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1.
Simone T. Harvey Jennifer A. Bennett Elizabeth Burmeister Marianne Wyder 《Collegian (Royal College of Nursing, Australia)》2018,25(5):525-531
Background
Perinatal mental illness is prevalent in Australia. Accessible and affordable specialist perinatal mental health services are important in ensuring optimal maternal and infant outcomes, but remain scarce in some areas.Aim
This paper describes the development and evaluation of a community model for perinatal mental health based on the practice principles of: nurse-led; partnership approach; individualised evidenced based treatments and accessible, flexible service delivery.Methods
Data collected prospectively as part of routine care for two years was analysed. Data included Edinburgh Depression Scale, Parent Coping Scale and Health of the Nation Outcome scale scores, rates of attendance, diagnostic codes, nurse practitioner prescribing and the appointment locations.Findings
There was a significant reduction in depressive and anxiety symptoms and for women parenting infants, an increase in their perception of coping with parenting. There were comparatively high rates of attendance once women attended once. Diagnostic codes indicated the service saw the target group with the majority of diagnoses consisting of adjustment disorders, depression and anxiety. The nurse practitioner role enhanced continuity of care for women requiring antidepressant treatment.Discussion
The perinatal nurse-led community model of service has been shown to provide effective specialist perinatal mental health assessment and brief intervention and treatment services.Conclusion
The model offers the potential for replication in other areas where service gaps for perinatal women and families persist and resources remain scarce. 相似文献2.
Andrew Cashin 《Collegian (Royal College of Nursing, Australia)》2018,25(1):141-146
Background
In 2004 a consensus was reached through a vote of membership of the American Association of Colleges of Nursing to move Nurse Practitioner education from the masters to the doctoral level by 2015.Aim
To determine progress to meet the goal of moving towards doctoral level education for American Nurse Practitioners and identify the associated discourse.Method
A scoping review was undertaken to dertermine the progress towards the goal of the of moving from the Master of Science Nursing to the Doctor of Nursing Practice degree as the point from which Nurse Practitioner certification and licensure can be applied for in the USA, the reported outcomes resulting from the introduction of the Doctor of Nursing Practice and the evolution of the discourse re the design and intent and of the Doctor of Nursing Practice.Findings
There has been ongoing evolution in the vision of the Doctor of Nursing Practice degree since 2004. Whilst there have been challenges, support for continued development and implementation of the Doctor of Nursing Practice is strong.Discussion
These findings are considered with regard to informing potential future directions for Nurse Practitioner education in Australia.Conclusion
It is timely in Australia to consider development of a post endorsement bespoke Professional Doctorate for Nurse Practitioners. To address the issue of course load in Nurse Practitioner Masters Programmes the discipline should work towards being recognized as able to offer an extended masters degree for Nurse Practitioners. Australian Nurse Practitioner faculty should come together as a group to consult on development of Nurse Practitioner education in Australia. 相似文献3.
Background
Use of diagnostic thoracic ultrasound (TUS) in medical professions to examine the pleura, lung parenchyma and diaphragm is gaining in popularity, however the ways in which physiotherapists are using TUS is unclear.Objective
The aim of this scoping review is to gain an understanding of the emerging evidence base surrounding physiotherapy use of TUS to inform research and clinical practice.Data sources
A systematic search was conducted of the following databases: Cochrane, EPPI centre, PROSPERO, Medline, CINAHL, AMED, EMBASE, HMIC, and BNI.Study selection
Inclusion criteria: primary research reporting the use of diagnostic TUS; a physiotherapist as part of the study design or as the chief investigator; published in English.Synthesis methods
Data regarding demographics, design, type of conditions and anatomical structures investigated and profession leading the TUS of included papers were compiled in a tabular format.Results
Of the 26 included papers, nine studied healthy participants, four studied COPD and four studied critical care patients. Most papers (n = 23) involved scanning the diaphragm. In eight studies the physiotherapist operated the TUS.Limitations
The paper selection process was performed by one author; with no cross-checking by another individual.Conclusion
Use of TUS by physiotherapists is an emerging area in both diaphragm and lung diagnostics. A wide range of patient populations may benefit from physiotherapists using TUS. Papers in this review are heterogeneous making any generalisability difficult but does show its potential for varied uses. TUS is an innovative skill in the hands of physiotherapists, but more research is needed. 相似文献4.
Background
Real time 1:1 videoconferencing (VC) has the potential to play an important role in the management of orthopaedic pathologies. Despite positive reporting of telemedicine studies uptake in clinical practice remains low. Acceptability to patients is an important element of system take-up in telemedicine and a focus towards qualitative methodology may explore the underlying reasons behind its acceptability. In this paper we have systematically reviewed qualitative studies that include evidence about patient responses to VC services in an orthopaedic setting.Objectives
To determine whether real time 1:1 videoconferencing is acceptable to patients in an orthopaedic setting.Data sources
MEDLINE, AMED, PsychINFO, CINAHL, SCOPUS, Cochrane Database, Evidence Search and Open Grey were searched with forwards and backwards reference screening of eligible papers.Eligibility criteria
Qualitative studies exploring the acceptability of VC in an orthopaedic setting were included.Study appraisal and synthesis methods
Studies were appraised using the CASP tool. A Directed Content Framework Analysis was conducted using Normalisation Process Theory.Results
Four studies were included for review. The themes for the four studies did not overlap and did not report clinician acceptability of VC. The Directed Content Analysis of these papers using Normalisation Process Theory highlighted factors which contribute towards its acceptability.Conclusions
All studies concluded that the use of VC was acceptable. Further qualitative research exploring both patient and clinician acceptability is required utilising a theoretical framework to allow for repeatability and generalisability.Systematic Review Registration Number: PROSPERO CRD42015024944. 相似文献
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6.
Angela Christiansen Elisabeth Jacob Di Twigg 《Collegian (Royal College of Nursing, Australia)》2018,25(5):567-571
Background
The need for new graduate nurses to have the capabilities to function effectively in increasingly complex, dynamic and diverse health care settings has energised debate about the need for four year nursing degrees.Questions
What types of four year bachelor degrees are evident globally and what are the key arguments and evidence suggesting a need for four year nursing degrees in Australia?Methods
A scoping of contemporary literature is conducted to identify and discuss the key trends, concerns and evidence that informs the current debate on the appropriate duration of nursing degrees.Findings
A unique combination of emerging health care challenges and shifting health care priorities are fuelling the call to reconsider the duration of nursing degrees in Australia.Discussion
Future nurses will need the capabilities to work effectively across organisational and geographical boundaries, work as partners with a well-informed public, engage with advancing technologies and work autonomously and collaboratively as equals in inter-professional teams.Conclusion
The need for nurse education to produce nurse graduates with key capability for the future, gives credence to a call for a four year nursing degree in Australia. 相似文献7.
Jane L. Phillips Elizabeth Lobb Paula Mohacsi Nicole Heneka David Currow 《Collegian (Royal College of Nursing, Australia)》2018,25(1):39-43
Background
Bereavement follow up is an integral element of palliative care. However, little is known about the systems that link bereavement services with bereaved carers.Aim
To map how effectively a specialist palliative care service linked bereavement service to bereaved carers.Methodology
A retrospective medical audit, using process mapping was undertaken within one Australian specialist palliative care service to identify the systems that linked bereavement services to a consecutive cohort of palliative care decedents (n=60) next of kin.Results
Bereavement records were located for 80% of decedents. Nearly all (98%) had a nominated next of kin, with just over half (54%) of those nominated contacted by bereavement services. Incomplete or missing contact details was the main reason (75%) that the bereavement service was unable to contact the decedents’ next of kin.Conclusion
Having access to a designated bereavement service can ensure that bereaved next of kin are contract routinely and in a timely way. However the effectiveness of this type of service is dependent upon the bereavement service having access to all relevant contact information. There are numerous opportunities to refine and strengthen the recording of palliative care next of kin details to optimize follow up. 相似文献8.
Kay Cooper Llinos M. Jehu Susan Klein Blair H. Smith Patricia Schofield 《Physiotherapy》2018,104(2):239-247
Objective
To determine the feasibility and acceptability of a training programme for peer volunteers to support older adults with chronic low back pain (CLBP) following discharge from physiotherapy.Design
Feasibility study.Setting
Community-based.Participants
17 adults (4 male, 13 female) with CLBP or experience of supporting someone with CLBP enrolled and 12 (2 male, 10 female) completed the volunteer training.Intervention
Volunteers took part in a face-to-face or blended delivery peer support training programme based on the Mental Health Foundation’s “Principles into Practice” and adapted for CLBP by the study team.Main outcome measures
Recruitment/retention rates; demographics; time & resources used to deliver training; training evaluation (questionnaire); knowledge questionnaire, and self-efficacy questionnaire.Results
17 participants enrolled on the training programme (11 face-to-face, 6 blended delivery). 12 (71%) completed the training (73% face-to-face, 67% blended delivery). The training was positively evaluated. All but two participants passed the knowledge quiz at the end of the training, and the majority of self-efficacy scores (90%) were high.Conclusions
It is feasible to develop, implement and evaluate a peer support training programme for the facilitation of CLBP self-management in older adults following discharge from physiotherapy. Blended delivery of training may facilitate the recruitment of greater numbers of peer support volunteers in future studies. Supported self-management of CLBP pain is widely recommended but can be difficult to achieve. Peer support might be a promising method of facilitating CLBP self-management without additional burden to health services, and should be further evaluated in a larger study. 相似文献9.
Evdokia Kalaitzidis Ann Harrington 《Collegian (Royal College of Nursing, Australia)》2018,25(5):509-515
Background
Worldwide research confirms that older people value autonomy, want to remain independent and want control over their lives for as long as possible. Accordingly, the aged care system in Australia is undergoing major government-initiated reforms and is moving towards consumer directed care.Aim
To explore the views of residents and care staff of resident decision-making, choice and control in the residential aged care context.Methods
Residents from across four residential aged care facilities in Adelaide were interviewed and staff focus groups were held. A thematic analysis of the data was conducted.Findings
Residents valued opportunities for privacy, communal engagement, productivity, negotiation with staff, and for opportunities to engage with systems of governance. How staff prioritise resident decision-making is influenced by the carer’s judgement of the resident’s characteristics and of the organisation’s rules and polices.Discussion
Older people living in residential care are no longer living in their own home but instead are dealing with organisational rules and routines framed by others upon whom they are dependent.Conclusion
The day-to-day decision-making process for residents is likely to remain complex due to residents having to take into account rules, regulations and policies operationalized through organisational channels. 相似文献10.
Background
A remuneration system greatly influences the quality of nursing care and services.Objective
The goal of this study was to identify the effects of a remuneration system on nurses’ performance.Design
This research used a literature review design and involved the analysis of 25 articles published in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, EMBASE, PsycINFO, and Global Health databases. The literature was limited to articles published in English between August 2006 and August 2015.Results
The results of this study indicate that the improvement of remuneration systems has positive consequences in terms of nurses’ performance and subsequent quality of healthcare services. A well-managed remuneration system has the potential to increase nurses’ motivation, productivity, satisfaction, and even improve retention. In contrast, poorly managed and low remuneration contributes to a shortage of nurses due to high turnover rates.Conclusions
Adequate remuneration has been shown to improve nurses’ performance and, consequently, improve the quality of healthcare. This literature review provides scientific evidence for decision-makers to consider the implementation of remuneration systems that include credentialing, re-credentialing, and career ladders. Future studies are suggested to investigate the development of well-managed remuneration systems for nurses. 相似文献11.
M.A. van Egmond M. van der Schaaf T. Vredeveld M.M.R. Vollenbroek-Hutten M.I. van Berge Henegouwen J.H.G. Klinkenbijl R.H.H. Engelbert 《Physiotherapy》2018,104(3):277-298
Background
Over the last few years, telerehabilitation services have developed rapidly, and patients value benefits such as reduced travelling barriers, flexible exercise hours, and the possibility to better integrate skills into daily life. However, the effects of physiotherapy with telerehabilitation on postoperative functional outcomes compared with usual care in surgical populations are still inconclusive.Objectives
To study the effectiveness of physiotherapy with telerehabilitation on postoperative functional outcomes and quality of life in surgical patients.Data sources
Relevant studies were obtained from MEDLINE, EMBASE, CINAHL, the Cochrane Library, PEDro, Google Scholar and the World Health Organization International Clinical Trials Registry Platform.Study selection
Randomised controlled trials, controlled clinical trials, quasi-randomised studies and quasi-experimental studies with comparative controls were included with no restrictions in terms of language or date of publication.Data extraction and synthesis
Methodological quality was assessed using the Cochrane risk of bias tool. Twenty-three records were included for qualitative synthesis. Seven studies were eligible for quantitative synthesis on quality of life, and the overall pooled standardised mean difference was 1.01 (95% confidence interval 0.18 to 1.84), indicating an increase in favour of telerehabilitation in surgical patients.Limitations
The variety in contents of intervention and outcome measures restricted the performance of a meta-analysis on all clinical outcome measures.Conclusions
Physiotherapy with telerehabilitation has the potential to increase quality of life, is feasible, and is at least equally effective as usual care in surgical populations. This may be sufficient reason to choose physiotherapy with telerehabilitation for surgical populations, although the overall effectiveness on physical outcomes remains unclear.PROSPERO registration number: CRD42015017744. 相似文献
12.
Gráinne Kelly Aoife Reilly Hannah Moloney Jonathan Moran Caitriona Cunningham Julie Broderick 《Physiotherapy》2018,104(4):359-366
Background
Randomised controlled trials (RCTs) are described as the gold standard of investigative clinical research. Evidence based practice is critical to the physiotherapy profession, and it is therefore important to explore the research underpinning practice by examining published RCTs.Objectives
The main aims of this review were to profile the quantity and quality of RCTs published in the journal Physiotherapy over the past 50 years.Data sources
Physiotherapy journal, hand searched (1967 to 1987) and electronically (1988 to 2017).Study selection or eligibility criteria
Studies identified as RCTs.Study appraisal and synthesis methods
Quality assessed via PEDRO criteria.Results
120 RCTs were identified from January 1967 to January 2017. The frequency of RCTs published has increased steadily and the UK was the most common source of RCTs, but the prevalence of non-UK based trials is increasing. The quality of RCTs improved steadily over the decades, with a mean PEDro score of 6.9 in the most recent decade (2017 to 2008), indicative of ‘high quality’. The mean number of trial participants was 60 and the most commonly evaluated area was musculoskeletal physiotherapy.Limitations
RCTs were not evaluated against CONSORT criteria.Conclusion and implications of key findings
Frequency of publication of RCTs in the journal Physiotherapy has increased over this time, mirroring trends in the wider medical literature. This highlights the predominance of some areas of research such as musculoskeletal and exercise-based research while other prominent areas such as neurology appear to be less researched. 相似文献13.
Objective
To compare clinical pain intensity, exercise performance, pain sensitivity and the effect of aerobic and isometric exercise on local and remote pressure pain thresholds (PPTs) in patients with chronic musculoskeletal pain with high and low levels of kinesiophobia.Design
An experimental pre–post within-subject study.Setting
An exercise laboratory in a multidisciplinary pain clinic.Participants
Fifty-four patients with chronic musculoskeletal pain.Interventions
Acute aerobic and isometric leg exercises.Main outcome measures
Clinical pain intensity (numerical rating scale, range 0 to 10), Tampa Scale of Kinesiophobia, aerobic and isometric exercise performances (intensity and maximal voluntary contraction), and PPTs at local and remote body areas before and after exercise conditions.Results
Patients with a high degree of kinesiophobia demonstrated increased pain intensity compared with patients with a low degree of kinesiophobia [high degree of kinesiophobia: 7.3 (1.6) on NRS; low degree of kinesiophobia: 6.3 (1.6) on NRS; mean difference 1.0 (95% confidence interval 0.08 to 1.9) on NRS]. Aerobic and isometric exercises increased PPTs, but no significant group differences were found in PPTs before and after exercise.Conclusions
Clinical pain intensity was significantly higher in patients with a high degree of kinesiophobia compared with patients with a low degree of kinesiophobia. Despite a difference in isometric exercise performance, the hypoalgesic responses after cycling and isometric knee exercise were comparable between patients with high and low degrees of kinesiophobia. If replicated in larger studies, these findings indicate that although kinesiophobic beliefs influence pain intensity, they do not significantly influence PPTs and exercise-induced hypoalgesia in patients with chronic musculoskeletal pain. 相似文献14.
Background
Caring for older people can be a burden for the family that led to mistreatment.Objective
To determine the relationship between the levels of family burden in caring for older people with the occurrence of mistreatment incidence. Design and participants: A cross sectional study design was conducted with 135 older people who live with their family as respondents.Setting
135 families with older people at Kelurahan/Village of Harjamukti area, Kecamatan/ District of Cimanggis, Depok city.Method
This study applied probability sampling technique with multistage cluster sampling.Results
Family characteristics show that almost half of older people were caring by family members (caregivers) who were aged 20-39 years, nearly all caregivers were women, family income mostly less than UMK, families mostly monosyllabic nation Betawi and caregivers mostly were their own child. Most of the families stated that no expense in caring for the older people (89.6%), but there are still families who feel the burden of caring. The highest type of mistreatmet of the older people is psychological mistreatments.Conclusions
From the statistical test obtained by p value equals to 0.553, it was concluded there was no correlation between the incidences of any family burden with mistreatment. 相似文献15.
Background
The Berg Balance Scale (BBS) is often used in clinical practice to predict falls in the older adults. However, there is no consensus in research regarding its ability to predict falls.Objective
To verify whether the BBS can predict falls risk in older adults.Data source
Manual and electronic searches (Medline, EMBASE, CINAHL, Ageline, Lilacs, Web of Science, Cochrane Library and PEDro) were conducted using blocks of words (older adults, falls, BBS, study design) and their synonyms, with no language restrictions and published since 1989.Study selection criteria
Prognostic studies or clinical trials were used to assess the BBS and falls history.Data extraction and data synthesis
In this narrative synthesis, two independent assessors extracted data from articles and a third reviewer provided consensus, in case of disagreement. The methodological quality was assessed using the Quality In Prognosis Studies tool.Results
1047 studies were found and 8 studies were included in this review. The mean BBS score was high, regardless of the history of falls. Three studies presented cut-off scores for BBS, ranging from 45 to 51 points. Two studies reported a difference in the BBS score between fallers and non-fallers. Studies presented low to moderate risk of bias.Limitations
Unfeasible to conduct a meta-analysis due the heterogeneity of included studies.Conclusion
The evidence to support the use of BBS to predict falls is insufficient, and should not be used alone to determine the risk of falling in older adults.Systematic review registration number
PROSPERO CRD42016032309. 相似文献16.
Effects of exercise training in water and on land in patients with COPD: a randomised clinical trial
J.M. Felcar V.S. Probst D.R. de Carvalho M.F. Merli R. Mesquita L.S. Vidotto L.R.G. Ribeiro F. Pitta 《Physiotherapy》2018,104(4):408-416
Objectives
To compare the effects of two similar 6-month protocols of high-intensity exercise training, in water and on land, in patients with chronic obstructive pulmonary disease (COPD).Design
Randomised controlled trial.Setting
University-based outpatient clinic.Participants
Thirty-six patients with predominantly moderate-to-severe COPD completed the study.Intervention
Patients were evaluated at baseline, at 3 months and at the end of the programme (i.e. 6 months). For both groups, the 6-month protocol consisted of high-intensity endurance and strength exercises with gradual increase in time and/or workload, totalling 60 sessions.Main outcomes
Objective monitoring of physical activity in daily life (PADL, primary outcome), lung function, peripheral and respiratory muscle strength, body composition, maximal and submaximal exercise capacity, functional status, quality of life, and symptoms of anxiety and depression.Results
After 6 months of training, a significant improvement in PADL was seen for both groups [mean difference (95% confidence interval): land group 993 (358 to 1628) steps/day; water group 1669 (404 to 2934) steps/day]. Significant improvements were also seen in inspiratory, expiratory and peripheral muscle strength; maximal and submaximal exercise capacity; quality of life and functional status for both groups. There were no significant improvements in lung function, body composition, and symptoms of anxiety and depression for either group. No difference was found in the magnitude of improvement between the two types of training for any outcome.Conclusion
High-intensity exercise training in water generates similar effects compared with training on land in patients with moderate-to-severe COPD, rendering it an equally beneficial therapeutic option for this population.Clinical trial registration number
NCT01691131. 相似文献17.
18.
Ashleigh E. Butler Beverley Copnell Helen Hall 《Collegian (Royal College of Nursing, Australia)》2018,25(5):561-566
Problem
Theoretical sampling is a key research process within grounded theory. However, whilst methodological texts provide a definition, it is difficult to find examples of how theoretical sampling is undertaken as a study develops. The lack of clear exemplars has caused confusion amongst researchers, with many grounded theory studies providing no evidence of theoretical sampling.Aim
This paper aims to demonstrate the theoretical sampling process as a grounded theory study progresses.Methods
A constructivist grounded theory study of bereaved parents’ experiences when their child dies in intensive care is used to illustrate the processes of theoretical sampling. Twenty-six bereaved parents participated in semi-structured, audio-recorded interviews. Data were analysed using constant comparative methods and theoretical memoing, with a theory developed that explained the changing nature of the parent-healthcare provider relationship when a child dies in intensive care.Findings
In this study, theoretical sampling necessitated the use of three different data collection techniques: Seeking new data collection sites, adding new interview questions, and sampling for specific participant characteristics. Each technique is discussed in detail and linked to the category and theory development in the exemplar study.Discussion
Though there are limitations to describing theoretical sampling processes on paper, clearly documented accounts can help novice researchers become familiar with the techniques involved and appreciate the benefits they bring to overall theory development.Conclusion
By providing a clear example of theoretical sampling linked to category and theory development, this paper has demonstrated the real world application of theoretical sampling in practice. 相似文献19.
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