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1.
Aust N Z J Obstet Gynaecol ; 62(2): 286-293, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34751946

RESUMO

BACKGROUND: Women with genetic mutations including BRCA1, BRCA2 and Lynch syndrome are at increased risk of developing gynaecological cancers with management options including surveillance and/or risk reduction surgery. Little is known about the information women require to inform their decisions around having risk reduction surgery, the implication this surgery has for them and the timing preferences to receive this information. AIMS: To identify the information needs of women who are considering or who have had risk reduction surgery due to having a diagnosed or suspected genetic mutation with subsequent increased risk of developing gynaecological cancer. MATERIALS AND METHODS: A pilot survey was undertaken in a tertiary, metropolitan hospital as part of a service improvement project. Women referred to the gynaecology-oncology service for gynaecological risk reduction surgery between January to December 2018 were invited to participate through completing either online or hard copy versions of a 12-item survey. RESULTS: A response rate of 60% (n = 32) was obtained from women between 27 and 77 years of age. Key information topics included sexuality and intimacy (90.6%; n = 29), the surgery itself (87.5%; n = 28) and surgical menopause (87.5%; n = 28). Over 90% (n = 31) of respondents stated they preferred to receive information about surgery pre-operatively and in written format (81.3%; n = 26). The importance of a multidisciplinary approach was recognised with women wanting information from allied health practitioners such as physiotherapists and social workers. CONCLUSIONS: Findings have enabled a better understanding of the type, timing and content of information desired by women making complex decisions about risk reduction surgery. Results have contributed to developing an information resource which will more adequately assist women to meet their information needs when considering gynaecological risk reduction surgery in our hospital.


Assuntos
Neoplasias dos Genitais Femininos , Ginecologia , Feminino , Neoplasias dos Genitais Femininos/cirurgia , Procedimentos Cirúrgicos em Ginecologia , Humanos , Medidas de Resultados Relatados pelo Paciente , Comportamento de Redução do Risco
2.
Aust Crit Care ; 34(5): 510-517, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33272768

RESUMO

BACKGROUND: Readmission after percutaneous coronary intervention is common in the early postdischarge period, often linked to limited opportunity for education and preparation for self-care. Attending a nurse-led clinic within 30 d after discharge has the potential to enhance health outcomes. OBJECTIVE: The aim of the study was to synthesise the available literature on the effectiveness of nurse-led clinics, during early discharge (up to 30 d), for patients who have undergone percutaneous coronary intervention. REVIEW METHOD USED: A systematic review of randomised and quasi-randomised controlled trials was undertaken. DATA SOURCES: The databases included PubMed, OVID, CINAHL, EMBASE, the Cochrane Library, SCOPUS, and ProQuest. REVIEW METHODS: Databases were searched up to November 2018. Two independent reviewers assessed studies using the Cochrane risk-of-bias tool. RESULTS: Of 2970 articles screened, only four studies, representing 244 participants, met the review inclusion criteria. Three of these studies had low to moderate risk of bias, with the other study unclear. Interventions comprised physical assessments and individualised education. Reported outcomes included quality of life, medication adherence, cardiac rehabilitation attendance, and psychological symptoms. Statistical pooling was not feasible owing to heterogeneity across interventions, outcome measures, and study reporting. Small improvements in quality of life and some self-management behaviours were reported, but these changes were not sustained over time. CONCLUSIONS: This review has identified an important gap in the research examining the effectiveness of early postdischarge nurse-led support after percutaneous coronary intervention on outcomes for patients and health services. More robust research with sufficiently powered sample sizes and clearly defined interventions, comparison groups, and outcomes is recommended to determine effectiveness of nurse-led clinics in the early discharge period.


Assuntos
Intervenção Coronária Percutânea , Padrões de Prática em Enfermagem , Assistência ao Convalescente , Humanos , Alta do Paciente , Qualidade de Vida
3.
BMC Med Educ ; 19(1): 267, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319892

RESUMO

BACKGROUND: Undergraduate students across health professions are required to be capable users of evidence in their clinical practice after graduation. Gaining the essential knowledge and clinical behaviors for evidence-based practice can be enhanced by theory-based strategies. Limited evidence exists on the effect of underpinning undergraduate EBP curricula with a theoretical framework to support EBP competence. A systematic review was conducted to determine the effectiveness of EBP teaching strategies for undergraduate students, with specific focus on efficacy of theory-based strategies. METHODS: This review critically appraised and synthesized evidence on the effectiveness of EBP theory-based teaching strategies specifically for undergraduate health students on long or short-term change in multiple outcomes, including but not limited to, EBP knowledge and attitudes. PubMed, CINAHL, Scopus, ProQuest Health, ERIC, The Campbell Collaboration, PsycINFO were searched for published studies and The New York Academy of Medicine, ProQuest Dissertations and Mednar were searched for unpublished studies. Two independent reviewers assessed studies using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. RESULTS: Twenty-eight studies reporting EBP teaching strategies were initially selected for review with methodological quality ranging from low to high. Studies varied in course duration, timing of delivery, population and course content. Only five included papers reported alignment with, and detail of, one or more theoretical frameworks. Theories reported included Social Cognitive Theory (one study), Roger's Diffusion of Innovation Theory (two studies) and Cognitive Apprenticeship Theory (one study). Cognitive Flexibility Theory and Cognitive Load Theory were discussed in two separate papers by the same authors. All but one study measured EBP knowledge. Mixed results were reported on EBP knowledge, attitudes and skills across the five studies. CONCLUSIONS: EBP programs for undergraduate health students require consideration of multiple domains, including clinical behaviors, attitudes and cognitive learning processes; Interventions grounded in theory were found to have a small but positive effect on EBP attitudes. The most effective theory for developing and supporting EBP capability is not able to be determined by this review therefore additional rigorous research is required.


Assuntos
Competência Clínica , Currículo , Prática Clínica Baseada em Evidências/educação , Ocupações em Saúde/educação , Estudantes de Ciências da Saúde/estatística & dados numéricos , Feminino , Humanos , Masculino , Modelos Teóricos , Estados Unidos , Adulto Jovem
4.
Worldviews Evid Based Nurs ; 16(5): 397-407, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31274232

RESUMO

BACKGROUND: Despite curriculum requirements for evidence-based practice (EBP) to be a key component of undergraduate health students' training, few studies have investigated factors influential to students' intention to use EBP after graduation. Self-efficacy is known to mediate and motivate behavior; therefore, it may be a crucial factor linking undergraduate students' EBP education and adoption of positive EBP behaviors. AIMS: To develop, test, and validate a multivariate, theory-based prediction model with the outcome of students' intention to use EBP after graduation. METHODS: A correlational study with structural equation modeling was conducted. Model factors were determined from Bandura's self-efficacy theory and previous literature. An online survey comprised of seven validated scales and a demographic tool was distributed to a sample of undergraduate nursing and paramedic students. Two episodes of data collection were conducted to test and validate the model. RESULTS: Evidence-based practice beliefs directly and significantly influenced student intention to use EBP in both models. Sources of EBP self-efficacy also had significant but indirect influence on the outcome variable. Overall variance for intention to use EBP was 25% for the initial model and 18% for the validated model. LINKING EVIDENCE TO ACTION: Evidence-based practice curriculum that supports positive EBP beliefs and integrates Bandura's sources of self-efficacy has potential to positively influence students' intention to use EBP after graduation.


Assuntos
Enfermagem Baseada em Evidências/educação , Previsões/métodos , Estudantes de Enfermagem/psicologia , Adulto , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/normas , Bacharelado em Enfermagem/estatística & dados numéricos , Enfermagem Baseada em Evidências/métodos , Feminino , Humanos , Intenção , Masculino , Psicometria/instrumentação , Psicometria/métodos , Reprodutibilidade dos Testes , Autoeficácia , Estudantes de Enfermagem/estatística & dados numéricos
5.
Worldviews Evid Based Nurs ; 15(2): 140-148, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29266816

RESUMO

BACKGROUND: Incorporating evidence-based practice (EBP) into clinical decision making and professional practice is a requirement for many health disciplines, yet research across health disciplines on factors that influence and predict student intention to use EBP following graduation has not been previously synthesized. AIM: To synthesize research on factors that influence development of EBP behaviors and subsequently predict undergraduate students' intention toward EBP uptake. METHODS: A systematic review of prediction modeling studies was conducted according to a protocol previously published on the Prospero database: https://www.crd.york.ac.uk/PROSPERO/. The outcome variable was undergraduate students' future use or intention to use EBP. Evidence synthesis methods were guided by resources from the Cochrane Methods Prognosis Group Web site (https://prognosismethods.cochrane.org). RESULTS AND FINDINGS: Only three studies were found to meet inclusion criteria for the review. Factors relating to EBP capability, EBP attitudes, as well as clinical and academic support were identified as influential toward students' intention to use evidence in practice. Heterogeneity limited data pooling, consequently, results are presented in narrative and tabular form. LINKING EVIDENCE TO ACTION: Although using a developing method, this review presents a unique contribution to further discussions regarding students' intention to use EBP following graduation. Despite limitations, consideration of identified factors for undergraduate curriculum could support student's intention to use EBP in their respective clinical environments.


Assuntos
Enfermagem Baseada em Evidências/educação , Pessoal de Saúde/educação , Intenção , Estudantes/psicologia , Atitude do Pessoal de Saúde , Currículo/normas , Humanos
7.
Worldviews Evid Based Nurs ; 11(3): 187-93, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24842532

RESUMO

BACKGROUND: Chemotherapy-related cognitive dysfunction (CRCD) refers to problems with memory, attention span, or concentration, experienced by patients with cancer who have had chemotherapy. CRCD can have a significant negative effect on a patient's quality of life. The exact cause of CRCD is unknown but is presumed to be multifactorial. OBJECTIVE: To conduct a systematic review of the effectiveness of psychosocial interventions designed to treat CRCD. METHODS: Participants of interest to the review were over 18 years of age, diagnosed with cancer, and receiving chemotherapy or had received chemotherapy in the past. Interventions of interest were methods to improve cognitive function. Included study designs were randomized controlled trials, quasi-experimental trials, and quantitative observational studies. The primary outcome of interest was level of cognitive function. A three-step search strategy was utilized to identify studies published from 1985 to 2011 from a wide range of databases. Joanna Briggs Institute systematic review methods were used but findings were analyzed using the Cochrane Collaboration Review Manager 5.1 program. Weighted mean differences with 95% confidence intervals were calculated from the continuous data. RESULTS: Searching identified 3,109 potentially relevant articles and 120 full-text articles were retrieved. Two further papers were sourced from reference lists of retrieved articles. From 122 papers, six were suitable for critical appraisal and six were included in the analysis. Meta-analysis was conducted on two cognitive behavioral therapy (CBT) trials for the outcome of inability to concentrate. Significant effect was seen for one CBT intervention at 20 weeks (p = .004). Significant effect from CBT on quality of life was seen at 6-month follow-up (p < .05). CONCLUSIONS: Despite some evidence of an effect, there is insufficient evidence at this stage to strongly recommend any of the interventions to assist in decreasing the effects of CRCD, except in terms of improving quality of life.


Assuntos
Transtornos Cognitivos/enfermagem , Transtornos Cognitivos/psicologia , Neoplasias/enfermagem , Neoplasias/psicologia , Enfermagem Oncológica/métodos , Apoio Social , Antineoplásicos/uso terapêutico , Enfermagem Baseada em Evidências/métodos , Humanos , Neoplasias/tratamento farmacológico
8.
JBI Evid Synth ; 22(4): 560-606, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-37851359

RESUMO

OBJECTIVE: The objective of this review was to determine the effect of educational programs that have been implemented in acute health care settings to manage or prevent aggressive behaviors toward staff perpetrated by patients, families, or visitors. INTRODUCTION: Health care staff working within acute-level and tertiary-level hospitals are at high risk of exposure to aggressive behaviors by patients, their family, or visitors. Negative staff and organizational impacts reported in the literature include individual psychological or emotional distress and severe harm, increased absenteeism, high staff turnover, and awarded compensation. Reports of this kind of occupational violence are increasing globally; therefore, strategies to address prevention and management are needed to mitigate the risk of harm to staff and the wider hospital service. Various educational activities have been implemented to address the issue, but the overall effect of these is unclear. INCLUSION CRITERIA: Experimental and quasi-experimental studies were considered for inclusion if they reported on an educational program or intervention for staff working within an acute hospital setting and aimed at managing or preventing occupational violence perpetrated by patients, family, or visitors. Reports of programs implemented to address occupational violence, whether verbal or physical, were included. Studies were excluded if they reported on upward violence or bullying, patients in psychiatric or dementia facilities, or pediatric patients, due to the specific care needs of these cohorts. METHODS: The following databases were searched: PubMed (PubMed Central), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Embase, ERIC (ProQuest), Cochrane Central Register of Controlled Trials (Cochrane Library), and Scopus. ProQuest Dissertations and Theses was searched for unpublished studies. To obtain a wider perspective of the issue, studies published in Chinese were also searched in WanFang Database, China National Knowledge Infrastructure, and Chongqing VIP. A date filter of 2008-2023 was applied in a deliberate effort to expand from previous work. No language filters were applied. The review was conducted in accordance with JBI methodology for systematic reviews of effectiveness, and reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: The search process retrieved 4681 citations. A total of 32 studies representing 3246 health staff were included in the review. The studies were either before-and-after or pre-test/post-test study designs. Methodological quality of studies varied, with the main issues being absence of CIs within statistical analysis, limited detail on participant selection or attrition/non-response, and underreporting of confounding factors. Educational programs varied in content and duration. Content delivery across the studies also varied, with several didactic, role-play, debriefing, group work, and simulation exercises reported. While studies reported some improvement in self-reported confidence levels, results were mixed for other outcomes. Determining overall effect of included studies was challenging due to heterogeneity within and across studies with regard to intervention types, populations, measurement tools, and outcomes. CONCLUSIONS: This review is unable to determine which workplace educational programs had an effect on staff outcomes or on the number of occupational violence incidents. In the future, educators and researchers could use the findings of this review to guide the design of educational programs and employ measures that are comparable to their settings. REVIEW REGISTRATION: PROSPERO CRD42020190538. SUPPLEMENTAL DIGITAL CONTENT: A Chinese-language version of the abstract of this review is available [ http://links.lww.com/SRX/A33 ].


Assuntos
Atenção à Saúde , Instalações de Saúde , Humanos , Criança , Exercício Físico , Hospitais , China
9.
JBI Evid Synth ; 22(3): 505-512, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38126358

RESUMO

OBJECTIVE: This review will explore the literature on contemporary incident analysis methods used in acute hospital settings, identifying types and characteristics of these methods and how they are used to minimize, prevent, or learn from errors and improve patient safety. INTRODUCTION: Safety is a major focus in health care; however, despite best efforts, errors and incidents still occur, leading to harm or potential harm to patients, families, carers, staff, or the organization. Incident analysis methods aim to reduce risk of harm. Traditional methods have been criticized for failing to consider the complexity of health care and the dynamic nature of acute care settings. Alternative methodologies are being sought to achieve higher levels of patient safety and care quality care in hospitals. Learning from errors and communicating with those involved in incidents are key requirements in contemporary incident analysis. INCLUSION CRITERIA: This review will consider empirical research published since 2013, reporting on the use of clinical incident analysis methods within acute care settings. The review will explore ways in which consumers or stakeholders (eg, clinicians or other hospital workers, patients, families, carers, visitors) have been included in these analysis methods and how data have been used to support changes in the service or organization. METHODS: Following JBI methods and PRISMA-ScR reporting guidance, we will search PubMed, CINAHL (EBSCOhost), Embase, Scopus, the Cochrane Library, Web of Science, and ProQuest Dissertations and Theses. Studies will be reviewed independently, with results presented in tables, figures, and narrative summaries according to the concepts of interest.

10.
J Palliat Care ; 38(4): 456-464, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36740947

RESUMO

Objective: Dignity therapy is a short-term psychotherapy used to help patients at end of life through addressing distress and enhancing dignity. The objective of this study was to assess the effectiveness and feasibility of introducing dignity therapy into a hospital-based cancer care service. Methods: A feasibility study was undertaken using a randomised controlled trial design. Participants were adult patients receiving systemic treatment for cancer or haematological malignancy with palliative intent, within an Australian ambulatory cancer treatment centre. Outcomes of interest were patient distress levels and feasibility of intervention delivery. Participants completed two self-reported distress scales at recruitment and four weeks following (control group) or one month after intervention delivery (intervention group). Patients receiving the intervention also completed the dignity therapy patient feedback questionnaire. Feasibility was measured by collecting data on time required to implement the intervention with subsequent crude cost estimates calculated. Study procedures are reported according to CONSORT guidance. Results: Fifteen patients were recruited for the study. Participants in the intervention group reported small but significantly different lower distress scores than those in the control group at 4 weeks. The time taken to deliver the intervention ranged from 5.5 to 11 h with subsequent cost dependent on the remuneration of the dignity therapy therapist. Conclusions: Findings support other studies on the benefit to patients from delivering a dignity therapy intervention at end of life. Feasibility is influenced by multidisciplinary team support, resource availability and the designated therapist delivering the intervention. Larger sample sizes are needed to ascertain effect.


Assuntos
Neoplasias , Assistência Terminal , Adulto , Humanos , Estudos de Viabilidade , Respeito , Austrália , Assistência Terminal/métodos , Neoplasias/terapia , Morte
11.
JBI Evid Synth ; 21(4): 769-776, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36214502

RESUMO

OBJECTIVE: The objective of this scoping review is to map the available literature on the role of specialist lung cancer nurses. INTRODUCTION: The international literature acknowledges the importance of specialist cancer nurses who provide supportive care to patients. Historically, however, there has been a lack of consistent evidence to inform development and implementation of the role. INCLUSION CRITERIA: This review will consider quantitative and qualitative studies of any design or methodology that report on role characteristics or behaviors, practices, or activities, or other aspects of specialist lung cancer nurses in the acute care setting. Systematic reviews, professional body reports, as well as unpublished or published studies and reports will also be considered for inclusion. Textual or opinion papers will be excluded. METHODS: This review will follow the JBI methodology for scoping reviews. Relevant papers from 2006 to 2022, in any language, will be searched for in the following databases and registries: MEDLINE (PubMed), CINAHL (EBSCO), Web of Science, Embase, and the Cochrane Register of Controlled Trials. Websites to be searched will include the World Health Organization, International Council of Nurses, and Agency for Healthcare Research and Quality. ProQuest Dissertations and Theses (ProQuest) and Grey Matters (CADTH) will be searched for unpublished literature. Results will be presented in tabular and narrative format and mapped according to the specified concepts of interest, as well as to the domains of practice for specialist nursing roles.


Assuntos
Neoplasias Pulmonares , Enfermeiras e Enfermeiros , Humanos , Cuidados Críticos , Pesquisa Qualitativa , Literatura de Revisão como Assunto
12.
Nurse Educ Pract ; 67: 103547, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36669295

RESUMO

AIM: This project aimed to evaluate student and staff satisfaction with, and perspectives on, changes to delivery and format of the Medication Unit of Competency within a Diploma of Nursing Program. BACKGROUND: Medication safety is an integral component of learning for pre-registration nursing students. The COVID-19 pandemic required rapid changes to be made to the medication competency unit being taught to students within a Diploma of Nursing, pre-registration course. Changes to sequencing of theory, mode of education delivery, class sizes, available resources and learning support were required. DESIGN: A multi-method evaluation process was conducted. The project is reported as per SQUIRE-EDU guidelines. METHODS: Focus groups and survey data were obtained from staff and students in December 2020, to evaluate responses to the changes. Student exam results and the number of learning support consultations accessed were also assessed to identify impact of changes. RESULTS: Staff and student evaluation identified mixed responses but overall, the change in sequence of theory and mode of delivery was positively received. Crude comparisons of final assessment results revealed improved marks compared to the previous cohort. The addition of an online medication resource was utilised by most students. The agility of staff in responding to the challenges was highlighted in the staff focus group and additional, flexible learning support was favourably received by students. CONCLUSIONS: Despite the need for rapid changes being made to the course, positive responses were received from both staff and students. Some students preferred the traditional sequencing of learning as they felt it matched their learning style. An added online resource and extra learning support supported student self-efficacy development of medication competency; however further research is needed to ascertain any associations. The online resource is still being utilised within course curriculum.


Assuntos
COVID-19 , Estudantes de Enfermagem , Humanos , Pandemias , Aprendizagem , Currículo , Estudantes
13.
AORN J ; 117(6): e1-e9, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37235623

RESUMO

Women receiving intrathecal morphine for cesarean delivery may experience hypothermia with paradoxical symptoms of sweating, nausea, and shivering. Despite being relatively rare in comparison to commonly experienced symptoms of perioperative hypothermia, hypothermia with paradoxical symptoms affects early maternal recovery and comfort. The cause is undetermined, and treatment approaches vary. Regular active-warming strategies may not be tolerated because of the paradoxical symptoms of sweating and feeling overheated. This case series aims to explore the phenomenon through the evaluation of health care records of women receiving intrathecal morphine for cesarean delivery at a single, tertiary health care institution in Australia from 2015 to 2018. We also summarize published literature to review treatment approaches used in the care of women experiencing profound heat loss while feeling overheated.


Assuntos
Hipotermia , Gravidez , Feminino , Humanos , Morfina/farmacologia , Regulação da Temperatura Corporal , Estremecimento , Analgésicos Opioides/uso terapêutico
14.
BMJ Open ; 13(11): e077472, 2023 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-37963694

RESUMO

OBJECTIVES: To develop a consensus on evidence-based principles and recommendations for perioperative hypothermia prevention in the Australian context. DESIGN: This study was informed by CAN-IMPLEMENT using the ADAPTE process: (1) formation of a multidisciplinary development team; (2) systematic search process identifying existing guidance for perioperative hypothermia prevention; (3) appraisal using the AGREE II Rigor of Development domain; (4) extraction of recommendations from guidelines meeting a quality threshold using the AGREE-REX tool; (5) review of draft principles and recommendations by multidisciplinary clinicians nationally and (6) subsequent round of discussion, drafting, reflection and revision by the original panel member team. SETTING: Australian perioperative departments. PARTICIPANTS: Registered nurses, anaesthetists, surgeons and anaesthetic allied health practitioners. RESULTS: A total of 23 papers (12 guidelines, 6 evidence summaries, 3 standards, 1 best practice sheet and 1 evidence-based bundle) formed the evidence base. After evidence synthesis and development of draft recommendations, 219 perioperative clinicians provided feedback. Following refinement, three simple principles for perioperative hypothermia prevention were developed with supporting practice recommendations: (1) actively monitor core temperature for all patients at all times; (2) warm actively to keep body temperature above 36°C and patients comfortable and (3) minimise exposure to cold at all stages of perioperative care. CONCLUSION: This consensus process has generated principles and practice recommendations for hypothermia prevention that are ready for implementation with local adaptation. Further evaluation will be undertaken in a large-scale implementation trial across Australian hospitals.


Assuntos
Hipotermia , Humanos , Hipotermia/prevenção & controle , Consenso , Austrália , Temperatura Corporal , Assistência Perioperatória
15.
JBI Evid Synth ; 21(5): 970-976, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-36692443

RESUMO

OBJECTIVE: The aim of this scoping review is to describe the literature reporting on ethical challenges faced by nurses during the COVID-19 pandemic, including the contextual characteristics of ethical challenges, and the strategies to address these challenges. INTRODUCTION: The COVID-19 pandemic presented many ethical challenges to nurses, ranging from allocating scarce resources, to balancing a duty of care with self-preservation, and implementing visitation restrictions. Internationally, there has been a range of reported issues, but few studies have described strategies to overcome these challenges. INCLUSION CRITERIA: Studies that report on ethical challenges faced by nurses while caring for patients during the COVID-19 pandemic will be included. Studies that report on strategies to address these challenges will also be considered for inclusion. METHODS: This scoping review will be conducted in accordance with the methods outlined by JBI and reported using PRISMA-ScR guidance. The following databases will be searched for eligible studies from November 2019 to present day: PubMed, CINAHL, Ovid, PsycINFO, the Cochrane Library, and Scopus. No language restrictions will be applied. Studies will be reviewed for inclusion by 2 independent reviewers and a data extraction form developed specifically for this review will be used to extract data relevant to the review questions. Results will be analyzed and presented according to the concepts of interest, using tables, figures, images, and supporting narrative synthesis.


Assuntos
COVID-19 , Humanos , Pandemias , Bases de Dados Factuais , Revisões Sistemáticas como Assunto , Literatura de Revisão como Assunto
16.
J Adv Nurs ; 68(6): 1369-79, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22032475

RESUMO

AIM: This study reports the use of exploratory factor analysis to determine construct validity of a modified advanced practice role delineation tool. BACKGROUND: Little research exists on specific activities and domains of practice within advanced practice nursing roles, making it difficult to define service parameters of this level of nursing practice. A valid and reliable tool would assist those responsible for employing or deploying advanced practice nurses by identifying and defining their service profile. This is the third article from a multi-phase Australian study aimed at assigning advanced practice roles. METHODS: A postal survey was conducted of a random sample of state government employed Registered Nurses and midwives, across various levels and grades of practice in the state of Queensland, Australia, using the modified Advanced Practice Role Delineation tool. Exploratory factor analysis, using principal axis factoring was undertaken to examine factors in the modified tool. Cronbach's alpha coefficient determined reliability of the overall scale and identified factors. RESULTS: There were 658 responses (42% response rate). The five factors found with loadings of ≥400 for 40 of the 41 APN activities were similar to the five domains in the Strong model. Cronbach's alpha coefficient was 0·94 overall and for the factors ranged from 0·83 to 0·95. CONCLUSION: Exploratory factor analysis of the modified tool supports validity of the five domains of the original tool. Further investigation will identify use of the tool in a broader healthcare environment.


Assuntos
Prática Avançada de Enfermagem , Papel do Profissional de Enfermagem , Padrões de Prática em Enfermagem , Adulto , Idoso , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa em Avaliação de Enfermagem , Queensland , Reprodutibilidade dos Testes , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-35409455

RESUMO

This study explored the feasibility of using experience-based co-design methods (EBCD), based on participatory action principles, to improve service delivery regarding parent information needs within a metropolitan postnatal maternity unit. Data were collected from January 2018 to March 2019 from parents and staff using surveys, video interviews, a focus group and ward observations of episodes where parents were provided information. Participants included postnatal mothers who had recently given birth, their partners and hospital staff. Survey results (n = 31) were positive regarding content and satisfaction with information delivery. Data from the staff focus group (seven participants) and in-depth video interviews with mothers (n = 4) identified common themes, including challenges to information delivery due to time pressures, the value of breastfeeding advice and environmental influences. Overall, parents were satisfied with the information delivered; however, inconsistencies were present, with time pressures and other environmental factors reported as influencing the process. Staff and parents both identified the amount of content being delivered in such a short time frame as a major challenge and tailoring information was difficult due to individual experiences and circumstances. Additional resources or alternative methods are suggested for conducting future studies to capture patient experience within a similar busy hospital setting.


Assuntos
Serviços de Saúde Materna , Estudos de Viabilidade , Feminino , Grupos Focais , Humanos , Gravidez , Inquéritos e Questionários
18.
Artigo em Inglês | MEDLINE | ID: mdl-36141433

RESUMO

Patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs) and patient satisfaction surveys provide important information on how care can be improved. However, data collection does not always translate to changes in practice or service delivery. This scoping review aimed to collect, map and report on the use of collected patient-reported data used within acute healthcare contexts for improvement to care or processes. Using JBI methods, an extensive search was undertaken of multiple health databases and trial registries for published and unpublished studies. The concepts of interest included the types and characteristics of published patient experience and PROMs research, with a specific focus on the ways in which data have been applied to clinical practice. Barriers and facilitators to the use of collected data were also explored. From 4057 records, 86 papers were included. Most research was undertaken in North America, Canada or the UK. The Hospital Consumer Assessment of Healthcare Providers and Systems tool (HCAHPS) was used most frequently for measuring patient satisfaction. Where reported, data were applied to improve patient-centred care and utilization of health resources. Gaps in the use of patient data within hospital services are noticeable. Engaging management and improving staff capability are needed to overcome barriers to implementation.


Assuntos
Satisfação do Paciente , Assistência Centrada no Paciente , Humanos , Medidas de Resultados Relatados pelo Paciente , Sistema de Registros , Inquéritos e Questionários
19.
JBI Evid Synth ; 20(7): 1821-1826, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35689172

RESUMO

OBJECTIVE: The objective of this review is to evaluate the effectiveness of social activity interventions for improving sleep among older people. INTRODUCTION: Sleep is one of the most important functions for humans because it assists in maintaining health. Sleep disturbance is common in older people. Social activity has shown to be associated with better sleep in the older population; however, the effectiveness of these interventions is unclear. INCLUSION CRITERIA: This review will consider studies that include people aged 60 years or older. Any type of social activity intervention will be included. Outcomes will include both objective (eg, sleep time) and subjective sleep measures (eg, subjective sleep satisfaction). This review will consider both experimental and quasi-experimental study designs. METHODS: MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Library, and Ichushi web will be searched for eligible studies. Sources of unpublished studies and gray literature to be searched include OpenGrey and ProQuest Dissertations and Theses. Studies published in any language will be considered. No date filter will be applied. Titles and abstracts will be screened by two independent reviewers who will then assess the full text of selected citations against the inclusion criteria. Eligible studies will be critically appraised by the reviewers using the JBI critical appraisal instruments. Where possible, studies will be pooled using meta-analysis. Where statistical pooling is not possible, the findings will be presented in narrative form. The degree of certainty of the evidence on sleep outcomes will be assessed using the GRADE approach. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPEPO CRD42022315454.


Assuntos
Transtornos do Sono-Vigília , Sono , Idoso , Atenção à Saúde , Humanos , Metanálise como Assunto , Satisfação Pessoal , Literatura de Revisão como Assunto , Transtornos do Sono-Vigília/terapia , Revisões Sistemáticas como Assunto
20.
JBI Evid Synth ; 20(4): 1113-1119, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35013041

RESUMO

OBJECTIVE: The objective of this review is to determine the effectiveness of behavioral economic interventions for promoting uptake of and adherence to cancer screening recommended by guidelines. INTRODUCTION: Cancer screening has been found to help reduce incidence of and mortality from advanced cancer. However, adherence to recommended cancer screening services is low in asymptomatic adults with average risk, possibly due to systematic decision biases. The findings of this review will demonstrate whether interventions informed by behavioral economic insights can help improve uptake of and adherence to cancer screening. INCLUSION CRITERIA: This review will consider experimental, quasi-experimental, and analytical observational studies that i) evaluate the effects of behavioral economic interventions in adults eligible for guideline-recommended cancer screening; and ii) report the number/percentage of individuals who used screening services; number/percentage of individuals who completed screening recommended by guidelines; participant self-reported intentions, choice, and satisfaction regarding the use of screening services; detection rates of early-stage cancers; use of early intervention for cancers; and cancer-related mortality. METHODS: A systematic literature search will be performed by one reviewer. After removing duplicates, two reviewers will independently screen and appraise eligible studies according to the JBI methodology for systematic reviews of effectiveness. Five databases will be searched: CINAHL, the Cochrane Library, PsyclNFO, PubMed, and Web of Science. Sources of gray literature and registered clinical trials will also be searched for potential studies. There will be no limits on publication date or language. Data synthesis will be conducted using meta-analysis and narrative synthesis where appropriate. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021258370.


Assuntos
Detecção Precoce de Câncer , Neoplasias , Adulto , Economia Comportamental , Humanos , Programas de Rastreamento , Metanálise como Assunto , Neoplasias/diagnóstico , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto
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