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1.
Ralf J. Jox Mirjam Krebs Martin Fegg Stella Reiter-Theil Lorenz Frey Wolfgang Eisenmenger Gian Domenico Borasio 《Journal of critical care》2010
Purpose
Deciding about the limitation of life-sustaining treatment (LST) is a major challenge for intensive care medicine. The aim of the study was to investigate the practices and perspectives of German intensive care nurses and physicians on limiting LST.Methods
We conducted an anonymous, self-administered questionnaire survey among the 268 nurses and 95 physicians on all 10 intensive care units of the Munich University Hospital, Germany.Results
The response rate was 53%. Of all respondents, 91% reported being confronted with the topic at least once a month. Although all reported limiting cardiopulmonary resuscitation, almost no one reported limiting artificial hydration. Half of nurses and junior physicians felt uncertain about the decision-making process. Junior physicians were most dissatisfied with their training for this task and expressed the highest fear of litigation. Nurses were less satisfied than physicians with the communication process. Both nurses and relatives were not routinely involved in decision making. There is no standardized documentation practice, and many notes are not readily accessible to nurses.Conclusions
Limiting LST is common in German intensive care units. The major shortcomings are team communication, communication with the patient's family, and documentation of the decision-making process. 相似文献2.
Fukui S Yoshiuchi K Fujita J Sawai M Watanabe M 《Journal of pain and symptom management》2011,42(6):882-892
Context
Japanese people's preferred place of end-of-life care may be affected by their experiences, perceptions, and knowledge related to the end of life.Objectives
The aims of this study were to clarify the Japanese population's preferences for the place of end-of-life care and death and to identify the determinants of each choice of preferred place of end-of-life care within their experiences, perceptions, and knowledge.Methods
A total of 2000 Japanese people aged 40–79 years participated in a cross-sectional nationwide survey.Results
Fifty-five percent (n = 1042) responded. Regarding place of end-of-life care, approximately 44% of the general population preferred home, 15% preferred hospital, 19% preferred palliative care unit, 10% preferred public nursing home, 2% preferred private nursing home, and the remaining 11% was unsure. Multinomial logistic regression analysis revealed that the following factors affect people’s preferences regarding place of care: 1) experiences, such as “visiting hospital regularly” and “experiencing home death of relatives,” 2) perceptions, such as “giving due thought to their own death on a daily basis” and “perceiving lower home palliative care costs to be appropriate after comparing hospital admission fees,” and 3) knowledge of “home care nursing” and “24-hour home palliative system by physicians and nurses using insurance.” These factors correlated with preference for hospital, palliative care unit, or public nursing home, when compared with the preference of home.Conclusion
The present findings may help to develop an effective end-of-life care system in Japan, in line with people’s various preferred locations for such care. 相似文献3.
Ward nurses' experiences of the discharge process between intensive care unit and general ward
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Wivica Kauppi RN CCRN MScN Matilda Proos RN CCRN MScN Sepideh Olausson RN CCRN MScN PhD 《Nursing in critical care》2018,23(3):127-133
Background
Intensive care unit (ICU) discharges are challenging practices that carry risks for patients. Despite the existing body of knowledge, there are still difficulties in clinical practice concerning unplanned ICU discharges, specifically where there is no step‐down unit.Aims and objectives
The aim of this study was to explore general ward nurses' experiences of caring for patients being discharged from an ICU.Design and methods
Data were collected from focus groups and in‐depth interviews with a total of 16 nurses from three different hospitals in Sweden. An inductive qualitative design was chosen.Findings
The analysis revealed three themes that reflect the challenges in nursing former ICU patients: a vulnerable patient, nurses' powerlessness and organizational structure. The nurses described the challenge of nursing a fragile patient based on several aspects. They expressed feeling unrealistic demands when caring for a fragile former ICU patient. The demands were related to their own profession and knowledge regarding how to care for this group of patients. The organizational structure had an impact on how the nurses' caring practice could be realized. This evoked ethical concerns that the nurses had to cope with as the organization's care guidelines did not always favour the patients.Conclusions
The structure of the organization and its leadership appear to have a significant impact on the nurses' ability to offer patients the care they need.Relevance to clinical practice
This study sheds light on the need for extended outreach services and intermediate care in order to meet the needs of patients after the intensive care period.4.
Objectives
The aim of this review is to construct a detailed account of the role of the district nurse (generalist registered nurse providing nursing care in primarily home settings) in providing palliative care, to determine if and how district nursing care provides effective care to such patients at home, and to examine the utility of a realist review for the above purpose.Design
Realist review of literature.Data sources
Papers in English reporting aspects of the district nurse role in the provision of palliative care are included. Electronic databases (Ovid Medline, Cinnahl, British Nursing Index, Embase, PsycINFO and EBM reviews) were searched, supplemented by citation tracking and grey literature searches.Review methods
Assumptions about district nursing practice with palliative care patients are derived from a range of sources. Reviewed papers are interrogated to support, refute or develop these statements.Results
Forty six papers employing a range of research methods are incorporated into the review. Studies focus on district nurses, patients, family carers and other professionals and include work from a range of countries. Studies highlight the value district nurses place on palliative care provision, the importance of developing a relationship with patients, and the emotional difficulties of providing such care. District nurses have key skills in providing physical care and in coordinating the work of others, but struggle more with psychological aspects of care. District nurses report feeling undervalued, and express some reluctance to work with other health and social care professionals to provide care.Conclusions
There is little in this synthesis to shed light on the outcomes of care or to explicitly guide practice. District nurses clearly articulate what they consider to be important, but research in this area is limited and needs to undergo a renaissance to examine what is important: namely what district nurses do in practice; what patients and family carers views are on what they do and do not do; and how district nurses can improve care outcomes. The inclusiveness of realist review works well for this field of study. 相似文献5.
Annicka G.M. van der Plas Luc Deliens Marlies van de Watering Wim J.J. Jansen Kris C. Vissers Bregje D. Onwuteaka-Philipsen 《International journal of nursing studies》2013
Background
In case management an individual or small team is responsible for navigating the patient through complex care. Characteristics of case management within and throughout different target groups and settings vary widely. Case management is relatively new in palliative care. Insight into the content of care and organisational characteristics of case management in palliative care is needed.Objectives
To investigate how many case management initiatives for palliative care there are in the Netherlands for patients living at home; to describe the characteristics of these initiatives with regard to content and organisation of care.Setting
Primary care.Design and participants
A nationwide survey of all 50 coordinators of networks in palliative care in the Netherlands was conducted. Additional respondents were found through snowball sampling. We looked at 33 possible initiatives using interviews (n = 33) and questionnaires (n = 30).Results
We identified 20 initiatives for case management. All stated that case management is supplemental to other care. In all initiatives the case managers are registered nurses and most possess higher vocational education and/or further training. All initiatives seek to identify the multidimensional care needs of the patients and the relatives and friends who care for them. Almost all provide information and support and refer patients who need care. Differences are found between the organisations offering the case management, their target groups, the names of the initiatives and whether direct patient care is provided by the case manager.Conclusions
In the Netherlands, case management in palliative care is new. Several models of delivery were identified. Research is needed to gain insight into the best way to deliver case management. By describing characteristics of case management in palliative care, an important first step is made in identifying effective elements of case management. 相似文献6.
Objectives
To investigate the current use of passive movements (PMs) by National Health Service (NHS) physiotherapists working with sedated and ventilated patients in critical care settings.Design
Postal questionnaire.Setting
All open NHS critical/intensive care units in England, Northern Ireland, Scotland and Wales.Participants
Physiotherapists working in UK NHS critical/intensive care units.Results
Questionnaires were posted to 246 physiotherapists working in intensive care units; 165 (67%) were returned. One hundred and fifty-two respondents routinely treated ventilated and sedated patients, of which 151 (99%) reported utilising PMs. They were used most commonly (>70%) in patients admitted to critical care with medical, neurological or surgical problems. Respondents reported using a median of five repetitions of PMs once daily, and the majority of respondents took joints to the end of range (>78%). Joints most commonly treated included the shoulder, hip, knee, elbow and ankle. Heart rate and blood pressure were monitored by over 84% of respondents during treatment.Conclusions
Whilst there is little empirical evidence to underpin the use of PMs, this study found that PMs were used regularly by 99% of respondents working in NHS critical care settings. Further work is now needed to evaluate the immediate and long-term effects of PMs in critically ill patients to inform and develop future practice. 相似文献7.
Annelies Wassenaar Jeroen Schouten Lisette Schoonhoven 《International journal of nursing studies》2014
Background
Feeling safe in the intensive care unit is of great importance while recovering from critical illness. Moreover, feeling unsafe can result in distress. In order to meet the safety needs of intensive care patients as well as to stimulate their recovery and prevent distress, nurses must be aware of factors promoting patients’ perception of feeling safe during an intensive care admission. To our knowledge, there is no synthesis of these factors available as yet.Objective
To systematically describe the factors that promote patients’ perception of feeling safe in an intensive care unit.Design
A systematic review of qualitative and quantitative studies.Data sources
PubMed, Embase, CINAHL, and PsycINFO were searched up to March 2012.Review methods
Methodological quality was assessed by two authors using the QualSyst tool. Data from the included studies were extracted into a customised data extraction form.Results
The initial search resulted in 1326 records. Ultimately, eleven studies were relevant to the research question and included in the review. No studies needed to be excluded because of low quality scores. Analysis of the factors in these studies resulted in four overarching themes that promote intensive care patients’ perception of feeling safe. These themes were: nursing care, patients’ issues, relatives, and technological support. Nursing care was described most frequently as an important factor promoting patients’ feeling of safety in an intensive care unit. Relatives were the link between intensive care patients and staff.Conclusions
Nurses can increase the perception of feeling safe in critically ill patients by taking into account the promoting factors described in this review. By being aware of these factors nurses can improve quality of care in their intensive care unit. 相似文献8.
Breanna Hetland Jill Guttormson Mary Fran Tracy Linda Chlan 《Australian critical care》2018,31(3):153-158
Introduction
Critical care nurses are responsible for administering sedative medications to mechanically ventilated patients. With significant advancements in the understanding of the impact of sedative exposure on physiological and psychological outcomes of ventilated patients, updated practice guidelines for assessment and management of pain, agitation, and delirium in the intensive care unit were released in 2013. The primary aim of this qualitative study was to identify and describe themes derived from critical care nurses' comments regarding sedation administration practices with mechanically ventilated patients.Methods
This is a qualitative content analysis of secondary text data captured through a national electronic survey of members of the American Association of Critical-Care Nurses. A subsample (n = 67) of nurses responded to a single, open-ended item at the end of a survey that evaluated nurses' perceptions of current sedation administration practices.Findings
Multiple factors guided sedation administration practices, including individual patient needs, nurses' synthesis of clinical evidence, application of best practices, and various personal and professional practice perspectives. Our results also indicated nurses desire additional resources to improve their sedation administration practices including more training, better communication tools, and adequate staffing.Conclusions
Critical care nurses endorse recommendations to minimise sedation administration when possible, but a variety of factors, including personal perspectives, impact sedation administration in the intensive care unit and need to be considered. Critical care nurses continue to encounter numerous challenges when assessing and managing sedation of mechanically ventilated patients. 相似文献9.
Siv K. Stafseth Diana Solms Inger Schou Bredal 《Intensive & critical care nursing》2011,27(5):290-294
Objective
This study compares the Nine Equivalents of Nursing Manpower Use Score (NEMS) to the Nursing Activities Score (NAS) in terms of characterising the nursing workload by examining and calculating the per-nurse NAS% over a 24-h period.Method
The sample consisted of 235 patients from four volunteered for the study multidisciplinary ICUs in Norway. The daily NEMS, NAS and number of nurses who were involved in patient care per ICU were measured over one month from 2008 to 2009.Results
The average length of stay for the included patients was 5 days, and the mean patient age was 52.8 years. The mean NEMS was 32.7 points (S.D., 8.98 points), and the mean NAS was 96.24% (S.D., 22.35%). Several nurses exhibited mean NEMS points that ranged from 16 to 39.7 per ICU per day. The correlation between the NEMS and NAS could only be separately determined for each ICU. The correlation was r = 0.16–0.40 [significant at the 0.01 level (2-tailed)] per unit. Depending on which unit was investigated, each nurse was observed to perform of capacity with a NAS as high as 75–90%.Conclusion
The study suggests that the actual numbers of nurses might explain the calculated NAS of 75–90% per nurse. 相似文献10.
Long-Sutehall T Willis H Palmer R Ugboma D Addington-Hall J Coombs M 《International journal of nursing studies》2011,48(12):1466-1474
Background
The process of withdrawal of treatment in critical care environments has created ethical and moral dilemmas in relation to end of life care in the UK and elsewhere. Common within this discourse is the differing demands made on health professionals as they strive to provide care for the dying patient and family members. Despite reports that withdrawal of treatment is a source of tension between those nurses and doctors involved in the process, the role of the nurse in facilitating withdrawal of treatment has received relatively little attention.Objectives
To illustrate how differing dying trajectories impact on decision-making underpinning withdrawal of treatment processes, and what nurses do to shape withdrawal of treatment.Design
Qualitative methods of enquiry using clinical vignettes and applying Charmaz's grounded theory method.Methods and settings
Single audio-recorded qualitative interviews with thirteen critical care nurses from four intensive care specialities: cardiac; general; neurological and renal were carried out. Interviews were facilitated by an end-of-life vignette developed with clinical collaborators.Findings
Across critical care areas four key dying trajectories were identified. These trajectories were shaped by contested boundaries associated with delayed or stalled decision-making around how withdrawal of treatment should proceed. Nurses provided end of life care (including collaborative and action-oriented skills) to shape the dying trajectory of patients so as to satisfy the wishes of the patient and family, and their own professional aims.Conclusions
Differing views as to when withdrawal of treatment should commence and how it should be operationalised appeared to be underpinned by the requirements of the role that health professionals fulfil, with doctors focusing on making withdrawal of treatment decisions, and nurse's being tasked with operationalising the processes that constitute it. Multidisciplinary teams need a ‘shared’ understanding of each other's roles, responsibilities, aims, and motivations when planning and implementing the dying trajectory of withdrawal of treatment. 相似文献11.
Karen Bulmer Smith Joanne Profetto-McGrath Greta G. Cummings 《International journal of nursing studies》2009,46(12):1624-1636
Aim
The purpose of this paper is to present findings of an integrative literature review related to emotional intelligence (EI) and nursing.Background
A large body of knowledge related to EI exists outside nursing. EI theory and research within nursing is a more recent phenomenon. A broad understanding of the nature and direction of theory and research related to EI is crucial to building knowledge within this field of inquiry.Method
A broad search of computerized databases focusing on articles published in English during 1995–2007 was completed. Extensive screening sought to determine current literature themes and empirical research evidence completed in nursing focused specifically on emotional intelligence.Results
39 articles are included in this integrative literature review (theoretical, n = 21; editorial, n = 5; opinion, n = 4 and empirical, n = 9). The literature focuses on EI and nursing education, EI and nursing practice, EI and clinical decision-making, and EI and clinical leadership. Research that links EI and nursing are mostly correlation designs using small sample sizes.Conclusion
This literature reveals widespread support of EI concepts in nursing. Theoretical and editorial literature confirms EI concepts are central to nursing practice. EI needs to be explicit within nursing education as EI might impact the quality of student learning, ethical decision-making, critical thinking, evidence and knowledge use in practice. Emotionally intelligent leaders influence employee retention, quality of patient care and patient outcomes. EI research in nursing requires development and careful consideration of criticisms related to EI outside nursing is recommended. 相似文献12.
Purpose
The aims of this study were to increase the reporting of patient safety events and to enhance report analysis and responsive action.Materials and Methods
A prospective, interventional study in 2 adult intensive care units (ICUs) in an academic center was used. A paper-based reporting system, adapted from a previously reported intervention, was introduced. A multifaceted approach, including education, reminders, regular updates, personal and group feedback, and weekly leadership rounds, was led by a patient safety committee. Committee members reviewed the reports and initiated solutions as required.Results
During the first year, a total of 332 safety events were reported using the new system, reflecting a significant increase in total reporting (10.3/1000 patient days preintervention to 34.5/1000 patient days postintervention; rate ratio, 3.35; 95% confidence interval, 2.23-5.04). Most reports were submitted by nurses (nurses, 75.3%; physicians, 10.5%; other workers, 7.8%). Overall reported events per 1000 patient days differed by unit (level 3 ICU, 44.1; level 2 ICU, 24.9; P < .001). Several system-based interventions were initiated in the ICUs to address reported safety hazards.Conclusions
After the introduction of this new approach, reporting rates have increased significantly throughout the first year. Differences in reporting rates among workers and units may reveal priorities and barriers to reporting. The integrated approach facilitated prompt response to selected reports. 相似文献13.
Objective
To determine factors that influence the nurses’ performance in family nursing care in public health centers in Jambi City.Method
A cross-sectional study was conducted from April to October 2016 using questionnaire with public health nurses as participants. The survey included questions on knowledge, attitude, self-confidence, motivation, personality, and nurses’ performance in family nursing care, and was completed by 114 nurses. Data analyses used for this study were chi-square test and logistic regression.Results
The factors affecting the nurses’ performance in family nursing care were attitudes (p 0.003; 95% CI 1.583–9.823), motivation (p 0.002; 95% CI 1.672–9.972), and personality (p 0.005; 95% CI 1.466–8.830).Conclusions
Need efforts to improve the attitude, motivation, and personality of nurses in providing family nursing care, such as training, supervision, and rewards. 相似文献14.
Diane J. Chamberlain RN BN BSc MNSc MPH PhD Eileen M. Willis Andrew B. Bersten 《Australian critical care》2011,24(4):229-243
Objective
The use of the sepsis bundles in patients with severe sepsis and septic shock has been controversial in the last decade. Clinical studies have reported beneficial, as well as negative results. We conducted a meta-analysis to assess the clinical evidence and to evaluate survival effects.Data source
Database searches (2004–current) of Medline, CINAHL, Pubmed, Cochrane, Scopus and Google scholar databases which covered full publications, abstracts from conferences and digital thesis were performed using the search terms sepsis, septic shock and/or bundles, processes of care, guidelines, early goal directed therapy, resuscitation.Results
From 253 identified studies, 21 sepsis bundle original studies were selected and included 23,438 patients. The Resuscitation 6 hour Bundle pooled analysis (1819 patients) achieved the greatest survival benefit (odds ratio (OR) 2.124, 95% CI 1.701–2.651, p < 0.000) with the Management 24 hour Bundle pooled analysis the lowest survival benefit (16,521 patients) (OR 1.646, 95% CI 1.036–2.614, p < 0.035). Both bundles together (Complete Bundle) achieved a combined survival benefit (OR 1.744, 95% CI 1.421–2.141, p < 0.000). ScvO2 and blood glucose components were analysed individually to assess their contribution to survival.Conclusion
The Resuscitation 6 hour bundle in the context of the patient population at hand is unlikely to do harm and is yet to be established in primary research in Australia. The Management 24 hour Bundle could not establish a strong enough survival benefit above current routine practice. The sepsis guidelines and bundles have demanded more credible process measurements and debate to induce positive changes in the intervention and treatment care of patients with severe sepsis. 相似文献15.
Rashan Haniffa A. Pubudu De Silva Saman Iddagoda Hasini Batawalage S. Terrance G.R. De Silva Palitha G. Mahipala Arjen Dondorp Nicolette de Keizer Saroj Jayasinghe 《Journal of critical care》2014
Purpose
To describe the extent and variation of critical care services in Sri Lanka as a first step towards the development of a nationwide critical care unit (CCU) registry.Materials and Methods
A cross-sectional survey was conducted in all state CCUs by telephone or by visits to determine administration, infrastructure, equipment, staffing, and overall patient outcomes.Results
There were 99 CCUs with 2.5 CCU beds per 100 000 population and 13 CCU beds per 1 000 hospital beds. The median number of beds per CCU was 5. The overall admissions were 194 per 100 000 population per year. The overall bed turnover was 76.5 per unit per year, with CCU mortality being 17%.Most CCUs were headed by an anesthetist. There were a total of 790 doctors (1.6 per bed), 1 989 nurses (3.9 per bed), and 626 health care assistants (1.2 per bed). Majority (87.9%) had 1:1 nurse-to-patient ratio, although few (11.4%) nurses had received formal intensive care unit training. All CCUs had basic infrastructure (electricity, running water, piped oxygen) and basic equipment (such as electronic monitoring and infusion pumps).Conclusion
Sri Lanka, a lower middle-income country has an extensive network of critical care facilities but with inequalities in its distribution and facilities. 相似文献16.
Sandra Sharp Margaret Mcallister Mark Broadbent 《Collegian (Royal College of Nursing, Australia)》2018,25(1):11-17
Problem
Person centred care is a key indicator of quality care and a policy direction in many hospitals yet some patients experience care that falls short of this standard.Background
Health services worldwide are prioritising the delivery of person centred in order to address historical concerns over patient safety and quality care and to improve workplace morale. Workplace culture is known to affect nurses’ care giving.Question
This research aimed to uncover the cultural factors that hindered or facilitated the delivery of person centred care in an acute setting and answer the question: How does workplace culture influence nurses’ delivery of person centred care?Methods
Critical ethnography provided the philosophical and methodological framework. Data were collected through participant observation, individual and focus group interviews, examination of care planning documents. Data were analysed hermeneutically and critically to make tacit cultural knowledge explicit and to suggest ways to reconstruct the culture of this specific nursing unit.Findings
Nurses organised their work in response to the urgency of the task at hand and nursing routines. People who received that care were rarely included in planning care.Discussion
Task focused ways of working can predominate in workplace cultures where an emphasis is placed on efficiency. Efficiency is part of the neoliberalist health care agenda and it stands in contrast to ideals of person-centred effectiveness because the latter may actually slow down procedures and require holistic approaches, rather than segmented care. Efficiency in this study appeared to be reinforced by an embedded and naturalised cultural practice amongst the nurses, which was to value fast-paced and completed tasks, because of the recognition it would receive from peers. Yet it also constituted a tension and bind for the nurses because the failure to be person-centred meant their professional values were unmet, and this led to moral distress and workplace dissatisfaction. If nurses were assisted to develop recognition of competing discourses in their work, and rationales to support a values-based practice, it is likely that they could be empowered to resist the status-quo and actually achieve the aspirations outlined in person-centred care rhetoric.Conclusion
Organisations and individuals striving for person-centred care need to develop awareness of the social and political forces that shape and constrain practice, in order to approach their work more consciously and critically. 相似文献17.
Aaron M. Joffe Stephen M. Pastores Linda L. Maerz Piyush Mathur Steven J. Lisco 《Journal of critical care》2014
Background
Non-physician advanced practice providers (APPs) such as nurse practitioners and physician assistants are being increasingly utilized as critical care providers in the United States. The objectives of this study were to determine the utilization of APPs in the intensive care units (ICU)s of academic medical centers (AMCs) and to assess the perceptions of critical care fellowship program directors (PDs) regarding the impact of these APPs on fellowship training.Methods
A cross-sectional national survey questionnaire was distributed to program directors of 331 adult Accreditation Council for Graduate Medical Education-approved critical care fellowship training programs (internal medicine, anesthesiology and surgery) in US AMCs.Results
We received 124 (37.5%) PD responses. Of these, 81 (65%) respondents indicated that an APP was part of the care team in either the primary ICU or any ICU in which the fellow trained. The majority of respondents reported that patient care was positively affected by APPs with nearly two-thirds of PDs reporting that fellowship training was also positively impacted.Conclusions
Our survey revealed that APPs are utilized in a large number of US AMCs with critical care training programs. Program director respondents believed that patient care and fellowship training were positively impacted by APPs. 相似文献18.
19.
Hsiu-Li Huang Yea-Ing Lotus Shyu Huei-Ling Huang Sien-Tsong Chen Hsiao-Juan Li Ming-Neng Shiu Mei-Chi Pong 《International journal of nursing studies》2013
Background
The incremental prevalence of dementia is making dementia management a worldwide issue. The role of community health nurses must grow along with the increasing aging population and the resulting increase in dementia cases.Objectives
Explore the factors related to dementia care practices among the different types of community health nurses in Taiwan.Design
Cross-sectional study.Setting
Primary care centers or institutions in New Taipei City.Participants
Community health nurses who work in health care centers (district nurses), long-term care centers (care managers), or home care institutions (home health care nurses).Methods
Self-completion questionnaires sent by mail.Results
A total of 195 participants returned the questionnaires (response rate 81.9%). Although 65.8% of participants had experience in case finding, just 34.6% of them reported using validated cognitive testing tools. Only 15% of participants provided case management following dementia case findings. The regression models showed that the different types of community health nurses, number of years working as a nurse, and their level of confidence was significantly related to their dementia care practice. District nurses identified significantly less suspected dementia cases and provided less nursing care to caregivers of dementia patients than care managers and home health care nurses. Among community health nurses, the care managers most often used formal cognitive instruments. District nurses provided the least amount of supportive resources information, had the most negative attitude and the lowest level of confidence toward dementia care than care managers and home health care nurses.Conclusions
This study presented the profiles of dementia care practice in Taiwan. It showed the considerable variation in knowledge, attitude, confidence and dementia care practices among the different community health nurses. The professional roles regarding dementia care in Taiwan remain blurred. Future training must focus on promoting the level of confidence of community health nurses to identify and manage people with dementia and raise awareness about demented person's and their caregiver's need. The priority of the policy on dementia care in the community must be raised to high, and the professional responsibilities and roles of the different types of community health nurses for the ever increasing dementia population in Taiwan must be redefined and optimized. 相似文献20.
Over the past three decades health policy within the United Kingdom (UK) has consistently acknowledged the potential for nurses to contribute to the health of individuals and communities. The educational curricular of pre and post registration nursing programmes has responded to such health policies by placing greater emphasis on the role of the nurse in health promotion and ill health prevention.