Women's attitudes to hormone replacement therapy in the aftermath of the Women's Health Initiative study

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldAIM: This paper is a report of a study conducted in 2004 on the determinants of attitudes towards hormone replacement therapy in the aftermath of the report on the findings of the Women's Health Initiative study. BACKGROUND: The unexpected findings of the Women's Health Initiative study, published in July 2002, showed that the risk of using combined hormones exceeded their benefits. This complicated women's decision-making about hormone use and made it important to study the determinants of their attitudes to hormone therapy, as these are likely to influence their behaviour. METHODS: A cross-sectional design was conducted with a sample of 561 women drawn from the National Registry of Iceland. A self-administered questionnaire, measuring attitudes towards hormone replacement therapy, attitudes towards menopause, extent and source of menopausal education, symptom experience, health and lifestyle and knowledge about the findings of the Women's Health Initiative, was used. The overall response rate was 56%. Attitudes to hormone replacement therapy were compared using anova, t-tests and correlations. RESULTS: Participants generally had positive attitudes. Knowledge about the Women's Health Initiative study was not associated with more negative attitudes. However, receiving the information from and discussing it with a doctor were associated with more positive attitudes. Positive attitudes towards hormone therapy were also associated with higher age, time since last menstrual period and current use of hormone replacement therapy. Negative attitudes were associated with use of natural remedies and receiving information from or discussing hormone therapy with family or friends. CONCLUSION: Research is needed to identify the dynamics of the medical interview, and the nature of input from friends, spouse and other family members. The content of these messages may be different and conflicting, for example, between doctors and family members. The nature of this conflict and conflicts of interests need to be identified in order to inform women's decision-making. In addition, action needs to be taken in order to strengthen the advisory role of nurses

Self-assessed occupational health and working environment of female nurses, cabin crew and teachers

To access Publisher full text version of this article. Please click on the hyperlink in Additional Links fieldAIM: The aim of this study was to describe and compare the self-assessed occupational health among female nurses, cabin crew and teachers, in relation to their working environment. Background: Similarities between the three occupations, i.e. predominantly female and service-oriented, render them interesting in comparison with respect to health and working environment. METHODS: The participants were female Icelandic cabin crew, nurses and elementary school teachers. A questionnaire including items on socio-demographics, working environment (addressing work pace, job security, monotonous work, assistance, physically strenuous work and physical environmental factors) and a symptom list was used for data collection. Factor analyses on the symptom list resulted in five symptom scales: Musculoskeletal, Stress and exhaustion, Common cold, Gastrointestinal and Sound perception scale. A total of 1571 questionnaires were distributed. The response rate was 65.7-69%, depending on occupation. Data were collected in 2002. RESULTS: Cabin crew reported worse gastrointestinal, sound perception and common cold symptoms than nurses and teachers. Cabin crew and teachers reported worse symptoms of stress and exhaustion than nurses (p < 0.05). When compared with teachers and nurses cabin crew reported less job security and more physically strenuous and monotonous work. Nurses were likelier to seek assistance from co-workers or patients as well as to take care of an older relative than teachers and cabin crew. Regression analysis found that within each occupation distress from environmental factors resulted in higher score on all the symptom scales. CONCLUSIONS: Nurses experience less stress and exhaustion than teachers and cabin crew. In comparison with one or both of the other occupations nurses are more likely to assist each other with their work, experience job security, reporting physically complex work and take care of older relatives. This should be highlighted as positive aspects of nurses' work praised as displaying responsibility and interconnectedness of nurses'

Lifestyle, harassment at work and self-assessed health of female flight attendants, nurses and teachers.

Health-related lifestyle, harassment at work, and self-assessed health of female flight attendants in comparison to that of female nurses and female primary school teachers were surveyed. A higher proportion of flight attendants than nurses or teachers were smokers, 26% vs. 15% and 17% respectively; and consumed alcohol at least once a week, 40% vs. 21% and 16%. Repeated sexual harassment at work was more common among the flight attendants, 31% vs. 8% and 4%; whereas bullying, physical violence and threats were less prevalent among the flight attendants (12%) than among nurses (19%). Flight attendants were on average somewhat taller, but weighed on average less, 63.8 kg vs. 72.4 kg and 72.7 kg respectively. Repeated exposure to sexual harassment, bullying, violence and threats was related to less physical and psychological well-being in all the groups. Teachers scored on average significantly lower than did the flight attendants on general health and physical well-being, while nurses did not

The content of the work of clinical nurse specialists described by use of daily activity diaries.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldAim.  Evaluate the usefulness of the role of clinical nurse specialists and the content of their work by mapping their activities. Background.  The clinical work of advanced practice nursing differs in different countries, and a clear picture is lacking on what exactly advanced practice nurses do. Design.  Prospective exploratory study. Method.  The setting of the study was the largest hospital in Iceland where over half of the country's active nursing workforce are employed, including the only clinical nurse specialists. Of 19 clinical nurse specialists working at the hospital, 15 participated. Data were collected over seven days with a structured activity diary that lists 65 activities, classified into six roles and three domains. In 17 instances, the 'role activities' and 'domain activities' overlap and form 17 categories of practice. The clinical nurse specialists coded their activities at 15-minutes interval and could code up to four activities simultaneously. Daily, the clinical nurse specialists evaluated their clinical nurse specialist background. Results.  The roles that occupied the greatest proportion of the clinical nurse specialists' time were education, expert practice and 'other' activities, while the smallest proportions were in counselling, research and practice development. The domain they worked in most was the institutional domain, followed by the client/family domain and the clinical outcome management domain. All of the clinical nurse specialists reported working on two activities simultaneously, 11 of them on three activities and six on four activities. They self-assessed their background as clinical nurse specialists as being very useful. Conclusion.  The activity diary is a useful tool for assessing the content of practice. Clinical nurse specialists spend too much time on activities related to the institution. Nurse managers are advised to provide clinical nurse specialists with ample time to develop the direct practice role in the client/family domain. Relevance to clinical practice.  The development of advanced nursing practice requires that clinical nurse specialists take an active and visible part in direct patient care

Commonwealth of Australia Federal Capitol Competition, awarded first prize: Section (G) and Section (H), 1912 [picture] /

Title from caption on item.; Part of: Eric Milton Nicholls collection.; Inscriptions: "Commonwealth of Australia Federal Capitol Competition, awarded first prize Walter Burley Griffin, Architect"--Centre beneath image.; Condition: Good.; Two images on one nagative.; Published: "The Western Architect, September 1912"--Lower left corner.; Also available in an electronic version via the Internet at: http://nla.gov.au/nla.pic-vn3944655; Purchased from Marie and Glynn Nicholls, 2006

Patientsäkerhet i Europa : Läkemedelsfel och vårdrelaterade infektioner

The Report was commissioned by the European Federation of Nurses Associations (EFN) in November 2007 in order to support its policy statements on Patient Safety (June 2004). In that statement the EFN declares its belief that European Union health services should operate within a culture of safety that is based on working towards an open culture and the immediate reporting of mistakes; exchanging best practice and research; and lobbying for the systematic collection of information and dissemination of research findings. This Report adressess specifically the culture of highly reliable organisations using the work of James Reason (2000). Medication errors and hospital-acquired infections are examined in line with the Reprt´s parameters and a range of European studies are used as evidence. An extensive reference list is provided that allows EFN to explore work in greater detail as required.En rapport om patientsäkerhet beställd av Europeiska federationen av sjuksköterskeorganisationer att användas i deras lobbyarbete. Rapporten redovisar granskning av europeiska studier om patientsäkerhet,särskilt läkemedelsfel och vårdrelaterade infektioner

Patientsäkerhet i Europa : Läkemedelsfel och vårdrelaterade infektioner

The Report was commissioned by the European Federation of Nurses Associations (EFN) in November 2007 in order to support its policy statements on Patient Safety (June 2004). In that statement the EFN declares its belief that European Union health services should operate within a culture of safety that is based on working towards an open culture and the immediate reporting of mistakes; exchanging best practice and research; and lobbying for the systematic collection of information and dissemination of research findings. This Report adressess specifically the culture of highly reliable organisations using the work of James Reason (2000). Medication errors and hospital-acquired infections are examined in line with the Reprt´s parameters and a range of European studies are used as evidence. An extensive reference list is provided that allows EFN to explore work in greater detail as required.En rapport om patientsäkerhet beställd av Europeiska federationen av sjuksköterskeorganisationer att användas i deras lobbyarbete. Rapporten redovisar granskning av europeiska studier om patientsäkerhet,särskilt läkemedelsfel och vårdrelaterade infektioner

Determinants of Knowledge and Attitudes Regarding Pain among Nurses in a University Hospital: A Cross-sectional Study.

To access publisher's full text version of this article click on the hyperlink belowThe aim of this cross-sectional study was to evaluate the primary determinants of knowledge and attitudes regarding pain among nurses in a hospital setting. All registered nurses employed at participating units at a university hospital were invited to participate. Information on work experience, education, and hospital unit was evaluated using a questionnaire. The Knowledge and Attitude Survey Regarding Pain instrument was used to assess knowledge on pain management. The difference in knowledge between nurses with different levels of education was assessed with analysis of variance. The discriminatory ability of each question was determined with item response theory, and the association between correct answers to individual items and the total score were calculated using linear regression. Participants were 235 nurses, 51% of the 459 invited. The overall pain knowledge score was 26.1 (standard deviation 5.3, range 8-38) out of a total of 40 possible. Those with an advanced degree in nursing scored on average 2.9 points higher than those who did not have an advance degree (95% confidence interval: 0.9-4.7). Responses to clinical vignette questions showed more difference between nurses with different levels of knowledge of pain management than the other questions. Participants with the correct response to the best discriminatory item had 5.35 (95% confidence interval 4.08-6.61) points higher total score than those with an incorrect answer. Higher education is associated with better knowledge on pain management. To assess pain knowledge, the ability to interpret and solve a clinical vignette leads to better results than answering direct questions.Icelandic Nurse Association Icelandic Research Fun

Lifestyle, harassment at work and self-assessed health of female flight attendants, nurses, and teachers

Abstract. Health-related lifestyle, harassment at work, and self-assessed health of female flight attendants in comparison to that of female nurses and female primary school teachers were surveyed. A higher proportion of flight attendants than nurses or teachers were smokers, 26% vs. 15% and 17% respectively; and consumed alcohol at least once a week, 40% vs. 21% and 16%. Repeated sexual harassment at work was more common among the flight attendants, 31% vs. 8% and 4%; whereas bullying, physical violence and threats were less prevalent among the flight attendants (12%) than among nurses (19%). Flight attendants were on average somewhat taller, but weighed on average less, 63.8 kg vs. 72.4 kg and 72.7 kg respectively. Repeated exposure to sexual harassment, bullying, violence and threats was related to less physical and psychological well-being in all the groups. Teachers scored on average significantly lower than did the flight attendants on general health and physical well-being, while nurses did not

Maternal attitudes towards home birth and their effect on birth outcomes in Iceland: A prospective cohort study.

To access publisher's full text version of this article click on the hyperlink belowOBJECTIVE: to examine the relationship between attitudes towards home birth and birth outcomes, and whether women's attitudes towards birth and intervention affected this relationship. DESIGN: a prospective cohort study. SETTING: the study was set in Iceland, a sparsely populated island with harsh terrain, 325,000 inhabitants, high fertility and home birth rates, and less than 5000 births a year. PARTICIPANTS: a convenience sample of women who attended antenatal care in Icelandic health care centres, participated in the Childbirth and Health Study in 2009-2011, and expressed consistent attitudes towards home birth (n=809). FINDINGS: of the participants, 164 (20.3%) expressed positive attitudes towards choosing home birth and 645 (79.7%) expressed negative attitudes. Women who had a positive attitude towards home birth had significantly more positive attitudes towards birth and more negative attitudes towards intervention than did women who had a negative attitude towards home birth. Of the 340 self-reported low-risk women that answered questionnaires on birth outcomes, 78 (22.9%) had a positive attitude towards home birth and 262 (77.1%) had a negative attitude. Oxytocin augmentation (19.2% (n=15) versus 39.1% (n=100)), epidural analgesia (19.2% (n=15) versus 33.6% (n=88)), and neonatal intensive care unit admission rates (0.0% (n=0) versus 5.0% (n=13)) were significantly lower among women who had a positive attitude towards home birth. Women's attitudes towards birth and intervention affected the relationship between attitudes towards home birth and oxytocin augmentation or epidural analgesia. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the beneficial effect of planned home birth on maternal outcome in Iceland may depend to some extent on women's attitudes towards birth and intervention. Efforts to de-stigmatise out-of-hospital birth and de-medicalize women's attitudes towards birth might increase women׳s use of health-appropriate birth services.The Icelandic Research Fund for Graduate Students Memorial Fund for Midwife Bjorg Magnusdottir and Farmer Magnus Jonasson Icelandic Midwives' Association's Research Fund Ingibjorg R. Magnusdottir Research Fun