Cross‐age peer mentoring approach to impact the health outcomes of children and families

Column Editor: Bonnie Gance‐Cleveland Family‐Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family‐to‐family support, and confidence building.     

Promoting the Health of Frontier Caregiving Grandparents: A Demonstration Project Evaluation

Column Editor: Bonnie Gance‐Cleveland Family‐Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family‐to‐family support, and confidence building.     

Can Journaling Provide Support for NICU Families?

Column Editor: Linda Franck Family‐Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family‐to‐family support, and confidence building.     

Engaging Families to Prevent Substance Use Among Latino Youth

Angela Chia-Chen Chen, Bonnie Gance-Cleveland, Albert Kopak, Steven Haas, and Mary Gillmore
Column Editor: Bonnie Gance-Cleveland Family-Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family-to-family support, and confidence building.     

The heart beads program

Column Editor: Bonnie Gance‐Cleveland Family‐Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family‐to‐family support, and confidence building.     

Administration of medication in the acute mental health ward: Perspective of nurses and patients

The administration of medication is an important therapeutic intervention. However, concerns have been raised about the management of this procedure in the acute area. Therefore, a survey was conducted with registered nurses (n = 24) and patients (n = 57) from three acute admission wards in an inner city hospital in the north west of England. Semistructured interviews were conducted immediately following medication administration and then analyzed using thematic analysis. Nurses' views were categorized into three themes: ward environment, communication, and sharing of information. Nurses reported that policies and procedures provided clear guidance, but that the task remained stressful and the role of other professionals affected the integrity of the procedure. Patients' views were categorized into four themes: effects and side‐effects of medication, the process of administration, therapeutic relationships, and the sharing of information. Most patients were accepting of the administration of their medication, but called for improvements in information sharing and side‐effect management. Information sharing is pivotal in establishing therapeutic relationships, but the time of administration might not be the most appropriate occasion for this.     

Access to needle and syringe programs and the relationship to equipment sharing among people who inject drugs in Kermanshah,Iran

Background: Needle and Syringe Programs (NSP) have been implemented in Iran since 2002. The primary aim of NSP is to prevent blood-borne virus transmission by providing sterile injecting equipment and information on safer injection practices. However, while NSP has been implemented in Iran for more than a decade, only a limited number of studies have evaluated the effect access to NSP has in reducing risk behaviors among people who inject drugs (PWIDs).Methods: Between September and December 2014 we used snow ball sampling to recruit PWID from Kermanshah for a cross-sectional survey. Participants completed a face-to-face interview and provided information on the frequency of injection and drug-related risk behaviors such as sharing (borrowing or lending) of previously used syringes/needles and the number of injecting partners with whom they have shared syringes/needles in the two months prior to interview. Correlation between drug-related risk behaviors and ability to access NSPs was assessed by bivariate and multiple logistic regression through the estimation of odds ratios (OR) and 95% confidence intervals (95% CI).Results: Of 500 PWIDs in this study, 18%, 36% and 46% reported low, medium and high ability to access NSPs in the two months prior to interview, respectively. The odds of receptive syringe sharing among people with low-access was 3.5 times the odds of people with high-access when adjusted for covariates and remained statistically significant (adjusted odds ratio (AOR): 3.5, 95%CI 1.4–7.7). The relationship between access to NSP and use of sterile-injecting equipment was not statistically significant. The AOR for outcomes like paraphernalia sharing (AOR: 2.5, 95%CI: 0.6–4.6, p-value: 0.6) was not statistically significant.Conclusions: Similar to the previous research in international settings, this study found that PWID who reported to have more access to needle and syringe programs were less likely to use a syringe after someone else had used it. NSP program staff should focus on encouraging more frequent visits, increasing the opening hours and number of locations providing access to sterile syringe in settings with high concentrations of PWID.     

Using SMS as a tool to reduce exclusions experienced by caregivers of people with disabilities in a resource-limited Colombian community

Purpose: The community of El Codito, located in the mountainside on the perimeter of Bogota, Colombia, is considered one of the most vulnerable and resource-limited communities in the region. This community-based research (CBR) project used short message service (SMS) messaging as a tool for information access and social interaction with caregivers of people with disabilities (PWD). Method: Using a focused ethnographic method, this research evaluated the experience of caregivers participating in the project. In addition to primarily qualitative methods, supplementary quantitative message data was also collected. This project utilized free and open source software for SMS message distribution. Results: Caregivers experienced the project as a window to possibility; the possibility of a social support network, the possibility of community participation and the possibility of change. During the three-month implementation, a total of 56 information messages were sent to caregivers, 20 question messages were received from caregivers and 30 social interaction messages were sent by caregivers to the group. Conclusions: The proliferation of mobile phones in this resource-limited setting provided a feasible method for reducing the exclusion of PWD and caregivers. SMS was a useful tool for sharing information and reducing the isolation experienced by this socially excluded population.

• Implications for Rehabilitation

• Mobile phones are a prevalent technology in many resource-limited settings; short message service (SMS) is a feasible tool for sharing information and reducing isolation experienced by people with disabilities (PWD) and their families.

• When developing technology-based projects in resource-limited settings, the field of rehabilitation could apply principles from the field of Information and Communication Technology for Development (ICT4D).

• Projects in resource-limited settings could consider using a community-based research (CBR) approach. This collaborative approach can enhance the contextual relevance of the project.

• Caregivers of PWD found the project to be both useful and meaningful, and as a result of the project became more involved in their community.

     

Experiences of Asian American Parents in a Group Intervention for Youth With Schizophrenia

PROBLEM: Schizophrenia, which frequently strikes during adolescence or young adulthood, can have devastating effects on the family. Parents, who are primary caregivers for mentally ill adolescents, often lack the information and skills necessary to cope with the multiple and complex consequences of a major psychiatric disorder. Moreover, parents are ill‐ prepared to help their other children cope with the unpredictable changes that accompany having a mentally ill sibling. Asian American parents face similar issues in dealing with their schizophrenic adolescents. However, there is limited information available about this population. METHODS: The purpose of this qualitative study was to examine the experiences of four Asian American parents who participated in a community‐based, family‐centered, self‐management intervention program for youth with schizophrenia. Participants were interviewed using semistructured interviews and language interpreters. Data were analyzed utilizing content analysis. FINDINGS: Four themes were identified: (a) same, but different; (b) sharing and learning; (c) using skills learned; and (d) working with interpreters. CONCLUSIONS: Results indicate that Asian American parents valued their participation in the group intervention and emphasized their similarities with non‐Asian American families who have a mentally ill youth.     

Post‐SARS knowledge sharing and professional commitment in the nursing profession

Aim. The aim of the present study was to examine the 2003 severe acute respiratory syndrome (SARS) crisis in relation to the degree of knowledge sharing and professional commitment, as perceived by the current nursing staff in Taiwan. Background. The mortality rate for medical personnel during the SARS outbreak in Taiwan, which began in April 2003, was the highest among Asian countries. The SARS crisis severely challenged not only the medical skills of nurses, but also their professional commitment. Design. Survey. Methods. This study was conducted between August–December 2005, in Taiwan. Data were collected by structured questionnaire. The questionnaire was distributed by post to 8056 nurses nationwide; 2833 nurses completed and returned the questionnaire for a valid response rate of 39%. Results. The results showed that knowledge sharing correlated positively with professional commitment but negatively with the impact of SARS. Professional commitment negatively correlated with SARS impact (r = ?0·074, p < 0·001); however, as knowledge sharing was a controlled variable, the partial correlation between SARS impact and professional commitment was ?0·039 with a p‐value of 0·045, indicating virtual insignificance. That is, knowledge sharing was an antecedent variable for both SARS impact and professional commitment. Conclusion. This cross‐sectional study provides preliminary evidence that knowledge sharing is significantly correlated with impact of SARS and professional commitment of nursing personnel. Relevance to clinical practice. Hospitals and healthcare services can enhance retention of medical personnel by encouraging knowledge sharing, which enhances professional commitment and alleviates the impact of newly introduced contagious diseases.     

Authentic leadership and its impact on creativity of nursing staff: A cross sectional questionnaire survey of Indian nurses and their supervisors

BackgroundNurses play a dominant role in the healthcare sector. However, the working condition of nurses in India is far from satisfactory due to a variety of factors. This is further compounded by the lack of respect for nurses and their profession. Therefore, there is a need to examine factors that could mitigate this situation.ObjectiveThe objective of this paper is to examine the relationship between authentic leadership and employee creativity, while determining the mediating effect of knowledge sharing behaviour and moderating effect of use of information technology on this association.DesignA questionnaire-based survey was used to collect the data. Macro process (Hayes) was used to examine the mediating role of knowledge sharing behaviour and the moderating role of use of information technology in the relationship between authentic leadership and employee creativity.SettingsData was collected from 43 small- and medium-sized hospitals in the state of Uttarakhand, India.ParticipantsThe participants in the present study were 405 nurses and their 81 supervisors from the above hospitals.ResultsResults indicate that authentic leadership is positively linked to the creativity of employees. Further, knowledge sharing behaviour is found to mediate the relationship between authentic leadership and employee creativity, while use of information technology acts as a moderator between knowledge sharing behaviour and employee creativity. The findings of this investigation can help healthcare managers understand the importance of knowledge creation and knowledge sharing among healthcare workers. This paper draws attention to the need for hospital administrators to establish an appropriate information technology infrastructure to effectively manage the knowledge pool of the organization. This study also highlights the importance of effective leadership style, namely authentic leadership, in positively influencing employee creativity in healthcare institutions, a service oriented industry.ConclusionThis study contributes to existing research on authentic leadership and employee creativity by showing that knowledge sharing behaviour and use of information technology are important and relevant variables that affect the degree of influence that authentic leadership has on employee creativity.     

Review article: Emergency department data sharing to reduce alcohol‐related violence: A systematic review of the feasibility and effectiveness of community‐level interventions

The present paper aims to review current evidence for the effectiveness and/or feasibility of using inter‐agency data sharing of ED recorded assault information to direct interventions reducing alcohol‐related or nightlife assaults, injury or violence. Potential data‐sharing partners involve police, local council, liquor licensing regulators and venue management. A systematic review of the peer‐reviewed literature was conducted. The initial search discovered 19 506 articles. After removal of duplicates and articles not meeting review criteria, n = 8 articles were included in quantitative and narrative synthesis. Seven of eight studies were conducted in UK EDs, with the remaining study presenting Australian data. All studies included in the review deemed data sharing a worthwhile pursuit. All studies attempting to measure intervention effectiveness reported substantial reductions of assaults and ED attendances post‐intervention, with one reporting no change. Negative logistic feasibility concerns were minimal, with general consensus among authors being that data‐sharing protocols and partnerships could be easily implemented into modern ED triage systems, with minimal cost, staff workload burden, impact to patient safety, service and anonymity, or risk of harm displacement to other licensed venues, or increase to length of patient stay. However, one study reported a potential harm displacement effect to streets surrounding intervention venues. In future, data‐sharing systems should triangulate ED, police and ambulance data sources, and assess intervention effectiveness using randomised controlled trials that account for variations in venue capacity, fluctuations in ED attendance and population levels, seasonal variations in assault and injury, and control for concurrent interventions.     

Relationship between nurses' perceptions of nursing assistant roles and information‐sharing behaviors: A cross‐sectional study

Information‐sharing between nurses and nursing assistants is necessary for appropriate inpatient care. Nurses who perceive nursing assistant roles highly may display positive behaviors related to information‐sharing with nursing assistants. This study aims to examine the relationship between nurses' perceptions of nursing assistant roles and the frequency of their sharing information with nursing assistants. Using a self‐administered, cross‐sectional survey questionnaire, data from 2,642 nurses in 182 hospitals were collected. Nurses' perceptions of nursing assistant roles were measured with a scale containing four factors: (i) improving patients' abilities through daily care; (ii) caring for various patients using broad perspectives; (iii) facilitating co‐ordination and co‐operation among team members; and (iv) increasing the amount of information on patients among team members. Information‐sharing behaviors included “expressing,” “asking,” “linguistic response,” and “feedback.” Multiple regression analyses for each nurse's information‐sharing behaviors were conducted. Nurses' perceptions of nursing assistant roles were positively correlated with the frequency of sharing information with nursing assistants. The degree of the correlations differed, depending on the type of information‐sharing behavior. Therefore, improving nurses' understanding of nursing assistant roles might increase their information‐sharing behaviors.     

Sharing,supporting and sobriety: a qualitative analysis of messages posted to alcohol-related online discussion forums in the United Kingdom

Background: In recent years there has been an exponential growth in the number of people accessing online discussion forums for information, advice and support in relation to a range of both acute and chronic health issues. However, there has been little attention given to exploring the role of alcohol-related forums in the United Kingdom. Methods: A total of 758 messages, retrieved from three public UK-based alcohol discussion forums were qualitatively analysed using thematic analysis. Results: An insight into the online experience of members was captured through three inter-related themes. The first theme “sharing” describes the process of disclosure and aspects of problem drinking, which were discussed by members. Second, the theme “supporting” identifies the ways through which members of the group engaged in mutually supportive communication. Thirdly, “sobriety” describes the collective goal for forum members and describes the challenges of achieving and maintaining this state. Conclusions: Participation in alcohol-related online discussion forums may confer some practical and emotional benefit for those living with alcohol-related problems. Future research is required to fully explore the nature and impact of peer support for this specific problem behaviour.     

‘It’s not what you know but who you know’: Role of social capital in predicting risky injection drug use behavior in a sample of people who inject drugs in Baltimore City

Background: Injection drug use is the third highest risk factor for HIV transmission. Injection drug users, marginalized population, continue to be at threat for several health problems, including HIV, Hepatitis B and C, and drug overdose. The area of social capital and risk behaviors is understudied. The current study aims to prospectively assess the relationship between social capital and the risk behaviors associated with injection drug use (IDU).

Methods: The sample of the present study is a subset of 130 drug users who reported IDU at both baseline and first follow-up wave for assessing the relationship between social capital and needle sharing in the city of Baltimore, MD. Factor analysis, structural equation modeling, and multivariate logistic regression were conducted to explore these relationships.

Results: A single-factor model fits well with factor loadings ranging from 0.20 to 0.95. Social capital is shown to be significantly and inversely associated (p < 0.05) with 35% decreased odds of the risk of sharing needles with every unit increase in social capital (AOR: 0.65, 95% CI: 0.06, 0.84).

Conclusion: The result from this study can be used to inform and fill gaps in the field of harm reduction. The interplay between social support, social participation and norms of trust, reciprocity generated from the index’s social network, and its relationship with behavior of needle sharing demonstrates that these leverage points should be emphasized in future harm reduction interventions.     

Cross-sectional study of HIV prevalence and the characteristics of injecting drug users in Colombia

Abstract

Objective: To determine socio-demographic characteristics, prevalence and risk behaviors of HIV in injecting drug users in three cities of Colombia.

Method: A cross-sectional study was conducted in three cities of Colombia; information was obtained from 796 participants over 18 years of age, with prior signed informed consent. Statistical analysis of the data and generated output tables were conducted in RDSAT and SPSS.

Results: There are extensive networks of injection drug users (IDUs). The population of IDUs was characterized as mostly men between 18 and 34. The data suggest a recent introduction of HIV into networks and a high degree of risk behavior for HIV spread in networks and used syringes. People who reported sharing syringes, were at greater risk of not using a condom when having sex with casual partners, this factor is increased when controlling for other variables consulted (OR?=?4.10, 95% CI 1.23 to 16.05; p?<?0.00).

Conclusions: The data in this report indicate a high risk for a possible expansion of HIV among injecting networks, supported the introduction of HIV into networks of injectors. For Colombia, this research constitutes a first step in the search for strategies to prevent the further spreading of the infection.     

Bed Sharing,SIDS Research,and the Concept of Confounding: A Review for Public Health Nurses

Confounding is an important concept for public health nurses (PHNs) to understand when considering the results of epidemiological research. The term confounding is derived from Latin, confundere, which means to “mix‐up” or “mix together”. Epidemiologists attempt to derive a cause and effect relationship between two variables traditionally known as the exposure and disease (e.g., smoking and lung cancer). Confounding occurs when a third factor, known as a confounder, leads to an over‐ or underestimate of the magnitude of the association between the exposure and disease. An understanding of confounding will facilitate critical appraisal of epidemiological research findings. This knowledge will enable PHNs to strengthen their evidence‐based practice and better prepare them for policy development and implementation. In recent years, researchers and clinicians have examined the relationship between bed sharing and sudden infant death syndrome (SIDS). The discussion regarding the risk of bed sharing and SIDS provides ample opportunity to discuss the various aspects of confounding. The purpose of this article is to use the bed sharing and SIDS literature to assist PHNs to understand confounding and to apply this knowledge when appraising epidemiological research. In addition, strategies that are used to control confounding are discussed.     

Development,standardisation and pilot testing of an online fatigue self-management program

Purpose. Although an effective face-to-face fatigue program is available, people with transportation, time or geographic restrictions cannot access this intervention. Therefore, the aim of this study was to develop and to evaluate effectiveness of an online fatigue self-management program (online FSMP).

Methods. Key features of the face-to-face program were captured and transferred to an online FSMP prototype. Subsequently, three pilot tests were conducted for formative evaluation of the program and necessary changes were made to improve the program. During the third pilot test, the effectiveness of the online FSMP was also tested using a pre-test post-test design on a sample of individuals with multiple sclerosis, Parkinson's disease or post-polio syndrome.

Results. The study resulted in a standardised 7-week online FSMP mimicking its face-to-face version. Participants were offered fatigue self-management skills through structured activities, sharing information and experiences, expressing their ideas or feelings and offering advice and support to one another. The participants in the third pilot study improved significantly on the Fatigue Impact Scale (p <0.05) and a trend toward significance was shown on the Personal Wellbeing index (p = 0.08).

Conclusions. The online FSMP is a viable treatment for people with neurological conditions and warrants further study.     

Canadian poison control centres: preliminary assessment of their potential as a resource for public health surveillance

Abstract

Context. In the United States (US) and Europe, surveillance based on calls to poison control centres has identified new hazards and evolving exposure trends. In Canada, the value of poison control centre calls as a tool for health hazard surveillance is largely unrecognized. Objectives. This preliminary survey was undertaken to describe current operational characteristics and surveillance capacities at Canadian poison control centres and to determine potential for developing a Canadian poison control centre collaborative network. Methods. A structured quantitative–qualitative survey was administered to medical directors and clinical supervisors at the five Canadian poison control centres between March and May, 2012. Results. All five Canadian poison control centres operate 24/7 with each serving more than one province/territory. Annual call volumes range from 10,000 to 58,000. Data analysis is limited to detection of previously unrecognized hazards and short-term event-based adverse health monitoring. Currently no centre maintains systematic ongoing collection, integration and analysis of data. Constraints on personnel, resources and funding were identified as barriers to increasing capacity to provide and analyse call data. Conclusions. The potential exists to use Canadian poison control data as a novel source of public health surveillance. That they serve as sentinels for new or unexpected exposure events, have real-time electronic call-record capacity and demonstrate an interest in developing and sharing their call-record information supports their integration into existing public health networks.