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1.
《Asian nursing research.》2021,15(5):303-309
PurposeThe purpose of this study was to explore male nurses’ experiences of workplace gender discrimination and sexual harassment in South Korea.MethodsPhenomenological qualitative methodology exploring male nurses’ experiences was employed to collect data, and thematic analysis of the data was conducted. Research subjects were recruited by convenience and snowball sampling. Ten male nurses participated in individual in-depth interviews via mobile phone. Data were collected from June 15 to July 24, 2020.FindingsTwo themes were extracted that described male nurses’ experiences of workplace gender discrimination and sexual harassment. In the first theme, “facing gender discrimination from various dimensions,” nurses’ thoughts and feelings regarding gender discrimination from various sources were expressed. The second theme, “experiencing sexual harassment at work as a man,” presented experiences of sexual harassment as a male nurse and difficulties in being recognized as a victim.ConclusionGender discrimination and sexual harassment experienced by male nurses stem from a wide range of socio-cultural factors, ranging from individuals to organizations, and institutions. Therefore, this problem requires a correspondingly broad approach for improvement, such as making efforts to avoid classifying certain roles according to gender, developing new standards considering the specific experiences of men as victims of sexual discrimination and sexual harassment, and continuing training to increase social sensitivity and interest in the harm suffered by minorities in society.  相似文献   

2.

Background

The incidence of contact isolation for multidrug-resistant organisms is increasing in acute hospitals and inpatient rehabilitation units alike. There is limited evidence on the effect of contact isolation on functional outcomes during inpatient rehabilitation.

Objective

To determine whether the use of a modified contact isolation protocol (MCI) resulted in noninferior functional outcomes compared with children without contact isolation (NCI) on inpatient rehabilitation.

Design

This is a retrospective noninferiority study.

Setting

One academically affiliated pediatric inpatient rehabilitation unit located in a children’s hospital.

Patients

All children with any diagnosis admitted to inpatient rehabilitation from January 1, 2007, to December 31, 2014.

Methods or Interventions

We compared functional outcomes for 2 groups of children.

Main Outcome Measurements

Primary outcome measures included the Functional Independence Measure for Children (WeeFIM) efficiency and the change in the Developmental Functional Quotient (DFQ) for the WeeFIM. Noninferiority margins of 0.63 for the WeeFIM efficiency and 0.092 for the change in DFQ for the WeeFIM were used.

Results

There were a total of 949 patients of whom 899 were NCI, 48 MCI, and 2 excluded due to missing information. Patients with MCI had functional outcomes that were noninferior to those with NCI including the WeeFIM efficiency (mean difference 0.002, 95% CI –0.38 to 0.404) and the change in DFQ for the WeeFIM (mean difference –0.05, 95% CI –0.058 to 0.003).

Conclusions

The modified contact isolation protocol, having resulted in noninferior functional outcomes in inpatient rehabilitation may provide adequate contact isolation while allowing for noninferior functional outcomes. This may be a guide in the face of an ever-increasing need for contact isolation.

Level of Evidence

III  相似文献   

3.
ABSTRACT

Aims: To better understand occupational therapists’ clinical decision making processes as they selected which rehabilitation environment to work in, and how the therapists perceived the environment impacted their choice of intervention. Methods: Focus group and individual interviews were conducted following observation of three occupational therapists providing interventions for 16 months with 12 clients following a stroke at an inpatient rehabilitation hospital stroke unit. Therapists could chose from three different environments for interventions: a therapy gym, homelike space, or a combination space. Results: Three themes emerged that revealed therapists’ habits influenced their clinical reasoning; the environment influenced therapists’ intervention choices; and therapists felt safer treating in the gym environment. Conclusion: The environment influenced the therapists’ intervention choices as well as their clinical reasoning. Rehabilitation services on an inpatient stroke program may be improved if therapists increase their awareness of the influence of the environment on interventions.  相似文献   

4.
ObjectiveTo compare health care usage between suicide decedents and living controls in the year before suicide in a large representative US population.Patients and MethodsCases (n=1221) and controls (n=3663) belonged to an integrated health care system from January 1, 2009, through December 31, 2014. Cases and controls were matched for age and sex in a 1:3 ratio, with diagnostic and/or billing codes used to enumerate and classify health care visits in the year before the index suicide. Matched analysis via conditional logistic regression related odds of suicide to visit type. A generalized estimating equation model was used to compare timing and frequency of visits between cases and controls.ResultsIn the year before death, cases had an increased odds of both inpatient hospitalizations and emergency department nonmental health visits (odds ratio [OR], 1.55; 95% CI, 1.27-1.88; P<.001 and OR, 1.42; 95% CI, 1.26-1.60; P<.001) but not outpatient nonmental health visits (OR, 1.00; 95% CI, 0.99-1.01; P=.63). Decedents increased health care utilization closer to suicide death and had significantly more health care visits than did controls 3 months before suicide (6 vs 2; P=.01) but not 9 to 12 months before suicide (4 vs 2; P=.07). At all time points, cases used more mental health care services than did controls.ConclusionCompared with controls, suicide decedents had emergency department visits and more inpatient hospitalizations, both mental health and nonmental health related. As death approached, cases' frequency of health care usage increased. The only category in which cases and controls did not differ was in the frequency of outpatient nonmental health visits.  相似文献   

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《Nurse Leader》2022,20(1):70-74
Nursing leaders must engage with evidence-based practice (EBP) to advance quality patient care. The purpose of this study was to understand the impact of an implementation science study on nurse manager competencies. Qualitative focus group interviews were conducted with leaders following an implementation science study. The AONL Nurse Manager Competency Framework was used as a guide. Leaders felt they were able to promote EBPs, influence others, and grow in their professional role after participating in the implementation science study. Involvement in nurse-led implementation science research can enhance frontline leaders’ ability to engage with and promote EBP.  相似文献   

7.
ObjectiveTo synthesize research on interpersonal trauma and women’s health from the Nurses’ Health Study II (NHS II) and to analyze conceptualization of interpersonal trauma across studies.Data SourcesA literature review was conducted in PubMed using a systematic search strategy.Study SelectionArticles were included in the review if they used data from the NHS II and involved investigations of interpersonal trauma. Theoretical articles, methodologic articles, and other literature reviews involving the NHS II were excluded. Initially, the search returned 61 articles. After exclusions, 45 articles met the criteria for inclusion in the review and data extraction.Data ExtractionInformation was extracted and consolidated in an evidence table. Data included study time frame, sample, definition of trauma, outcomes studied, and journal of publication.Data SynthesisTrauma was not operationalized consistently across studies, even though the NHS II assessed trauma experiences in childhood, adolescence, and adulthood. Most investigations focused on childhood abuse, with investigations of childhood sexual abuse overrepresented in comparison to other abuse experiences. Authors conducting studies of trauma at any time in the life course consistently found a negative association with physical and mental health outcomes, which were increased by the presence of posttraumatic stress symptoms. Results from a small number of studies suggested a negative intergenerational impact of trauma on the children of women in the NHS II.ConclusionInterpersonal trauma across the life course was strongly associated with many leading causes of morbidity and mortality among female nurses. Trauma conceptualization and operationalization varied across studies, and future investigations should leverage the full range of trauma measures available in the NHS II data set.  相似文献   

8.

Objective

To determine whether the early trials in chronic medical conditions demonstrate an effect size that is larger than that in subsequent trials.

Methods

We identified randomized controlled trials (RCTs) evaluating a drug or device in patients with chronic medical conditions through meta-analyses (MAs) published between January 1, 2007, and June 23, 2015, in the 10 general medical journals with highest impact factor. We estimated the prevalence of having the largest effect size or heterogeneity in the first 2 published trials. We evaluated the association of the exaggerated early effect with several a priori hypothesized explanatory variables.

Results

We included 70 MAs that had included a total of 930 trials (average of 13 [range, 5-48] RCTs per MA) with average follow-up of 24 (range, 1-168) months. The prevalence of the exaggerated early effect (ie, proportion of MAs with largest effect or heterogeneity in the first 2 trials) was 37%. These early trials had an effect size that was on average 2.67 times larger than the overall pooled effect size (ratio of relative effects, 2.67; 95% CI, 2.12-3.37). The presence of exaggerated effect was not significantly associated with trial size; number of events; length of follow-up; intervention duration; number of study sites; inpatient versus outpatient setting; funding source; stopping a trial early; adequacy of random sequence generation, allocation concealment, or blinding; loss to follow-up or the test for publication bias.

Conclusion

Trials evaluating treatments of chronic medical conditions published early in the chain of evidence commonly demonstrate an exaggerated treatment effect compared with subsequent trials. At the present time, this phenomenon remains unpredictable. Considering the increasing morbidity and mortality of chronic medical conditions, decision makers should act on early evidence with caution.  相似文献   

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Background

The accurate identification of children with a concussion by emergency physicians is important to initiate appropriate anticipatory guidance and management.

Objectives

We compared the frequency of persistent concussion symptoms in children who were provided the diagnosis of concussion by an emergency physician versus those who met Berlin/Zurich international criteria for this diagnosis. We also determined the clinical variables independently associated with a physician-diagnosed concussion.

Methods

This was a planned secondary analysis of a prospective, multicenter cohort study. Participants were 5–17 years of age and met the Zurich/Berlin International Consensus Statement criteria for concussion.

Results

There were 2946 enrolled children. In those with physician-diagnosed concussion vs. no concussion, the frequency of persistent symptoms was 62.5% vs. 38.8% (p < 0.0001) at 1 week, 46.3% vs. 25.8% (p < 0.0001) at 2 weeks, and 33.0% vs. 23.0% (p < 0.0001) at 4 weeks. Of those meeting international criteria, 2340 (79.4%) were diagnosed with a concussion by an emergency physician and 12 variables were associated with this diagnosis. Five had an odds ratio (OR) > 1.5: older age (13–17 vs. 5–7 years, OR 2.9), longer time to presentation (≥16 vs. <16 h, OR 2.1), nausea (OR 1.7), sport mechanism (OR 1.7), and amnesia (OR 1.6).

Conclusions

Relative to international criteria, the more selective assignment of concussion by emergency physicians was associated with a greater frequency of persistent concussion symptoms. In addition, while most children meeting international criteria for concussion were also provided this diagnosis for concussion by an emergency physician, the presence of 5 specific variables made this diagnosis more likely.  相似文献   

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《Pain Management Nursing》2022,23(3):324-329
BackgroundAlthough nurse's knowledge and attitudes regarding pain management has been sufficiently studied worldwide, the impact of an educational intervention program in improving such attitudes and knowledge has not been likewise researched, especially in Middle Eastern countries.AimsTo examine nurses’ knowledge and attitudes regarding pain at a university hospital in Lebanon before and after the introduction of a pain management educational program. And to assess the relationship between the characteristic of nurses and their pain knowledge.MethodsDesign; A nonrandomized pretest posttest study design was used. Setting; A university hospital in Lebanon. Participants; Included 183 nurses using the Nurses' Knowledge and Attitudes Survey Regarding Pain questionnaire. The pain educational intervention was based on the principles of Ajzen's theory of planned behavior.ResultsA significant difference between the pre and post test scores was noted (p = .016). Questions answered correctly by 80% of participants were related to questions about pain, pain assessment and management, and questions related to medications, such as correct dosages and opioid side effects were not answered correctly by the majority of nurses. There were significant associations between test scores and the nurses’ educational level, their age, and their years of experience. Nurses who worked in critical care units, the emergency department and oncology had higher scores than nurses who worked on general units.ConclusionsDespite the intensive pain education provided at our institution, the pain knowledge of nurses remains below that recommended level which indicates a dire need for more intensive and continuous education in order to provide a pain free environment.  相似文献   

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15.
《Death Studies》2012,36(1):1-11
Abstract

This study aims to identify parenting experiences after the death of a child. Using interpretive phenomenological analysis, we mapped the experiences of 16 parents with school-aged surviving children after the death of their sibling to the 2014 Sewol ferry disaster in South Korea. Interviews illuminate five master themes of parenting surviving children following a child’s death: (a) parental anxiety, (b) conflicts and obstacles in the parent-child relationship, (c) changes in parenting style, (d) striving to support children’s grief, and (e) seeking outside help for parenting. Implications for supporting grieving parents and their children are discussed in light of the findings.  相似文献   

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17.

Introduction:

Social Network Analysis (SNA) provides an important, underutilized approach to evaluating Community Academic Partnerships for Health (CAPHs). This study examines administrative data from 140 CAPHs funded by the Healthier Wisconsin Partnership Program (HWPP).

Methods:

Funder data was normalized to maximize number of interconnections between funded projects and 318 non‐redundant community partner organizations in a dual mode analysis, examining the period from 2003–2013.Two strategic planning periods, 2003–2008 vs. 2009–2014, allowed temporal comparison.

Results:

Connectivity of the network was largely unchanged over time, with most projects and partner organizations connected to a single large component in both time periods. Inter‐partner ties formed in HWPP projects were transient. Most community partners were only involved in projects during one strategic time period. Community organizations participating in both time periods were involved in significantly more projects during the first time period than partners participating in the first time period only (Cohen''s d = 0.93).

Discussion:

This approach represents a significant step toward using objective (non‐survey) data for large clusters of health partnerships and has implications for translational science in community settings. Considerations for government, funders, and communities are offered. Examining partnerships within health priority areas, orphaned projects, and faculty ties to these networks are areas for future research.  相似文献   

18.

OBJECTIVE

Latinos with type 2 diabetes (T2D) face major healthcare access and disease management disparities. We examined the impact of the Diabetes Among Latinos Best Practices Trial (DIALBEST), a community health worker (CHW)–led structured intervention for improving glycemic control among Latinos with T2D.

RESEARCH DESIGN AND METHODS

A total of 211 adult Latinos with poorly controlled T2D were randomly assigned to a standard of healthcare (n = 106) or CHW (n = 105) group. The CHW intervention comprised 17 individual sessions delivered at home by CHWs over a 12-month period. Sessions addressed T2D complications, healthy lifestyles, nutrition, healthy food choices and diet for diabetes, blood glucose self-monitoring, and medication adherence. Demographic, socioeconomic, lifestyle, anthropometric, and biomarker (HbA1c, fasting blood glucose, and lipid profile) data were collected at baseline and 3, 6, 12, and 18 months (6 months postintervention). Groups were equivalent at baseline.

RESULTS

Participants had high HbA1c at baseline (mean 9.58% [81.2 mmol/mol]). Relative to participants in the control group, CHWs had a positive impact on net HbA1c improvements at 3 months (−0.42% [−4.62 mmol/mol]), 6 months (−0.47% [−5.10 mmol/mol]), 12 months (−0.57% [−6.18 mmol/mol]), and 18 months (−0.55% [−6.01 mmol/mol]). The overall repeated-measures group effect was statistically significant (mean difference −0.51% [−5.57 mmol/mol], 95% CI −0.83, −0.19% [−9.11, −2.03 mmol/mol], P = 0.002). CHWs had an overall significant effect on fasting glucose concentration that was more pronounced at the 12- and 18-month visits. There was no significant effect on blood lipid levels, hypertension, and weight.

CONCLUSIONS

DIALBEST is an effective intervention for improving blood glucose control among Latinos with T2D.  相似文献   

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20.
Abstract

Aims: This study aimed to explore and understand how older adults experience community mobility within an urban Indian context, using a phenomenological approach. Methods: Ten older adults residing in Chennai city participated in this study. The investigator conducted individual, in-depth interviews of 60–75?minutes each. Results: Participants placed high value on community mobility, which contributed to their occupational participation and well-being. Participants identified numerous physical, social and attitudinal barriers to community mobility in their environment, leading to fear and restrictions in community mobility. Conclusion: The study findings underscore the need for the development of age-friendly communities within Indian society to promote occupational justice for older adults. Occupational therapists in India can intervene at the government, community, family and individual levels to enable older adults’ community mobility and occupational participation. Future research to investigate context-specific interventions to facilitate older adults’ community mobility is recommended.  相似文献   

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