Do gynaecology outpatients use the Internet to seek health information? A questionnaire survey

Background The Internet is a rich source of medical information and the general opinion among doctors is that the number of patients attending clinics with information from a web search is increasing. The purpose of this study was to assess the demographics of those who access the Internet and their attitudes towards the quality and usefulness of information provided by the Internet. This study also looked at the various sources of health information and the satisfaction rates. Design Cross‐sectional observational study. The study group consisted of a cohort of women attending the gynaecology outpatient clinic at a district general hospital in the United Kingdom. In total, 484 patients attending the gynaecology outpatient clinic completed a questionnaire which included 13 structured questions regarding access to and attitudes towards the Internet and other health sources of information. Setting Questionnaires were distributed to 564 women attending gynaecology outpatient clinics for 3 months from 1 June 2005. Results A total of 484 patients (85.6%) completed the questionnaire. Age range was 41–65 years and the median education level was completion of General Certificate of Secondary Education (GCSE). In total, 360/484 (74%) had sought health information about their condition from a variety of sources before attending the outpatient clinic. In total, 399/484 (82.4%) respondents had access to the Internet. Of 399 with access, 107 (26.8%) of the patients used the Internet to find information about their condition before their appointment. General practitioners remain as the primary source of health information, mainly to improve the knowledge of the condition. A total of 78/107 (73.3%) who had used the Internet before their appointment would like to continue using the Internet as a health information resource. Conclusion A significant proportion of patients had access to the Internet to find health information. The widespread availability and increased usage of medical websites by patients raises important issues regarding the need for quality control and impacts on the doctor–patient relationship.     

Community health nurses’ learning needs in relation to the Canadian community health nursing standards of practice: results from a Canadian survey

Background

Canadian Community health nurses (CHNs) work in diverse urban, rural, and remote settings such as: public health units/departments, home health, community health facilities, family practices, and other community-based settings. Research into specific learning needs of practicing CHNs is sparsely reported. This paper examines Canadian CHNs learning needs in relation to the 2008 Canadian Community Health Nursing Standards of Practice (CCHN Standards). It answers: What are the learning needs of CHNs in Canada in relation to the CCHN Standards? What are differences in CHNs’ learning needs by: province and territory in Canada, work setting (home health, public health and other community health settings) and years of nursing practice?

Methods

Between late 2008 and early 2009 a national survey was conducted to identify learning needs of CHNs based on the CCHN Standards using a validated tool.

Results

Results indicated that CHNs had learning needs on 25 of 88 items (28.4%), suggesting CHNs have confidence in most CCHN Standards. Three items had the highest learning needs with mean scores > 0.60: two related to epidemiology (means 0.62 and 0.75); and one to informatics (application of information and communication technology) (mean = 0.73). Public health nurses had a greater need to know about “…evaluating population health promotion programs systematically” compared to home health nurses (mean 0.66 vs. 0.39, p <0.010). Nurses with under two years experience had a greater need to learn “… advocating for healthy public policy…” than their more experienced peers (p = 0.0029). Also, NPs had a greater need to learn about “…using community development principles when engaging the individual/community in a consultative process” compared to RNs (p = 0.05). Many nurses were unsure if they applied foundational theoretical frameworks (i.e., the Ottawa Charter of Health Promotion, the Jakarta Declaration, and the Population Health Promotion Model) in practice.

Conclusions

CHN educators and practice leaders need to consider these results in determining where to strengthen content in graduate and undergraduate nursing programs, as well as professional development programs. For practicing CHNs educational content should be tailored based on learner’s years of experience in the community and their employment sector.

     

A survey of 'teamwork' in mental health: is it achievable in practice?

As part of an ENB educational evaluation of teamworking in mental health, a report-and-respond survey was used as one of five data collection methods. This instrument disseminated earlier findings back to the participants and invited further comments. This article discusses the usefulness of this type of survey as a data collection tool and presents the findings of the survey which was administered to service professionals, educationalist, students, users and carers involved in mental health throughout England. The findings show that when groups of professionals are working within increasingly tight financial constraints and increased workloads, multiprofessional teamworking can be scarce in reality. These tensions present issues for nurse education and training at both pre- and post-registration levels in relation to the teaching of, for and about effective teamwork.     

Does a multi-disciplinary health degree provide a satisfactory post-registration course for nurses? A follow-up survey of health science studies graduates

The purpose of this investigation was to find out if nurses who had chosen to take a particular post-registration health science studies degree (rather than a nursing degree) were satisfied, retrospectively, with the usefulness of this type of degree to their professional development and career progress. The investigation also examined if these graduates were remaining in nursing, if they were active in nursing research, and the role of their employers in the choice of degree course. Questionnaires were sent to 10 cohorts of nurse graduates from one health science studies course. The idea to study for a degree had usually come from the nurses themselves, and most employers had taken little interest in the course content. The nurses showed a high level of satisfaction with their chosen course and considered that it had significantly improved their job performance. Almost all the graduates had remained in nursing; many had been involved in carrying out research, or hoped to be research-active in future. More than half the respondents had gained a post-graduate qualification or were in the process of studying for one. It is suggested from the evidence gathered that in this case a broad health degree seems to have provided a useful and satisfactory educational experience for nurses.     

The relationship between stroke patients’ socio-economic conditions and their quality of life: the 2010 Korean community health survey

[Purpose] The relationship between stroke patients’ socio-economic conditions and quality of life (QOL) using the 2010 Korean Community Health Survey (KCHS) statistics was examined. [Subjects and Methods] A total of 4,604 stroke patients were analyzed. Socio-economic conditions were sex, age, educational level, monthly household income, occupation, residential area, and living with family. [Results] The results show a statistically significant lower QOL for men than for women, for those aged 75 years or over compared to individuals between 19 years and 64 years, and for elementary (or lower) or middle school graduates compared to higher education graduates. QOL was also significant lower among patients whose household income was KRW4 million (US$3,746.72) or less a month. Finally, QOL was significantly lower for patients without an occupation compared to those with an occupation, for patients in rural areas compared to urban areas, and for patients who did not live with family compared to those who lived with family. [Conclusion] We showed the importance of the relationships between socio-economic conditions and QOL of stroke patient.Key words: Stroke, Quality of life, Korean Community Healthy Survey     

What should be the future focus of mental health nursing? Exploring the perspectives of mental health nurses,consumers, and allied health staff

The landscape of mental health care and service delivery is changing, as is our understanding of the underlying causes for mental distress. It is now apparent that biogenic explanations have been overstated and instead experiences of trauma and adversity constitute the main contributor to people’s experiences of mental health challenges. The shortcomings of treatments traditionally used in mental health care are also evident, and with a contemporary focus on person-centred care, the utility of diagnostic labels has been called into question. Taking all this into consideration, this study sought to explore, what should be the future focus of mental health nursing? Three separate focus groups were conducted. One with a sample of senior clinical mental health nurses, one with a sample of consumer representatives and another with allied health professionals. The common theme across all three focus groups was the centrality of the therapeutic role of mental health nurses (MHNs). Consumers and allied health participants, in particular, advocated for a de-emphasis on medications, psychiatric diagnoses, and custodial practices. The MHNs role in health promotion, working collaboratively with consumers, being hopeful, understanding the individual perspective, and appreciating the social determinants of mental health were all highlighted in framing the future focus of MHN practice.     

There is no health without mental health: Are we educating Australian nurses to care for the health consumer of the 21st century?

One in five Australians has a diagnosable mental illness and the impact of the illness on the individual, their family, and the community is significant. Since comprehensive nursing was introduced in the 1980s there have been repeated concerns raised regarding the preparedness of graduates from Australian undergraduate nursing programs to care for people who have a mental illness. In 2009, despite a recent comprehensive national review of the mental health/illness content in pre‐registration curricula, these concerns remain. The nursing profession must have a responsibility to the global community to ensure that registered nurses are educated to meet evolving health challenges and the needs of the health consumer in the 21^st Century. The purpose of this paper is to highlight the prevalence and impact of mental illness on health care outcomes in all settings and to challenge the profession to acknowledge that mental health nursing content must be a core area of all undergraduate curricula. A nationally coordinated response to address the long standing identified deficits in the educational preparation of comprehensive nurses is now a priority to ensure that nurses remain a major stakeholder group in the delivery of health care and key health informants and decision makers within the global health care arena.     

Social determinants of mental health: the missing dimensions of mental health nursing?

In this paper we explore how aspects of the social world may be linked to mental health and psychiatric morbidity and propose that conditions should be created which allow individuals and communities greater opportunities for self-care and self-management. Specifically the focus is on social connections, disability and homelessness and work stress. There is a clear policy direction pursued by many national governments and international organizations such as the World Bank to build healthy communities. The environment as it relates to health and well-being can be thought of in terms of physical and social dimensions. We will argue that self-care and self-management at both the individual and the community level, in partnership with economic and health policies, are necessary to effectively address social determinants. It will also be suggested that although many in the profession will make the usual refrain that this has little relevance to mental health nurses, the opposite may be the case as mental health nurses have an important, albeit ill-defined, role to play in tackling social determinants.     

Can the health utilities index measure change?

BACKGROUND: The Health Utilities Index (HUI) is a multidimensional, preference-weighted measure of health status. It comprises eight health attributes, aggregated into a single utility score. OBJECTIVES: The purpose of the study was to investigate the ability of the HUI to detect changes in health status in a general population cohort. RESEARCH DESIGN: Health status changes were analyzed in the full cohort and in persons who were diagnosed with chronic conditions, hospitalized, or became restricted in daily activities. SUBJECTS: To assess responsiveness, longitudinal data was used from the National Population Health Survey conducted in Canada in 1994 - 1995 and 1996 - 1997. We used cross-sectional data from the 1996 sample to classify chronic conditions into mild, moderate, and severe. MEASURES: Two measures of responsiveness were calculated: Standardized Response Mean (SRM) and Sensitivity Coefficient (SC). The HUI was compared with a global health index-the Self-Rated Health (SRH) scale. RESULTS: HUI scores improved between the two NPHS cycles in all age-sex groups, except men 65 years of age and older. Among the respondents who remained free of chronic conditions, improvements were seen primarily in the cognitive and emotional domains. The HUI deteriorated among persons who were diagnosed between the two cycles with a severe chronic condition, were hospitalized, or became restricted in activity, but not in those diagnosed with a moderate condition. The SRMs were generally smaller for the HUI compared with the SRH. CONCLUSIONS: The HUI responds to changes in health status associated with serious chronic illnesses. However, changes in the HUI do not always coincide with changes in self-reported health. Properties of the HUI scales require further study.