148 research outputs found
Developing a stoma acceptance questionnaire to improve motivation to adhere to enterostoma self-care
IntroductionIn stoma care, patient education is often weak in terms of improving patientsâ level of acceptance of living with a stoma. Self-care educational interventions in enterostomal patients, which according to Oremâs Theory should take into account these patientsâ specific needs, require instruments that measure patientsâ stoma acceptance to improve motivation based on the resumption of activities they used to carry out before having a stoma.MethodsThe aim was to develop an instrument that measures the level of stoma acceptance to improve motivation to adhere to enterostoma self-care.Aspects that improve stoma acceptance and consequently motivation to adhere to enterostoma self-care were identified through 10 focus groups. In the focus groups, the motivation indicators were grouped, categorised and results entered into a Stoma Acceptance Questionnaire (SAQ). The SAQ was then piloted with 104 enterostomal patients from three general hospitals. The SAQ latent structure was explored using nonparametric item response theory.ResultsA three-factor structure was demonstrated for the 16 items of the SAQ: Autonomy and normality; Self-determination and normality; and Trust and burden. Mokken Scaling identified the âresumption of enterostomal patientsâ normal activitiesâ as a measure of stoma acceptance.DiscussionThe SAQ could enable nurses to adopt a standardized approach to the assessment of enterostomal patientsâ motivation to resume their normal activities and identify needs linked to this. The SAQ could also be used to measure the effectiveness of psychosocial and educational interventions aimed at improving stoma acceptance
Incorporating nursing complexity in reimbursement coding systems: the potential impact on missed care
Spiritual Assessment within Clinical Interventions Focused on Quality of Life Assessment in Palliative Care: A Secondary Analysis of a Systematic Review
One of the most crucial palliative care challenges is in determining how patients' needs are defined and assessed. Although physical and psychological needs are commonly documented in patient's charts, spiritual needs are less frequently reported. The aim of this review was to determine which explicit, longitudinal documentation of spiritual concerns would sufficiently affect clinical care to alleviate spiritual distress or promote spiritual wellbeing. A secondary analysis of a systematic review originally aimed at appraising the effectiveness of complex interventions focused on quality of life in palliative care was conducted. Five databases were searched for articles reporting interventions focused on QoL including at least two or more QoL dimensions. A narrative synthesis was performed to synthesize findings. In total, 10 studies were included. Only three studies included spiritual wellbeing assessment. Spirituality tools used to assess spiritual wellbeing were different between studies: Hospital QoL Index 14; Spiritual Needs Inventory; Missoula-Vitas QoL Index; and the Needs Assessment Tool: Progressive Disease-Cancer. Only one study reported a healthcare professional's session training in the use of the QoL tool. Two out of three studies showed in participants an improvement in spiritual wellbeing, but changes in spiritual wellbeing scores were not significant. Overall patients receiving interventions focused on QoL assessment experienced both improvements in their QoL and in their spiritual needs. Although spiritual changes were not significant, the results provide evidence that a spiritual need exists and that spiritual care should be appropriately planned and delivered. Spiritual needs assessment precedes spiritual caring. It is essential that interventions focused on QoL assessment in palliative care include training on how to conduct a spiritual assessment and appropriate interventions to be offered to patients to address their spiritual needs
Holistic Nursing of Forensic Patients: A Focus on Spiritual Care
Prisons are a unique context where nurses are required to have specific skills to ensure that prisoners receive the same type of holistic care as anyone else out of prison, including spiritual care. This discussion paper focuses on understanding how nurses deliver spiritual care in Italian prisons where there are often limited resources and where organizational priorities hinder the provision of holistic nursing. This paper draws from a previous qualitative research study that we had conducted. In this study, we observed that prison nurses reported that they experienced many difficulties related to the provision of holistic care to prisoners. This was particularly true for spiritual care in vulnerable forensic patients, such as older individuals, and physically and mentally frail prisoners. Prison officers did not allow nurses to just "listen and talk" to their patients in prison, because they considered it a waste of time. The conflict between prison organizational constraints and nursing goals, along with limited resources placed barriers to the development of therapeutic relationships between nurses and prisoners, whose holistic and spiritual care needs remained totally unattended. Therefore, prison organizational needs prevailed over prisoners' needs for spiritual care, which, while fundamental, are nevertheless often underestimated and left unattended. Educational interventions are needed to reaffirm nurses' role as providers of spiritual care
The general results of the RN4CAST survey in Italy
The issue of health workforce shortage and in particular of nurses, has been debated globally for almost three decades (Aiken & Mullinix 1987, Aiken et al. 1996, 2001, 2010), and has been exacerbated by the recent global financial crisis. The European RN4CAST project has shifted focus from considering only nursing workforce planning and workforce volumes to considering the impact of adequate nurse-patient ratios and work environment on patient safety and the quality of care (Sermeus et al. 2011)
The Edinburgh feeding evaluation in dementia scale: a longitudinal study in nursing home residents
Aims/Background: The Edinburgh Feeding Evaluation in Dementia (EdFED) scale has been shown to have good psychometric properties using a range of methods including Mokken scaling. We aimed to study the Italian version of the EdFED using Mokken scaling. Methods: Data were gathered at 7 time points from 401 nursing home residents affected by dementia in the course of a 6-month intervention study using analysis of variance, Mokken scaling, and person-item fit statistics. Results: The properties of the EdFED-I scale were stable over the course of the study with 4 items showing invariant item ordering at all time points. Some items behaved differently at different levels of difficulty in the scale and also depending on the mean level of feeding difficulty. The test information function showed a dip in the mid-range of difficulty scores
Experiences of participating in intergenerational interventions in older people's care settings: A systematic review and meta-synthesis of qualitative literature
Aims: To synthesize the findings of qualitative research exploring the experiences of being involved in intergenerational interventions in older people's care settings. Design: A meta-synthesis of the qualitative literature, employing Sandelowski and Barroso's method, was conducted. Data Sources: Eight databases were searched in March 2017. Review Methods: The PRISMA statement was used for reporting the different phases of the literature search and the Critical Appraisal Skills Programme (CASP) qualitative research checklist was used as an appraisal framework. Data synthesis was conducted using Sandelowski and Barroso's method. Results: Four qualitative studies were included in the meta-synthesis. Thematic analysis revealed four themes: ‘Recreating the family’; ‘Building intergenerational empathy and respect’;‘Uplifting and energizing’; and ‘Engagement risks and challenges’. Conclusion: The meta-synthesis strengthens the evidence that intergenerational interventions can be positive. However, it also shows that there may also be some negative aspects if not planned or managed carefully. Impact: This review contributes to the body of evidence by synthesizing the experiences of older people and children involved in intergenerational interventions. Although qualitative literature supports the quantitative evidence that intergenerational interventions can have a positive effect, intergenerational interventions could also have negative effects on some participants. Older people may feel tired, or experience feelings of infantilization. Practitioners need to be more aware of the potential negative effects of intergenerational interventions and include risk assessment, possibly by requiring ethical scrutiny
Italian nurses' COVID-19 experiences from mass media interviews: a qualitative study
Introduction: The COVID-19 pandemic is heavily hitting healthcare systems around the world, and nurses are battling in the front line. Previous studies have reported nurses’ responses to catastrophic situations, but also interviews released by Italian nurses to the main mass media channels could bear important messages for policy makers and stakeholders.This study describes Italian front-line nurses’ experiences during the COVID-19 pandemic through television interviews.
Methods: This is a descriptive qualitative study. Data were collected through purposive sampling from Italian front-line nurses’ interviews during the COVID-19 pandemic. Publicly available interviews between 7th and 29th March 2020 were collected from the websites of national and regional television stations. Thematic content analysis was used to describe, summarize, and classify data into macro themes. The study is compliant with Standards for Reporting Qualitative Research.
Results: A total of 21 television interviews were collected from front-line clinical nurses, nursing managers, nursing trade union representatives and representatives of the Nursing Regulator. Thematic analysis yielded four macro-themes: psycho-social effects of the COVID-19 pandemic on health professionals; altered patient relationships; personal safety; recognition and promotion of the profession.
Conclusions: The COVID-19 pandemic has exacerbated some problems already present, such as the shortage of nurses, but has also turned the spotlight on the nursing profession. Highly involved and affected by the pandemic, nurses have become better known by the public and often also protagonists of public discussions. It is important that nurses’ value as allies of the public emerges stronger from this dramatic situation
Italian nurses' COVID-19 experiences from mass media interviews: a qualitative study
Introduction. The COVID-19 pandemic is heavily hitting healthcare
systems around the world, and nurses are battling in the front line.
Previous studies have reported nurses\u2019 responses to catastrophic situations,
but also interviews released by Italian nurses to the main mass
media channels could bear important messages for policy makers and
stakeholders. This study describes Italian front-line nurses\u2019 experiences
during the COVID-19 pandemic through television interviews.
Methods. This is a descriptive qualitative study. Data were collected
through purposive sampling from Italian front-line nurses\u2019 interviews
during the COVID-19 pandemic. Publicly available interviews
between 7th and 29th March 2020 were collected from the websites
of national and regional television stations. Thematic content analysis
was used to describe, summarize, and classify data into macro
themes. The study is compliant with Standards for Reporting Qualitative
Research.
Results. A total of 21 television interviews were collected from
front-line clinical nurses, nursing managers, nursing trade union
representatives and representatives of the Nursing Regulator. Thematic
analysis yielded four macro-themes: psycho-social effects of
the COVID-19 pandemic on health professionals; altered patient
relationships; personal safety; recognition and promotion of the
profession.
Conclusions. The COVID-19 pandemic has exacerbated some problems
already present, such as the shortage of nurses, but has also
turned the spotlight on the nursing profession. Highly involved and
affected by the pandemic, nurses have become better known by the
public and often also protagonists of public discussions. It is important
that nurses\u2019 value as allies of the public emerges stronger from
this dramatic situation
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