共查询到20条相似文献,搜索用时 15 毫秒
1.
Anthony G Tuckett Karen Hughes Philip J Schluter Cathy Turner 《Journal of clinical nursing》2009,18(10):1501-1509
Aim and objective. To validate the Caring Assessment Report Evaluation Q‐sort questionnaire in the residential aged‐care setting. Based on this determination, to conclude with what degree of confidence the questionnaire can be used to determine the ranking of the importance of caring behaviours amongst aged‐care nurses and residents in residential aged‐care. Background. Perceptions of caring may be context specific. Caring in residential aged‐care may stand in contrast to the sense of caring understood and practiced in other settings. Design. Self‐administered survey. Methods. Residents from three not‐for‐profit aged‐care facilities, across both high‐care (nursing‐home) and low‐care (hostel care) were surveyed relying on the Caring Assessment Report Evaluation Q‐sort questionnaire. A sub‐sample of registered and enrolled nurses working in residential aged‐care and registered with the Nurses & Midwives e‐cohort study completed the same survey. Results. Although the Caring Assessment Report Evaluation Q‐sort questionnaire showed good internal consistency for the sample of nurses, the results for the residents were more erratic. Both groups displayed large ranges for the inter‐item correlations. The results of the Mann–Whitney U‐test indicated that the nurses rated the Comforts, Anticipates and Trusting relationship as significantly more important than the residents. Both groups rated the Explains and facilitates subscale as least important. All subscales, however, received median scores greater than, or equal to, six (seven‐point, Likert scale) indicating that all were considered important overall. Conclusion. Based on poor Cronbach's alpha coefficients, negative inter‐item correlations and qualitative observations, without further development within the residential aged‐care facility the free response format version of the Caring Assessment Report Evaluation Q‐sort may not be an appropriate measure to use with residential aged‐care residents. More research needs to be conducted into how residents and nurses are interpreting the items in the Caring Assessment Report Evaluation Q‐sort. Relevance to clinical practice. There will always remain a need for nurses to enact behaviours that are meaningful to residents (and patients generally). 相似文献
2.
Ruishuang Zheng MSN RN Susan Fiona Lee PhD RN Melissa Jane Bloomer PhD RN 《Journal of clinical nursing》2018,27(1-2):e39-e49
Aims and objectives
To review literature on nurses’ coping strategies with patient death.Background
Dealing with the loss of a patient was viewed as one of the most demanding and challenging encounters in clinical practice. Those nurses who are not competent in coping with patient death may be inadequate in supporting dying patients and their family members, and minimise the quality of end‐of‐life care. To get a broader understanding of how nurses cope with patient death and to develop meaningful and effective interventions, a systematic review which would help underpin the multidimensional approaches is needed.Design
A systematic review.Methods
Exhaustive searching in ten databases: CINAHL Plus, EMBASE, MEDLINE, AMED, PsycINFO, ProQuest Health & Medical Complete, ProQuest Dissertations & Theses Global, Google Scholar, EThOS and CareSearch. Meta‐aggregation was used to synthesise the findings of the included studies.Results
This systematic review aggregated ten categories from the sixteen qualitative studies included, and then two synthesised findings were derived: intrinsic resources and extrinsic resources. The intrinsic resources consisted of setting boundaries, reflection, crying, death beliefs, life and work experience, and daily routines and activity. The extrinsic resources were comprised of talking and being heard, spiritual practices, education and programmes, and debriefing.Conclusion
This systematic review synthesised the findings about what resources nurses use when coping with patient death and made recommendations on future directions. Areas which could be developed to improve deficiencies that nurses had when faced with the losses of their patients were identified. Nurses need more support resources, which better assist them in coping with patient death.Relevance to clinical practice
The results of this systematic review could provide evidence for nurses’ coping strategies when dealing with patient death, and the recommendations could be employed by nurses to cope with the losses of patients. 相似文献3.
Anastasia A. Mallidou Greta G. Cummings Corinne Schalm Carole A. Estabrooks 《International journal of nursing studies》2013
Background
Organizational resources such as caregiver time use with older adults in residential long-term care facilities (nursing homes) have not been extensively studied, while levels of nurse staffing and staffing-mix are the focus of many publications on all types of healthcare organizations. Evidence shows that front-line caregivers’ sufficient working time with residents is associated with performance, excellence, comprehensive care, quality of outcomes (e.g., reductions in pressure ulcers, urinary tract infections, and falls), quality of life, cost savings, and may be affiliated with transformation of organizational culture.Objectives
To explore organizational resources in a long-term care unit within a multilevel residential facility, to measure healthcare aides’ use of time with residents, and to describe working environment and unit culture.Methods
An observational pilot study was conducted in a Canadian urban 52-bed long-term care unit within a faith-based residential multilevel care facility. A convenience sample of seven healthcare aides consented to participate. To collect the data, we used an observational sheet (to monitor caregiver time use on certain activities such as personal care, assisting with eating, socializing, helping residents to be involved in therapeutic activities, paperwork, networking, personal time, and others), semi-structured interview (to assess caregiver perceptions of their working environment), and field notes (to illustrate the unit culture). Three hundred and eighty seven hours of observation were completed.Results
The findings indicate that healthcare aides spent most of their working time (on an eight-hour day-shift) in “personal care” (52%) and in “other” activities (23%). One-to-three minute activities consumed about 35% of the time spent in personal care and 20% of time spent in assisting with eating. Overall, caregivers’ time spent socializing was less than 1%, about 6% in networking, and less than 4% in paperwork.Conclusions
Re-organizing healthcare aides’ routine practices may minimize the short one-to-three minute intervals spent on direct care activities, which can be interpreted as interruptions to continuity of care or waste of time. Fewer interruptions may allow healthcare aides to use their time with residents more effectively. 相似文献4.
5.
Faith Donald PhD NP‐PHC Ruth Martin‐Misener PhD NP Nancy Carter PhD RN Erin E. Donald MSN RN Sharon Kaasalainen PhD RN Abigail Wickson‐Griffiths MN RN Monique Lloyd PhD RN Noori Akhtar‐Danesh PhD Alba DiCenso PhD RN 《Journal of advanced nursing》2013,69(10):2148-2161
Aim
To report quantitative evidence of the effectiveness of advanced practice nursing roles, clinical nurse specialists and nurse practitioners, in meeting the healthcare needs of older adults living in long‐term care residential settings.Background
Although studies have examined the effectiveness of advanced practice nurses in this setting, a systematic review of this evidence has not been conducted.Design
Quantitative systematic review.Data sources
Twelve electronic databases were searched (1966–2010); leaders in the field were contacted; and personal files, reference lists, pertinent journals, and websites were searched for prospective studies with a comparison group.Review methods
Studies that met inclusion criteria were reviewed for quality, using a modified version of the Cochrane Effective Practice and Organisation of Care Review Group risk of bias assessment criteria.Results
Four prospective studies conducted in the USA and reported in 15 papers were included. Long‐term care settings with advanced practice nurses had lower rates of depression, urinary incontinence, pressure ulcers, restraint use, and aggressive behaviours; more residents who experienced improvements in meeting personal goals; and family members who expressed more satisfaction with medical services.Conclusion
Advanced practice nurses are associated with improvements in several measures of health status and behaviours of older adults in long‐term care settings and in family satisfaction. Further exploration is needed to determine the effect of advanced practice nurses on health services use; resident satisfaction with care and quality of life; and the skills, quality of care, and job satisfaction of healthcare staff. 相似文献6.
7.
Beverly O’Connell RN PhD FRCNA Joan Ostaszkiewicz RN MN Khalil Sukkar RN BSN MHLSc FQSA Kay Plymat RN MSN 《International journal of nursing practice》2008,14(6):411-417
Providing residential aged care is challenging because of the complexity of residents’ health status, difficulties recruiting and retaining skilled staff, and financial and regulatory constraints. This paper discusses some of these challenges and describes an innovative model of care, termed ‘The Tri‐focal model of care’. This model was developed based on the concepts of ‘partnership‐centred care’, ‘positive work environment’ and the need for evidence‐based practice to underpin all aspects of care. It is envisaged that the implementation of this model will provide a rich learning environment that advances the teaching‐nursing home concept and the quality of residential aged care. 相似文献
8.
Lucille S. Eller PhD RN Changrong Yuan PhD RN FAAN Ann Vreeland Watkins MSLS D‐AHIP 《International journal of nursing knowledge》2018,29(1):38-48
PURPOSE
The pragmatic utility method of concept analysis was used to explore the usefulness of the concept self‐care self‐efficacy.DATA SOURCES
Empirical studies across disciplines published between 1996 and 2015 were used as data.DATA SYNTHESIS
A data matrix was developed. Analytical questions and responses were derived from the data to understand patterns, develop new knowledge and achieve synthesis.CONCLUSION
Usefulness of the concept is contingent on how it is defined and measured. Self‐care self‐efficacy is associated with performance of self‐care activities and positive health outcomes in diverse populations.IMPLICATIONS
Research can guide development of targeted interventions to increase patients' self‐care self‐efficacy, thus reducing costs, and assisting people to achieve optimal health. 相似文献9.
Clinical effectiveness and cost‐effectiveness of nurse‐led care in Chinese patients with rheumatoid arthritis: A randomized trial comparing with rheumatologist‐led care 下载免费PDF全文
Junru Wang PhD Xiulan Zou MD Ling Cong MD Huina Liu MD 《International journal of nursing practice》2018,24(1)
Background and aim
The concept of nurse‐led care (NLC) was not familiar in China. This study was designed to evaluate the clinical effectiveness and cost‐effectiveness of NLC versus rheumatologist‐led care (RLC) in Chinese patients with rheumatoid arthritis (RA).Methods
Patients of either gender (aged ≥18 years) with RA were enrolled at Wenhai Central Hospital, China (January 2015 to December 2015). The participants were then randomized to NLC or RLC. Outcomes of both the groups were compared in terms of effectiveness by measuring the Disease Activity Score 28, visual analogue scores pertaining to pain and fatigue, and duration of morning stiffness. Costs associated with resource use for RA were assessed and compared between both groups.Results
A total of 214 RA patients in 2 groups (n = 107 in each group) were enrolled and analysed. Improvements in clinical outcomes (disease activity, pain, fatigue, and morning stiffness) over 12 months were significantly greater in the NLC group compared to RLC (P < 0.001). Overall, costs associated with resource use were higher in the RLC group compared to the NLC group (P < 0.05).Conclusions
Our preliminary finding suggested that RA patients managed by NLC compared to RLC may have better clinical outcomes and more cost‐effective care in China. 相似文献10.
Background
Western governments have initiated reforms to improve the quality of care for nursing home residents. Most of these reforms encompass the use of regulations and national quality indicators. In the Norwegian context, these regulations comprise two pages of text that are easy to read and understand. They focus particularly on residents?? rights to plan their day-to-day life in nursing homes. However, the research literature indicates that the implementation of the new regulations, particularly if they aim to change nursing practice, is extremely challenging. The aim of this study was to further explore and describe nursing practice to gain a deeper understanding of why it is so hard to implement the new regulations.Methods
For this qualitative study, an ethnographic design was chosen to explore and describe nursing practice. Fieldwork was conducted in two nursing homes. In total, 45 nurses and nursing aides were included in participant observation, and 10 were interviewed at the end of the field study.Results
Findings indicate that the staff knew little about the new quality regulations, and that the quality of their work was guided by other factors rooted in their nursing practice. Further analyses revealed that the staff appeared to be committed to daily routines and also that they always seemed to know what to do. Having routines and always knowing what to do mutually strengthen and enhance each other, and together they form a powerful force that makes daily nursing care a taken-for-granted activity.Conclusion
New regulations are challenging to implement because nursing practices are so strongly embedded. Improving practice requires systematic and deeply rooted practical change in everyday action and thinking. 相似文献11.
Lars Sonde RPT PhD Azita Emami RN RNT PhD Hannes Kiljunen RN Gunilla Nordenram PhD 《Scandinavian journal of caring sciences》2011,25(1):92-99
Scand J Caring Sci; 2011; 25; 92–99 Care providers’ perceptions of the importance of oral care and its performance within everyday caregiving for nursing home residents with dementia Background: The oral caregiving in nursing homes for persons with dementia often becomes complicated due to the patients’ lack of compliance, which in turn can result in giving oral care a low priority in daily care. Furthermore, directives for responsibilities are unclear. Objective: The aim of this article was to describe care providers’ perception of and reasoning for the oral care for nursing home residents with dementia and to describe registered nurses’ reasoning in relation to their responsibility for monitoring oral care interventions within the regular caregiving routines for nursing home residents with dementia. Methods: Two sub‐studies were carried out; focus group discussions with nine care providers and interviews with four nurses. All participants were staff in nursing home units specialized in dementia. Results: The focus group discussion revealed three themes: Art of caregiving, Barriers and Treatment strategies. Themes related to the nurses’ statements about oral hygiene within caregiving were Care, Responsibility for care and Information. Conclusion: Three main findings from the study are discussed: Unclear responsibilities of different staff members related to daily oral care for the nursing home patients; a lack of guidelines and routines for oral hygiene and a lack of guidelines for sharing information between the different professional groups. 相似文献
12.
Cancer patients' perceptions of quality‐of‐care attributes—Associations with age,perceived health status,gender and education 下载免费PDF全文
Riitta Suhonen PhD RN FEANS Minna Stolt PhD Agneta Berg PhD RNT Jouko Katajisto MSocSci Chryssoula Lemonidou PhD RN Elisabeth Patiraki PhD RN Katarina Sjövall PhD RNT Andreas Charalambous PhD RN 《Journal of clinical nursing》2018,27(1-2):306-316
Aims and objectives
The aim of this study was to explore the associations between patients' gender, education, health status in relation to assessments of patient‐centred quality and individuality in care and trust in nurses for those <65 (working age) and ≥65 years (older people).Background
Patients' assessments of the quality of care they receive are essential for the development of the provision of patient care and services. Previous studies have revealed age of the patient is associated with their assessment of care quality attributes.Design
The study employed a cross‐sectional, multicultural comparative survey design.Methods
The data were collected using questionnaires among hospitalised cancer patients (N = 876, n = 599, 68%) in four European countries: Greece, Cyprus, Sweden and Finland. The data were divided into two subgroups based on age (cut point 65 years) and were analysed statistically.Results
Cancer patients' age, gender and level of education were not related to their assessments of care quality attributes: person‐centred care quality, individuality in care and trust in nurses. Subgroup analysis of the older adults and those of working age showed clear associations with patients' assessments of quality‐of‐care attributes and perceived health status. The lower the perceived health status, the lower the assessment of care quality attributes.Discussion
The results suggest that the cancer itself is the strongest determinant of the care delivered, rather than any patient characteristics, such as age, education or gender. Perceived health status, in association with cancer patient assessments of care quality attributes, may be useful in the development of patient‐centred, individualised care strategies alongside a stronger focus on people instead of cancer‐care‐related processes and duties.Conclusions
Health status was the only factor associated with cancer patients' assessments of care quality attributes. Cancer itself may be the strongest determinant of the care quality perceptions, rather than any patient characteristics.Relevance to clinical practice
The findings of this study have implications for cancer care professionals in terms of patient assessment and care planning. The measures may be useful in assessing quality of cancer nursing care. 相似文献13.
Anthony Tuckett Karen Hughes Jean Gilmour Desley Hegney Annette Huntington Cathy Turner 《Journal of clinical nursing》2009,18(18):2604-2612
Aim. The aim of this e‐cohort sub‐study was to explore and describe nurses’ understandings of ‘caring’ in residential aged‐care. Background. The quality of the work environment is an important issue for recruitment, retention and workforce planning. Knowledge about the people in and the place that is the residential aged‐care facility may assist with the problems surrounding the recruitment and retention of nurses in the workforce. Design. Qualitative electronic cohort sub‐study. Methods. This paper presents the qualitative research findings from an electronic cohort sub‐study of 58 registered and enrolled nurses working in the residential aged‐care sector in 2007. Data were collected through an open ended question and a qualitative content analysis was used to generate the core categories. Results. The concept of caring was grounded in and constrained by, the everyday reality of the nurses in the study. Organisational imperatives for the completion of documentation necessary for accreditation and funding combined with under‐staffing restricted the time available for caring practices. Some nurses represented residential care faculties as devoid of care, others as a place where the resident was central to their work and care. The staff perceived of themselves as an ageing workforce in need of rejuvenation and resourcing. Conclusion. The concept of caring is manifest in nurses’ language as they describe their workplace, the residents, themselves and the structures that impact on what they do. Good caring manifests itself when the residents are central to the business of the aged care facility. However, nurses in this study describe a range of restrictive factors impeding caring practices and diminishing workforce morale and motivation to create environments that can truly be called a ‘home‐away‐from‐home’ and one that all people would find acceptable. Relevance to clinical practice. These findings have implications for aged‐care sector recruitment, retention and workforce planning within residential aged‐care facilities. 相似文献
14.
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15.
Parental perceptions of disease‐severity and health‐related quality of life in school‐age children with congenital heart disease 下载免费PDF全文
Kristine M. Ruggiero PhD MSN RN CPNP‐BC Patricia A. Hickey PhD MBA RN NEA‐BC FAAN Robin R. Leger PhD MS BSN RN Judith A. Vessey PhD MBA RN DPNP FAAN Laura L. Hayman PhD RN FAAN FAHA 《Journal for specialists in pediatric nursing》2018,23(1)
16.
Evaluation of a self‐efficacy enhancement program to prevent pressure ulcers in patients with a spinal cord injury 下载免费PDF全文
Aim
This study developed a self‐efficacy enhancement program and evaluated its effects on the self‐care behaviors, self‐care knowledge, and self‐efficacy regarding pressure ulcer prevention in patients with a spinal cord injury.Methods
This was a multicenter randomized controlled trial. Six hospitals were invited to recruit patients with a spinal cord injury who were undergoing rehabilitation after receiving acute treatment. These hospitals were randomly allocated into experimental (three hospitals) or control (three hospitals) groups and 47 patients participated (24 in the experimental group and 23 in the control group). The experimental group was given an 8 week self‐efficacy enhancement program for pressure ulcer prevention. The self‐efficacy enhancement program consisted of small‐group face‐to‐face intervention (education and skills training), education with computer animation, phone counseling, face‐to‐face counseling, and self‐management records. The control group only received a pressure ulcer prevention information booklet. Self‐care knowledge, self‐efficacy, self‐care behaviors, and pressure ulcer incidence were measured at baseline and after the 8 week self‐efficacy enhancement program.Results
The experimental group showed a significantly greater improvement in self‐care knowledge, self‐efficacy, and self‐care behaviors for pressure ulcer prevention than did the control group. One participant in the control group developed a pressure ulcer, while none of the participants in the experimental group developed a pressure ulcer; this difference was not statistically significant.Conclusions
The self‐efficacy enhancement program enabled patients with a spinal cord injury to engage in continued self‐care behaviors and helped them to improve their knowledge and self‐efficacy concerning pressure ulcer prevention.17.
Yuh‐Min Chen PhD RN Yueh‐Ping Li PhD RN Min‐Ling Yen MSN RN 《International journal of nursing practice》2016,22(3):239-246
The purpose of this study was to apply self‐efficacy theory to explore predictors of regular exercise among older residents of long‐term care institutions. Convenience sampling was used to collect data from 151 older adults residing in three residential care homes in Taiwan. Data collection instruments included a background data sheet, Self Efficacy for Exercise Scale, Outcome Expectations for Exercise Scale and self‐reported regular exercise. Results indicated that older residents who exercised regularly had fewer chronic diseases, better perceived health status and functional status, and higher self‐efficacy expectations and outcome expectations related to exercise. Older residents with a regular exercise habit prior to institutionalization were more likely to engage in regular exercise. Logistic regression analysis indicated past exercise participation and self‐efficacy expectations to be significant positive predictors of regular exercise. To promote regular exercise within this population, these can be potential target areas for interventions. These factors should be targeted in the development and implementation of interventions to promote regular exercise among older residents of long‐term care institutions. 相似文献
18.
Sascha G. Schmidt Martin N. Dichter Sabine Bartholomeyczik Hans Martin Hasselhorn 《Geriatric nursing (New York, N.Y.)》2014
Background
The increasing prevalence of residents with dementia in Nursing Homes (NH) leads to a demanding work with high physical and psychological workloads. This study focuses on NH nurses and their satisfaction with quality of care for residents with dementia (SQCD) and its impact on nurses' general health, burnout and work ability.Method
Two-wave (2007/2009) self-report questionnaire data of 305 nurses (RNs and nurses' aides) from 50 German NHs.Results
58.6% (2007) and 64.9% (2009) of the respondents reported satisfaction with the quality of care of the dementia residents. However, when dissatisfied, this was perceived as substantial work stressor and was adversely associated with nurses' individual resource outcomes. Those nurses who between 2007 and 2009 had become dissatisfied or were dissatisfied at both measurements showed the most adverse scorings for burnout, general health and work ability.Discussion
The findings imply that in NHs, SQCD may be a relevant work factor with substantial impact on nurses' core resources. 相似文献19.
Helena Hansson RN MSc PhD Maria Björk RN PhD Sheila Judge Santacroce RN CPNP FAANP PhD Mette Raunkiær RN PhD 《Scandinavian journal of caring sciences》2023,37(4):917-926
Background
There is insufficient knowledge available about the impact of paediatric palliative care at home on meeting family needs and ensuring the highest quality of care for the dying child. The aim of this study was to elucidate parents’ experiences of how and why home-based paediatric palliative care impacted the entire family during their child's final phase of life.Methods
The study used a qualitative design. Semi-structured interviews were conducted with the bereaved parents of children who had received palliative care at home from a paediatric cancer hospital department programme that was based on collaboration with community nurses and the paediatric palliative care service. The interviews were transcribed verbatim, and qualitative content analysis was applied. The Ecocultural theory was used to explain the findings.Results
Three main themes emerged: (1) involvement enabling a sense of control and coping, (2) sustaining participation in everyday family life routines and (3) making room for presence and comfort during and after the end-of-life trajectory.Conclusion
End-of-life palliative care at home can enable parents and other family members to maintain a sense of control, presence and semblance of everyday life. It contributes to managing and alleviating the burden and distress during the last phase of the child's life and during bereavement. We suggest that healthcare professionals support family members in participation and daily life routines and activities during a child's EOL care, as it affects the well-being of the entire family. 相似文献20.
A Q‐methodology study among caregivers of people with moderate intellectual disabilities on their clients’ health care: An example in oral health 下载免费PDF全文
A. M. Eijsink G. Schipper J. H. Vermaire 《Journal of Applied Research in Intellectual Disabilities》2018,31(5):915-926