Student supervision using the Scrub Practitioners List of Non-Technical Skills (SPLINTS-no): The experiences of Norwegian operating room nurses

Master's thesis in Nursing ScienceBakgrunn: Forskning viser at en stor andel av pasientskader oppstår i forbindelse med kirurgi, og at ikke-tekniske ferdigheter hos operasjonssykepleierne har betydning for pasient-sikkerheten på operasjonsavdelingen. SPLINTS-no er et observasjons- og vurderingsverktøy som har til hensikt å stimulere utviklingen av ikke-tekniske ferdigheter hos operasjons-sykepleierstudenter og uerfarne operasjonssykepleiere. Formål: I vårt kvalitetsforbedringsprosjekt ble SPLINTS-no brukt i veiledning av operasjons-sykepleierstudenter i kliniske studier. Hensikten med prosjektet var å beskrive operasjons-sykepleieres erfaringer med å bruke SPLINTS-no i veiledning av ikke-tekniske ferdigheter hos operasjonssykepleiestudenter i kliniske studier. Metode: Vi har brukt kvalitativ metode for å få svar på problemstillingen. Data ble samlet via semistrukturerte intervju av operasjonssykepleiere som har brukt SPLINTS-no i student-veiledning. Datamaterialet er analysert i henhold til Graneheim og Lundmans kvalitative innholdsanalyse (2004). Funn: Vår analyse resulterte i to tema, hvert med to sub-tema: Fordeler med implementering av SPLINTS-no, med subtema: Økt oppmerksomhet på ikke-tekniske ferdigheter og Forbedret og forenklet studentveiledning. Utfordringer med implementering av SPLINTS-no, med subtema: Grundig teoretisk opplæring, praktisk øvelse og egeninnsats er nødvendig for en vellykket implementering og Arbeidsgiver må tilrettelegge for tid til opplæring i SPLINTS-no for å støtte implementering. Konklusjon: Studien indikerer at SPLINTS-no gir en forbedret og mer strukturert studentveiledning på ikke-tekniske ferdigheter hos operasjonssykepleiestudenter i kliniske studier, og at tilrettelegging fra arbeidsgiver er nødvendig i videre arbeid med implementering av SPLINTS-no

Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial

Background Generalised anxiety disorder (GAD) is a frequent and severe disorder among older adults. For older adults with GAD the effect of the recommended treatment, cognitive behaviour therapy (CBT), is reduced. Physical exercise (PE) may enhance the effect of CBT by improving cognitive function and increasing levels of brain-derived neurotrophic factor (BDNF), a predictor of the effect of CBT in patients with anxiety. The aim of the study was to assess the feasibility of a randomized controlled trial (RCT) investigating treatment effect of the combination of CBT and PE for GAD in a sample of older adults, including procedures for assessment and treatment. Methods Four participants aged 62–70 years (M = 65.5, SD = 3.2) with a primary diagnosis of GAD were included. Participants received 15 weeks of PE in combination with 10 weeks of CBT. Participants completed self-report measures, and clinical, biological, physiological and neuropsychological tests at pre-, interim- and post-treatment. Results Procedures, protocols, and results are presented. One participant dropped out during treatment. For the three participants completing, the total adherence to PE and CBT was 80% and 100%, respectively. An independent assessor concluded that the completers no longer fulfilled the criteria for GAD after treatment. Changes in self-report measures suggest symptom reduction related to anxiety and worry. The sample is considered representative for the target population. Conclusions The results indicate that combining CBT and PE for older adults with GAD is feasible, and that the procedures and tests are suitable and manageable for the current sample.publishedVersio

Usikker tilknytning og sårbar narsissisme - reaksjoner og mestring ved brudd i parforhold

The association between insecure (anxious and avoidant) attachment and dissolution of romantic relationships has been investigated in previous studies. The aim of this paper was to review literature examining the association between adult insecure attachments, reactions to, and coping with breakups. A literature search resulted in seven articles, from the period between 1992 and 2011, investigating insecure attachment and dissolution of romantic relationships. The present review showed that anxious attachment was associated with negative emotions, proximity-seeking and hostile behavior, appraise of the breakup as a threat, and a lack of ability to handle it, in addition to less adequate coping strategies. Avoidant attachment was associated with both positive and negative emotions, avoidant behavior, assessment of the breakup as a threat, positive assessment of the ability to handle the situation, and little use of social support as coping strategies. The association between avoidant attachment and reactions to, and coping with, breakups was affected by differing operationalization of attachment. The results are discussed in light of general attachment theory. On the basis of a theoretical similarity between insecure attachment and vulnerable narcissism the results are discussed in relation to vulnerable narcissism. The knowledge obtained from this review can have implications for clinical practice, and for further research regarding the association between vulnerable narcissism and romantic relationships dissolution

Student supervision using the Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS-no): A qualitative study

Background The importance of non-technical skills in the prevention of adverse events in the operating room is well documented through research. With the increased attention to non-technical skills, the need for structured training to support the development of such skills has emerged. The Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS) is an instrument for structuring observation as well as rating and feedback of non-technical skills for operating room nurses, and it can be used for student supervision and self-reflection. SPLINTS-no is the Norwegian translation and adaptation of SPLINTS. Objective To explore the experiences of operating room nurse preceptors using SPLINTS-no in the supervision of operating room students' non-technical skills. Design An explorative qualitative design was used. Methods Data were collected using semi-structured qualitative interviews with 10 operating room nurse preceptors in a Norwegian university hospital. The data were analysed by inductive qualitative content analysis. Results The operating room nurse preceptors experienced that the use of SPLINTS-no had an impact on the quality of student supervision. They improved their supervision competencies, and the use of SPLINTS-no contributed to consistency in observation and supervision. There were also findings supporting that reflection over non-technical skills contributed to building an increased awareness of these skills. Conclusions SPLINTS-no has an impact on clinical student supervision through an increased awareness on non-technical skills. It is well accepted by the operating room nurses as a supportive tool in the supervision of non-technical skills of student operating room nurses during clinical placement

Physical exercise as an add-on treatment to cognitive behavioural therapy for anxiety: A systematic review

Background: Cognitive behavioural therapy (CBT) is currently the treatment of choice for most anxiety disorders. Yet, with recovery rates of approximately 50%, many patients fail to achieve complete remission. This has led to increased efforts to enhance treatment efficacy. Physical exercise (PE) has in recent years been advocated as means to augment the effects of CBT for anxiety disorders. PE appears to reduce anxiety through other mechanisms than CBT, some of which might also have the potential to augment the effects of psychological treatment. Aims: The current review aimed to summarize and discuss the current research status on CBT augmented with PE for anxiety. Method: A systematic literature search was conducted in the databases PsychInfo, Medline and Web of Science to evaluate the potential augmentative effect of combining PE with CBT for anxiety disorders. These effects were intended to be evaluated in a meta-analysis, but findings from the few and diverse studies were better summarized in a systematic review. Results: Eight articles were included in this review, of which two had no control group, while six had from two to four experimental arms. Six of the studies concluded in favour of benefits of add-on PE, while two studies found no added benefits of the combined interventions. Conclusions: The combination of PE and CBT appears feasible. Add-on PE seems to be more beneficial for clinical populations, when administered regularly several times per week, across several weeks. Future studies should investigate further how and for whom to best combine PE and CBT.publishedVersio

Physical exercise as an add-on treatment to cognitive behavioural therapy for anxiety: A systematic review

Background: Cognitive behavioural therapy (CBT) is currently the treatment of choice for most anxiety disorders. Yet, with recovery rates of approximately 50%, many patients fail to achieve complete remission. This has led to increased efforts to enhance treatment efficacy. Physical exercise (PE) has in recent years been advocated as means to augment the effects of CBT for anxiety disorders. PE appears to reduce anxiety through other mechanisms than CBT, some of which might also have the potential to augment the effects of psychological treatment. Aims: The current review aimed to summarize and discuss the current research status on CBT augmented with PE for anxiety. Method: A systematic literature search was conducted in the databases PsychInfo, Medline and Web of Science to evaluate the potential augmentative effect of combining PE with CBT for anxiety disorders. These effects were intended to be evaluated in a meta-analysis, but findings from the few and diverse studies were better summarized in a systematic review. Results: Eight articles were included in this review, of which two had no control group, while six had from two to four experimental arms. Six of the studies concluded in favour of benefits of add-on PE, while two studies found no added benefits of the combined interventions. Conclusions: The combination of PE and CBT appears feasible. Add-on PE seems to be more beneficial for clinical populations, when administered regularly several times per week, across several weeks. Future studies should investigate further how and for whom to best combine PE and CBT

Physical Exercise and Serum BDNF Levels : Accounting for the Val66Met Polymorphism in Older Adults.

BACKGROUND: Brain-derived neurotrophic factor (BDNF) expression, which can be measured in blood serum, has been found to increase with aerobic exercise. The link between BDNF level, physical exercise, and genetic status (Val66Met polymorphism) has not been well researched in older adults. OBJECTIVE: To investigate the possible link between BDNF expression, acute aerobic exercise, and the Val66Met polymorphism in older adults. METHOD: Twenty-three healthy older adults participated in one session of acute aerobic exercise. Their serum BDNF levels were measured both at baseline and post exercise. Saliva samples were collected to identify each individual's genetic status. RESULTS: At baseline, the individuals' mean serum BDNF level was 16.03 ng/mL (Val66Val = 15.89 ng/mL; Val66Met = 16.34 ng/mL); post exercise, the individuals' mean serum BDNF level was 16.81 ng/mL (Val66Val = 16.14 ng/mL; Val66Met = 18.34 ng/mL). CONCLUSION: One session of acute aerobic exercise significantly increased the individuals' mean serum BDNF level. Males had higher BDNF levels than females. There was a significant interaction between gender and BDNF expression post exercise and a significant between-group effect of gender. The Val66Met carriers had a more positive response to the acute aerobic exercise compared with the Val66Val carriers, although without a significant difference between the two groups

Correction to: Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): study protocol for a randomized controlled trial.

Following the publication of our article [1], we have become aware of one error in the exclusion criteria, inconsistencies in Figure 1 and Figure 2, and a typo in the reference list