Challenges of Recruiting a Vulnerable Population in a Grounded Theory Study

Recruitment is a crucial and fundamental part of research and one that poses various degrees of difficulty. This is particularly so when the area of research is one that is either highly sensitive, or that involves participants who are deemed to be particularly vulnerable. This article explores the inherent tensions in matters of participant recruitment among meeting the demands of institutional ethics committees, satisfying the concerns of clinicians in the field and the need to maintain methodological rigor. A postgraduate research student’s experience of these tensions underpins the discussion. The article concludes with an outline of the student’s strategies and resolution of these issues.postprin

The need for a definition of big data for nursing science: A case study of disaster preparedness

© 2016 by the author; licensee MDPI, Basel, Switzerland. The rapid development of technology has made enormous volumes of data available and achievable anytime and anywhere around the world. Data scientists call this change a data era and have introduced the term âBig Dataâ, which has drawn the attention of nursing scholars. Nevertheless, the concept of Big Data is quite fuzzy and there is no agreement on its definition among researchers of different disciplines. Without a clear consensus on this issue, nursing scholars who are relatively new to the concept may consider Big Data to be merely a dataset of a bigger size. Having a suitable definition for nurse researchers in their context of research and practice is essential for the advancement of nursing research. In view of the need for a better understanding on what Big Data is, the aim in this paper is to explore and discuss the concept. Furthermore, an example of a Big Data research study on disaster nursing preparedness involving six million patient records is used for discussion. The example demonstrates that a Big Data analysis can be conducted from many more perspectives than would be possible in traditional sampling, and is superior to traditional sampling. Experience gained from the process of using Big Data in this study will shed light on future opportunities for conducting evidence-based nursing research to achieve competence in disaster nursing.Link_to_subscribed_fulltex

The Experiences and Evaluation of a Complex Intervention for Couples Coping With Stroke

BACKGROUND: Globally, stroke is a leading cause of death and disability. With a strong sense of filial responsibility, Asian caregivers are committed to caring for their ill family members. In response, the 3H (Head, Heart, Hands) intervention was developed and implemented in Singapore to support couples in their coping after a stroke. The purpose of this study is to explore the experiences of the participants taking part in the 3H intervention and evaluate the intervention after they had participated in it.METHODS: An interpretive descriptive design was used. Semistructured qualitative interviews were conducted with 7 patients and 7 spousal caregivers. Data were analyzed using conventional content analysis.RESULTS: The participants' experience was described as one of becoming more prepared to face the storm. The "storm" resulted from a stroke, where the participants were worried and uncertain about their future. After participating in the intervention, the couples' coping processes had improved. They coped by breaking the silence and engaging in conversations, cultivating a sense of support, and conveniently fulfilling their educational needs. It was evaluated that extending the 3H intervention for community nursing is necessary to strengthen the care transition of couples from the hospital to home.CONCLUSION: New knowledge has been gained that the 3H intervention is useful and may be implemented in a clinical context before a patient's discharge from hospital. As a result of participating in the 3H intervention, effective coping was evident where participants engaged in conversations, cultivated a sense of support, and fulfilled their educational needs. Primary healthcare professionals should pay more attention to the difficulties and needs of this group of people, provide more resources to support them, and improve their quality of life.</p

Balancing cognitive diversity and mutual understanding in multidisciplinary teams.

BACKGROUND: Interprofessional health care teams are increasingly utilized in health care organizations. Although there is support for their capacity to solve complex problems, there is also evidence that such teams are not always successful. In an effort to understand the capacity of interprofessional teams to innovate successfully, we investigate the role of cognitive diversity to establish whether and how knowledge differences lead to innovation. PURPOSES: The aim of this study was to construct and investigate a model of team innovation predicted by cognitive diversity. In addition to investigating the direct impact of cognitive diversity in interprofessional health care teams, we develop a model incorporating mediated and moderated effects. In this study, we explore the role of debate as a mediating factor capable of explaining the impact of cognitive diversity on innovation. We further propose that the link between cognitive diversity and innovation through debate is contingent upon trans-specialist knowledge, knowledge shared by health care professionals, spanning specialist divides and enabling mutual understanding. METHODOLOGY: The hypotheses were investigated using a cross-sectional, correlational design. Survey data received from 75 interprofessional teams employed in an acute care setting, representing a 36% response rate, were used to investigate our model. FINDINGS: Analysis supports a significant relationship between cognitive diversity and debate, which is stronger when teams rate highly for trans-specialist knowledge. Results also support a positive relationship between debate and innovation and our full moderated mediated pathway. PRACTICE IMPLICATIONS: A range of strategies are indicated by our results to increase innovation in interprofessional teams. In particular, interventions such as interprofessional education and training, which have been shown to facilitate the development of shared language and meaning, are recommended by our findings

The significance of personal learning environments (PLEs) in nursing education: extending current conceptualizations.

Background - Personal learning environments (PLE) have been shown to be a critical part of how students negotiate and manage their own learning. Understandings of PLEs appear to be constrained by narrow definitions that focus primarily on technological engagement with a range of web tools and associated applications. This paper addresses a gap in the literature around PLEs for students currently enrolled in undergraduate nursing degrees. Purpose - To provide in-depth insights into how undergraduate students of nursing manage and experience their learning. Methods - This was an international multi-site qualitative study, utilizing focus groups. A schedule of 10 questions and nominal group techniques were used. Findings - Whilst the focus groups took place in very different geographical locations, there were strong similarities in student understandings of effective PLEs. These went well beyond current technological definitions. Findings were organized into three major themes; technologies, learning modalities and influencing factors. Discussion - We propose a broader understanding of PLEs that acknowledges individual personal and cultural contexts which we call the personally significant learning environment (PSLE). There is a need for greater investigation of how students understand and systematize their PSLE. Conclusions - This paper and our findings will be of interest to educators, researchers and institutions for developing appropriate frameworks that may maximize learning outcomes, encourage cultural sensitivities and facilitate greater understandings of how to support students to create appropriate PSLEs

Understanding the ecology of the Personally Significant Learning Environment (PSLE): one year on.

Background - Personal learning environments (PLE) have been shown to be critical in how students negotiate, manage and experience their learning. Understandings of PLEs are largely restricted by narrow definitions that focus on technology alone. The idea of a PLE is often conflated with virtual learning environments. In this presentation, we draw on empirical findings from an international study. Our findings will be of interest to students, educators, researchers and institutions and will facilitate a more in depth understanding of how to support students to create appropriate PLEs for effectively managing their own learning

Evaluation of a virtual reality based interactive simulator with haptic feedback for learning NGT placement

Background The placement of a nasogastric tube is a blind process; the tube may be mistakenly inserted into other locations, leading to possible complications or fatal incidents. Effective education and training of nursing students to perform this procedure is essential. Purpose To investigate the application of the virtual reality based simulator with haptic feedback to nursing students for their learning around nasogastric tube placement. Methods A quasi-experimental non-equivalent group pre- and post-test study, in which the outcome measures of two classes of pre-registration nursing students were compared for their evidence of learning about the advanced NGT simulator (in addition to usual training) against the control group who only used mannequins for their usual education and training. Results There was a decrease, though remaining at a good level, in the technology acceptance rating within (p = .000) and between (p < .05) the simulator group than the control over time at post-test. Taking into consideration of some demographic differences at baseline between the two groups, analysis of results demonstrated that there was no predictor effect of those factors in relation to technology acceptance (F = .02, p = .922), but in scores for the test using multiple-choice questions (MCQ) about knowledge in nasogastric tube insertion (F = 23.4, p = .000). Both groups demonstrated significant increases in MCQ scores at post-test, with higher scores in the simulator group at both pre-test (p < .05) and post-test (p = .000). There was no significant difference in learning outcomes around competence in skills within the evaluation results between groups at post-test. Usability of the simulator system as rated by the simulator group was good. Conclusions Students did not reject the use of the new simulator for their learning about nasogastric tube placement. As an adjunct to conventional teaching and learning, the use of the simulator appears to be promising in enhancing the education and training of nursing students for development of the important clinical skill of safe nasogastric tube placement. Future studies are warranted, with the design inclusive of equivalent groups and a larger sample size to further the evidence in substantiating the use of this simulator for better learning outcomes

Intensive care nurse-family engagement from a global perspective: A qualitative multi-site exploration

Background: Critical illness is distressing for families, and often results in negative effects on family health that influence a family\u27s ability to support their critically ill family member. Although recent attention has been directed at improving care and outcomes for families of critically ill patients, the manner in which nurses engage with families is not fully understood. Objectives: To describe nurses’ perceptions and practices of family engagement in adult intensive care units from a global perspective. Design: A qualitative-descriptive multi-site design using content analysis. Settings: The study was conducted in 26 intensive care units of 12 urban, metropolitan, academic medical centers in ten countries, spanning five continents. Participants: A total of 65 registered nurses (77% women, age of M = 39.5, SD = 11.4 years) participated. Most held intensive care certification (72%) and had worked on average 10 (SD = 9.6) years in the ICU. Methods: Semi-structured, individual interviews (M = 38.4 min, SD = 12.0) were held with ICU nurses at the hospital (94%) or their home using an interview guide. Qualitative interview data were analysed using inductive content analysis. Results: We found that nurse-family engagement was an ebb and flow of relational power that needed to be carefully negotiated and balanced, with nurses holding and often exerting more power than families. Constant fluctuations in nurses’ practices of engagement occurred in day-to-day practice from shift-to-shift and from nurse-to-nurse. Family engagement was dependent on individual nurses’ attitudes and perceptions of family, the patient\u27s condition, and workload. Lastly, family engagement was shaped by the ICU context, with team culture, collaborative relationships, unit structures and organizational resources either enabling or limiting nurses’ ability to engage with families. Conclusions: This global study provides an in-depth understanding of the way nurses engage with families in ICU and reflects many different cultures and health systems. We found that nurse-family engagement was marked by a shifting, yet often unequal power distribution in the nurse-family relationship, inconsistent nurse engagement practices, both of which resulted in variable family engagement in intensive care. Our research contributes a detailed description of engagement as practiced in the everyday delivery of health care. A more concentrated team effort, based on a shared culture and defined framework of family care is needed to ensure that families of critically ill persons are fully engaged in all aspects of intensive care

Attitude, acceptability and knowledge of HPV vaccination among local university students in Hong Kong

© 2016 by the authors; licensee MDPI, Basel, Switzerland. The Human Papillomavirus (HPV) vaccine has the great potential to prevent HPV-related infections for millions of women and men worldwide. However, the success of the vaccine is highly dependent on the vaccination rate. Factors influencing the attitudes of undergraduate students towards HPV vaccination should be studied. This is a cross-sectional survey that was conducted to estimate the HPV vaccination rate among undergraduate students in Hong Kong, and to identify the predictors of their attitude towards HPV vaccination. The results showed that the HPV vaccination rate was 13.3%. Factors related to knowledge of vaccination were the main predictors of the studentsâ attitude towards vaccination (there were seven predictors, with B = 1.36 to 2.30; p < 0.05), followed by gender (B =-1.40; p < 0.05), acceptable maximum price (B = 0.35; p < 0.05), and willingness to receive the HPV vaccine if it can protect against cervical/anal cancer and genital warts (B =-1.90; p < 0.001).Theregressionmodelthatwasdevelopedbasedonthepredictorshadamoderateeffect size (adj-R 2 = 0.33). To conclude, the HPV vaccination rate among undergraduate students in Hong Kong was low. They should be provided with more active education and activities to promote HPV vaccination to improve their knowledge on the subject.Link_to_subscribed_fulltex

A brief cognitive-behavioral psycho-education (B-CBE) program for managing stress and anxiety of main family caregivers of patients in the intensive care unit

© 2016 by the authors; licensee MDPI, Basel, Switzerland. Having a loved one in the intensive care unit (ICU) is a stressful event, which may cause a high level of anxiety to the family members. This could threaten their wellbeing and ability to support the patients in, or after discharge from, the ICU. To investigate the outcomes of a brief cognitive-behavioral psycho-education program (B-CBE) to manage stress and anxiety of the main family caregivers (MFCs), a pragmatic quasi-experimental study involving 45 participants (treatment group: 24; control group: 21) was conducted in an ICU. The Depression and Anxiety Stress Scale and the Critical Care Family Need Inventory were used to evaluate the primary outcomes on stress and anxiety, and satisfaction with family needs. The treatment group reported significantly better improvement in the information satisfaction score compared to the control group (p < 0.05; η 2 = 0.09). Overall main effects were observed on the stress (p < 0.01; η 2 = 0.20), anxiety (p < 0.01; η 2 = 0.18), depression (p < 0.05; η 2 = 0.13), support satisfaction (p < 0.05; η 2 = 0.13), and comfort satisfaction (p < 0.05; η 2 = 0.11) scores. The experience of this study suggest that MFCs are in great need of additional support like B-CBE to manage their stress and anxiety. Given the brevity of B-CBE, it is practical for critical care nurses to deliver and MFCs to take within the industrious context of an ICU. More studies are needed to investigate these types of brief psychological interventions.published_or_final_versio