Health professionals' attitudes toward older people and older patients: A systematic review

Attitudes toward older people and older patients among healthcare professionals are of concern throughout the world, but there are no recent systematic reviews which have examined and compared the attitudes across the various healthcare professionals who provide healthcare to older people. A comprehensive literature search (2000–2011) was undertaken on electronic databases (CINAHL, MEDLINE, EMBASE, British Nursing Index, PsycINFO, Chinese Biomedical database, China Medical Academic Conference and China Academic Journal) using a combination of terms. We identified 2179 articles indexed with these terms. Initial screening was undertaken by two researchers and then checked by a third researcher. In total, the reviewers selected 117 articles which, on the basis of their abstracts, appeared to meet the criteria for inclusion. We obtained the full texts and two reviewers assessed each full text paper to further examine whether it met all the criteria. The final review identified 51 studies. Publications over the last 10 years show that attitudes towards older people and older patients range from neutral to positive among healthcare professionals and highlight the need for well-designed studies of both qualified and student healthcare professionals recruiting random samples across multiple sites and utilizing validated instruments consistently to permit comparison over time and across countries.     

Health professionals' attitudes toward older people and older patients: A systematic review

Attitudes toward older people and older patients among healthcare professionals are of concern throughout the world, but there are no recent systematic reviews which have examined and compared the attitudes across the various healthcare professionals who provide healthcare to older people. A comprehensive literature search (2000-2011) was undertaken on electronic databases (CINAHL, MEDLINE, EMBASE, British Nursing Index, PsycINFO, Chinese Biomedical database, China Medical Academic Conference and China Academic Journal) using a combination of terms. We identified 2179 articles indexed with these terms. Initial screening was undertaken by two researchers and then checked by a third researcher. In total, the reviewers selected 117 articles which, on the basis of their abstracts, appeared to meet the criteria for inclusion. We obtained the full texts and two reviewers assessed each full text paper to further examine whether it met all the criteria. The final review identified 51 studies. Publications over the last 10 years show that attitudes towards older people and older patients range from neutral to positive among healthcare professionals and highlight the need for well-designed studies of both qualified and student healthcare professionals recruiting random samples across multiple sites and utilizing validated instruments consistently to permit comparison over time and across countries.     

Health care professionals' knowledge and attitudes regarding substance use and substance users

In Ireland one in four (28%) of those attending hospital emergency departments have substance abuse-related injury/illness and one in eight (13%) present in a state of clinical intoxication. Health care professionals working in emergency departments are frequently exposed to patients with substance use problems and are in ideal positions to provide early diagnosis and treatment. The success rate in detecting these patients is however disturbingly low (25-50%) and as a result many substance use problems are misdiagnosed or remain undetected. International studies that focus on primary care and addiction within the mental health sector suggest that health care professionals' knowledge and attitudes regarding substance use and substance users may negatively influence the care that these patients receive. There is a dearth of empirical research, internationally, and particularly in Ireland that addresses health care professionals' knowledge and attitudes in relation to substance use and substance users with no empirical evidence to ascertain in particular, emergency department doctors' and nurses' knowledge and attitudes.     

Health professionals' attitudes towards suicide prevention initiatives

Preventing suicide can depend upon the ability of a range of different health professionals to make accurate suicide risk assessments and treatment plans. The attitudes that clinicians hold towards suicide prevention initiatives may influence their suicide risk assessment and management skills. This study measures a group of non-mental health professionals' attitude towards suicide prevention initiatives. Health professionals that had attended suicide prevention education showed significantly more positive attitudes towards suicide prevention initiatives. The findings in this study further support the effectiveness of educating non-mental health professionals in suicide risk awareness and management.     

Health care professionals' death attitudes, experiences, and advance directive communication behavior

The study surveyed 135 health care professionals (74 nurses, 32 physicians, and 29 social workers) to examine their personal death attitudes and experiences in relation to their reported advance directive communication practice behavior. Negative correlations were found between collaborating with other health care professionals regarding the directives and fear of death, avoidance of death, and escape acceptance of death. Approach acceptance of death positively correlated with initiating the discussion of advance directives. Practitioners indicating recent personal experiences with terminal illness reported disclosing more information about the documents.     

Nursing students' attitudes toward persons who are aged: An integrative review

ObjectivesTo analyze empirical studies from the United States and Canada to gain an understanding on how nursing education affects nursing students' attitudes toward persons who are aged.DesignAn integrative literature review was completed using Garrard's (2011) Matrix Method.Data SourcesArticles were identified through the electronic database search engines of CINAHL, Pub Med, and Academic Search Complete. Only peer reviewed research articles from 2009 to 2015 were reviewed.Review MethodsA review matrix was created to abstract information from 11 studies so that synthesis could occur. Information in the columns of the review matrix was used to compare the studies. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 27 item check list was used to help with reporting the findings. Studies were graded using the American Association of Critical Care Nurses' (AACN) level of evidence.ResultsA key finding is student engagement with gerontological content in the classroom or clinical setting results in improving nursing students' attitudes toward persons who are aged.ConclusionsSeveral gaps exist in the literature. Further research including longitudinal studies and large scale, multi-site samples would add to the existing knowledge.     

Health professionals' knowledge of women's health care

Until 1986, the only issues in women's health which received direct attention were those related to childbearing. At that time the National Institutes of Health made inclusion of women in research a criteria for funding. Since then, the knowledge base to guide disease prevention and treatment of women has grown dramatically. Unfortunately, the incorporation of these data into clinical practice has been much slower. The purpose of this needs assessment was to establish a comprehensive data base on which future programming decisions could be based. Areas of interest identified by health care providers included stress reduction, breast health, prevention of heart disease, and osteoporosis. Other topics that emerged were menopause and reproduction issues, cancer prevention, domestic violence, substance abuse, nutrition, and weight control. These data suggest topics for future programming.     

Nursing students' ethical dilemmas regarding patient care: An integrative review

BackgroundThe ethical and moral complexities are inherent to nursing practice. Ethical dilemmas of professional nurses and nursing students' ethical concerns with their preceptors are well-documented. No reviews have synthesized students' ethical dilemmas regarding patient care.ObjectivesThis review aimed to develop a comprehensive understanding of nursing students' ethical dilemmas regarding patient care in clinical settings.DesignAn integrative review based on Whittemore and Knafl's methodology.Data sourcesLiterature was searched within PubMed, CINAHL, Google Scholar, Scopus, and Science Direct databases and 13 articles including eight qualitative, three quantitative, one mixed methods and one secondary data analysis were reviewed. The articles were published from January 2000–March 2019.Review methodsThe Mixed Methods Critical Appraisal Tool was used for quality assessment. Two reviewers independently reviewed the articles and the third reviewer validated the extracted and synthesized findings. Literature summary tables were developed for data extraction and thematic synthesis techniques and narratives were used for data synthesis. For synthesis, findings from strongly and moderately rated studies were given more weight and those from the low-quality studies were used to support the synthesized themes.ResultsThree themes emerged: a) applying learned ethical values vs. accepting unethical practices, b) desiring to provide ethical care but lacking autonomous decision making, and c) Silence vs. whistleblowing patient care neglects.ConclusionsNursing students feel torn between the conflicts of whether to provide ethical care or accept unethical practices, stay silent about patient care neglect or confront and report it, provide ethical and quality care or adapt to the culture due to lack of autonomous decision making. Such conflicts can be detrimental to students' professional learning and mental health. Therefore, educators and nursing institutions should develop programs to support students and help them develop ethical competence and courage to confront such dilemmas.     

Psychiatric nursing staffs’ attitudes towards the use of containment methods in psychiatric inpatient care: An integrative review

One of the international objectives in psychiatric care is reducing the use of coercion. Containment methods are meant to keep patients safe, yet usually include coercion. Nurses play a key role in deciding whether or not containment should be used and, as such, their attitudes towards containment can significantly impact the extent to which these methods are applied. The aim of this integrative review was to identify, analyse, and synthesize the available research on psychiatric nursing staffs’ attitudes towards containment methods in inpatient psychiatric care. An electronic search was conducted using the CINAHL, Scopus, and PsycINFO databases. In addition, the citations of identified studies were screened for relevant research. A total of 24 relevant papers published between 2002 and 2017 were selected for further analysis. These studies revealed variation in nursing staffs’ attitudes towards the use of containment methods. The use of containment methods seems to be widely accepted and nurses reported rarely considering alternative measures. It appears that attitudes towards containment have continuously become more negative, although the change has not been very pronounced. The concept of attitude was only defined in two studies. Thus, future research should strive to clarify this concept, as a generally accepted definition for attitude within nursing research and the utilization of all dimensions of this concept are both essential to the nursing field. Currently, it would be important to focus on changing attitudes among psychiatric nursing staff to reduce the use of containment methods; this calls for more research on nursing staffs’ attitudes.     

Physical restraints in intensive care–An integrative review

Background

Physical restraints (PRs) are commonly used in intensive care units (ICUs) worldwide for the prevention of treatment interference. While PRs are fundamentally used to maintain patient safety, they can negatively impact the experiences of patients and their families and cause moral and ethical dilemmas for ICU nurses.

Health literacy in geriatric patients: An integrative review of the literature

The concept of health literacy is a recent addition to healthcare literature, appearing in the early to mid 1990s. Health literacy refers to individuals' ability to understand their healthcare issues and effectively care for themselves in the healthcare system. Individuals' health literacy abilities vary greatly and can be viewed on a continuum ranging from adequate to marginal to inadequate. Repeated research has demonstrated that older individuals, the geriatric patient population, are at risk of inadequate or marginal health literacy. This risk impacts health outcomes and cost for caring for the older people in our society who are the consumers of a large quantity of healthcare services. The demographic data from the research show that multiple factors influence an individual's health literacy. Besides age, individuals with less education, lower income, "blue collar" jobs, and poor health status (mental and physical) can be at risk of marginal or inadequate health literacy. Providing care to low health literacy patients is complicated by commercially prepared healthcare materials and presentations that are often written well above the average national literacy level. Studies in this review examine various approaches to healthcare education and provide viable options for educating those with low health literacy. This review stresses the importance of healthcare professionals identifying older individuals with marginal or inadequate health literacy and being able to provide education in an effective manner to this segment of the population.     

Family members’ participation in palliative inpatient care: An integrative review

Aim

To analyse how family members participate in hospital inpatient palliative care, and how their participation could be supported.

Methods

This review followed a methodology outlined in the literature for integrative reviews. A literature search supplemented by a manual search was conducted on four electronic databases during 2020 to 2021: PubMed, CINAHL, PsycINFO, and Cochrane Library. A critical appraisal of the included studies was performed, and data were analysed using inductive content analysis.

Results

The literature search resulted in 4990 articles, of which 14 articles were included in this review. Four main categories were identified concerning the participation of family members in hospital inpatient palliative care: participation in the physical care, provision of emotional support, promoting good patient care, and support provided by healthcare professionals for family members’ participation. Family members’ participation can be supported in different ways, including active communication and adequate information.

Conclusion

Family members’ participation in hospital inpatient palliative care has been an important part of palliative care in hospital settings. Family members should be offered the opportunity to participate in patient care, and their presence in the hospital should be accommodated. Research on the topic is still scarce, and future research is needed from different perspectives, including intervention research.