętnie z wynikiem ogólnym narzędzia. Analiza wskazuje również, że usunięcie pojedynczego pytania z narzędzia nie wpłynie na jego ogólną wysoką rzetelność. Wyniki samooceny kompetencji opiekuńczych wśród studentów pielęgniarska wskazują na wzrost kompetencji na poszczególnych etapach studiów. Na poziom kompetencji ma wpływ również doświadczenie zawodowe studentów studiów niestacjonarnych. Wnioski. Polskojęzyczna skala CNPI-70 do badania kompetencji opiekuńczych pielęgniarek uwzględnia szeroki przekrój ról zawodowych pielęgniarki. Przeprowadzone badania potwierdziły wysoką rzetelność skali rekomendując jej stosowanie w badaniach naukowych w pielęgniarstwie i w edukacji

Self-reported questionnaires for assessment adherence to treatment in patients with cardiovascular diseases

Introduction: The treatment of acute coronary syndromes, besides coronary interventions, includes pharmaco-therapy and lifestyle changes, which together determine a favourable prognosis. Adherence to treatment is a term describing a patient’s behaviour in respect to the patient’s maintenance of the health care provider’s recommendations. Unfortunately, according to WHO data, adherence to long-term therapies for chronic illnesses in developed countries averages only 50%. Covered areas: Our study focused on available questionnaires for adherence assessment in everyday practice. A comprehensive search of data bases was conducted using appropriate keywords. Out of an initially identified 2081 citations, 93 articles were considered eligible for further analysis. Eventually, nine adherence scales were identified and reviewed. Expert opinion: There is no so-called “gold standard survey” allowing accurate assessment of every patient for medication adherence. The use of a specific scale must be justified by its validation in a similar group of patients in well designed and properly conducted studies

The impact of readiness to discharge from hospital on adherence to treatment in patients after myocardial infarction

Background: The healthcare professionals involved in in-hospital treatment of myocardial infarction (MI) are also responsible to patients for their education before leaving the hospital.   This education aims to modify patient behaviour in order to reduce relevant risk factors and improve self-control and adherence to medications. The aim of the study was to analyse the relationship between readiness for discharge from hospital and adherence to treatment at follow-up in MI patients. Methods: An observational, single-center, MI cohort study with  6-month follow-up was conducted between May 2015 and July 2016.  The Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD-MIS) and the Adherence in Chronic Diseases Scale (ACDS) were applied. Results: Two hundred and thirteen patients aged 30–91 years (62.91 ± 11.26) were enrolled in the study. The RHD-MIS general score ranged from 29 to 69 points (51.16 ± 9.87).   A high level of readiness was found in 66 patients (31%), intermediate in 92 (43.2%), and low in 55 (25.8%) of patients. Adherence level assessed with the ACDS 6-months after discharge from hospital ranged from 7 to 28 points (23.34 ± 4.06). An increase in objective assessment of patient knowledge according to RHD-MIS subscale resulted in significantly higher level of adherence at the follow-up visit (p = 0.0154); R Spearman = 0.16671, p = 0.015; p for trend = 0.005. During the 6-month follow-up 3 (1.41%) patients died and 17 (7.98%) were hospitalized for a subsequent acute coronary syndrome. Conclusions: This study provided preliminary evidence of a long-term association between the results of assessment of readiness for discharge from hospital and adherence to treatment in patients after MI

Validation of the Functioning in Chronic Illness Scale (FCIS)

Diagnosis of deficient areas in the functioning of patient with chronic disease is necessary to undertake the adequate therapeutic actions. The aim of the study was to validate a new self-reported questionnaire for patients with chronic disease assessing the impact of the disease on the patient, the patient’s impact on the disease and the impact of the disease on patient’s attitudes. Results: The internal consistency of the questionnaire expressed by a-Cronbach coefficient = 0.855, indicates its high reliability and homogeneity. The set of 24 items fulfilled the assumption of factor analysis: the determinant of correlation matrix was 0.001, Kaiser-Mayer-Olkin (K-M-O) statistic was 0.843 and the Bartlett’ test of sphericity was statistically significant. The factor analysis was conducted using the principal component analysis with Varimax rotation. The scale and subscale levels were determined based on the percentiles scale. Conclusion: The validation procedure revealed that FCIS is a reliable and homogeneous tool to measure patient’s physical and mental functioning in the chronic illness. The set of items divided into 3 subscales allows evaluation of: the impact of the disease on the patient, the patient’s impact on the disease and the impact of the disease on the patient’s attitudes

Relation of the Readiness for Hospital Discharge after Myocardial Infarction Scale to socio-demographic and clinical factors. An observational study

Introduction: The aim of the study was to analyse the relationship between the Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD MIS) scores and socio-demographic and clinical factors in patients after acute myocardial infarction (AMI) treated with percutaneous coronary angioplasty. Material and methods: The study was conducted as a single-centre, prospective, cohort, 6-month observa-tion, including 213 patients: 59 women and 154 men aged 30–91 years (average age of 62,91 ± 11.26 years). Results: Patients’ economic status was found to have a significant impact on the readiness for discharge measured by RHD-MIS general score. Among all three investigated RHD-MIS subscales, objective assessment of knowledge was influenced by gender (p = 0.012) and place of residence (p = 0.025). There was a linear trend for increase of knowledge along with increase in education level (p = 0.030). The only factor influencing patients’ expectations was their economic status (p value for heterogeneity: 0.014). A linear correlation between growing of patients’ expectations and worsening of their economic status (p = 0.008) was observed. Conclusion: Readiness to discharge should be routinely assessed in all patients hospitalized with myo-cardial infarction. The result of this assessment should be used to identify patients requiring additional education. Further research is prompted to determine the cut-off values of RHD-MIS results qualifying patients for additional educational interventions

The Adherence in Chronic Diseases Scale — a new tool to monitor implementation of a treatment plan

Wstęp. Celem pracy była ocena adherence z zastosowaniem nowej skali w populacji osób z chorobą wieńcową (CAD) po zawale serca (MI) w odniesieniu do parametrów socjodemograficznych i klinicznych. Materiał i metody. Badanie przeprowadzono w populacji 100 kolejnych osób (40 kobiet, 60 mężczyzn) w wieku 30–88 lat, średnio 63,4 roku, pół roku po hospitalizacji z powodu MI. Wyniki. Wyniki oceny w Adherence in Chronic Diseases Scale (ACDS) zawierały się między 6 a 28 punktów; mediana wynosiła 24 punkty (21–28). Wynik wysoki (> 26 pkt.) osiągnęły 24 osoby, 53 badanych uzyskało wynik średni (między 21 a 26 pkt.), a 23 — niski wynik (< 21 pkt.). Dla optymalnego modelu regresji wielorakiej współczynnik korelacji R wynosił 0,539, a skorygowany współczynnik determinacji R2 — 0,26 (p = 0,000002). Niezależnymi czynnikami wpływającymi na adherence ocenianymi w ACDS były: subiektywna ocena stanu zdrowia (b = 0,48 ± 0,23; p = 0,036), wiek badanych (b = –0,11 ± 0,04; p = 0,004), więcej niż jeden pobyt w szpitalu z powodu CAD (b = –1,78 ± 0,87; p = 0,044) oraz cukrzyca (b = –2,02 ± 0,91; p = 0,029). Wnioski. Subiektywna ocena stanu zdrowia, wiek pacjentów, liczba hospitalizacji z powodu CAD oraz współwystępowanie cukrzycy wpływają na adherence w terapii przewlekłej po zawale serca.Introduction. The aim of this study was to assess adherence to treatment with use of the new scale in a population of patients with coronary artery disease (CAD) after myocardial infarction (MI) with respect to some socio-demographic and clinical factors. Material and methods. The study was conducted in a population of 100 consecutive patients (40 women, 60 men) aged from 30 to 88 years (mean 63.4), six months after hospitalization for MI. Results. The results of the assessment with the Adherence in Chronic Diseases Scale (ACDS) comprise between 6 and 28 points; median 24 points (21–28). Twenty-four patients had high score (> 26 pts.), 53 patients had intermediate score (between 21–26 pts.) and 23 — low score (< 21 pts.). For optimal model of multiple regression, the correlation coefficient R was 0.539; and the adjusted coefficient of determination R2 = 0.26, p = 0.000002. Independent factors affecting adherence according to the ACDS scale were: subjective assessment of health status (b = 0.48 ± ± 0.23, p = 0.036), age of the respondents (b = –0.11 ± 0.04, p = 0.004), more than one hospitalization due to CAD (b = –1.78 ± 0.87, p = 0.044), and diabetes mellitus (b = –2.02 ± 0.91, p = 0.029). Conclusions. Subjective assessment of health status, age of patients, the number of hospitalizations due to CAD and diabetes affect the adherence in the course of long-term treatment after myocardial infarction.

Knowledge about health and disease in obese patients after myocardial infarction. An observational study

Introduction. Conscious implementation of a therapeutic plan immediately after discharge from hospital is pivotal in myocardial infarction survivors. Obesity and overweight are known as factors increasing the risk of adverse cardiovascular events and worsening long-term clinical outcome. The aim of the study was to assess the knowledge regarding cardiovascular diseases in patients with myocardial infarction undergoing in-hospital brochure-based education in relation to the prevalence of overweight and obesity. Patients and methods. A prospective, single-centre, cohort, observational study was conducted in 228 patients hospitalised due to myocardial infarction (women n = 52, men n = 176). A dedicated questionnaire containing 20 single-choice questions was applied for the knowledge assessment. Patients were divided into three groups depending on the BMI level (normal, overweight, obesity). Results. Comparison of patients’ knowledge at baseline and on the day of discharge revealed a significant increase of overall result (p = 0.0264) and of knowledge about prophylaxis (p = 0.0115). Multivariate analysis showed education level (-5.82 ± 2.576, p = 0.025) and BMI (-4.54 ± 1.771, p = 0.011) as independent factors determining the overall increase in patients’ knowledge. Conclusions. Educational interventions in overweight and obese patients should be intensified. The brochure is an effective educational tool

Knowledge and learning preferences of patients with myocardial infarction

Introduction. The objective of the research was to study the knowledge about ischaemic heart disease and learning preferences of hospitalised patients as a result of myocardial infarction. Methods. The tested group comprised of 248 patients, aged 63 ± 11.25, who were hospitalised as a result of myocardial infarction A questionnaire with 20 single-choice questions was used in the research. The questionnaire tested the knowledge of the patients as far as ischaemic heart disease, myocardial infarction symptoms, and preventive healthcare are concerned. The patients were divided into groups depending on what knowledge sources on ischaemic heart disease they preferred — brochures, magazines, radio and TV, individual talks, group talks, films, the Internet. Results. The proportion of correct answers was 58.49 ± 19.89%; in the area of the disease knowledge 62.74 ± 31.52%; in the area of the preventive healthcare 57.14 ± 23.38%; and in the area of the disease symptoms 56.94 ± 25.84%. The source of health knowledge selected the most was educational brochures (80.2%), while radio and TV was selected the least (17.6%). The knowledge varied depending on patients’ preferences: so those who selected films — the knowledge of the disease symptoms was higher compared to the others (64.44 ± 26.93% vs. 55.27 ± 25.35%; p = 0.02; those who selected individual talks — the knowledge of the disease symptoms was lower compared to the others (55.33 ± 24.80 vs. 61.68 ± 26.51; p = 0.007); those who selected group talks — the knowledge of the disease symptoms was higher compared to the others (62.30 ± 28.07 vs. 55.16 ± 24.96; p = 0.02). As far the other two areas of knowledge are concerned, there were no significant differences in any group. Conclusions. Educational brochures are the most preferred source of knowledge about ischaemic heart disease by hospitalised patients as a result of myocardial infarction. The knowledge of ischaemic heart disease in patients with myocardial infarction is inadequate and it is not connected with patients’ preferences from the point of view of learning methods.

Effectiveness of therapeutic education in patients with myocardial infarction

Introduction. Notwithstanding the development of modern diagnostic-therapeutic techniques, cardiovascular diseases still pose a grave health, social, and economic issue. Patients hospitalised for acute coronary syndrome should, in addition to establishing an optimal pharmacotherapy, be made aware of how to prevent this disease and recognise it using its typical symptoms and signs. Objective. The objective of the study was to evaluate the effectiveness of educational intervention based on educational brochures in patients with myocardial infarction with regard to socio-demographic factors and baseline patients’ knowledge. Material and methods. The single-centre, prospective, observational study was conducted in a cohort of 248 patients with myocardial infarction (women n = 72, men n = 176), hospitalised between May 2015 and July 2016. Consistently with the results of univariate analysis, multivariate analysis identified age (–3.73/10 years; p < 0.0006) and the level of education (10.37; p < 0.0001) as independent factors influencing patients’ prehospital knowledge. Results. According to multivariate analysis of the level of knowledge following the educational intervention, the only factors affecting the process of learning were age (–2.04/10 years; p < 0.03) and remaining in a steady relationship (9.7; p = 0.0003). Among factors influencing the increase of knowledge, only the level of education was of statistical significance (–6.09; p < 0.02). Conclusions. The educational brochure proved to be an effective tool for therapeutic education, allowing minimisation of the disparities between the examined groups and improvement of the breadth of patients’ knowledge