Evolution of post-traumatic growth during the first 12 months of dialysis: A longitudinal study.

BACKGROUND: Initiating dialysis can produce psychological benefits. These positive changes, most frequently referred to as posttraumatic growth (PTG), have not previously been explored in these patients. OBJECTIVE: To identify patterns in the temporal course of PTG in patients during their first 12 months of dialysis, and to relate to perceived stress. DESIGN: A prospective, longitudinal, observational study. SETTING AND METHODS: The sample included 98 patients, aged from 18 to 70 years, who commenced dialysis in the nine nephrology units of the Basque Country, Spain. Three assessments were carried out at 1, 6 and 12 months, using a PTG questionnaire and the Perceived Stress Scale. ANOVAs with post-hoc analysis were performed to identify significant differences between the groups. RESULTS: Four groups were established based on the observed changes in PTG over time: high, increasing, decreasing and low PTG. Maintaining high PTG and decreasing PTG levels was associated with moderate levels of perceived stress. CONCLUSION: Four different patterns of PTG have been identified, contributing to our understanding of the dynamics of the process of growth and enabling us to identify patients who may be more vulnerable.

Online training course on critical appraisal for nurses: adaptation and assessment.

BACKGROUND: Research is an essential activity for improving quality and efficiency in healthcare. The objective of this study was to train nurses from the public Basque Health Service (Osakidetza) in critical appraisal, promoting continuous training and the use of research in clinical practice. METHODS: This was a prospective pre-post test study. The InfoCritique course on critical appraisal was translated and adapted. A sample of 50 nurses and 3 tutors was recruited. Educational strategies and assessment instruments were established for the course. A course website was created that contained contact details of the teaching team and coordinator, as well as a course handbook and videos introducing the course. Assessment comprised the administration of questionnaires before and after the course, in order to explore the main intervention outcomes: knowledge acquired and self-learning readiness. Satisfaction was also measured at the end of the course. RESULTS: Of the 50 health professionals recruited, 3 did not complete the course for personal or work-related reasons. The mean score on the pre-course knowledge questionnaire was 70.5 out of 100, with a standard deviation of 11.96. In general, participants' performance on the knowledge questionnaire improved after the course, as reflected in the notable increase of the mean score, to 86.6, with a standard deviation of 10.00. Further, analyses confirmed statistically significant differences between pre- and post-course results (p < 0.001). With regard to self-learning readiness, after the course, participants reported a greater readiness and ability for self-directed learning. Lastly, in terms of level of satisfaction with the course, the mean score was 7 out of 10. CONCLUSIONS: Participants significantly improved their knowledge score and self-directed learning readiness after the educational intervention, and they were overall satisfied with the course. For the health system and nursing professionals, this type of course has the potential to provide methodological tools for research, promote a research culture, and encourage critical thinking for evidence-based decision making.