Nurses attitudes towards the importance of families in psychiatric care following an educational and training intervention program

This study measures the attitudes of the psychiatric nurses, after having received an education and training intervention program (ETI-PROGRAM) in family systems nursing, towards the importance of the families in their care. Nurses' knowledge of the impact that family nursing intervention can have on family members may increase positive attitudes towards families. However, little is known about the impact that education and training intervention can have on nurses' attitudes, towards families in clinical practice. Quasi-experimental design was used to assess the change in nurses' attitudes towards families in psychiatric care after the intervention, which included a one-day seminar on the Calgary family nursing conceptual frameworks and skills training with clinical vignettes of families from psychiatry. The Families Importance in Nursing Care - Nurses' Attitude questionnaire was used to evaluate nurses' attitudes. A total of 81 nurses (65%) working in psychiatric care responded to the questionnaire. Nurses with more than 15 years of work experience were significantly more supportive of families in their care compared with less experienced nurses. Out of the 81 nurses, 52 (64%) answered the questionnaire again 14 months later. Furthermore, psychiatric nurses saw families significantly less burdensome after having participated in the ETI-PROGRAM.     

Knowing the family: Interpretations of family nursing in oncology and palliative care

PurposeFamilies are acknowledged as a focus of care in oncology nursing in many countries but the meaning of “family nursing” in this practice setting has received little attention from researchers and theorists. In this article, we report the findings of a study that explored family nursing practices in three adult cancer care settings: ambulatory care (medical and radiation oncology clinics), a palliative care service, and an in-patient unit.MethodData included in-depth interviews with 30 nurses and 19 families, as well as participant observations in each practice setting. The interviews were transcribed verbatim and the analyses guided by philosophical hermeneutics.ResultsWe identified several narratives related to family nursing practices, and in this article we offer the interpretations of two of these narratives: 1) knowing the family and being known; and 2) addressing family concerns and distress. In knowing the family and being known nurses opened relational space for families to become involved in the care of their loved ones and gained an understanding of the family by “reading” non-verbal and para-verbal cues. Knowing the family created opportunities for nurses to address family concerns and distress in meaningful ways. These included guiding families by being a bridge, helping families to conserve relationships, and negotiating competing family agendas. Nurses relied on questioning practices to create relational space with, and among, family members.ConclusionsImplications for the development of family nursing practice, theory, and education are discussed.     

Registered nurses’ knowledge,attitudes and beliefs about end-of-life care in non-specialist palliative care settings: A mixed studies review

AimThe aim of this study was to describe, evaluate and synthesise the literature on registered nurses’ knowledge, attitudes and beliefs towards end-of-life care in adult non-specialist palliative care settings.BackgroundLittle is known about the knowledge, attitudes and beliefs of Registered Nurses working in non-specialist palliative care settings about end-of-life care.DesignA mixed-methods systematic review and narrative synthesis was conducted (PROSPERO Registration No: CRD4202148114). Five databases (Medline, CINAHL, PubMed, PsycINFO and Web of Science) were searched from inception to August 2020. Study quality was assessed using the Mixed Methods Appraisal Tool.ResultsNineteen studies met the inclusion criteria. Registered nurses in non-specialist palliative care settings demonstrated good knowledge of pain symptoms and management and positive attitudes towards caring for dying patients and their families. Knowledge deficits were identified in the psychosocial and spiritual aspects of end-of-life care and registered nurses reported negative attitudes towards communication about death. Only five of the included studies explored registered nurses’ beliefs towards end-of-life care.ConclusionsThere is a need to enhance palliative care education in clinical practice settings and in undergraduate programs to improve registered nurses’ knowledge, attitudes and beliefs about end-of-life care. Future studies that use reliable and validated methods to measure registered nurses’ beliefs about end-of-life care should be conducted.Tweetable abstractRNs in non-specialist palliative care settings want more education on pain management & greater knowledge on communicating about death/dying.     

Family functioning of families experiencing intensive care and the specific impact of the COVID-19 pandemic: A grounded theory study

ObjectivesIn order to provide a deeper understanding of family functioning, the aim of this study was to identify, describe and conceptualise the family functioning of families where a formerly critically ill family member had stayed at the intensive care unit, with the impact of a pandemic.Research methodology/designThe study has a grounded theory design including interviews with eight families.SettingFormer adult intensive care patients cared for Covid-19 infection and their family. Eight patients and twelve family members from three different intensive care units.Main outcome measuresThe results presented are grounded in data and identified in the core category “Existential issues” and the categories “Value considerateness; Anxiety and insecurity in life; Insight into the unpredictability of life.”FindingsThe core category could be found in all data and its relationship and impact on the categories and each other. The core is a theoretical construction, whereas the family functioning of families where a formerly critically ill family member had stayed at the intensive care unit was identified, described, and conceptualised. Being able to talk repeatedly about existential issues and the anxiety and insecurity in life, with people that have similar experiences helps the patient and their family to consider and gain insight into the unpredictability of life, and thereby better cope with changes in life.ConclusionThere is awareness about the love that exists within the family. A willing to supporting each other in the family even if the critical illness made the family anxious and afraid.Implications for clinical practiceEven if the pandemic Covid-19 led to restrictions inhibiting family focused nursing, it is important to confirm the family as a part of the caring of the ICU patient. The patients are not alone, their family are fighting together for the future.     

Nurses’ perceptions of dealing with death in the emergency department

BackgroundProviding end-of-life care to patients and their families in the emergency department (ED) is challenging, with high workloads, the busy environment, and a focus on providing lifesaving treatments to patients at odds with providing end-of-life and palliative care.AimThe purpose of this study was to investigate nurses’ experiences of providing end-of-life care in EDs, including their perceptions of the most vital elements of care, ability to provide aspects of care, as well as perceptions of their role, communication processes, family presence/involvement, and the ED environment.MethodsNurses (n = 211) working in Australian EDs for at least 12 months completed an anonymous online survey.FindingsNurses identified vital elements of care for dying patients including adequate pain control and a move away from burdensome treatments, sensitive care of families and family access to loved ones, and a quiet environment. However, nurses were not always able to provide such care to their patients. Often, the ED was seen as an unsuitable place for end-of-life care or care of families once the patient had died, and communication between staff and between staff and families was challenging.DiscussionThe ED physical environment, lack of staff training and debriefing, and lack of time to communicate with family, particularly after death, may compromise nurses’ ability to provide end-of-life care that is satisfying to them, their patients, and families.ConclusionThere is a need for focus on the ED physical environment, staff training, and consideration of the emotional experiences of frontline nurses caring for patients at the end of life.     

Fulfilling the psychological and information need of the family members of critically ill patients using interactive mobile technology: A randomised controlled trial

BackgroundIntensive care nurses may have an important role in empowering families by providing psychological support and fulfilling the family's pivotal need for information.AimTo determine whether ‘education of families by tab’ about the patient’s condition was more associated with improved anxiety, stress, and depression levels than the ‘education of families by routine’.Research designA randomized control trial of 74 main family caregivers (intervention: 39; control: 35).SettingAn adult intensive care unit.Main outcome measuresDepression Anxiety Stress Scale, and Communication and Physical Comfort Scale.ResultsAlthough information need satisfaction was not significantly different between intervention and control groups, the former reported significantly better depression score on Depression Anxiety Stress Scale comparing to the control group (p < 0.01; η² = 0.09) with a medium effect size. Reduction of anxiety in the intervention group were clinically significant.ConclusionThe results suggest that use of ‘education of family by tab’ is promising for intensive care nurses to provide psychological support for family members. More studies are needed to investigate this aspect of family care for better psychological support and information need satisfaction that contributes to the evidence-based practice of intensive care nursing.     

First-year nursing students’ attitudes towards artificial intelligence: Cross-sectional multi-center study

AimTo assess the attitudes of nursing students toward artificial intelligence.BackgroundPossible applications of artificial intelligence-powered systems in nursing cover all aspects of nursing care, from patient care to risk management. Although the final acceptance of artificial intelligence in practice will depend on positive 'nurses' attitudes toward artificial intelligence, those attitudes have gained little attention so far.DesignA cross-sectional multicenter study.MethodsThe study was performed at nursing schools of four Croatian universities, surveying a total of 336 first-year nursing students (response rate 69.7%) enrolled in 2021. A validated instrument, the General Attitudes towards Artificial Intelligence Scale, consisting of 20 Likert-type items, was chosen for the study. Where applicable, the items were contextualized for nursing. Four sub-scales were identified based on the outcomes of the factor analysis.ResultsThe average attitude score was (mean ± standard deviation) 64.5 ± 11.7, out of a maximum of 100, which was significantly higher than the neutral score of 60.0 (p < 0.001). The attitude towards AI did not differ across the universities and was not associated with students’ age. Male students scored slightly higher than their female colleagues. Scores on subscales “Benefits of artificial intelligence in nursing”, “Willingness to use artificial intelligence in nursing practice”, and “Dangers of artificial intelligence” were favorable of artificial intelligence-based solutions. However, scores on the subscale “Practical advantages of artificial intelligence” were somewhat unfavorable.ConclusionsFirst-year nursing students had slightly positive attitudes towards artificial intelligence in nursing, which should make it easier for the new generations of nurses to embrace and implement artificial intelligence systems. Reservations about artificial intelligence in daily nursing practice indicate that nursing students might benefit from education focused specifically on applications of artificial intelligence in nursing.     

What influences student nurses’ intention to work with older people? A cross-sectional study

BackgroundStudies have reported that student nurses hold positive attitudes towards older people; nevertheless, working with older people has consistently remained one of the least desired career choices among student nurses in most countries.ObjectivesThe current study aimed to assess student nurses’ intentions to work with older people and to determine the predictors of working intentions among nursing students.DesignThe study adopted a cross-sectional design.SettingsMultistage sampling was used to recruit nursing students from five states in Malaysia.ParticipantsA total of 1462 nursing students from eleven nursing education institutions participated in this study.MethodsA self-administered questionnaire was used to collect data. This study is underpinned by the Theory of Planned Behaviour. The Intent to Work with Older People Scale and Kogan Attitudes Toward Old People Scale were used to assess nursing students’ intentions and attitudes towards care of older people respectively. Researcher-developed instruments were used to assess subjective norms and perceived behavioural control among nursing students.ResultsThe present study found that nursing students in Malaysia demonstrated a moderate level of intention to work with older people, with a mean of 39.72 (±4.38). There were significant differences in effects of gender, ethnic group, academic level, type of nursing institution and setting of older person care clinical experience on intentions to work with older people. There was a moderate and positive relationship between attitudes towards older people and intentions to work with older people, as well as between perceived behavioural control and intentions to work with older people; it was found that r = 0.36 for both relationships. Attitudes, subjective norms and perceived behavioural control accounted for 19.7% of the variance in intentions to work with older people.ConclusionThe primary findings of this national study revealed that Malaysian nursing students have a moderate level of intention to work with older people. It is imperative to develop educational interventions to nurture attitudes for caring and promote stronger intentions to work with older people.     

Knowledge and attitudes towards patients with Alzheimer's disease across different educational levels of nursing and in different care settings: A cross-sectional study

AimTo evaluate Alzheimer’s disease (AD) knowledge and attitudes among Israeli nursing students and nurses with different educational backgrounds working in varied geriatric settingsBackgroundAlzheimer’s disease (AD) management and treatment relies on multidisciplinary care, providing comprehensive treatment to these patients. Nurses are vital to treatment provision. However, less nursing students are expressing interest to work with the geriatric population, including those with dementia.DesignThis was a cross-sectional study.MethodsParticipants were 231 nursing students and nurses of various educational backgrounds and from varied geriatric settings. Study measures included sociodemographic characteristics, the Alzheimer’s disease Knowledge Scale, and the Dementia Attitude Scale. Participants were recruited via social media, nursing administrations in medical facilities, and snowballing methods. Overall scores by educational background and correlations between the measures and select sociodemographic variables were evaluated.ResultsThe overall knowledge and attitudes towards dementia among Israeli nurses is moderate to high. The mean knowledge score was 23.32/30. The highest scores (for knowledge and attitude) were found among geriatric nurse practitioners. The lowest knowledge scores were found among registered nurses without a degree, while the lowest attitude scores was found among nursing students.ConclusionsDespite relatively high scores, there is still a need to minimize the gap in specific knowledge and attitude domains. There is a need for domain-specific training, such as risk factors related to dementia, and providing nurses of all educational backgrounds with the tools they need to feel comfortable in caring for AD patients.     

Cardiovascular nurses' experiences of working in the COVID-19 intensive care unit: A qualitative study

BackgroundCardiovascular nurses’ skills and experiences of cardiac critical care, management of cardiovascular emergencies, and mechanical circulatory support have been considered vital in providing nursing care for COVID-19 patients in intensive care units during the COVID-19 pandemic. To our knowledge, there are no studies have focused on the contribution and experiences of cardiovascular nurses in the critical care of COVID-19 patients.ObjectivesTo explore the experiences of cardiovascular nurses working in a COVID-19 intensive care unit during the pandemic.MethodsThe study was conducted as a qualitative study with phenomenological approach in June-December 2020. Study data were gathered from ten cardiovascular nurses through semi-structured interviews.ResultsSix themes emerged from the interview data: the duties and responsibilities in a COVID-19 intensive care unit; the differences of COVID-19 intensive care unit practices from cardiovascular practices; the transferrable skills of cardiovascular nurses in a COVID-19 intensive care unit; the difficulties encountered working in a COVID-19 intensive care unit; the difficulty of working with personal protective equipment; and the psychosocial effects of working in a COVID-19 intensive care unit.ConclusionCardiovascular nurses made an important contribution to the management of nursing services with their experiences and skills in the COVID-19 pandemic.     

El significado del lenguaje estandarizado NANDA-NIC-NOC en las enfermeras de cuidados intensivos madrileñas: abordaje fenomenológico

Nursing standardized language is a tool that makes it possible to integrate a theoretical framework of problem identification, interventions and outcomes in care. Its use in the difference care settings is varied. In the case of intensive care units, it is necessary to study the implications that integration of this language would have in nursing area.ObjectiveTo describe the meaning of standardized NANDA-NIC-NOC language for the nurses working in Intensive Care Units in Madrid.MethodA phenomenological qualitative study was conducted. Inclusion criteria: ICU in Madrid of nurses with one year or more experience at the time of the study who were working in the ICU.SamplePurposive and Snowball sampling technique.Data collectionUnstructured interviews, personal documents (letters, diaries). Interviews were recorded and transcribed verbatim for later analysis.AnalysisGiorgi proposal. Identifying meaning units, groups of common senses and themes.ResultsThree themes made up the meaning of standardized language in intensive care nursing. “Living integrating 2 sides of the same coin”, “living a conceptual imposition”, and “living a development opportunity and professional autonomy”.ConclusionsThere is a gap in the theory of language and its clinical application. Nurses report feeling imposition of a specific conceptual language. This creates the construction of a hierarchy between nurses based on the use of NANDA-NIC-NOC. Even so, the standardized language is experienced as a professional development opportunity.     

Attitudes of nurses towards families: validation of the scale Families' Importance in Nursing Care--Nurses Attitudes

The attitudes of nurses towards families determine the care process. With this study, we aimed to obtain an instrument that would allow us to learn about this variable. Hence, our purpose was to perform the cross-cultural adaptation and evaluate the psychometric features of the Portuguese version of the instrument Families' Importance in Nursing Care - Nurses Attitudes (FINC-NA), which aims to evaluate the attitudes of nurses towards the importance of involving the patient's family in the nursing care. The method recommended by the literature was followed. The sample consisted of 136 nurses working in primary health care. The results obtained in the reliability tests showed good internal consistency (Cronbach's Alpha=0.87). The psychometric study permits us to state that the Portuguese version of the FINC-NA, which in Portuguese is referred to as A importancia das famílias nos cuidados de enfermagem - atitudes dos enfermeiros (IFCE-AE), is a reliable and valid tool.     

Nurses’ experiences and expectations of family and carers of older patients in the emergency department

BackgroundOlder people are often accompanied by family/carers to the emergency department (ED). Few studies investigate nurses’ experiences of interacting with these family/carers.AimThis study was an exploration of the experiences and expectations that ED nurses have of family and carers accompanying the older adult patient.MethodFocus group interviews (four, n = 27) were conducted and interviews were audio-taped, transcribed and then thematically analysed.ResultsThree themes emerged relating to the way nurses judged family/carers of the older person, with the main theme the importance of time. Family/carers were evaluated as supportive and helpful when they saved nurses time and demanding and obstructive when they cost nurses time. A second theme was the family/carer as a knowledge resource. Nurses evaluated family/carers according to whether they could provide timely and useful information on the older patient. The third theme centred on nurses’ evaluations of family/carers getting in the way of assessing or treating the patient, by their physical presence and demands and by limiting open communication with the patient.ConclusionEmergency nurses have clear expectations of older patients’ families and/or carers. Future research must determine how nursing roles can sustain positive interactions with older patients’ families and/or carers in the ED.     

Core competencies for family and community nurses: A European e-Delphi study

AimTo identify the core competencies of family and community nurses.BackgroundThe European Union is facing common health challenges in the field of primary care, according to European health policies and the World Health Organization, which need to be addressed through better and innovative ways of working that require joint actions. There is evidence that ‘Family and Community Nurses’ play a key role in the field of primary care, but there is no agreement on which core competencies they are required to have.DesignAn e-Delphi studyMethodsA 4-round e-Delphi study was conducted from March to July 2018 as part of the Erasmus+ Project “EuropeaN curriculum for fAmily aNd Community nursE” (ENhANCE). A panel of 23 experts from 10 European countries were asked to approve, modify, or add items and then prioritize each skill.ResultsThis e-Delphi, as part of the ENhANCE project, produced core 28 competencies, which were used by the “ENhANCE” partners to develop the European Core Curriculum for Family and Community Nurses. The ENhANCE partners ensured that the core competencies were consistent with World Health Organization recommendations, the European Skills/Competencies, Qualifications and Occupations (ESCO) and with the European Credit System for Vocational Education and Training (ECVET).ConclusionsThe results of this study will provide the basis for universities across Europe to develop their own post-graduate teaching programs with common educational goals for Family and Community Nurses and a cadre of nurse practitioners with transferrable skills across the continent.Tweetable AbstractThis e-Delphi, as part of the ENhANCE project, produced 28 competencies for the European Core Curriculum for Family and Community Nurses.     

A Single Clinical Experience in a Nursing Home Improves Physiotherapy Students' Attitudes Towards,and Confidence to Communicate With,Older People

ABSTRACT

Aims: To evaluate how an early, single clinical experience in a nursing home influences physiotherapy students' attitudes towards older people and self-perceived confidence in communication. Methods: 102 Bachelor and 32 Master pre-registration physiotherapy students participated in a single visit to a nursing home, during which they interviewed (with educator support) an older person. Students completed surveys addressing their attitudes towards older people (Geriatrics Attitudes Scale), self-perceived confidence in communication (pre- and post-visit), and satisfaction with the innovation. Results: Bachelor students reported a positive change in attitudes towards older people for 3 Geriatrics Attitudes Scale items (P < 0.035). Bachelor and Master students demonstrated greater perceived confidence in their ability to perform several communication tasks with older people (P < 0.018) post-intervention, and reported high satisfaction towards the learning innovation. Conclusions: A single, early exposure to a nursing home can positively influence aspects of physiotherapy students' attitudes and perceived communication skills related to gerontology.