Exploring resilience for people with type 2 diabetes who have a wound

Comorbidities related to diabetes such as chronic wounds can increase the need for surgical procedures, with at least 10% of all patients undergoing surgery having diabetes. Being diagnosed with diabetes can be seen as a risk factor for developing wound healing problems. Discussion: This short report highlights the potential positive influences gained from providing resilience education and self- management education to people with type 2 diabetes, potentially enhancing self-managing abilities and reducing poor wound healing. Summary: Modern wound care practice is centred on symptom reduction and working with pathology; however, working with people to enhance their personal resilience and promoting positive psychological adaptation can impact positively on their mental health

Exploring Resilience When Living with a Wound — An Integrative Literature Review

The psychological impact for patients with wounds can be significant, and adverse psychological effects frequently occur when there are permanent changes in the body’s structure or function. Evidence suggests that anxiety, depression and stress can adversely affect the wound healing process. An integrative review examined any paper that discussed any patient in any health care setting who had experienced a psychological impact from the experience of having a wound and the experience of being resilient in that context. Ninety nine papers were located in the initial search with twelve meeting the inclusion criteria and being reviewed. A review of the papers identified that improvement and maintenance of quality of life was perceived to be an important aspect of patient management, but none focused on resilience as a primary endpoint. Further research is required into the clinical benefits of resilient behaviours in patients living with a wound

Exploring quality of life, physical and psychosocial morbidity for patients with non-infected wounds: a pilot study

This article reports on the results of a pilot study exploring health-related quality of life and the experience of being resilient in patients who develop acute, non-infected surgical wounds. By investigating this under-researched area of wound management, the project team intended to highlight the aspects of patient empowerment in healing post-surgery, encompassing the physical, social and psychological domains. Participants were recruited from patients who had undergone a surgical procedure resulting in an acute non-infected healing wound, and who met the inclusion criteria of the study. Patients were excluded if they had a chronic wound in addition to their acute surgical wound. Valid scores on the physical health (PCS) and mental health (MCS) domains of the SF-12 could only be obtained from six patients pre-operatively. A further six patients completed the SF12 instrument pre-operatively (five valid sets of scores obtained); these patients did not complete the HADS scale. Paired samples t-tests conducted on patients from whom both pre- and postoperative scores were obtained found no significant difference between pre-operative and postoperative PCS scores (p=0.468) or MCS scores (0.806); or between pre-operative and postoperative scores on the anxiety subscale on the HADS scale (p=0.951) or the depression subscale (p=0.951). However, as a pilot study, the study was not powered to detect significant differences. Higher levels of anxiety were revealed in this pilot study than in the wider population. No differences were observed between pre-operative and postoperative scores for physical and mental wellbeing. The findings, while from a small sample set, indicate anxiety is experienced by people living with a wound, and needs to be a consideration in care management plans to enhance adaptation

Are new nurses work ready – the impact of preceptorship. An integrative systematic review

The aim of this integrative systematic review was to systematically search, critically appraise, and summarise reported research related to readiness to practice and types of clinical support offered to newly registered nurses and preregistration nurses (such as, mentoring, preceptorship, or clinical facilitation). The review was undertaken in February 2017. The databases of Medline, CINAHL, Academic Search Complete, and Cochrane Library were searched. The search returned 137 articles. The final number of papers (after screening and exclusions) was 15 articles related to the topic. Key findings that influence work readiness for newly registered nurses were - Importance of Preceptors for Facilitating Work Readiness with the sub themes of Positive relationships between the preceptors and the student or newly registered nurse, Preparing and supporting the preceptor for the role and Using a model to guide preceptorship of students, the second theme was related to Clincal Exposure, including a sub theme of Adequate clinical exposure and clinical competence. Work readiness has been attributed to many factors and this review has revealed a number of key factors that contribute to newly registered nurses’ work readiness such as preparation of the preceptor, positive relationships and adequate clinical exposure.

Wearable activity trackers and health awareness : nursing implications

Purpose: Wearable devices are commonly used to measure physical activity. However, it remains unclear the effect of wearing these devices on health awareness. Our aim was to provide evidence related to wearing physical activity trackers and health awareness. Methods: A quantitative comparison study design was used comparing participants who wore physical activity tracking devices (n = 108) and those who did not (n = 112). A paper-based Physical Health Knowledge survey designed for the purpose of this research was used for data collection in 2018. Results: A difference between participants who wore physical activity tracking devices and those that did not was identified in relation to activity levels and physical health awareness. Wearable devices are suggested as an opportunity for nurses to engage people in physical activity with the potential to improve their health awareness. Conclusions: Nurses are well placed in the healthcare landscape to work with patients who own an activity tracker device concerning increasing activity self-monitoring. This information the patient has from the device can also form the basis of health discussions between nurses and the people in their care. © 2020 Chinese Nursing Associatio

General Hospital Health Professionals' Attitudes and Perceived Dangerousness Towards Patients with co-Morbid Mental and Physical Health Conditions: Systematic Review and Meta-Analysis

The stigmatisation of mental health is present in general hospital settings impacting quality of care. We hypothesised that health professionals in these areas would elicit negative attitudes and a perceived level of dangerousness across a range of mental health disorders. We aimed to conduct a systematic review and meta-analysis to examine these attitudes and perceptions. We searched the bibliographic databases of CINAHL Complete, MEDLINE Complete, PsycINFO and Psychology and Behavioral Sciences Collection in May 2017 (no date parameters were set). Quantitative studies investigating generalist health professionals’ attitudes towards mental health conditions were selected. Initially prevalence meta-analyses were conducted to assess the extent of perceived danger, followed by a series of comparative meta-analyses in which the perceived dangerousness of mental health conditions were compared. Of the 653 citations retrieved, eight studies met the inclusion criteria. The overall sample included 2548 health professionals. A majority of health professionals perceived patients with substance use disorder as dangerous 0.60 (95% CI: 0.32 to 0.88) when compared with patients who had an alcohol-related disorder, schizophrenia and depression. The results also indicated that a large proportion of staff perceived patients with a diagnosis of schizophrenia as dangerous 0.42 (95% CI: 0.33 to 0.52). Negative attitudes towards people experiencing mental illness in general hospital settings may be attributed to poor mental health literacy, skills and limited exposure, and social and cultural beliefs about mental illness. Ongoing professional development targeting mental health knowledge is recommended for health professionals working in general hospital settings

The fabric of a career in mental health nursing from an Australian and UK perspective

As the prevalence of mental illness increases globally, Australia and the United Kingdom (UK) share concerns regarding the recruitment and retention of nurses to the field of mental health care. The level of preparedness of nurses is thought to have a bearing on recruitment and retention in mental health nursing practice. This study sought to uncover what Australian and UK undergraduate students perceived as motivational in choosing a career in, and being prepared for, working in mental health settings. METHOD This study employed mixed methods, using a questionnaire comprising of both quantitative and qualitative questions. Quantitative data was analysed using SPSS (V.16.0) and content analysis was undertaken for analysing the qualitative data. FINDINGS Following ethical approval, data was collected from, four universities in Australia and two in the UK. A total of 447 undergraduate nursing and midwifery students, who had completed a mental health placement, completed the questionnaire. Findings revealed that motivational factors influencing their interest in mental health nursing were clinical experience (49.7%), personal/life experiences (42.9%) and the role of the lecturer (23%). However, 47.7% of all participants had some previous experience of mental illness, with only 18.4% having had work experience in the field prior to starting their course. IMPLICATIONS This study adds to extant knowledge of what encourages people to choose a career trajectory in mental health nursing and what could be harnessed with regard to retention. The knowledge gained from these findings is useful in informing recruitment processes and can also inform curriculum

Effect of a thermal care bundle on the prevention, detection and treatment of perioperative inadvertent hypothermia

Aims and Objectives: To improve the prevention, detection, and treatment of perioperative inadvertent hypothermia (PIH) in adult surgical patients by implementing a Thermal Care Bundle. Background: Keeping patients normothermic perioperatively prevents adverse surgical outcomes. Hypothermia leads to serious complications including increased risk of surgical bleeding, surgical site infections, and morbid cardiac events. The Thermal Care Bundle consists of three elements: 1) assess risk; 2) record temperature; and (3) actively warm. Design: A pre-post implementation study was conducted to determine the impact of the Thermal Care Bundle on the prevention, detection and treatment of PIH. Methods: The Thermal Care Bundle was implemented using an adapted version of the Institute of Healthcare Improvement's Breakthrough Series Collaborative Model. Data were collected from auditing medical records. Results: Data from 729 patients (pre-implementation: n=351; post-implementation: n=378) at four sites were collected between December 2014 to January 2016. Improvements were recorded in the percentage of patients with a risk assessment; at least one documented temperature recording per perioperative stage; and appropriate active warming. Despite this, the overall incidence of PIH increased post-implementation. Conclusion: The Thermal Care Bundle facilitated improved management of PIH through increased risk assessment, temperature recording, and active warming but did not impact on PIH incidence. Increased temperature recording may have more accurately revealed the true extent of PIH in this population