French healthcare professionals' perceived barriers to and motivation for therapeutic patient education: A qualitative study

Therapeutic patient education is effective for various patient outcomes; however, healthcare professionals sometimes lack the motivation to carry out patient education. Surprisingly, this issue has rarely been addressed in research. Therefore, this study explores healthcare professionals' perceived barriers to and motivation for therapeutic patient education. Healthcare professionals, mainly nurses, working in different French hospitals were interviewed. Thematic content analysis was performed. Findings included a lack of skills, knowledge, and disillusionment of the effectiveness of therapeutic patient education were features of a demotivated attitude. In contrast, a positive attitude was observed when therapeutic patient education met a need to work differently and more effectively. A key factor motivating professionals was the integration of therapeutic patient education in routine care within a multidisciplinary team. To keep healthcare professionals motivated, managers should ensure that therapeutic patient education is implemented in accordance with its core principles: a patient‐centered approach within a trained multidisciplinary team. In the latter case, therapeutic patient education is viewed as an efficient and rewarding way to work with patients, which significantly motivates healthcare professionals.     

Patient self-medication--a change in hospital practice

Aims and objectives. The purpose of this study was to evaluate the effectiveness of a self‐medication programme (SMP) for inpatients of the Nursing Convalescent Unit, a 26‐bed unit with medical and surgical patients. Background. Self‐medication is an important part of self‐management of chronic illness. Self‐medication is a way of allowing patients to give themselves their medications in hospital after receiving education instead of the usual practice of medications administered by a Registered Nurse (RN). Design. The pilot study was undertaken over a six‐month period to examine the relationship between a programme of self‐medication and patient knowledge and adherence to medication regimens, number of medication errors, efficiency in relation to the number of nursing hours associated with the SMP, patient and nursing satisfaction. Methods. A total of 220 patients participated in the study. The SMP included three levels of patient self‐administration of medications: level one, medications administered by a RN; level two, self‐medication directly supervised by a RN and level three, self‐medication indirectly supervised by a RN. Outcome measures included staff and patient satisfaction, number of medication errors, time taken by nurses to undertake activities related to the SMP and the number of patients who achieved levels two and three. Results. Study findings showed that 45% of patients remained on level one, 26% achieved level two and 29% achieved level three. There were no patient initiated medication errors during the study period. Efficiencies were identified in staff workload associated with patient discharge procedures. Overall, nurses perceived that the SMP increased their knowledge of medications and contributed to effective patient education. Conclusions. In selected patients, the SMP was an effective aid for improving adherence to medication regimens. Relevance to clinical practice. Collaboration between nurses, medical staff, pharmacists, patients and carers is integral to the success of in hospital SMP.     

Nurses' experiences and perceptions of influencing barriers to postoperative pain management

Despite decades of research and the availability of effective analgesic approaches, many patients continue to experience moderate to severe pain after surgery. Greater research efforts are needed to identify the factors that impede effective pain management. Despite the fact that a variety of research and clinical studies on all aspects of pain have been conducted in many countries, the factors affecting pain management have not been completely identified.
Aim:  To identify nurses' experiences and perceptions about the barriers to postoperative pain management.
Methods:  A qualitative approach was adopted using content analysis of semi-structured interviews carried out with 26 Iranian registered nurses from three large educational hospitals in Tehran city. The data were analysed using constant comparative method.
Findings:  Ninety-three primary codes were achieved. Four main themes emerged from the data. From the participants' points of view, 'lack of educational preparation', 'nurses' limited authority', 'limited nurse–patient relationship', and 'disturbances in pain management interventions' are considered barriers to pain management.
Conclusion:  The conclusion embraces implications for clinical practice to improve the knowledge of nurses and nursing manager and insight in postoperative pain management. Clearly, programmes for change must address not only knowledge improvement, but also the wider complex influences on barriers to pain management.     

Adherence to self-care and social support

The purpose of the study reported in this paper was to describe adherence to self-care, perceived difficulties and social support in a group of adult patients (n = 213) with insulin-treated diabetes from two outpatient clinics in Northern Finland. Data were collected by questionnaire. The instruments were developed to measure adherence to self-care, difficulties in self-care and social support. The response rate was 76%. One-way ANOVA, logistic regression analysis, contingency and Pearson's correlation coefficients were used in the statistical analysis. A fifth of the respondents were neglecting their self-care. The others undertook flexible, regimen-adherent or self-planned self-care. The subjects had no difficulties with insulin treatment, but had more problems with other aspects of self-care. Poor metabolic control, smoking and living alone predicted neglect of self-care, but if patients had support from family and friends, living alone was not a predictor of neglect of self-care. Those with poor metabolic control perceived themselves as getting peer support from other persons with diabetes.     

Nurses' Perspectives of Encouraging Clients' Care‐of‐Self in a Short‐Term Rehabilitation Unit Within a Long‐Term Care Facility

This article presents a study conducted on a short‐term rehabilitation unit in a long‐term care facility. The purpose of the study was to explore, through qualitative methods, nurses' perspectives of encouraging clients to care for themselves. Although the literature suggested that encouraging self‐care does not occur, the findings of this study showed that nurses have a broader view than what is currently known in nursing as “self‐care.” Potential impediments to nursing practice were overcome by the development of nurse‐client relationships through which the nurses encouraged clients in what is described throughout this study as “care‐of‐self” Rehabilitation nurses play an important role in helping clients to integrate and reclaim the care of their emerging new selves. Care‐of‐self may be critical to clients not only in reaching their outcome goals for discharge but also in maintaining outcomes beyond discharge.