A Middle-Range Theory of Social Isolation in Chronic Illness

: Chronic illnesses and social isolation are major public phenomena that drive health and social policy worldwide. This article describes a middle-range theory of social isolation as experienced by chronically ill individuals. Key concepts include social disconnectedness, loneliness, and chronic illness. Antecedents of social isolation include predisposing factors (e.g., ageism and immigration) and precipitating factors (e.g., stigma and grief). Outcomes of social isolation include psychosocial responses (e.g., depression and quality of life), health-related behaviors (i.e., self-care), and clinical responses (e.g., cognitive function and health service use). Possible patterns of social isolation in chronic illness are described

Measures of Self-Care in Heart Failure: Issues with Factorial Structure and Reliability

Dear Editor We read with great interest the recently published paper by Dr Lambrinou and colleagues1 entitled “The Greek version of the 9-item European heart failure self-care behaviour scale: A multidimensional or an uni-dimensional scale?” The paper is one of several papers published on the psychometric properties of the European Heart Failure Self-care Behaviour Scale (EHFScBS) and continues to raise the important questions: (1) Is self-care of heart failure (HF) a multidimensional or an uni-dimensional construct? (2) Is self-care of HF a generalizable construct across countries? (3) Is Cronbach\u27s alpha the best approach to estimate reliability of instruments

The Problem with Cronbach\u27s Alpha: Comment on Sijtsma and Van der Ark (2015)

Knowledge of a scale\u27s dimensionality is an essential preliminary step to the application of any measure of reliability derived from classical test theory--an approach commonly used is nursing research. The focus of this article is on the applied aspects of reliability and dimensionality testing. Throughout the article, the Self-Care of Heart Failure Index is used to exemplify real-world data challenges of quantifying reliability and to provide insight into how to overcome such challenges

Searching for a nursing job in an increased complexity of the labour market: An integrative review of the literature

Introduction. Recently, the unemployment ratio for nurses at European level reached 9% and an increased among nurses has been reported around the world. In several countries, such as Italy, searching for a nursing job has become a complex challenge. However, factors affecting the success in finding a nursing position have not received attention to date. Material and methods. Aiming to synthesize the knowledge available on the process of searching for a job as a nurse, an integrative review of the literature was performed. A total of 419 articles were retrieved and 126 studies were eligible. Two researchers working independently have scrutinized the eligible articles. A total of 6 studies have been included and a content analysis was performed. Results. A content analysis of the studies was performed and the articles were categorized in accordance to the key findings in three themes: 1) voluntary and forced unemployment; 2) strategies adopted by nurses in searching for a job, and 3) factors influencing success in searching for a nursing job. Individual factors may play a great role in finding a nursing job in times of economic crisis. The lack of clinical preparedness and managerial competence perceived by newly graduated nurses may affect their success in searching for a nursing job. Conclusions. Newly graduated should be prepared to face with the challenging process of finding a nursing job. Different policies have been suggested at individual, faculty and hospital levels

The dyadic self-care experience of stroke survivors and their caregivers: A qualitative descriptive study

background promoting self-care is the core response strategy of the global health system to the burden of stroke. although self-care in stroke represents a dyadic phenomenon, the dyadic self-care experience of stroke survivors and their caregivers is often overlooked in clinical practice. objectives the aim of this study was to explore the dyadic self-care experience of stroke survivors and their caregivers. design a descriptive qualitative design was used to conduct the study. results the consolidated criteria for reporting qualitative research was used for study reporting. a total of 21 stroke survivor-caregiver dyads were recruited for this study between may 2022 and september 2022. data were collected through semistructured interviews and analyzed using thematic analysis. In this study, four themes were identified: (1) poor relationship quality of the dyads, (2) dyadic incongruence in managing stroke, (3) a slow and tiring dyadic self-care process and (4) happy cooperation in coping with dyadic self-care. discussion and conclusion healthcare professionals should give greater consideration to the contradictions and disparities that may arise between stroke survivors and caregivers during the self-care process. It is crucial for them to provide personalized and tailored support and interventions that can assist these individuals in achieving a more optimal balance in their dyadic self-care. patient/public contribution patients were involved in the formulation of interview questions for this study. no members of the public were involved in this study

Organizational health and quality of life: survey among ambulance nurses in prehospital emergency care

Background: The workplace plays a central role in causing stress and different kinds of syndromes and diseases. More generally, organizational procedures and practices could have an impact on nurses’ quality of life. Although several studies have investigated this link, none of them considered nurses working in prehospital emergency care. Objectives: To investigate the role of organizational health factors that affect the quality of life and psychosomatic complaints of ambulance nurses.Method: Our sample included 411 ambulance nurses. Workers were administered two questionnaires to assess organizational health and quality of life. Descriptive and correlational analyses were used to test our assumptions. Conclusion: Several organizational health dimensions provided an explanation for the complaints reported by nurses working in prehospital emergency care in terms of quality of life and psychosomatic disorders.The results allowed identification of possible interventions focusing on specific duties and organizational aspects that would improve the quality of nurses’ health

Self-Care Confidence May be More Important than Cognition to Influence Self-Care Behaviors in Adults with Heart Failure: Testing a Mediation Model

Background Cognitive impairment can reduce the self-care abilities of heart failure patients. Theory and preliminary evidence suggest that self-care confidence may mediate the relationship between cognition and self-care, but further study is needed to validate this finding. Objectives The aim of this study was to test the mediating role of self-care confidence between specific cognitive domains and heart failure self-care. Design Secondary analysis of data from a descriptive study. Settings Three out-patient sites in Pennsylvania and Delaware, USA. Participants A sample of 280 adults with chronic heart failure, 62 years old on average and mostly male (64.3%). Methods Data on heart failure self-care and self-care confidence were collected with the Self-Care of Heart Failure Index 6.2. Data on cognition were collected by trained research assistants using a neuropsychological test battery measuring simple and complex attention, processing speed, working memory, and short-term memory. Sociodemographic data were collected by self-report. Clinical information was abstracted from the medical record. Mediation analysis was performed with structural equation modeling and indirect effects were evaluated with bootstrapping. Results Most participants had at least 1 impaired cognitive domain. In mediation models, self-care confidence consistently influenced self-care and totally mediated the relationship between simple attention and self-care and between working memory and self-care (comparative fit index range: .929–.968; root mean squared error of approximation range: .032–.052). Except for short-term memory, which had a direct effect on self-care maintenance, the other cognitive domains were unrelated to self-care. Conclusions Self-care confidence appears to be an important factor influencing heart failure self-care even in patients with impaired cognition. As few studies have successfully improved cognition, interventions addressing confidence should be considered as a way to improve self-care in this population

Patterns of self-care in adults with heart failure and their associations with sociodemographic and clinical characteristics, quality of life, and hospitalizations: A cluster analysis

Background: Self-care is important in heart failure (HF) treatment, but patients may have difficulties and be inconsistent in its performance. Inconsistencies in self-care behaviors may mirror patterns of self-care in HF patients that are worth identifying to provide interventions tailored to patients. Objectives: The aims of this study are to identify clusters of HF patients in relation to self-care behaviors and to examine and compare the profile of each HF patient cluster considering the patient's sociodemographics, clinical variables, quality of life, and hospitalizations. Methods: This was a secondary analysis of data from a cross-sectional study in which we enrolled 1192 HF patients across Italy. A cluster analysis was used to identify clusters of patients based on the European Heart Failure Self-care Behaviour Scale factor scores. Analysis of variance and [chi]2 test were used to examine the characteristics of each cluster. Results: Patients were 72.4 years old on average, and 58% were men. Four clusters of patients were identified: (1) high consistent adherence with high consulting behaviors, characterized by younger patients, with higher formal education and higher income, less clinically compromised, with the best physical and mental quality of life (QOL) and lowest hospitalization rates; (2) low consistent adherence with low consulting behaviors, characterized mainly by male patients, with lower formal education and lowest income, more clinically compromised, and worse mental QOL; (3) inconsistent adherence with low consulting behaviors, characterized by patients who were less likely to have a caregiver, with the longest illness duration, the highest number of prescribed medications, and the best mental QOL; (4) and inconsistent adherence with high consulting behaviors, characterized by patients who were mostly female, with lower formal education, worst cognitive impairment, worst physical and mental QOL, and higher hospitalization rates. Conclusion: The 4 clusters identified in this study and their associated characteristics could be used to tailor interventions aimed at improving self-care behaviors in HF patients

Nurses and Stigma at the Time of COVID-19: A Phenomenological Study

The COVID-19 pandemic is putting strain on every country in the world and their health systems. Healthcare professionals struggle on the frontline and they can experience stigma, which can create difficulties in controlling epidemic diseases, influencing the mental health of healthcare professionals, caregivers, families, communities, and the provided quality of care. The aim of this study is to explore the lived experience of Italian nurses about perceived stigma during COVID-19 pandemic with the phenomenological Cohen method. The principal themes that emerged from data analysis were “stigma in the working environment” and “stigma in everyday life”. Each of these themes had subthemes: “looks like gun sights”, “avoiding closeness to others”, “nobody wants to touch you”, and “the fault of being your family members”. Public health emergencies, such as the COVID-19 pandemic, are stressful events for individuals and communities. Stigma can be more dangerous than the disease, and a major obstacle to appropriate medical and mental health interventions. Understanding how healthcare professionals experience stigma is essential to design and implement specific educational, psychological, and organisational programmes

Contextual Coding in Qualitative Research Involving Participants with Diverse Sociocultural Backgrounds

Understanding participants’ perspectives in qualitative research is contingent on unravelling the essential meaning of their speech. When data are collected in native language and translated into English language, the underlying sociocultural meaning of participants’ speech can be missed. This paper discusses a new contextual coding approach and illustrates its application in research. The technique was used in a phenomenological study in Pakistan and a mixed methods study in Europe. Contextual coding entails a preliminary coding stage involving data reading in native language, choosing socially and culturally relevant words and phrases, and developing preliminary codes. The concluding coding stage focuses on creating a sociocultural query list, seeking answers through discussions among multilingual individuals, and finding a common language for code description. Contextual coding can enable researchers to understand sociocultural meaning of their data at an early stage, rather than waiting at the later stage of theme development to contextualize the findings