Empowering Support for Family Members of Patients With Traumatic Brain Injury During the Acute Care: Insights From Family Members and Nurses.

AIM: To investigate the perceptions of family members (FMs) of patients with traumatic brain injury (TBI) and nurses on empowering support and its implementation during the acute phase within Finnish neurosurgical and neurological care in hospital settings, focusing on identifying similarities and differences in their viewpoints. DESIGN: Participatory qualitative descriptive study. METHODS: Data were collected from seven FMs and 11 nurses using the World Café method in November 2019. An abductive approach was employed for data analysis, combining deductive interpretation within the conceptual framework of empowering support and inductive content analysis. RESULTS: Four main themes were identified: (1) FMs' diverse information and guidance needs of TBI, treatment and its impact on family life, (2) support based on empowering FMs in participation, competence and decision-making, (3) empowering FMs through collaborative nursing practices and interprofessional support, and (4) internal and external hospital support enhancing and promoting the empowerment of FMs. CONCLUSION: The perceptions of FMs and nurses regarding empowering support were largely consistent, yet diverged in its implementation in nursing practice. Nurses play a crucial role in fostering the empowerment of FMs; however, further research is needed to explore the impact of organisational and community factors on the implementation of empowering support. IMPACT: Our study contributes to advancing nursing practices by underscoring the necessity for a paradigm shift towards a family-centred approach. Furthermore, it emphasises the urgency for standardising nursing practices to ensure equitable access to empowering support for FMs, applicable across various care settings for patients with TBI. PUBLIC CONTRIBUTION: This review is part of a larger research project in which FMs of patients with TBI and nurses were involved in designing the project. REPORTING METHOD: This study was reported using the Consolidated Criteria for Reporting Qualitative Checklist for qualitative studies.

Empowering Support for Family Members of Brain Injury Patients in the Acute Phase of Hospital Care: A Mixed-Methods Systematic Review.

This review aimed to identify and synthesize empowering support for the family members of patients in the acute phase of traumatic brain injury hospital treatment. CINAHL, PubMed, Scopus, and Medic databases were searched from 2010 to 2021. Twenty studies met the inclusion criteria. Each article was critically appraised using the Joanna Briggs Institute Critical Appraisals Tools. Following a thematic analysis, four main themes were identified about the process of empowering traumatic brain injury patients' family members in the acute phases of hospital care: (a) needs-based informational, (b) participatory, (c) competent and interprofessional, and (d) community support. This review of findings may be utilized in future studies focusing on designing, implementing, and evaluating an empowerment support model for the traumatic brain injury patient's family members in the acute care hospitalization to strengthen the current knowledge and develop nursing practices.

Registered nurses' psychological capital: A scoping review.

AIMS: The aim was to examine the extent and scope of empirical research concerning registered nurses' psychological capital. BACKGROUND: In a time of global nursing shortage, identifying variables that could positively contribute to the retention of the nursing workforce is essential. Prior research has shown that psychological capital correlates positively with employees' better performance and well-being. DESIGN: A scoping review. DATA SOURCES: A systematic literature search was conducted in the following databases: PubMed, CINAHL, PsycINFO, Web of Science and Scopus covering the period from 1 January 2005 to 7 May 2023. REVIEW METHODS: The JBI methodological guidance for scoping reviews was followed. The results were summarized narratively. RESULTS: A total of 111 studies reported in 114 peer-reviewed articles were included. Studies were carried out across 20 countries, with the majority from China (45), Australia (nine), Pakistan (nine), Canada (eight), South Korea (eight) and the United States (eight). A positive correlation was found between registered nurses' psychological capital and desirable work-related outcomes, such as work engagement, commitment and retention intention. CONCLUSION: A comprehensive overview of research evidence suggests that psychological capital is associated with many positive work-related outcomes and might therefore be a valuable resource for reducing nurse turnover.

Traumatic brain injury patients' family members' evaluations of the social support provided by healthcare professionals in acute care hospitals.

AIMS AND OBJECTIVES: The study aimed to examine traumatic brain injury (TBI) patient family members' (FMs) experiences of the support they received from healthcare professionals in acute care hospitals. BACKGROUND: The length of hospitalisation following TBI is constantly decreasing, and patients may return home with several problems. FMs care for the patients at home although they may not be prepared for the patient's medical needs or financial burden of the illness. The burden which some FMs experience can impair patient care and rehabilitation outcomes. Therefore, FMs require support during acute phases of TBI treatment. DESIGN: A structured questionnaire was sent to 216 TBI patients FMs. The response rate was 47% (n = 102). METHODS: A structured questionnaire-based on a systematic literature review and a previous questionnaire on TBI patient FMs' perceptions of support-was developed and used in the data collection. The questionnaire included 46 statements and 11 background questions. Data were collected via an electronic questionnaire. The STROBE checklist was followed in reporting the study. RESULTS: A factor analysis identified five factors that describe the guidance of TBI patient FMs: guidance of TBI patients' symptoms and survival; benefits of guidance; needs-based guidance; guidance for use of services; and guidance methods. Most of the FMs (51%-88%) felt that they had not received enough guidance from healthcare professionals in acute care hospitals across all five aspects of support. CONCLUSIONS: The content of guidance should be developed, and healthcare staff should be trained to consider a FM's starting point when providing guidance. A calm environment, proper timing, sufficient information in different forms and professional healthcare staff were found to be key factors to comprehensive guidance. Involving FMs in the discharge process and rehabilitation of their loved ones both supports the abilities of caregivers and promotes the outcome of the patient's rehabilitation. RELEVANCE TO CLINICAL PRACTICE: This study provides varied information on the need for social support of TBI patients FMs in the early stages of treatment from the FMs' perspective. This research adopted the FM's perspective to identify various areas of social support that need to be developed so that the FMs of TBI patients receive enough support during the early stages of TBI treatment.

Care Personnel's Attitudes and Fears Toward Care Robots in Elderly Care: A Comparison of Data from the Care Personnel in Finland and Japan.

PURPOSE: The aim of the study was to analyze and compare elderly care personnel attitudes toward care robots in Finland and Japan. DESIGN: Cross-sectional survey in Finland and Japan. METHODS: The Finnish sample was collected from care personnel in home care facilities in five municipalities in 2016. The Japanese sample was collected from personnel in two rehabilitative day centers and three residential care homes for the elderly in the north of Honshu Island in 2017. The data were analyzed using basic statistical methods and calculated descriptive statistics (frequencies). Differences between the Finnish and Japanese data have been analyzed using the Mann-Whitney U test. FINDINGS: Overall, Japanese care personnel assessed the usefulness of robots more positively than did their Finnish counterparts. The data showed substantial national differences in the perceived importance of various potential tasks for care robots. The findings show that there are also certain fears related to the introduction of care robots, in particular among the Finnish care personnel. DISCUSSION: The data from the Japanese care personnel bring new perspectives to the concept of a close human-robot relationship. The differences seen in the results between Finland and Japan can be partly explained by cultural dissimilarity, but it is also known that Japan is a more developed country with regard to the use of robotics in nursing care. The research highlights the importance of cultural factors when examining the issue of care robotics. The factors affecting fear are a concern that care robots would be used to replace people, the dehumanization of treatment, and an increased loneliness in the elderly. Thus, further research is required to demonstrate the relationship between different cultural factors, and attitudes and conceptions toward care robots. CLINICAL RELEVANCE: Management plays a key role when implementing robotics. It is important to help care personnel accept care robots, and to diminish any fears that their introduction would make the treatment of elderly people inhumane or in some way add to their loneliness. As such, education is crucial in changing attitudes and making care personnel understand that care robots can perform routine tasks, allowing care personnel to focus on providing improved care and nursing.

The adoption of care robots in home care-A survey on the attitudes of Finnish home care personnel.

AIMS AND OBJECTIVES: This article examines the attitudes of Finnish home care registered nurses, licensed vocational nurses and other health and social care personnel towards the introduction and use of care robots in home care. BACKGROUND: The significance of care robotics has been highlighted in recent years. However, personnel-related social psychological barriers to the introduction of care robots have been given very little study. DESIGN: Cross-sectional study conducted by questionnaire. The theoretical framework of the study is based on Ajzen's theory of planned behaviour and the research discussion about attitudes towards robots. METHODS: The research data were collected in five municipalities in different parts of Finland in 2016, and the questionnaire was answered by a total of 200 home care workers. The research data were analysed using exploratory factor analysis, Pearson product-moment correlation, one-way analysis of variance and linear regression analysis. RESULTS: The results are consistent with Ajzen's theory and previous studies on the acceptance of information systems in health care. Personnel behavioural intentions related to the introduction of robot applications in home care are influenced by their personal appreciation of the usefulness of robots, the expectations of their colleagues and supervisors, as well as by their own perceptions of their capacity to learn to use care robots. In particular, personnel emphasised the value of care robots in providing reminders and guidance, as well as promoting the safety of the older people. CONCLUSIONS: The study shows that an intimate human-robot relationship can pose a challenge from the perspective of the acceptance of care robots. RELEVANCE TO CLINICAL PRACTICE: From the perspective of the introduction of care robots in home care, personnel training and the construction of a positive working atmosphere play a key role. In addition, the introduction of robots requires further consideration of a number of ethical issues.

Attitudes towards care robots among Finnish home care personnel - a comparison of two approaches.

STUDY'S RATIONALE: The significance of care robotics has been highlighted in recent years. AIMS AND OBJECTIVE: The article examines the adoption of care robots in home care settings, and in particular Finnish home care personnel's attitudes towards robots. The study compares the importance of the Negative Attitudes towards Robots Scale advanced by Nomura and specific positive attitudes related to the usefulness of care robots for different tasks in the home care. METHODOLOGICAL DESIGN: A cross-sectional study conducted by questionnaire. The research data were gathered from a survey of Finnish home care personnel (n = 200). RESEARCH METHODS: Exploratory factor analysis, Pearson's correlation coefficient and linear regression analysis. MEASURES: The Negative Attitudes towards Robots Scale (NARS), by Nomura, with a specific behavioural intention scale based on Ajzen's theory of planned behaviour, and a measure of positive attitudes towards the usefulness of care robots for different tasks in home care and the promotion of independent living of older persons. RESULTS: The study shows that NARS helps to explain psychological resistance related to the introduction of care robots, although the scale is susceptible to cultural differences. Care personnel's behavioural intentions related to the introduction of robot applications are influenced also by the perception of the usefulness of care robots. STUDY LIMITATIONS: The study is based only on a Finnish sample, and the response rate of the study was relatively small (18.2%), which limits the generalisability of the results. CONCLUSIONS: The study shows that the examination of home care personnel's attitudes towards robots is not justified to focus only on one aspect, but a better explanation is achieved by combining the perspectives of societal attitudes, attitudes related to psychological reactions and the practical care and promotion of the independent living of older people.

The provision of emotional support to the families of traumatic brain injury patients: perspectives of Finnish nurses.

AIMS AND OBJECTIVES: To examine nursing staff's perceptions about how often they provide interventions of emotional support and the level of competence needed on neurosurgical wards to support traumatic brain injury patients' family members. BACKGROUND: Traumatic brain injury in one individual affects the health of their whole family. Studying the emotional support provided by nursing staff is important because such support is crucial for the family members of a traumatic brain injury patient during the acute phase of treatment. Members of the nursing staff provide emotional support to family members by consoling them; this alleviates insecurity, anxiety, hopelessness and depression. DESIGN: A structured self-reported questionnaire presented to 172 nurses working on neurosurgical wards. The response rate was 67% (n = 115). METHODS: Descriptive statistics were used to determine how often nurses provided emotional support to the traumatic brain injury patients family members and one-way anova to examine the relationships between the background variables and the respondents' evaluations of how often they gave emotional support to brain injury patients' family members. RESULTS: Thirty-seven percentage of nurses stated that they always took account of family members' individuality and 65% that they were always respectful. All registered nurses and staff members with long work experience (21 years or more) on a neurosurgical ward reported that they took family members' feelings of anger and guilt into consideration slightly more often than other nursing staff did. Most nurses considered these skills to represent basic competencies. CONCLUSION: Further service training on dealing with difficult emotions of traumatic brain injury patients' family members could help nurses to face these situations. Both education and work experience affected the frequency at which nursing staff provided emotional support to traumatic brain injury patients' family members. RELEVANCE TO CLINICAL PRACTICE: The results are relevant for example when planning specialised studies or in-service training for neuro-nurses, as well as when selecting the subjects to be addressed during the orientation of a new staff member. In addition, the results should help nursing staff to understand their role in the emotional support of family members.

The introduction of care robots as a leadership challenge in home care facilities in Finland.

AIMS: This paper analyses the factors that influence home care employees' intention to introduce robots. BACKGROUND: The introduction of different kinds of care robots is a topical issue in elderly care now and in the near future. METHODS: Cross-sectional research conducted through a questionnaire. The survey data (N = 162) were collected in five locations around Finland in 2019. The analysis was carried out by regression analysis, Sobel test and by Hayes' bootstrapping method. RESULTS: The results show that self-efficacy is pivotal in the willingness to introduce care robots. Employees' age increases the enthusiasm to introduce robots but reduces self-efficacy. Work engagement does not correlate with self-efficacy or behavioural intention related to the introduction of care robots. CONCLUSIONS: The present paper reveals the significance of attitudes, cognitive factors and age in the adoption of care robots in home care facilities. PRACTICAL IMPLICATIONS: It is important to pay attention to supporting the employees' sense of technology management and the construction of a robot-positive atmosphere when introducing care robots, and the development of skills of older employees and employees with a lower educational level should be supported.

A systematic review of mentoring nursing students in clinical placements.

AIM AND OBJECTIVE: This systematic review describes mentoring of nursing students in clinical placements. BACKGROUND: Mentoring in nursing has been widely investigated, but mentoring among students has remained vague. There is no universal agreement on student mentoring in nursing placements; therefore, mentoring approaches vary. A unified description of student mentoring is needed to ensure the quality of placement learning in nursing organisations. DESIGN: Systematic review. METHOD: The data were collected from nursing research articles over 20 years (1986-2006). The articles (n = 23) were analysed using inductive content analysis. RESULTS: Mentoring of nursing students in clinical placements was described according to two themes: (1) facilitating nursing students' learning by creating supportive learning environments and enabling students' individual learning processes, (2) strengthening students' professionalism by empowering the development of their professional attributes and identities and enhancing attainment of students' professional competence in nursing. DISCUSSION: This description of student mentoring in nursing clinical placements integrates environmental, collegial, pedagogical and clinical attributes. To ensure effective student mentoring, an individual mutual relationship is important, but also essential is organisation and management to provide adequate resources and systematic preparation for mentors. CONCLUSIONS: The description of student mentoring needs to be systematically reviewed to reflect changes in nursing and education and compared within related concepts to achieve and maintain a workable description. A clear and systematic strategy for student mentoring in nursing organisations could be one opportunity to enhance recruitment of nursing students to the workforce. RELEVANCE TO CLINICAL PRACTICE: A unified description of student mentoring will help improve the quality of placement learning opportunities and support for students, also for exchange students. A clear description of student mentoring enables the development of systematic provisions for mentoring of nursing students in placements and adequate mentor preparation programmes for nurses.

Summative assessment of clinical practice of student nurses: A review of the literature.

OBJECTIVES: To provide an overview of summative assessment of student nurses' practice currently in use. DESIGN: Narrative review and synthesis of qualitative and quantitative studies. DATA SOURCES: With the support of an information specialist, the data were collected from scientific databases which included CINAHL, PubMed, Medic, ISI Web of Science, Cochrane library and ERIC published from January 2000 to May 2014. Sources used in all of the included studies were also reviewed. REVIEW METHODS: 725 articles concerned with student nurse clinical practice assessment were identified. After inclusion and exclusion criteria, 23 articles were selected for critical review. RESULTS: Findings suggest that the assessment process of student nurses' clinical practice lacks consistency. It is open to the subjective bias of the assessor, and the quality of assessment varies greatly. Student nurses' clinical assessment was divided into 3 themes: acts performed before final assessment, the actual final assessment situation and the acts after the final assessment situation. Mentors and students need teachers to provide them with an orientation to the assessment process and the paperwork. Terminology on evaluation forms is sometimes so difficult to grasp that the mentors did not understand what they mean. There is no consensus about written assignments' ability to describe the students' skills. Mentors have timing problems to ensure relevant assessment of student nurses. At the final interview students normally self-assess their performance; the mentor assesses by interview and by written assignments whether the student has achieved the criteria, and the role of the teacher is to support the mentor and the student in appropriate assessment. The variety of patient treatment environments in which student nurses perform their clinical practice periods is challenging also for the assessment of student nurses' expertise. CONCLUSIONS: Mentors want clinical practice to be a positive experience for student nurses and it might lead mentors to give higher grades than what student nurses in fact deserve. It is very rare that student nurses fail their clinical practice. If the student nurse does not achieve the clinical competencies they are allowed to have extra time in clinical areas until they will be assessed as competent. Further research needs to be carried out to have more knowledge about the final assessment in the end of clinical practice. Through further research it will be possible to have better methods for high quality assessment processes and feedback to student nurses. Quality in assessment improves patient safety.

Support for traumatic brain injury patients' family members in neurosurgical nursing: a systematic review.

This systematic literature review describes how adult traumatic brain injury (TBI) patients' family members received support. The research question was "What in healthcare constitutes support for a TBI patient's family members?" The data for this review were based on 22 empirical studies published in scientific journals in 2004-2010, which were found in the Cinahl, PsychINFO, and ISI Web of Knowledge databases. The review includes the study design, sample, method, and main results. The data were analyzed using content analysis. Social support for brain injury patients' family members was divided into 3 main categories: informational, emotional, and practical support. The subcategories of informational support were information about the patient's symptoms, information about care, quality of information, and information about the prognosis. The subcategories of emotional support were taking emotions into account, caring, listening, and respecting. The subcategories of practical support were support in decision making, promoting the welfare of the family, encouraging family members to participate in care, cooperation with the family members, and counseling services. The results are available for nurses in practical work. The review offers nurses a structure for supporting TBI patients' families, and according to this review, supporting TBI patients' families appears to have many dimensions. The results suggest that nurses should be informed that it is important for family members to know the facts about TBI to understand the condition and to receive practical advice on how to help their significant other with TBI with daily activities. In addition, the results provide a basis for further research and development of interventions that support brain injury patients and their family members.