Upoštevanje vodila »Ne oživljaj

Uvod: Med oblike odločitev za prenehanje aktivnega zdravljenja spada vodilo »Ne oživljaj.«. Raziskave navajajo, da vloga medicinske sestre pri upoštevanju vodila vključuje pomoč pacientom, družinam, članom zdravstvenega tima pri sprejemanju informiranih odločitev. Namen pregleda literature je raziskati izkušnje in stališča medicinskih sester do upoštevanja vodila. Metode: Uporabljen je bil integrativni pregled literature v obdobju od leta 2012 do leta 2022 v podatkovnih bazah COBIB, CINAHL in PubMed s ključnimi besedami: »vodilo Ne oživljaj.«, »medicinske sestre«, »do not resuscitate orders« in »nurses«. Potek pregleda literature prikazuje diagram PRISMA. V integrativni pregled je bilo vključenih osemnajst raziskav. Uporabljena je bila metoda vsebinskega združevanja in primerjava spoznanj vključenih raziskav. Rezultati: Na podlagi analize člankov smo oblikovali tri kategorije: (1) dejavniki v povezavi z etiko zdravstvene nege, (2) demografski in poklicni dejavniki medicinskih sester in (3) dejavniki medsebojnih odnosov (družina, družba). Diskusija in zaključek: : Rezultati so pokazali, da na vprašanja, povezana z življenjem in smrtjo, vplivajo kultura, verska prepričanja družbe in pogled na avtonomijo. Medicinske sestre izražajo pomen upoštevanja pravic pacientov, pomen izobraževanja in dodatnega usposabljanja. Pojavljajo se tudi različne interpretacije o upoštevanju vodila »Ne oživljaj.«. Izražajo tudi potrebo po razpravi znotraj interdisciplinarnih timov, s pacienti in njihovimi družinami

Skupno etično odločanje zdravstvenih delavcev

Introduction: Making shared ethical decisions about patients' further healthcare involves coordinating the opinions of healthcare professionals, and patients and their relatives. The purpose of the research was to examine the joint ethical decision-making of healthcare professionals. Methods: A review of the scientific literature performed in the COBISS, Springer Link and PubMed databases was used. To search for literature in the Slovenian language, the following words were used: "etika", "zdravstveni delavci", "skupne odločitve" and in the English language: "ethics", "health professionals", "shared decision making". The literature review was carried out using the PRISMA diagram. Results were synthesized using thematic analysis. Results: 19 articles were included in the final analysis. We created three thematic categories: (1) ethical competence of healthcare workers, (2) problems in the area of joint ethical decision-making and (3) new approaches to joint ethical decision-making to improve outcomes in clinical practice. In the field of joint ethical decision-making of healthcare professionals, the importance of ethical competence, issues in the field of joint ethical decision-making and new approaches to joint ethical decision-making for improving results in clinical practice is demonstrated. Discussion and conclusion: The findings of the research contribute to illuminating the importance of joint ethical decision-making and giving an insight into the factors of joint ethical decision-making. The end result of certain ethical decisions that affect the interaction of healthcare professionals and all levels in healthcare are important

Nursing students' cultural beliefs and understanding of dementia: A phenomenological study across three continents

Background: Migrant nurses have reported difficulties adapting to their new culture and providing culturally sensitive care for people with dementia. However, to date no studies have explored the impact of student nurse's cultural heritage on their beliefs and understanding of dementia. Objectives: To explore the cultural beliefs of dementia of student nurses studying in England, Slovenia, Philippines and New Zealand. Design: An explorative hermeneutic phenomenology design. Settings: Higher Education Institutes delivering undergraduate nursing education in England (University of Greenwich and University of Essex), Slovenia (Angela Boškin Faculty of Health Care), New Zealand (University of Auckland), and the Philippines (University of Silliman). Participants: Student nurses studying nursing in England (n = 81), Slovenia (n = 41), Philippines (n = 53) and New Zealand (n = 6). Participants from England and New Zealand were from diverse cultural backgrounds. Student nurses at the beginning of their studies (n = 100) and towards the end of their studies (n = 81) participated. Methods: Completion of focus groups (n = 23), in England (n = 10), Slovenia (n = 6), Philippines (n = 6), and New Zealand (n = 1). All focus groups were audio recorded and transcribed verbatim. Data was analysed by applying an inductive theoretical approach of the Framework Method, which supports the generation of themes through open unhindered coding, pinpointing, examining, and recording patterns within the data. Results: Two major themes were identified in the data: familial piety and dementia discourse. Familial piety emerged from the importance of family and caring for family members with dementia, subthemes included: ‘my granddad’: familial experience, and ‘better to be with her’: familial home. Dementia discourse emerged from the terminology student nurses applied, such as: ‘preconceptions and misconceptions’ of aggression, and ‘considered crazy’ stigma of dementia due to a lack of awareness. Conclusions: The cultural heritage of student nurses impacted on their beliefs of dementia; however their understanding of the needs, care and support of a person with dementia changed and developed through clinical experience and education

Prednosti in slabosti različnih protokolov vodenja vrednosti glukoze v krvi pri kritično bolnih pacientih

Uvod: Medicinske sestre v enotah intenzivne terapije uravnavajo ciljno vrednost glukoze v krvi pri kritično bolnih po sprejetih in veljavnih protokolih. Namen raziskave je bil raziskati prednosti in slabosti različnih protokolov vodenja  vrednosti glukoze v krvi pri kritično bolnih. Metode: Uporabljen je bil sistematični pregled znanstvene in strokovne literature. Iskanje literature je potekalo od 1. 2. 2017 do 8. 8. 2017. V pregled so bile vključene naslednje baze: COBIB.SI, Digitalna knjižnica Slovenije – Dlib.si, CINAHL, ProQuest, PubMed in Google Učenjak. Iskanje je potekalo z različnimi kombinacijami ključnih besed v slovenskem in angleškem jeziku: prednosti, slabosti, medicinske sestre, kritično bolni, glukoza v krvi in protokoli za vodenje vrednosti glukoze v krvi. Uporabljen je bil Boolov operater AND. Iz iskalnega nabora 1064 zadetkov je bilo v končno analizo  vključenih 15 člankov. Za obdelavo podatkov je bil uporabljen model analize konceptov. Rezultati: Identificirana so bila tri tematska področja: (1) primernost različnih protokolov za vodenje vrednosti glukoze v krvi, (2) delovne obremenitve medicinskih sester pri teh protokolih in (3) varnost protokolov. Prednosti računalniško podprtega protokola za vodenje vrednosti glukoze v krvi so v boljšem doseganju ciljne vrednosti koncentracije glukoze v krvi, slabosti pa v pojavu odstopanj v zvezi z načrtovanim časom za merjenje glukoze v krvi. Diskusija in zaključek: Nekatere raziskave ugotavljajo prednosti računalniško podprtih protokolov za vodenje vrednosti glukoze v krvi v smislu tehnoloških izboljšav, zmanjšanja delovnih obremenitev medicinskih sester in izboljšanja varnosti pacientov. Raziskava prispeva k izboljševanju klinične prakse pri delu s kritično bolnimi pacienti

Methodological approach for assessment of sick building syndrome among health workers and co - workers in observed hospital

Izhodišča Zdravstveni delavci, zdravstveni sodelavci/drugi zaposleni in pacienti so v bolnišničnem okolju izpostavljeni številnim dejavnikom tveganja. Epidemiološke presečne raziskave navajajo od 21 do 80 % pogostost sindroma bolnih stavb (SBS) v bolnišničnem okolju, medtem ko pogostost SBS v drugih notranjih okoljih znaša okoli 30 %. Namen Namen doktorske disertacije je bil razviti metodološki pristop za celovito oceno pogostosti SBS v povezavi z okoljskimi parametri pri zdravstvenih delavcih, zdravstvenih sodelavcih/drugih zaposlenih v opazovani bolnišnici. Metode Epidemiološka presečna raziskava je temeljila na različnih metodoloških pristopih. Uporabili smo mešano metodološko zasnovo, kombinacijo kvantitativne in kvalitativne raziskave. Podlaga za izvedbo raziskave je bil sistematični pregled znanstvene literature. Raziskava je potekala na vzorcu zdravstvenih delavcev (n = 258) in zdravstvenih sodelavcev/drugih zaposlenih (n = 78) v opazovani bolnišnici. Za samooceno pogostosti SBS med opazovanima populacijama smo uporabili standardizirana merska instrumenta za ocenjevanje kakovosti notranjega okolja (MM 040 NA Hospital in MM 040 NA Office). Kot orodje za analizo smo uporabili statistično programsko opremo SPSS za Windows (različica 21.0IBM CorpArmonk. NY. ZDA) (licenca: Univerza v Ljubljani, Slovenija). Uporabili smo metode opisne statistike, razlike smo testirali s Kruskal-Wallisovim testom ali ?2-kvadrat testom. Z metodo multiple regresijske analize smo ocenili vpliv neodvisnih spremenljivk (ocena prisotnih dejavnikov tveganja, dejavniki delovnega okolja, potencialno moteči dejavniki) na pojavnost simptomov SBS. Rezultate smo kot statistično značilne vrednotili pri vrednostih p ? 0,05. Rezultati Ugotovili smo, da so splošni simptomi SBS najpogostejši izmed vseh simptomov SBS pri zdravstvenih delavcih (51,9 %) in zdravstvenih sodelavcih/drugih zaposlenih (44,9 %). Zdravstveni delavci so izmed vseh okoljskih dejavnikov tveganja v najvišjem deležu samoocenili neprijeten vonj (39,1 %), zdravstveni sodelavci/drugi zaposleni pa zatohel zrak (34,6 %). Večje število zaznanih okoljskih dejavnikov tveganja zdravstvenih delavcev je pomenilo večje število navedenih simptomov SBS (ß = 0,205p = 0,001). Manjša možnost vpliva na organizacijo dela je pomenila prisotnost večjega števila simptomov SBS (ß = 0,192p = 0,001). Pri zdravstvenih delavcih, ki so redkeje ocenjevali prevelik obseg dela smo ugotovili pojavnost manjšega števila simptomov SBS (ß = –0,140p = 0,021). Prisotnost nočnega dela je pozitivno vplivala na večjo prisotnost simptomov SBS (ß = 0,139p = 0,012). Manjša zaskrbljenost s spremembami v delovni situaciji je pomenila pojavnost manjšega števila simptomov SBS (ß = –0,234p = 0,000). Med izmerjenimi okoljskimi dejavniki tveganja ter obema skupinama opazovancev med ogrevalno in neogrevalno sezono smo ugotovili statistično značilno razliko v temperaturi zraka notranjih prostorov [°C] (p =Theoretical background Health workers, co-workers/other employees and patients are exposed to a number of risk factors in a hospital setting. Epidemiological cross-sectional studies report a 21 to 80 % incidence of sick building syndrome (SBS) in hospital settings, whereas the incidence of SBS in other indoor settings is about 30 %. Purpose The purpose of the doctoral dissertation was to develop a methodological approach for a comprehensive assessment of the frequency of SBS in relation to environmental parameters in health workers, co-workers/other employees in the observed hospital. Methods Epidemiological cross-sectional research was based on different methodological approaches. We used a mixed methodological design, a combination of quantitative and qualitative research. The basis for conducting the research was to conduct a systematic review of the scientific literature. The research was conducted on a sample of health workers (n = 258) and co-workers/other employees (n = 78) in the observed hospital. For self-assessment of the frequency of SBS among the observed populations, we used standardised measurement instruments to assess the quality of the internal environment (MM 040 NA Hospital and MM 040 NA Office). We used the statistical software SPSS for Windows (version 21.0IBM CorpArmonk. NY. USA) (license: University of Ljubljana, Slovenia). In our analysis we used descriptive statistics and the differences found were tested using the Kruskal - Wallis test or the chi-square test. Using the multiple regression analysis method, we assessed the influence of independent variables (assessment of present risk factors, work environment factors and potentially - disturbing factors) on the occurrence of SBS symptoms. The results were evaluated as statistically significant at p 䁤 0.05. Results We found that the general symptoms of SBS are the most common of all the symptoms of SBS experienced by health workers (51.9 %) and co-workers/other employees (44.9 %). Of all the environmental risk factors, health workers rated unpleasant odour the highest (39.1 %), while co-workers/other employees rated stale air (34.6 %) the highest. A higher number of perceived environmental risk factors by health workers meant a higher number of reported SBS symptoms (β = 0.205p = 0.001). Due to a reduced capability of influencing the organisation of work meant there was a presence of a larger number of SBS symptoms (β = 0.192p = 0.001). A lower number of SBS symptoms (β = -0.140p = 0.021) were found in health workers who rarely considered their workload as excessive. The presence of night work had a positive effect on the increased incidence of SBS symptoms (β = 0.139p = 0.012). Less concern about changes in the work situation meant the occurrence of fewer SBS symptoms (β = -0.234p = 0.000). A statistically significant difference was found between the measured environmental risk factors and both groups of observed individuals dependent on seasons where heating was either used or not used/ with ambient indoor air temperature [°C] (p

Vloga staršev in vzgoje za zdravje pri oblikovanju odgovornega spolnega vedenja

Uvod: Spolno vedenje je pogosto povezano z določenim zdravstvenim tveganjem, kar vključuje nizko spolno ozaveščenost, značilno za spolno vedenje mladih brez izkušenj. Namen raziskave je bil ugotoviti odnos učencev do spolnega vedenja ter vlogo staršev in spolne vzgoje pri zavedanju učencev o posledicah tveganega spolnega vedenja. Metode: Izvedena je bila kvantitativna neeksperimentalna metoda raziskovanja, s pomočjo strukturiranega vprašalnika na vzorcu 144 učencev ene izmed osnovnih šol na Gorenjskem, septembra 2013. Za analizo podatkov so bili uporabljeni opisna statistika, Mann Whitneyjev U-test, Kruskall – Wallisov test ter linearna večkratna regresijska analiza. Rezultati: Trditev »Kadar imam težave, mi družina nudi oporo« ima statistično značilen vpliv na pozitivno oblikovanje mnenj o spolnem vedenju (β = 0,259, p = 0,002). Ugotovili smo statistično pomemben vpliv zavedanja anketirancev o posledicah tveganega spolnega vedenja in proučevanih spremenljivk, kot sta »Spolna vzgoja pomaga pri razumevanju telesnih in čustvenih sprememb, ki jih prinaša puberteta (β = 0,089,p < 0,001)« in »Pri prvem spolnem odnosu moram paziti, da sem zaščiten/-a« (β = 0,066, p = 0,001). Diskusija in zaključek: Anketirani učenci so dovzetni za ustvarjanje boljšega spolnega vedenja takrat, ko jim podporo - pogosto kot prvi vir - nudi družina. Spolna vzgoja predstavlja preventivo pred tveganim spolnim vedenjem. Gre za proces, v katerem posameznik pridobi informacije in oblikuje stališče / prepričanja o spolnosti, spolni identiteti, odnosih in intimnosti.

Association between sick building syndrome and indoor environmental quality in Slovenian hospitals

Increased exposure times to various health risk factors and the vulnerability of building users might result in significantly higher prevalence rates of sick building syndrome (SBS) in a hospital setting compared to other indoor environments. The purpose of our study was to assess the association between SBS symptoms and measured environmental parameters at a Slovenian general hospital. A combination of a self-assessment study and field measurements was conducted in order to estimate the health risk factors for SBS symptoms among the users of a Slovenian general hospital. The Chi-square test was used to analyse the association between observed health and environmental parameters. The response rate was 67.5%. A total of 12.0% of healthcare workers at hospital wards reported at least six SBS symptoms, 19.0% reported 2–3 SBS symptoms. At the observed hospital wards, the most deviations were recorded for the level of lighting (83.3%), noise level (73.6%), and room temperature (55.3%). A statistically significant association was found between indoor environmental quality and skin-related SBS symptoms (χ$^2$ = 0.009p = 0.006). This information will be of great value in defining an integral strategy of environmental health activities aimed at healthier indoor environmental quality in hospitals

Student work and nursing student's performance during study

Introduction: According to different studies, student work has both positive and negative effects on the academic performance of nursing students. The purpose of the study was to examine the effect of student work based on a sample of Slovenian nursing students. Methods: The method of non-experimental quantitative research with a sampling survey was used. 432 nursing students participated. The reliability of the questionnaire was determined by internal consistency analysis (from 0.608 to 0.753) and factor analysis. The data were collected in October and November 2012. Descriptive statistics, the chi-square test, correlation analysis and ANOVA were used for the statistical analysis. Results: Students of four higher education institutions did not provide statistically significant differences in the assessment of their financial status (p = 0.189). The number of hours of student work does not statistically correlate (p = 0.776) with the time for studying. The monthly total of the hours of student work revealed a statistically significant difference (p = 0.001), with students at higher education institution A stating the least hours of student work (x = 19.9), and students at higher education institution B stating the greatest amount of student work (x = 48.5). Discussion and conclusion: The monthly amount of hours of student work does not affect students’ academic performance. Students opt for student work because they wish to acquire clinical experience, clinical practice, meet potential employers and improve their employment prospects after graduation

Mentorstvo tujim študentom zdravstvene nege: študija primera

Uvod: Multikulturalizem, globalizacija in internacionalizacija predstavljajo neizogiben dejavnik razvoja, ki so mu izpostavljeni tako visokošolski prostor kot klinična okolja. Raziskave kažejo, da klinični mentorji nimajo dovolj multikulturnih kompetenc. Namen raziskave je bil proučiti izkušnje kliničnih mentorjev in visokošolskih učiteljev z mentorstvom tujim študentom. Metode: S kvalitativnim pristopom – študijo primera so bile raziskane izkušnje kliničnih mentorjev in visokošolskih učiteljev z mentorstvom tujim študentom zdravstvene nege enega od visokošolskih zavodov. Podatki so bili zbrani januarja 2014, s tehniko skupinskega intervjuja, uporabljen je bil polstrukturiran vprašalnik. V vzorec je bilo vključenih šest kliničnih mentorjev in visokošolskih učiteljev. Pogovori so bili transkribirani in besedilo podrobno analizirano s pristopom indukcije. Rezultati: Odgovori so bili strnjeni v pet glavnih tem: kulturno zavedanje, poznavanje kultur, kulturne spretnosti, medkulturni stiki in želja po kulturni osveščenosti. Kategorije opisujejo izkušnje intervjuvancev v novih kulturah, posebnosti mentorstva, željo po kulturni osveščenosti in jezikovne ovire. V želji po kulturni osveščenosti ugotavljamo vpliv kulture na kakovost zagotavljanja zdravstvene nege, željo po novih znanjih in pozitiven odnos do internacionalizacije praktičnega usposabljanja. Diskusija in zaključek: Intervjuvanci navajajo, da je pomembno medsebojno spoštovanje različnih kultur. Izražajo željo po razumevanju drugačnosti, ne navajajo posebnih priprav na izmenjavo tujih študentov. Jezikovna ovira in strah se ob vsakodnevnem stiku s tujimi študenti zmanjša. Raziskava prispeva k boljšemu razumevanju razmer v procesu mentorstva tujih študentov zdravstvene nege