Medication adherence in adults after hospitalization for heart failure: A cross-sectional study.

Background: Medication non-adherence in heart failure (HF) leads to increased mortality, morbidity and healthcare costs. However, no study has investigated HF patients' post-hospitalization medication non-adherence in Switzerland. Objectives: Our primary aim was to assess the prevalence of post-discharge medication non-adherence in patients with HF. A secondary objective was to identify differences between fully and partially adherent patients regarding selected unplanned therapy-related inpatient/outpatient cardiology visits. Methods: A non-experimental cross-sectional study was applied. The prevalence of medication adherence was assessed with a German-translated version of the Medication Adherence Report Scale (MARS-5) and analyzed descriptively. Differences between adherent and partially adherent patients' numbers of medications, dosing per day and 180-day unplanned inpatient stays or cardiology outpatient visits were explored. Results: Of 153 recruited patients, 72 participated in the survey. Of these, 26.4 % were not fully adherent. Their most common reason was forgetfulness (23.7 %). There were no significant group differences regarding therapy-related variables or 180-day unplanned cardiology stays/visits. Conclusions: Considering that over one-quarter of surveyed HF patients were not fully medication adherent, Swiss cardiology nurses need to be sensitized to this issue and trained in adherence-enhancing interventions. Reaching acceptable adherence levels in patients with HF will require further research and action.

Patients' sexual harassment of nurses and nursing students: A cross-sectional study.

Background: Workplace sexual harassment towards nurses is a global phenomenon: approximately one quarter of all nurses are affected by sexual harassment. The extent and type of sexual harassment vary greatly depending on the country, culture, level of education, and care setting. Notably, patients are amongst the main perpetrators. Importantly, sexual harassment has serious consequences on nurses' health and work performance. Objective: This study examined the prevalence of patients' workplace sexual harassment towards nurses and nursing students at a University of Applied Sciences in Switzerland. Design: A quantitative cross-sectional descriptive correlational design was used. Setting: The survey was conducted at the university's Institute of Nursing under the Department of Health. Participants: Nurses and nursing students who were studying or attending a continuing education programme and had worked as a nurse with direct contact with patients in the last 12 months could qualify as participants. A final sample of 251 participants was used for the analysis. Methods: Data were collected using the 'Sexually Harassing Behaviour Questionnaire from an extraorganizational perspective'. Preliminary analysis involved computing the percentage and absolute frequencies, mean scores, standard deviations, and ranges. The hypotheses were tested using non-parametric tests, such as the Wilcoxon test for two independent samples, Spearman correlation test, and Kruskal-Wallis H test. Results were considered statistically significant at alpha < 0.05. Results: Most participating nurses were women (88.5%) and worked in adult acute care (54.2%). The mean age was 25.5 (SD = 7.5) years. On average, they had worked in the nursing profession for 7 years. 17.1% of the participants had received training on sexual harassment. Overall, 95.6% of the participants reported experiencing sexual harassment of any type at least once in the last 12 months. The most common type of harassment was verbal sexual harassment. Notably, sexual harassment was statistically significantly more frequent the younger the nurses were [rs = -0.13, p = 0.046]. Furthermore, it was statistically significantly more prevalent in adult acute care than in paediatrics [H (10) = 18.4; p = 0.048; Cohen's d = 0.4]. Conclusions: Patients' sexual harassment of participant nurses and nursing students is highly common. The high prevalence of sexual harassment and low number of nurses who have received training on sexual harassment demonstrate the need for initiatives to address this phenomenon in the basic education of nurses. Furthermore, evidence-based interventions against sexual harassment in the nursing profession are needed.

Psychosocial Impact of Multiple Sclerosis on Couples: Relationship Between Anxiety, Depression, and Stress Communication of Both Partners.

BACKGROUND: Multiple Sclerosis (MS) influences the relationships of affected couples, whereby the disease-related stress can lead to a deterioration of communication. This, in turn, makes it difficult for the couples to cope successfully. To support couples affected by MS for coping with the disease, the first step in developing an intervention is to examine whether this situation also applies in the Swiss context. METHODS: A cross-sectional study was conducted to examine the psychosocial situation of couples where 1 partner has MS, regarding anxiety, depression, and stress communication. The Hospital Anxiety and Depression Scales (HADS-D) were used to assess depression and anxiety in both partners of 462 couples, while their stress communication was assessed using questions formulated according to the corresponding subscales of the Dyadic Coping Inventory (DCI). A comparison of the assessments of both partners was performed using the Mann-Whitney U test. Furthermore, the relationship between their stress communication and the severity of anxiety and depression was calculated using Spearman's rank correlation. RESULTS: Life partners rated the stress communication of their partners with MS significantly higher than the partners with MS themselves. Moreover, life partners could not distinguish whether their partners with MS expressed a sense of burden or a need for support. These findings indicate that the stress communication skills of both partners show potential for optimization. Health status regarding depression and anxiety revealed the following: 34.2% of the persons with MS and 34% of their life partners experienced clinically high levels of anxiety (HADS-D/A ≥ 8.0), and 31.4% of those with MS and 20.2% of the life partners showed clinically high levels of depression (HADS-D/D ≥ 8.0). CONCLUSION: In the Swiss context, psychosocial intervention, which includes communication training for both partners, might be effective in improving the health status regarding depression and anxiety as well as the stress communication.

[Psychosocial interventions for couples living with cancer. A literature review]. / Psychosoziale Interventionen für Paare, die mit einer Krebserkrankung leben. Eine Literaturübersicht.

Couples experience cancer as a dyad. Step by step, they have to learn to integrate the illness into their lives. It can be assumed that psychosocial nursing interventions would offer them helpful support. Yet, there is no evidence showing which interventions are the most effective in supporting the couple in the illness management. This literature review was undertaken to explore this issue and was guided by following questions: 1) What kind of psychosocial intervention programmes exist for couples experiencing cancer? 2) Which instruments were used to measure the effectiveness of the interventions and what were the results? 3) What was the contribution of the interventions to an improved dyadic illness management process? Five articles were retrieved that met both the in- and exclusion criteria. The intervention programs varied regarding content and structures. The instruments used in the studies were very heterogeneous, making comparisons difficult. Even so, the results of the review found that psychosocial interventions decreased the levels of depression and hopelessness in both partners. The interventions also made it easier for the partners to advise and support each other in everyday situations. The conclusion was drawn that targeted information materials, structured information, and professional support represent effective psychosocial nursing interventions for couples living with cancer.

[Survey of work schedules of Swiss intensive care units and assessment of their possible impact on nurses]. / Erhebung und Bewertung der Gesundheits- verträglichkeit der Arbeitszeitmodelle Schweizer Intensivpflegestationen.

Work schedules impact significantly on the health and well-being of health care professionals. The prevailing schedules can place the care providers 'at risk both psychologically and physically as well as in their social and private sphere. The added burden of daily activities in intensive care units (ICUs) intensifies these effects. The present quantitative study was designed to determine the range of work schedules currently in practice in intensive care units in Switzerland and to assess their possible health impact on nurses. Furthermore, it assessed how the organizational context differs between intensive care units with better and worse work schedules. A questionnaire was developed, pilot tested, and distributed to 84 ICUs in Switzerland. All 84 professionals responsible for designing the work schedules of nurses on ICUs were requested to fill out the questionnaire. The collected data were analyzed using descriptive statistical methods. To assess the health impact of the work schedules, a method was developed which considers the most important health relevant dimensions of the work schedules for a global estimate. Finally, the most extreme groups regarding the health impact of the working schedules were compared regarding their organizational context using non-parametric and parametric tests. The findings show that the working schedules in ICUs could be considerably improved, particularly regarding duration and density of working hours as well as regarding supportive structures of the hospitals.