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1.
Cheryl Ross Cath Rogers Christine King 《Collegian (Royal College of Nursing, Australia)》2019,26(1):1-7
Background
Nursing workload remains an issue in current health care contexts. The use of quantitative methodologies, methods and tools to measure workload has not produced adequate data to inform workforce policy to resolve workforce concerns about workload.Objective
This study aimed to identify the influence of both culture and climate as factors in nursing workload.Methods
This research used an overall critical ethnographic methodology to investigate the real lifeworkload issues of nurses. Methods included fieldwork observations and informal discussions over a 3 year period and 11 in-depth interviews.Results
The study identifies the impact of safety mandates on nursing workload as an invisible phenomenon within current workload methodologies. Such mandates add to nursing roles and routines, and become a ‘taken-for-granted’ activity that is not always directly related to patient care, nor is a visible factor in workload measurement.Conclusion
Given that workload measurements are formulated on direct patient care activities, indirect and unrecognised activities may create additional nursing workload. 相似文献2.
Lisa McKenna Pamela Wood Allison Williams Margaret O’Connor Cheryle Moss Debra Griffiths Phillip Della Ruth Endacott Wendy Cross 《Collegian (Royal College of Nursing, Australia)》2019,26(1):80-85
Background
Enrolled Nurses constitute an important part of the Australian health care system. Recently, improvements to education and medication endorsement have initiated expansion to EN scope of practice.Aim
This paper reports on a study conducted to inform development of revised Nursing and Midwifery Board (NMBA) of Australia Enrolled Nurse practice standards that explored with ENs their scope of practice.Design
A qualitative design using focus groups and individual interviews with ENs across Australia. Data were analysed using thematic analysis.Findings
ENs work in diverse practice contexts with differing scope of practice. Confusion existed regarding EN scope of practice as a result of many different types of ENs in practice. Care of unstable patients was seen to be outside the EN scope of practice. They were also often required to supervise the work of nursing assistants and new registered nurses. Lack of career pathway was seen as a limitation to ENs.Conclusions
EN education and scope of practice has evolved significantly, particularly in many practice settings, since the existing standards were developed. Further work is needed to address issues related to EN supervision of new RNs and AINs (Assistants in Nursing), and clarity of EN supervision in specialist clinical areas. 相似文献3.
Melissa J. Bloomer Mari Botti Fiona Runacres Peter Poon Jakqui Barnfield Alison M. Hutchinson 《Collegian (Royal College of Nursing, Australia)》2019,26(1):22-27
Background
With an ageing population and chronic illness the leading cause of death, challenges exist in meeting the healthcare needs of older people. For older people, care may be provided in subacute care services where, although the focus is on rehabilitation and optimisation of functioning, many older people will die.Aim
To investigate end-of-life care provision for older people in subacute care.Methods
A retrospective clinical chart audit of all subacute inpatient deaths in one year.Results
54 inpatients died in subacute care and almost all had been transferred from an acute care setting. The mean age was 83 (SD = 9), patients had multiple diagnoses and were admitted for assessment or to establish a safe discharge destination. None were identified as ‘terminal’ on admission and none had an Advance Care Plan to guide care preferences. Prior to death, more than half (57.4%) received terminal care compliant with the Promoting Improved Care of the Dying (PICD) guideline. 53.7% were referred for specialist palliative care review, and despite a mean wait time of 0.6 days (SD = 0.8), 11.1% of patients died before specialist palliative care review. Documentation of communication with patients/family of the likelihood of death occurred in two key sequential time points; the first was information-related and the second decision-related. When these time points occurred impacted end-of-life care provision. Ambiguity in language used to communicate patient deterioration and dying with clinicians and family, impacted understanding and provision of end-of-life care.Conclusions
Education is needed to aid clinicians in subacute care to identify patient deterioration and dying and communicate the likelihood of death to the multidisciplinary team and with patients and families. Nursing and allied health clinicians are well placed to have greater involvement in communicating patient deterioration and likely death. 相似文献4.
Ibrahim M. Alananzeh Cannas Kwok Lucie Ramjan Janelle V. Levesque Bronwyn Everett 《Collegian (Royal College of Nursing, Australia)》2019,26(1):40-48
Background
Arab cancer survivors and their caregivers often have high levels of unmet information needs. However, whether these information needs are the same for cancer survivors living in Arab speaking countries compared to Arab migrants is not clear.Objective
To identify the information needs and information sources among Arab cancer survivors and their caregivers.Methods
Arab cancer survivors (n = 143) in Jordan and Australia were surveyed to explore their information needs and information sources. Interviews with cancer survivors and their caregivers, and focus groups with health care providers were conducted in both countries.Findings
While lack of information about cancer, its treatment and side effects were common to both groups, Arab Australian cancer survivors expressed greater need for information about managing their illness (P = .027), receiving explanations about tests (P = .016) and the benefits and side-effects of treatments before making choices (P = .041) than Jordanian cancer survivors. Qualitative findings revealed preferences for spoken rather than written information, and the provision of diagrams and drawings. Although information provided by doctors was a trusted source, almost half the participants indicated they used the Internet for information. Despite the use of interpreters, Australian health care providers expressed concern at whether the information they provided had been delivered and understood.Conclusion
Arab cancer survivors and their caregivers have unmet cancer information needs resulting in them seeking information from potentially unreliable sources such as the Internet. Arab migrants may need additional assistance to ensure they receive information relevant to their disease and are linked with the most trusted source of information. 相似文献5.
6.
Objective
To measure foot sensitivity and blood glucose levels among diabetic patients as measures of improvement pre and post Apiyu massage.Method
Quasi experimental research was employed to measure foot sensitivity and blood glucose levels before and after APIYU massage for fifty-five (55) purposive sampled consented adult patients with diabetes from Rejosari and Langsat Health Centers in Pekanbaru Riau, Indonesia. The intervention was given about three times in a week for thirty (30) minutes.Result
Revealed that there were significant differences between measures before and after massage using the Apiyu tool on: (a) mean sensitivity levels for pre-tests and post-tests on the right foot (pre-test 9.49, post-test 9.64; p-value = 0.011) and the left foot (pre-test 9.55, post-test 9.80; p-value = 0.004), and (b) blood glucose levels (pre-test 271.6, post-test 220.7; p-value = 0.001).Conclusion
The APIYU massage was proven effective for improving foot sensitivity and reducing blood glucose among diabetic patients. 相似文献7.
Ruben Barakat Ignacio Refoyo Javier Coteron Evelia Franco 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2019,23(2):148-155
Background
Excessive gestational weight gain is associated with several adverse events and pathologies during pregnancy.Objective
The purpose of this study was to examine the effects of an exercise program throughout pregnancy on maternal weight gain and prevalence of gestational diabetes.Method
A randomized controlled trial was designed that included an exercise intervention group (EG) and standard care control group (CG). The exercise intervention included moderate aerobic exercise performed three days per week (50–55 minutes per session) for 8–10 weeks to 38–39 weeks gestation.Results
594 pregnant women were assessed for eligibility and 456 were included (EG n = 234; CG n = 222). The results showed a higher percentage of pregnant women gained excessive weight in the CG than in the EG (30.2% vs 20.5% respectively; odds ratio, 0.597; 95% confidence interval, 0.389–0.916; p = 0.018). Similarly, the prevalence of gestational diabetes was significantly higher in the CG than the EG (6.8% vs 2.6% respectively; odds ratio, 0.363; 95% confidence interval, 0.138–0.953; p = 0.033).Conclusion
The results of this trial indicate that exercise throughout pregnancy can reduce the risk of excessive maternal weight gain and gestational diabetes. 相似文献8.
9.
J. Morel C. Herlin B. Amara C. Mauri H. Rouays C. Verollet I. Almeras N. Frasson A. Dupeyron C. Jourdan J.-P. Daures A. Gelis 《Annals of physical and rehabilitation medicine》2019,62(2):77-83
Background
Flap surgery for deep pelvic pressure ulcers (PPUs) has been found effective, but the recurrence rate remains high and few risk factors have been identified.Objective
We evaluated risk factors for PU recurrence after primary flap surgery in people with spinal cord injury (SCI).Patients and methods
This observational retrospective study based on medical charts included all individuals with SCI who underwent primary flap surgery for a PPU in the Hérault department in France between 2006 and 2014. Overall, 100 biomedical, psychological, socioeconomic and care management factors were studied. The primary outcome was PPU recurrence (surgical site and/or other pelvic site). The secondary outcome was recurrence at the surgical site. Cox proportional hazards regression was used to determine associated factors, estimating hazard ratios (HRs) and 95% confidence intervals (CIs).Results
We included 85 patients. Half had a PPU recurrence, and in one-third, the recurrence was at the surgical site. On multivariate analysis, global PPU recurrence was associated with colostomy (HR = 2.79) and living with a partner (HR = 2.29). Non-traumatic SCI and sacral wound were associated with PPU recurrence (HR = 3.39, HR = 0.48) and recurrence at the surgical site (HR = 3.3, HR = 0.3).Conclusion
Risk factors of PPU recurrence are based on both biomedical and social models. After primary flap surgery, the risk of recurrence justifies regular follow-up and strict monitoring. 相似文献10.
A. Sampath Kumar Arun G. Maiya B.A. Shastry K. Vaishali N. Ravishankar Animesh Hazari Shubha Gundmi Radhika Jadhav 《Annals of physical and rehabilitation medicine》2019,62(2):98-103
Background
Insulin resistance is a determining factor in the pathophysiology of type 2 diabetes mellitus (T2DM). Exercise is known to improve insulin resistance, but a systematic review of the literature is lacking.Objective
This systematic review and meta-analysis focused on identifying evidence for the effectiveness of a structured exercise intervention program for insulin resistance in T2DM.Methods
We searched MEDLINE via PubMed, CINHAL, Scopus and Web of Science, and the Cochrane Central Register of Controlled Trials for reports of studies on fasting insulin, homeostatic model assessment for insulin resistance (Homa-IR), fasting blood sugar, glycated hemoglobin and body mass index in patients with T2DM and healthy controls that were published between 1990 and 2017. Data are reported as the standardized mean difference or mean difference with 95% confidence intervals (CIs).Results
Among 2242 records retrieved, only 11 full-text articles were available for meta-analysis. Data for 846 participants were analyzed, 440 in the intervention group, and 406 in the control group. The mean difference for fasting insulin level was ?1.64 (95% CI; ?3.38 to 0.10), Homa-Ir 0.14 (?1.48 to 1.76), fasting blood sugar ?5.12 (?7.78 to ?2.45), hemoglobin A1c 0.63 (?0.82 to 2.08) and body mass index ?0.36 (?1.51 to 0.79).Conclusion
The evidence highlights the effectiveness of a structured exercise intervention program for insulin resistance in T2DM with a moderate level 2 of evidence. 相似文献11.
12.
Objective
This study aims to determine the effectiveness of health education through audiovisual media on improving family knowledge in the prevention of dengue fever (DHF).Method
This study used a Quasi Experiment research design with a research design of Non-Equivalent Control Group. The study was conducted in the community with a sample of 40 people, consisting of 20 for experimental group and 20 for control group. The samples were selected using purposive sample collection method. The measuring instrument used is a questionnaire that has been tested for validity and reliability. The analysis was done through univariate analysis and bivariate analysis using t-independent test.Result
This study found that the showed a significant increase in changes in the level of attitudes and actions of families in the prevention of dengue fever by using audiovisual media, (p = 0.000), (p = 0.000).Conclusion
It is recommended that the health workers should provide health education by using audiovisual media in the prevention of dengue fever. 相似文献13.
Jane Currie Mary Chiarella Thomas Buckley 《Collegian (Royal College of Nursing, Australia)》2019,26(1):8-15
Background
Nurse practitioners (NPs) have been practising in Australia since 2001, predominantly in the public sector. To facilitate the expansion of NPs working in community and primary health care settings, legislative changes in 2010 led to privately practising NPs (PPNPs) being eligible to provide care subsidised through the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS). To date, there has been little evaluation of PPNP services in Australia. Reported in this paper is the process through which national survey data enabled the refinement and development of theories on PPNP services in Australia.Aim
To describe the development and refinement of theories to answer the research question how, why and in which contexts PPNP services impact on patient access to care.Methods
The first part of a realist evaluation of privately practising nurse practitioner (PPNP) services in Australia has been conducted. A literature review and a national survey (n = 73) of PPNPs was undertaken to develop and refine preliminary realist theories and hypotheses.Findings
The theories developed relate to three broad aspects of PPNP practice activities: reimbursement, collaborative arrangements and scope of practice. National survey results support the preliminary theory that the current structure of the NP MBS items heavily influenced PPNPs’ reasoning processes in the design and delivery of patient services. Survey data also supports the theory that medical practitioners’ level of understanding of PPNPs’ roles and of collaborative arrangement legislation influences how they engage with PPNPs and the concomitant service outcomes.Conclusions
The national survey data confirmed the significance of theories about reimbursement, collaborative arrangements and scope of practice and how these have impacted on how PPNPs provide patient access to services. 相似文献14.
15.
Objective
The purpose of this study was to examine the relationship between spirituality and health status outcome in nursing home (PSTW Khusnul Khotimah) in Pekanbaru, Riau-Indonesia.Method
This study methods was a cross-sectional study with 36 elderly people as samples and it was taken by total sampling technique. JAREL Spiritual Well-Being Scale was used to assess elderly people spirituality level. Univariate and bivariate use non-parametric analysis were performed to determine the relationship between elderly people spirituality and self-reported health status.Results
Majority marital status of respondent (85.8%) were divorce with their couple. Seventy two point two percent elderly health status was not good and 52.8% (the results spiritual statement of indicates: When I was sick, I reduced spiritual welfare 33.3%, I cannot accept changes in my life 27.8%) of them have less spirituality. This study also found that the elderly people who has low spirituality level more likely have health problems. There was significant correlation between spirituality and elderly health status in nursing home (p = 0.035).Conclusion
It was important to increase the elderly people spirituality to prevent health status degradation in elderly people in nursing home. 相似文献16.
Michelle Barakat-Johnson Michelle Lai Timothy Wand Kathryn White 《Collegian (Royal College of Nursing, Australia)》2019,26(1):95-102
Background
Hospital-acquired pressure injuries are a quality indicator in healthcare, including nursing care. Successful implementation of interventions to prevent pressure injuries can be impeded by factors beyond the control of nursing staff. Limited research exists on nurses’ experiences of providing pressure injury prevention and management in a hospital setting.Aim
To gain an in-depth understanding of nurses’ experiences concerning pressure injury prevention and management in a hospital setting.Methods
A qualitative study design was employed. The purposive sample consisted of twenty nurses working in units with a high incidence of pressure injuries across a local health district in Sydney, Australia. Participants were interviewed between May and September 2016, either individually or as a group using semi-structured interviews.Findings
Four themes were identified that captured the experiences of nurses providing pressure injury prevention and management in a hospital setting: “managing competing demands in complex clinical settings”; “the importance of knowledge and skill”; “clarifying organisational expectations, purpose and successes”; and “feeling ethically challenged when unable to provide quality patient care”.Discussion
Participants were aware of the importance of pressure injury prevention and management but found it difficult to provide quality care due to competing priorities and challenges faced at both an organisational and patient level.Conclusion
Pressure injury prevention and management is just one aspect of patient care and should not be considered on its own to change existing practice. Participants wanted to implement preventative strategies and provide optimal pressure injury care, however, complexities associated with a hospital setting hindered this process. Hospitals need to put measures in place that support and enable nurses to deliver the quality care required to prevent and manage pressure injuries. 相似文献17.
Objectives
this study aimed to identify the influence of health education about HIV/AIDS towards enhancing knowledge and HIV prevention efforts in household wives.Method
A quasy experimental design with pretest and posttest nonequivalent control group study was conducted among housewives in Rumbai Pekanbaru, Riau Province from March to August 2018. A systematic random sampling technique was used to select 144 housewives. A total of 72 intervention groups and 72 control groups. The intervention group was given health education with videos and leaflets. A questionnaire that it tested for validity and reliability has been applied. The Paired-Samples T-Test and Independent Samples T-Test were applied to analyze data.Results
There were differences in pretest and posttest preventive knowledge and prevention behavior scores on HIV in the intervention group (p-value = 0.000). However, there was no significant difference in prevention behavior in the control group (p-value = 0.0120). Based on this results, it can be concluded that health education can increase the knowledge and behavior of prevention of HIV/AIDS in household wives (p-value = 0.000).Recommendation
The health education on HIV/AIDS counseling and testing are key interventions for reducing number of HIV/AIDS cases. It is recommended that housewives to conduct HIV status on health services, and for HIV program holders are expected to increase the frequency of health education by using attractive media and VCT mobile services in order to reach more housewives. 相似文献18.
Background
Entering the paediatric intensive care unit with a critically ill child is a stressful experience for parents. In addition to fearing for their child’s well-being, parents must navigate both a challenging environment and numerous new relationships with healthcare staff. How parents form relationships with staff and how they perceive both their own and the healthcare providers’ roles in this early stage of their paediatric intensive care journey is currently unknown.Purpose
This paper explores bereaved parents’ perceptions of their role and their relationships with healthcare providers when their child is admitted to the intensive care unit, as part of a larger study exploring their experiences when their child dies in intensive care.Methods
A constructivist grounded theory approach was utilised to recruit 26 bereaved parents from 4 Australian intensive care units. Parents participated in audio-recorded, semi-structured interviews lasting 90–150 min. All data were analysed using the constant comparative analysis processes, supported by theoretical memos.Results
Upon admission, parents viewed healthcare providers as experts, both of their child’s medical care and of the hospital system. This expertise was welcomed, with the parent–healthcare provider relationship developing around the child’s need for medical care. Parents engaged in 2 key behaviours in their relationships with staff: prioritising survival, and learning ‘the system’. Within each of these behaviours are several subcategories, including ‘Stepping back’, ‘Accepting restrictions’ and ‘Deferring to medical advice’.Conclusions
The relationships between parents and staff shift and change across the child’s admission and subsequent death in the paediatric intensive care unit. However, upon admission, this relationship centres around the child’s potential survival and their need for medical care, and the parent’s recognition of the healthcare staff as experts of both the child’s care and the hospital system. 相似文献19.
Anne Mette Rustaden Lene Annette Hagen Haakstad Gøran Paulsen Kari Bø 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2019,23(2):156-163