Balancing professional and personal satisfaction of nurse managers: current and future perspectives in a changing health care system

OBJECTIVE: The objectives of this research were to explore and describe emerging new roles of First-Line Nurse Managers (F-LNMs i.e. individuals who oversee the daily operations of nursing units, regardless of their titles) in one Canadian province, identify their requisite knowledge, skills, competencies, and determine the training and development needs of these managers. BACKGROUND: F-LNMs, recognized as key players in health care systems, face major challenges (e.g. continuing organizational change, lack of resources) daily. These challenges affect their ability to achieve quality work experiences for their staff members and quality of nursing care for their patients and for themselves. METHODS: The research design entails a triangulation of investigators (nursing and management), methods (interviews and a Delphi Study), samples (interviews with 26 F-LNMs and a Delphi Study with 62 panelists), and data (qualitative and quantitative). Institutions were randomly selected and then F-LNMs were randomly selected to participate in personal interviews and the remaining F-LNMs, along with nominated senior administrators, were invited to participate in the Delphi Study. RESULTS: Key findings relate to role changes (e.g. job enlargement and emphasis on efficiency), challenges (e.g. staffing and retention, frustrations), and recommendations for administrators (e.g. provide resources, training and development) and educators (e.g. link education to organizational needs). Ultimately, organizational changes and challenges affect how F-LNMs perceive their future professional (e.g. providing quality of patient care) and personal (e.g. high quality of life) satisfaction levels. CONCLUSIONS: This research suggests that the role of F-LNMs continues to evolve, consistent with the changing health care system. F-LNMs face challenges that compromise performance of their functions as they believe their work should be completed. To enhance satisfaction in their roles, F-LNMs express a desire for balance in their professional and personal lives.     

Emotional problems in primary care: what is the potential for increasing the role of nurses?

It has been suggested that the role of primary care and community nurses should be expanded in relation to mental health in order to assist in the prevention and management of prevalent emotional disorders such as depression and anxiety. However, relatively little is known about the mental health work presently undertaken by these nurses. Furthermore, nurses'training needs, attitudes and organizational barriers to role expansion in this area have not been systematically explored. This article seeks to review the literature on nurses' potential and current mental health work, current and future training needs, the views of patients and nurses concerning an expanded nursing role, and organizational issues of relevance. Educational interventions which have been systematically evaluated are also reviewed. The results suggest that nurses are already involved in emotional health care with a variety of patient groups, although this is not always acknowledged as mental health work. While clear potential for an expanded role exists, there is little consensus as to what role would be most effective for each nursing group, and few educational interventions have been demonstrated to be of proven effectiveness.     

全程健康教育对宫颈癌术后患者性生活质量的影响

目的:探讨全程健康教育对宫颈癌患者术后性生活质量的影响。方法:随机抽取实验组和对照组各30例,对照组按照宫颈癌常规护理宣教;实验组在常规护理宣教的基础上,由健康教育小组成员通过院内、院外灵活实施全程健康教育。通过自行设计调查问卷分别于术后6个月、1年对两组患者进行性生活满意度调查。结果:实验组患者术后6个月、1年性生活状况优于对照组,两组比较差异有统计学意义(P0.05)。结论:全程健康教育能改善宫颈癌术后患者性生活质量。     

Adaptation of an instrument to measure the informational needs of men with prostate cancer

AIM OF THE STUDY: The aim of this study is to adapt an instrument suitable for assessment of the informational needs of men with prostate cancer. BACKGROUND: In recent years prostate cancer has become an important public health problem world-wide with considerable social and economic consequences. It is reported that it is the most common cancer affecting British men, with an average lifetime risk of occurrence of one in twelve. DESIGN/METHODS: Methodological research was conducted to develop an instrument to assess the informational needs of men with prostate cancer on hormonal manipulation therapy (HMT) regarding their disease and treatment. The Toronto Informational Needs Questionnaire (TINQ-BC) (Galloway et al. 1997) was modified for use with this client group and was applied to a sample of 90 men generated from three urology centres in Northern Ireland. RESULTS/FINDINGS: Construct and content validity of the instrument was established. Internal consistency reliability using Cronbach's alpha was calculated and found to be satisfactory (0.92). Using confirmatory factor analysis, factor loadings ranging from 0.37 to 0.90 were obtained and considered satisfactory. The subsections of the TINQ-BC categorized as Disease, Investigative tests, Treatment, Psychosocial and Physical needs were confirmed as individual factors. These results indicate that this instrument can be validly applied to this client group. As the instrument was initially developed in Canada and successfully used in the United Kingdom (UK), it is suggested that this instrument also has the potential for cross-cultural application. It has the potential to be used as a clinical reference instrument to assess the informational needs of this patient group. Health care professionals must be aware of the domains of information that these men perceive important so that educational interventions can be accurately and appropriately planned.     

中青年冠心病患者PCI术后恢复性生活的健康需求研究

目的 了解中青年冠心病患者经皮冠状动脉介入治疗术后对恢复性生活的健康需求.方法 采用一般资料调查表、冠心病患者经皮冠状动脉介入术术后恢复性生活健康信息需求问卷对北京市某三级甲等医院心脏中心治疗的140例中青年冠心病患者经皮冠状动脉介入治疗术后患者进行调查.结果 冠心病患者经皮冠状动脉介入治疗术后恢复性生活健康信息需求总...     

Issues in educating health professionals to meet the diverse needs of patients and other service users from ethnic minority groups

AIM: The main aim of the study was to undertake training needs analysis among a multi-professional group for the purpose of improving care for ethnic minority patients and other service users. BACKGROUND: Evidence from the literature identifies that some of the explanations advanced for the failure of health professionals to meet the needs of ethnic minorities include lack of understanding of cultural diversities, racism, racial stereotyping, lack of knowledge, exclusivity, and ethnocentrism. While these issues have been addressed in different countries, little work has been carried out to examine these from the perspective of health professionals caring for ethnic minorities. This study is therefore an attempt to find out what health professionals know about caring for patients and other service users from minority ethnic groups and their perception of training needs in this area of work. METHODS: A pre- and post-training design phase structured the qualitative approach. A purposive sample of individuals working across five health service organizations located in a multi-racial city yielded a multi-professional group of participants. Views of 22 participants were obtained by semi-structured interviews at a pretraining phase. Training needs of health professionals drew on Walklin's (1992) six stages used to structure data collection, data analysis and delivery of training. The post-training phase used questionnaires to evaluate immediate learning that based on a 4-week period of reflection and applied to practice. The questionnaires were complemented by a facilitator-lead focus group. RESULTS: The majority of the participants confirmed that no attention was given in their initial education to the health care needs of minority ethnic groups. Instead, participants engaged in self-initiated learning to improve their knowledge and understanding. The issue of communication was viewed with dissatisfaction and seen as affecting the sufficiency of caring for these patients. All participants rated meeting the needs of ethnic minorities as very important and believed that they had gained a better understanding of the concepts of ethnicity and race and resources available in local communities as a result of the training. They also reported changes in thinking about ethnic minorities and had started to acquire greater confidence to engage with colleagues about different cultural values and practices and the implications of these for caring. While a quarter of the participants had transferred some learning to practice, the majority were not able to bring about any change. This majority response challenged the sustainability of learning about ethnic minorities when training takes place away from the context in which professionals practise. CONCLUSION: Training embedded in clinical and nonclinical environment where patients and other service users and professionals interact is offered as a major finding.     

Who cares? Who cures? The ongoing debate in the provision of health care

Who cares? Who cures? The ongoing debate in the provision of health care ¶In the debate about the role of health professionals, two normative models have been placed in opposition —‘care vs. cure’. To many, the cure model has been associated with physicians, and the care model with nursing and the other allied health professions. As the shortcomings of a cure-orientated model have been recognized, particularly in dealing with chronic disease, more attention has been focused on care, with many writing as though the two were mutually exclusive. In this paper, we suggest that these models are instead end-points on a continuum which ideally should be used by all health providers, rather than being characteristic of different clinical professionals. This conceptualization places less concern on what should be done by doctors as opposed to nurses, and more on the needs of the particular situation. The resulting convergence among roles should not imply that nursing and the allied health professions will adopt the medical model, but that medicine, nursing and others will work together with patients for all members’ mutual benefit. In this expanded continuum, the focus for decision making becomes the patient and family in partnership and collaboration with health professionals.     

Educating healthcare professionals to act on the physical health needs of people with serious mental illness: a systematic search for evidence

Healthcare professionals in primary and secondary care should monitor the physical health of people with serious mental illness, yet in practice this does not appear to be a routine intervention. Our objective is to develop evidence-based training for healthcare professionals to enable them all to offer better physical care to this population. We performed a systematic search with the aim of evaluating the current evidence of the efficacy of education interventions. Search terms covered Severe Mental Illness, Physical Health and Education. The search yielded 147 papers, of which none were eligible for inclusion. A number of studies were excluded from this review as although there was an implicit education package provided to healthcare professionals, no information was reported on the outcomes of this education with regard to healthcare professionals' knowledge, attitudes and behaviours. The only information that these studies provided was patient-specific outcomes. It is vital that researchers start to publish details of healthcare professional education and their outcomes in physical health and serious mental illness research.     

Awareness of testicular cancer among young men: A literature review

What is the degree of knowledge and awareness regarding testicular cancer and what interventions may improve information about testicular cancer in the male population? Testicular cancer incidence rates are increasing among young men, who typically demonstrate poor awareness and a lack of knowledge about this disease. Although testicular self‐examination might be an effective method for early detection, few people know about this process or regularly perform it. This lack of examination could delay the diagnosis, which would affect treatment outcomes and mortality rates. A literature review was conducted starting from a bibliographic research in the major databases, and 450 documents were identified. The final analysis included 19 studies and found that men feel anxious about testicular cancer, which leads to a delay in their diagnosis and treatment, especially in developing countries. A widespread lack of awareness and knowledge about testicular cancer and self‐examination exists in these nations. Few males performed testicular self‐examination; most considered this procedure to be an invasion of their privacy and masculinity. The most effective tools to disseminate awareness about testicular cancer prevention were television, radio and YouTube. It is important to educate young males to spread information and improve awareness and knowledge about testicular cancer and self‐examination. However, the support of regular self‐examination is controversial, as this practice might also produce more harm than benefits due to the resulting false positives, fear and anxiety. Regular testicular cancer screening is therefore recommended in limited populations, including patients with risk factors, such as cryptorchidism or a family history of this cancer.     

恢复期精神病患者健康教育的实施与研究

目的消除恢复期精神病患者的各种心理负担,改变其不良生活习惯,恢复和增强他们的生活能力。方法将120例患者分为实验组和对照组,实验组重点对恢复期精神病患者开展健康教育,通过知(知识和学习)、信(信念和态度)、行(促进健康行为)的模式进行项目计划设计、执行和评价,把健康教育贯穿于日常生活护理、治疗和康复之中;对照组实施常规治疗护理。结果通过对照观察表明,健康教育能缩短精神病患者恢复期的疗程和平均住院天数。结论健康教育对提高患者出院后的社会适应能力和预防病情复发具有重要意义。     

Bone health: the effect of androgen deprivation therapy in prostate cancer patients

Androgen deprivation therapy (ADT) in the management of prostate cancer poses a considerable risk to bone health in prostate cancer patients, throughout their continuum of care. Associated decreases in bone mineral density and an increased risk of fracture can lead to major quality‐of‐life concerns and an adverse impact on morbidity and mortality, in an often already overburdened patient. Urology nurses in their administration and monitoring of the effects of ADT are essential for identifying at‐risk patients and ensure timely and effective assessment and treatment. As health educators, they are ideally situated to promote and influence patients to adopt essential lifestyle changes in a multidisciplinary arena, to reduce risk factors. Supportive treatments are available to significantly reduce both bone loss and fracture risk that can easily be adopted by urology nurses in their existing clinical working environments to further strengthen positive management strategies for bone health.