Stress and related factors experienced by nurses working in a university hospital dealing with COVID-19 patients

PURPOSE: The purpose of this study was to identify the current stress experienced by nurses working at a university hospital that accepts COVID-19 patients and the factors associated with it, and to obtain suggestions on how to provide effective support to them. METHODS: An online, anonymous, self-administered survey was conducted among 845 nurses. The number of “yes” responses to 25 questions on the “Stress Checklist for COVID-19 Responders” was used as the subject’s stress level. RESULTS: The median stress level was 3, and the most common type of stress was “anxiety about infection”． Comparison between factors showed that nurses with “direct patient care experience”, “more than 10 years of experience”, and “certified as a response nurse” had higher stress levels. These three attributes were also significantly associated with stress levels in the multivariate analysis. Nurses were working to maintain their mental health by taking measures such as “enjoying activities at home”, and “getting enough sleep”, but at the same time, “a sense of mission as a nurse”, “sense of social obligation”, “benefits” etc. were the driving forces for continuing work. CONCLUSION: In order for nurses to fulfill their job responsibilities with satisfaction, they need not only the encouragement of their supervisors, but also an ongoing support system in the hospital organization, including emotional support, work adjustment, and financial rewards

Changes in attitudes toward home health care of young nurses who worked in wards and participated in a newly-designed training course on home-oriented health care.

The purpose of this study was to explore changes in the attitude toward home health care of young nurses who worked in wards and participated in a training course on home-oriented health care from May 2015 to February 2018. A questionnaire was distributed to 37 nurses of whom 28 agreed to participate. The attitude toward home health care of individual participant was evaluated using a visual analogue scale, and the “Yamagishi Scale” was used to evaluate home-oriented nursing practice. The attitude toward home health care was positively enhanced after one and two years during the course, and it remained so one year after the end of the course. Home-oriented nursing practice was significantly improved one year after the end of the course. These results indicated a positive impact provided by the training course on the attitude of young nurses toward home health care

Qualitative Analysis of the Psychosocial Adaptation Process in Children with Chronic Kidney Disease : Toward Effective Support During Transition from Childhood to Adulthood

【Background】 Pediatric chronic renal disease only shows abnormal values in a urinalysis in the initial stage, and subjective signs and symptoms are rare. If adolescents with chronic renal disease face a disease crisis combined with the usual developmental crisis, this may cause psychosocial maladaptation. We analyzed psychosocial adaptation in Japanese children with chronic renal disease in order to identify factors influencing healthy adaptation. 【Methods】 Ten children and adult patients with chronic kidney disease attending Tottori University Hospital, Japan in 2016 participated in a semi-structured interview (a modified version of the grounded theory approach) comprising questions about episodes since disease onset and thoughts/feelings at onset. 【Results】 Twenty-four concepts extracted from the data were sorted into 5 categories. These concepts and categories were expanded on an orthogonal axis with time and self-esteem in order to establish an adaptation model for children with chronic kidney disease. Category names are as follows. (Cat. 1: Emotional impact on being informed of disease, Cat. 2: Social challenges of treatment and resulting identity diffusion, Cat. 3: Emotional conflict on school return, Cat. 4: Resilience and related factors, Cat. 5: Re-establishment of identity). 【Conclusion】 Since pediatric chronic renal disease has few manifestations, it is difficult for patients to accept. Children facing a chronic disease crisis plus adolescent developmental crisis may show identity diffusion. In order for children to re-establish their identity and adapt to society, factors supporting resilience are important. Key factors include school life, interactions with friends, counseling by adult mentors and family acceptance. Healthcare professionals need to provide age-appropriate information on renal disease and support patients

Cognitive and Emotional Changes in Peer Educators of Type 2 Diabetes Patients After Starting Peer-Support Activities

Background: Diabetes self-management education through peer support has beneficial effects, especially in regions with limited medical resources. To ensure peer educators continue to provide peer-led education programs, it is important that they remain motivated to instruct patients. Here, to explore measures to enhance peer-educators’ motivation toward such programs, we examined the cognitive and emotional changes in Filipino type 2 diabetics after 7-month activities as peer educators. Methods: We individually performed semi-structured interviews with 13 peer educators with 20 years of age or above in August 2017 (immediately before starting their peer-education activities) and in March 2018 (7 months after the start). The first interview was performed after the peer educators had received 2-day training of diabetes self-management. In both interviews, we asked the peer educators about their feelings toward peer-led educational activities (e.g., satisfaction, difficulty, reward, confidence, and challenges). Their replies about their own cognition and emotions were interpreted and integrated, and then analyzed qualitatively. Results: Four and seven categories were extracted from the first and second interviews, respectively. The category “Cognition of patients’ active learning attitudes and of positive changes in patients’ physical conditions and behavior” observed in the second interview led to “Cognition of growth as a peer educator” and “Satisfaction with supporting patients as a peer educator.” These two feelings gave the peer educators’ “Increased motivation to continue the activities as a peer educator.” This motivation was also associated with “Active collaboration among peer educators,” which was affected by “Difficulties and concerns in working as a peer educator.” Conclusion: To sustain diabetic peer-led education programs, we suggest that interventions be implemented that increase peer educators’ motivation toward their activities and stimulate their awareness of the importance of collaborating with one another. Such collaboration should help to overcome the difficulties they may face in providing peer-led education

A Conceptual Model for Quality of Life Among People with Type 2 Diabetes in the Philippines

[Background] The increased prevalence of chronic diseases is a social issue in developing countries. [Methods] To create a conceptual model representing the quality of life of low-income people with type 2 diabetes in the Philippines, 117 low-income adult participants in a public support group were studied, and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores on quality of life (QOL) were analyzed in terms of their relationships with the following factors: basic attributes, physical factors (glycated hemoglobin level, complications, comorbidities, and symptoms), social factors (support, education, and financial status), and cognitive factors (knowledge, attitude, self-efficacy, and self-management behavior). [Results] Based on correlation coefficients among variables and goodness-of-fit test results through a path analysis, 2 models representing causal relationships were created, both of which showed sufficient goodness-of-fit. [Conclusion] Glycated hemoglobin levels, knowledge of blood glucose levels, self-efficacy, and self-management behavior (exercise) influenced PCS scores, while age, glycated hemoglobin levels, neuropathy, knowledge of insulin, self-efficacy, and self-management behavior (exercise) influenced MCS scores. The influence of self-efficacy was prominent in both cases, providing an important insight for healthcare professionals to develop effective support methods