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1.
Health Expect ; 27(3): e14100, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38872440

RESUMEN

INTRODUCTION: Increased awareness of testicular diseases can lead to early diagnosis. Evidence suggests that men's awareness of testicular diseases is low, with many expressing their willingness to delay help-seeking for symptoms of concern. The risk of testicular diseases is higher in gender and sexual minority groups. In this study, we discuss the codesign, refinement and launch of 'On the Ball', an inclusive community-based 'testicular awareness' campaign. METHODS: The World Café participatory research methodology was used. Individuals from Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, policymakers, media/marketing experts and graphic designers were recruited. Participants were handed a brief for 'On the Ball', which was designed based on feedback from a previous World Café workshop. They were assigned to three tables. Participants rotated tables at random for three 20-min rounds of conversations. Each table had a facilitator who focussed on one element of the campaign brief. Data were collected using audio recorders and in writing and were analysed thematically. RESULTS: Thirteen individuals participated in the workshop. The following themes emerged from the data: (i) campaign identity, (ii) campaign delivery and (iii) campaign impact. Participants recommended enhancements to the campaign logo, slogan, social media posts and poster. They suggested delivering the campaign online via social media and offline using various print and broadcast media. Participants recommended targeting areas with a large number of men such as workplaces. To help measure the impact of the campaign, participants proposed capturing social media analytics and tracking statistics relating to testicular diseases. Recommendations were used to refine the 'On the Ball' campaign and launch it in a university. In total, 411 students engaged with the various elements of the campaign during the soft launch. CONCLUSIONS: 'On the Ball' campaign visuals ought to be inclusive. Online and offline campaign delivery is warranted to reach out to a wider cohort. Campaign impact can be captured using social media analytics as well as measuring clinical outcomes relating to testicular diseases. Future research is needed to implement the campaign online and offline, explore its impact and evaluate its feasibility, acceptability, cost and effect on promoting testicular awareness. PATIENT OR PUBLIC CONTRIBUTION: The 'On the Ball' campaign was codesigned and refined with members of Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, health policymakers, media and marketing experts and graphic designers using the World Café participatory research methodology.


Asunto(s)
Promoción de la Salud , Minorías Sexuales y de Género , Humanos , Masculino , Promoción de la Salud/métodos , Conocimientos, Actitudes y Práctica en Salud , Adulto , Investigación Participativa Basada en la Comunidad , Enfermedades Testiculares , Femenino
2.
J Clin Nurs ; 33(7): 2374-2387, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38481071

RESUMEN

AIM: To synthesise evidence from studies that explored the impact of electronic and self-rostering systems to schedule staff on healthcare organisations and healthcare workers. DESIGN: Mixed-method systematic review. METHODS: Studies were screened by two independent reviewers and data were extracted using standardised data extraction tables. The quality of studies was assessed, and parallel-results convergent synthesis was conducted. DATA SOURCES: Academic Search Complete, CINAHL, ERIC, MEDLINE, PsycINFO and PsycARTICLES were searched on January 3, 2023. RESULTS: Eighteen studies were included (10 quantitative descriptive studies, seven non-randomised studies and one qualitative study). Studies examined two rostering interventions including self-rostering (n = 12) and electronic rostering (n = 6). It was found that the implementation of electronic and self-rostering systems for staff scheduling impacted positively on both, healthcare workers and healthcare organisations. Benefits included enhanced roster efficiency, staff satisfaction, greater control and empowerment, improved work-life balance, higher staff retention and reduced turnover, decreased absence rates and enhanced healthcare efficiency. However, self-rostering was found to be less equitable than fixed rostering, was associated with increased overtime, and correlated with a higher frequency of staff requests for shift changes. CONCLUSION: The impact of electronic and self-rostering systems to schedule staff on healthcare organisations and healthcare workers' outcomes was predominantly positive. Further randomised controlled trials and longitudinal studies are warranted to evaluate the long-term impact of various rostering systems, including electronic and self-rostering systems. IMPLICATIONS FOR HEALTHCARE: Rostering is a multifaceted responsibility for healthcare administrators, impacting patient care quality, workforce planning and healthcare expenditure. IMPACT: Given that healthcare staffing costs constitute a substantial portion of global healthcare expenditure, efficient and strategic resource management, inclusive of healthcare staff rostering, is imperative. REPORTING METHOD: The 27-item Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.


Asunto(s)
Personal de Salud , Humanos , Personal de Salud/psicología , Admisión y Programación de Personal , Satisfacción en el Trabajo
3.
J Tissue Viability ; 33(1): 75-88, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37977894

RESUMEN

AIM: Surgical site infections (SSIs) are common healthcare associated infections with serious consequences for patients and healthcare organisations. It is critical that healthcare professionals implement prevention strategies to reduce the incidence of such infections. Prevention strategies are key to reducing the incidence of SSIs. The aim of this systematic review is to describe the effect of interventions conducted in acute care settings on the incidence of SSIs (primary outcome), length of stay, intensive care unit admission, and mortality rate (secondary outcomes). MATERIALS AND METHODS: This review is reported using the Preferred Reporting Items for Systematic review and Meta-Analysis checklist. A search was undertaken in Academic Search Complete, CINAHL, ERIC, MEDLINE, PsycARTICLES, PsycINFO and Web of Science for studies published between January 2017 and March 2022. Studies that focused on interventions within acute hospital settings in patients undergoing elective surgery with the aim of reducing the incidences of SSIs were included. Due to heterogeneity results were synthesised narratively. RESULTS: In total, 23 studies were included. Findings show that interventions that are effective in reducing the incidences of SSIs have multiple components including care bundles, stakeholder engagement, targeted surveillance and education. Few studies were identified that evaluated the effect of SSI prevention interventions on length of stay and mortality, and none assessed intensive care admission rates. CONCLUSIONS: The included interventions varied widely, which made it difficult to draw definitive conclusions regarding specific interventions that reduce SSI. Multicomponent interventions and care bundles showed promise in reducing the occurrence of SSIs. Further studies should focus on standardised evidence-based interventions and compliance using randomised controlled designs.


Asunto(s)
Cuidados Críticos , Infección de la Herida Quirúrgica , Humanos , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/prevención & control , Incidencia
4.
Psychooncology ; 32(2): 214-228, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36443527

RESUMEN

OBJECTIVE: To examine the effect of interventions used to enhance cognitive function in patients experiencing cancer-related cognitive impairment. METHODS: Studies including adults with a non-metastatic cancer who have received chemotherapy as part of their treatment and who have undergone interventions targeting cancer-related cognitive impairment were included. Studies involving patients with metastatic cancer and pre-existing cognitive deficits were excluded. Academic Search Complete, CINAHL Plus with full text, MEDLINE, Education Full Text, PsycARTICLES, PsycINFO, and ERIC were searched for studies published between January 2011 and September 2022. Data extraction and quality appraisal were conducted by two authors and cross-checked by the review team. Quality appraisal was conducted using 12 items from the Mixed Methods Appraisal Tool. Findings were presented narratively without meta-analysis. RESULTS: Thirty-one studies were included. Interventions were categorised as integrative/complementary, cognitive behavioural therapy and compensatory strategies, exercise, psychoeducational/psychosocial, brain-training, and pharmacological. Over 100 instruments were identified, including the Functional Assessment of Cancer Therapy-Cognitive, Trail Making Tests-A and B, and instruments measuring secondary outcomes, including depression. Instruments often measured attention and concentration, language, memory, executive function, and/or patient-reported outcomes. Improvements were reported, with most studies measuring some or various aspects of cognitive functioning and very few studies measuring all domains of cognitive functioning, making it difficult to draw definitive conclusions about effectiveness. CONCLUSIONS: Various interventions are available to treat cancer-related cognitive impairment. Outcome measurement was inconsistent and future research should prioritise using standardised measures. Current evidence, whilst not being definitive, suggests that certain interventions show greater promise than others, including cognitive behavioural therapy and brain training.


Asunto(s)
Trastornos del Conocimiento , Disfunción Cognitiva , Neoplasias , Adulto , Humanos , Cognición , Disfunción Cognitiva/etiología , Disfunción Cognitiva/terapia , Función Ejecutiva , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/terapia , Neoplasias/complicaciones , Neoplasias/terapia
5.
Support Care Cancer ; 31(9): 530, 2023 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-37603072

RESUMEN

PURPOSE: To identify supportive care interventions for men with urological cancers. METHODS: Experimental studies conducted among men with any urological cancer were eligible for inclusion. Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, Social Sciences Full Text (H.W. Wilson), SocINDEX with Full Text, ERIC, Google Scholar and ClinicalTrials.gov were searched on 6 December 2022. No database limits were applied. The included studies were methodologically appraised. A narrative synthesis of the results was conducted. RESULTS: Thirty studies were included with 10 categories of interventions identified. Over 300 outcomes were measured, and more than 100 instruments were used. Multicomponent interventions generally led to positive changes in physiological outcomes like body mass index, as well as exercise tolerance and quality of life. This change, however, was not sustained in the long term. Cognitive-behavioural interventions significantly improved psychological symptoms but seldom physical symptoms. Telephone and web-based interventions showed great promise in improving outcomes like depression, positive affect, negative affect, perceived stress, spiritual wellbeing and fatigue. Findings from physical activity/exercise-based interventions were promising for both, physical and psychological outcomes. Rehabilitative interventions were associated with significant improvements in quality of life, urinary symptoms and psychological symptoms, albeit in the short term. Mixed results were reported for nurse-led interventions, family-based interventions and nutritional interventions. CONCLUSION: All but one study focused exclusively on prostate cancer. The included studies were significantly heterogeneous. Multicomponent, cognitive-behavioural, telephone and web-based, physical activity/exercise-based and rehabilitative interventions showed great promise in improving various outcomes. This improvement, however, was often short-lived.


Asunto(s)
Terapia Cognitivo-Conductual , Neoplasias de la Próstata , Neoplasias Urológicas , Masculino , Humanos , Calidad de Vida , Neoplasias Urológicas/terapia , Índice de Masa Corporal
6.
Health Expect ; 2023 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-37877701

RESUMEN

INTRODUCTION: Testicular cancer is the most common cancer in men aged 15-44 years in many countries. Most men with testicular cancer present with a lump. Testicular symptoms are more likely to occur secondary to benign diseases like epididymo-orchitis, a common sexually transmitted infection. Gender and sexual minorities are at an increased risk of testicular diseases and health disparities. The aim of this study was to co-design an inclusive community-based campaign to promote testicular awareness. METHODS: This study uses the World Café methodology. Participation was sought from Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, health policy makers, media and marketing experts and graphic designers. Participants engaged in three rounds of conversations to co-design the campaign. Data were collected using drawing sheets, artefact cards, sticky notes, coloured markers and a voice recorder. Deductive thematic analysis was conducted. RESULTS: Seventeen individuals participated in the study. Six themes emerged from the analysis as follows: (i) online communication; (ii) offline communication; (iii) behavioural targeting and education; (iv) campaign frequency and reach; (v) demographic segmentation; and (vi) campaign identity. The use of social media for campaign delivery featured strongly in all conversations. Participants also recommended offline communication using posters and radio/television advertisements to scale up the campaign and achieve wider reach. Advertisements to overcome embarrassment surrounding testicular health were particularly recommended. Participants emphasised that campaign delivery must be dynamic whilst ensuring that the health-promoting messages are not diluted or lost. They stressed the importance of being inclusive and tailoring the campaign to different age groups, gender identities and sexual orientations. CONCLUSIONS: Study recommendations will be used to design and deliver the campaign. Future research will be needed to evaluate the feasibility, acceptability, cost and effect of the campaign on promoting testicular awareness and early detection of testicular diseases. PATIENT OR PUBLIC CONTRIBUTION: A participatory research approach was used to co-design the campaign with members of Lesbian, Gay, Bisexual, Transgender and Queer+ (LGBTQ+) friendly organisations, LGBTQ+ student bodies, LGBTQ+ staff networks, LGBTQ+ sports clubs, men's health organisations, testicular cancer survivors, health policy makers, media and marketing experts and graphic designers.

7.
Comput Inform Nurs ; 41(10): 815-824, 2023 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-36749836

RESUMEN

Virtual reality simulation offers students the opportunity to acquire clinical and psychomotor skills in a safe and interactive environment. This study describes the usability of virtual reality simulation among undergraduate nursing and midwifery students. Participants were recruited using convenience and snowball sampling and engaged in a 20-minute virtual reality simulation scenario of their choice. They then completed a 21-item survey comprising a sociodemographic questionnaire, the System Usability Scale, a satisfaction questionnaire, and open-ended questions. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using deductive content analysis. Forty-three students participated in this study. The mean (SD) System Usability Scale score was 75.87 (13.7), indicating that virtual reality simulation was acceptable. Almost all participants were either "extremely satisfied" or "somewhat satisfied" with virtual reality simulation, which was perceived as informative and enjoyable, fostering safe and self-directed learning without causing patient harm. Participants recommended using virtual reality simulation to practice clinical skills, prepare for clinical placements, and learn about rare clinical situations. Virtual reality simulation needs to be underpinned by a strong pedagogy and aligned with learning outcomes. Educators and students should be trained in virtual reality simulation prior to its integration into the curriculum.


Asunto(s)
Bachillerato en Enfermería , Educación en Enfermería , Partería , Estudiantes de Enfermería , Realidad Virtual , Embarazo , Humanos , Femenino , Partería/educación , Simulación por Computador , Competencia Clínica
8.
Health Promot Int ; 37(3)2022 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-35810412

RESUMEN

Lung cancer is the leading cause of cancer death globally. Most cases are diagnosed late. Primary healthcare professionals are often the first point of contact for symptoms of concern. This study explored primary healthcare professionals' experience of referring individuals with signs and symptoms suggestive of lung cancer along the appropriate healthcare pathway and explored strategies to help primary healthcare professionals detect lung cancer early. Focus groups and individual interviews were conducted with 36 general practitioners, community pharmacists, practice nurses, and public health nurses. Data were analysed thematically. Participants identified typical lung cancer signs and symptoms such as cough and coughing up blood (i.e., haemoptysis) as triggers for referral. Atypical/non-specific signs and symptoms such as back pain, pallor, and abnormal blood tests were perceived as difficult to interpret. Participants often refrained from using the word 'cancer' during conversations with patients. Ireland's Rapid Access Lung Clinics were perceived as underused, with some general practitioners referring patients to these clinics only when clear and definitive lung cancer signs and symptoms are noted. Lack of communication and the resulting disruption in continuity of care for patients with suspected lung cancer were highlighted as healthcare system flaws. Education on early referral can be in the form of communications from professional organizations, webinars, interdisciplinary meetings, education by lung specialists, and patient testimonials. Lung cancer referral checklists and algorithms should be simple, clear, and visually appealing, either developed as standalone tools or embedded into existing primary care software/programmes.


Asunto(s)
Médicos Generales , Neoplasias Pulmonares , Humanos , Irlanda , Neoplasias Pulmonares/diagnóstico , Atención Primaria de Salud , Investigación Cualitativa
9.
J Clin Nurs ; 31(9-10): 1228-1242, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34296483

RESUMEN

AIMS AND OBJECTIVES: This study explored nursing students' views of using virtual reality in healthcare. BACKGROUND: The popularity and use of virtual reality in healthcare delivery and education is on the rise. Yet, the views of future nurses regarding this technology remain underexplored. DESIGN: This is a qualitative descriptive study guided by a naturalistic inquiry and reported using the Standards for Reporting Qualitative Research checklist. METHODS: Nursing students (n = 26) were recruited using convenience and snowball sampling. They were first exposed to a virtual reality intervention aimed to enhance men's awareness of testicular diseases. This was attempted to familiarise participants with the technology and initiate conversations around its use in healthcare. Participants were then interviewed face-to-face, either individually or within focus groups. Data were analysed using thematic analysis. RESULTS: Four themes were identified: (i) positive experiences of virtual reality; (ii) challenges to using virtual reality; (iii) settings where virtual reality can be implemented; and (iv) blue-sky and future applications of virtual reality. Participants described this technology as novel, enjoyable, immersive, memorable and inclusive. They questioned, however, the suitability of virtual reality for older adults, reported minor technical difficulties and stressed the importance of prior preparation in the use of the technology. Virtual reality was recommended for use in outpatient healthcare settings, schools and the community. Participants suggested using virtual reality in health promotion, disease prevention and management, and to promote nurses' empathy towards patients. CONCLUSIONS: Findings highlight the potential role of virtual reality in assisting nurses in promoting health and managing disease. Future research is needed to establish the long-term effect of virtual reality interventions among more diverse participants. RELEVANCE TO CLINICAL PRACTICE: Virtual reality can be implemented in outpatient, educational and community settings in order to promote health, prevent disease, enhance disease and self-management, and increase nurses' empathy towards patients.


Asunto(s)
Estudiantes de Enfermería , Realidad Virtual , Anciano , Atención a la Salud , Promoción de la Salud , Humanos , Masculino , Investigación Cualitativa
10.
J Cancer Educ ; 37(4): 1026-1035, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-33131021

RESUMEN

Lung cancer (LC) is the most common cancer and the leading cause of cancer mortality globally. A positive association between LC incidence and socioeconomic deprivation exists. High-risk individuals are less likely to be aware of LC and to correctly appraise LC symptoms and seek medical help accordingly. This qualitative study explored strategies to promote early detection of LC among at-risk individuals living in high-incidence areas in Ireland. Five semi-structured focus groups were conducted with 46 individuals. Data were collected face-to-face in community centres and organisations in high-incidence areas in two Irish counties and analysed using inductive qualitative content analysis. Participants believed that there was insufficient information regarding LC and recommended promoting LC awareness at a young rather than old age. They favoured public health messages that are Simple, clear, and honest; Worded positively; Incorporating a shock element; Featuring a celebrity, healthcare professional, or survivor; and Targeted (SWIFT). Most participants reported becoming immune to messages on cigarette packaging and recommended using a combination of broadcast and print media within national government-run campaigns to promote LC awareness and early detection. Study findings suggest that promoting LC awareness, help-seeking, early presentation, and diagnosis can be achieved by developing and testing targeted interventions. Promoting LC awareness requires a multi-sectoral policy network, or a whole systems approach. Such approaches ought to consider the multifactorial drivers of LC risk behaviours; involve coordinated, collective actions across various stakeholders; operate across multiple agencies; and take a life course perspective.


Asunto(s)
Neoplasias Pulmonares , Salud Pública , Grupos Focales , Personal de Salud , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/prevención & control , Investigación Cualitativa
11.
Health Promot Int ; 36(6): 1656-1671, 2021 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-33647930

RESUMEN

Lung cancer (LC) is the leading cause of cancer death. Barriers to the early presentation for LC include lack of symptom awareness, symptom misappraisal, poor relationship with doctors and lack of access to healthcare services. Addressing such barriers can help detect LC early. This systematic review describes the effect of recent interventions to improve LC awareness, help-seeking and early detection. This review was guided by the Cochrane Handbook for Systematic Reviews of Interventions. Electronic databases MEDLINE, CINAHL, ERIC, APA PsycARTICLES, APA PsycInfo and Psychology and Behavioral Sciences Collection were searched. Sixteen studies were included. Knowledge of LC was successfully promoted in most studies using educational sessions and campaigns. LC screening uptake varied with most studies successfully reducing decision conflicts using decision aids. Large campaigns, including UK-based campaign 'Be Clear on Cancer', were instrumental in enhancing LC awareness, promoting help-seeking and yielding an increase in chest X-rays and a decrease in the number of individuals diagnosed with advanced LC. Multimodal public health interventions, such as educational campaigns are best suited to raise awareness, reduce barriers to help-seeking and help detect LC early. Future interventions ought to incorporate targeted information using educational resources, face-to-face counselling and video- and web-based decision aids.


Asunto(s)
Neoplasias Pulmonares , Detección Precoz del Cáncer , Humanos , Neoplasias Pulmonares/diagnóstico
12.
Comput Inform Nurs ; 39(11): 704-713, 2021 07 12.
Artículo en Inglés | MEDLINE | ID: mdl-34238834

RESUMEN

Advancements in information technology and computer science have resulted in the development of computerized healthcare information systems. Information technology can optimize patient care through providing immediate electronic education. The purpose of this mixed-methods systematic review was to synthesize evidence from studies exploring nurses and nursing students' attitudes and beliefs regarding the use of technology in patient care. Electronic databases Academic Search Complete, CINAHL, MEDLINE, Education Full Text, PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO, and ERIC were searched. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool. Convergent integrated synthesis was conducted. Eight studies were included. Technologies used in the reviewed studies include smartphones (n = 4) and Web-based information/educational resources (n = 4). Overall, nurses and nursing students' attitudes and beliefs regarding the use of smartphone applications were positive. When compared with other healthcare professionals, nurses were more likely to have access to Web-based resources and to appraise the importance of such resources in patient education. Nurses and nursing students are in a prime position to use technology in patient care and education. It is important therefore that nurses' positive attitudes toward technology be reinforced to increase the use and application of Web-based and smartphone technologies in clinical practice.


Asunto(s)
Enfermeras y Enfermeros , Estudiantes de Enfermería , Actitud , Humanos , Atención al Paciente , Tecnología
13.
J Nurs Manag ; 29(8): 2523-2533, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34213054

RESUMEN

AIM: This study aimed to evaluate differences in supervisees' understanding of clinical supervision and their perceptions of organisational functioning before and after engaging in peer-group clinical supervision. BACKGROUND: Protected reflective time allows discussion of complex issues affecting health care. Peer-group clinical supervision is one model of clinical supervision that could facilitate this, but it is poorly understood. METHODS: A pre-post intervention pilot study was performed. The intervention was delivered over a 12-month period. Data were collected using surveys on demographic and work-related factors and experience of clinical supervision pre- and post intervention. RESULTS: Adaptability increased significantly between the pre- and post surveys. The post survey data showed finding time for clinical supervision scoring lowest with open-ended comments reinforcing this. The supervisees found the sessions to offer a safe place despite initial concerns. CONCLUSION: The peer-group model of clinical supervision allowed supervisees to build a rapport and trust with their colleagues and share experiences. IMPLICATIONS FOR NURSING MANAGEMENT: The benefits to participating in peer-group clinical supervision traversed the individual and organisation. These data support the implementation of such sessions while addressing workload and time pressures to aid participation.


Asunto(s)
Partería , Enfermeras y Enfermeros , Femenino , Humanos , Relaciones Interpersonales , Grupo Paritario , Proyectos Piloto , Embarazo
14.
Int J Qual Health Care ; 32(8): 558-566, 2020 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-32797153

RESUMEN

PURPOSE: To examine international approaches to the ethical oversight and regulation of quality improvement and clinical audit in healthcare systems. DATA SOURCES: We searched grey literature including websites of national research and ethics regulatory bodies and health departments of selected countries. STUDY SELECTION: National guidance documents were included from six countries: Ireland, England, Australia, New Zealand, the United States of America and Canada. DATA EXTRACTION: Data were extracted from 19 documents using an a priori framework developed from the published literature. RESULTS: We organized data under five themes: ethical frameworks; guidance on ethical review; consent, vulnerable groups and personal health data. Quality improvement activity tended to be outside the scope of the ethics frameworks in most countries. Only New Zealand had integrated national ethics standards for both research and quality improvement. Across countries, there is consensus that this activity should not be automatically exempted from ethical review but requires proportionate review or organizational oversight for minimal risk projects. In the majority of countries, there is a lack of guidance on participant consent, use of personal health information and inclusion of vulnerable groups in routine quality improvement. CONCLUSION: Where countries fail to provide specific ethics frameworks for quality improvement, guidance is dispersed across several organizations which may lack legal certainty. Our review demonstrates a need for appropriate oversight and responsive infrastructure for quality improvement underpinned by ethical frameworks that build equivalence with research oversight. It outlines aspects of good practice, especially The New Zealand framework that integrates research and quality improvement ethics.


Asunto(s)
Mejoramiento de la Calidad , Australia , Canadá , Inglaterra , Humanos , Irlanda , Nueva Zelanda , Estados Unidos
15.
J Adv Nurs ; 75(11): 2340-2351, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31162701

RESUMEN

AIMS: To identify, describe, and summarize evidence from quantitative, qualitative, and mixed-method studies conducted to prepare nurses and nursing students to lead on and/or deliver compassionate care. DESIGN: Mixed-method systematic review. DATA SOURCES: CINAHL, Medline, PsychINFO, and SocINDEX (January 2007-February 2018). REVIEW METHODS: Papers were screened by two independent reviewers using an online screening tool and data were extracted using a standardized data extraction table. Parallel-results convergent synthesis was used to synthesize evidence from included qualitative, quantitative, and mixed-method studies. Quality appraisal and risk of bias assessment were conducted. RESULTS: Fifteen studies were included with three main themes and six sub-themes: (a) programme impact (impact on ward-level and senior nurses and impact on nursing students and educators); (b) programme characteristics (characteristics leading to positive outcomes and characteristics leading to negative outcomes); and (c) programme implementation (implementation barriers and implementation facilitators). Compassionate care education programmes helped enhance nurses' ability to engage in reflective practice, deal with clinical challenges, and gain confidence. The importance of nurturing compassionate care delivery in nursing education was highlighted in the literature. Various nursing-level, patient-level, and organizational barriers to compassionate care delivery were identified. CONCLUSION: The impact of compassionate care educational programmes on nurses was predominantly positive. Further evaluation of the long-term impact of these programmes on nurses, patients, and organizations is warranted. IMPACT: Optimal delivery of compassionate care can be achieved by building organizational infrastructures that support nurses from all levels to attend education programmes and lead on compassionate care delivery.


Asunto(s)
Educación en Enfermería/organización & administración , Empatía , Estudiantes de Enfermería/psicología , Humanos
16.
Br J Nurs ; 28(11): 708-714, 2019 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-31188670

RESUMEN

Compassionate care delivery enhances patient satisfaction and quality of life and reduces nurse burnout. This study measured the perceptions of nursing and midwifery leaders regarding the impact of the 'Leaders for Compassionate Care Programme' on their personal development, learning experience, service and care delivery, programme quality, and satisfaction with the programme. Seventy-nine leaders were surveyed using the Leaders for Compassionate Care Outcomes Evaluation Questionnaire and the Leaders for Compassionate Care Evaluation Questionnaire. Participants' perceived ability to support peer learning, manage conflict, and build trust with patients increased significantly following the programme (P≤0.001). Over 80% of participants reported that they were able to apply to practice what they had learnt from the programme and reported an increase in their motivation to lead in compassionate care delivery. Various strategies are needed to improve compassionate care leadership and further research is needed to explore the long-term impact of the programme.


Asunto(s)
Empatía , Liderazgo , Relaciones Enfermero-Paciente , Personal de Enfermería en Hospital/psicología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación en Evaluación de Enfermería , Personal de Enfermería en Hospital/estadística & datos numéricos
17.
Psychooncology ; 27(2): 410-419, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28728212

RESUMEN

OBJECTIVE: Preventive strategies are known to reduce cancer risk and incidence and improve prognosis. Men seldom seek medical information about cancer prevention and risk reduction. The aim of this meta-narrative systematic review was to critically appraise evidence from qualitative, quantitative, and mixed-methods studies that explored men's information-seeking behaviors in relation to cancer prevention and risk reduction. METHODS: MEDLINE, CINAHL Plus with Full Text, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, Education Full Text, and ERIC were systematically searched for studies published in English between January 1, 2006 and May 30, 2016. A total of 4117 titles were identified; of which, 31 studies were included (21 qualitative studies, 9 quantitative studies, and 1 mixed-methods study). The methodological quality of the studies was appraised by using different tools. RESULTS: Most studies focused on screening for prostate (n = 18) and colorectal cancer (n = 7). Most men were passive information-gatherers rather than active information-seekers. Key sources of information included the Internet for active information-seekers and health care professionals for passive information-gatherers. Barriers to information-seeking included information overload, embarrassment, and fear. Low literacy and health literacy levels were addressed in 3 studies and were identified as impediments to active information-seeking. Facilitators to information-seeking included family support, media, celebrity endorsements, and targeted information. CONCLUSIONS: Men's information-seeking behavior regarding cancer risk reduction, prevention, and screening is influenced by several factors. This necessitates targeted interventions aimed at raising awareness of cancer prevention and screening, while accounting for men's informational needs, preferred learning strategies, and literacy levels.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Conducta en la Búsqueda de Información , Hombres , Neoplasias/diagnóstico , Neoplasias/prevención & control , Humanos , Masculino
18.
Nurs Res ; 67(2): 169-176, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29489637

RESUMEN

BACKGROUND: Health outcomes among men are markedly poorer than women. Testicular disorders can be life-threatening if left untreated. Few studies promoting awareness of testicular disorders have been underpinned by theory. Theory-based interventions are more likely to achieve positive health outcomes than interventions that lack a theoretical foundation. OBJECTIVES: The purpose of the study is to present a theory-focused analysis of the preconscious awareness to action framework (PAAF), developed to enhance testicular awareness and help-seeking intentions and behaviors among men. METHODS: The following approach was used to develop the PAAF: The empirical literature on men's awareness of testicular disorders was reviewed. A qualitative study was conducted to explore men's awareness of testicular disorders, help-seeking intentions for testicular symptoms, and preferred learning strategies in relation to testicular disorders and symptoms. An iterative narrative review process of the theoretical literature on health promotion and symptom appraisal was undertaken. RESULTS: The PAAF comprises seven steps: preconscious awareness, unconscious awareness, conscious awareness, unconscious appraisal, conscious appraisal, intention, and behavior. The concept of testicular awareness was developed to familiarize men with their own testes and promote timely help-seeking. DISCUSSION: Researchers are encouraged to use the PAAF to design health-promoting interventions aimed at enhancing testicular awareness, symptom appraisal, and help-seeking.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud , Aceptación de la Atención de Salud , Autoexamen , Enfermedades Testiculares/prevención & control , Humanos , Masculino , Salud del Hombre , Teoría de Enfermería
19.
Nurs Res ; 67(5): 349-358, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30059354

RESUMEN

BACKGROUND: The incidence of benign and malignant testicular disorders is on the rise. Three literature reviews and one qualitative study found that men's awareness of testicular disorders was lacking, and their intentions to seek help for symptoms of testicular disease were low. OBJECTIVES: The aim of the study was to enhance men's awareness of testicular disorders, help-seeking intentions for testicular symptoms, and intention and behavior to feel their testes. METHODS: Men aged 18-50 years were recruited from a university and asked to engage in a three-level, educational, virtual reality experience. The Medical Research Council framework guided the development and pilot testing of the intervention. Knowledge, awareness, perceived risk, implementation intentions, help-seeking intentions, and behaviors were measured at pretest (T0), immediately posttest (T1), and 1 month posttest (T2). RESULTS: Data were available from 49 participants. In comparison to T0, a significant increase in knowledge (mean difference [MD] = 3.5, 95% CI [2.8, 4.26]); testicular awareness (MD = 0.2, 95% CI [0.01, 0.41]); implementation intentions (MD = 0.6, 95% CI [0.33, 0.90]); and help-seeking intentions for testicular swelling (MD = 0.3, 95% CI [0.12, 0.51]), lumpiness (MD = 0.3, 95% CI [0.08, 0.46]), and pain (MD = 0.6, 95% CI [0.25, 1.01]) was noted at T1. This increase was maintained at T2. Participants who expressed an intention to feel their testes at T0 were more likely to report performing this behavior at T2. DISCUSSION: The intervention succeeded in promoting knowledge, testicular awareness, implementation intentions, help-seeking intentions, and behaviors. A randomized controlled trial of the Enhancing Men's Awareness of Testicular Disorders intervention with a larger sample size is warranted.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Aceptación de la Atención de Salud , Educación del Paciente como Asunto/métodos , Enfermedades Testiculares , Realidad Virtual , Adolescente , Adulto , Conductas Relacionadas con la Salud , Humanos , Intención , Masculino , Persona de Mediana Edad , Proyectos Piloto , Enfermedades Testiculares/diagnóstico , Enfermedades Testiculares/etiología , Enfermedades Testiculares/terapia , Adulto Joven
20.
J Chem Phys ; 146(24): 244312, 2017 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-28668071

RESUMEN

Tributyl-phosphate (TBP), a ligand used in the PUREX liquid-liquid separation process of spent nuclear fuel, can form an explosive mixture in contact with nitric acid that might lead to a violent explosive thermal runaway. In the context of safety of a nuclear reprocessing plant facility, it is crucial to predict the stability of TBP at elevated temperatures. So far, only the enthalpies of formation of TBP are available in the literature with rather large uncertainties, while those of its degradation products, di-(HDBP) and mono-(H2MBP), are unknown. In this goal, we have used state-of-the art quantum chemical methods to compute the formation enthalpies and entropies of TBP and its degradation products di-(HDBP) and mono-(H2MBP) in gas and liquid phases. Comparisons of levels of quantum chemical theory revealed that there are significant effects of correlation on their electronic structures, pushing for the need of not only high level of electronic correlation treatment, namely, local coupled cluster with single and double excitation operators and perturbative treatment of triple excitations, but also extrapolations to the complete basis to produce reliable and accurate thermodynamics data. Solvation enthalpies were computed with the conductor-like screening model for real solvents [COSMO-RS], for which we observe errors not exceeding 22 kJ mol-1. We thus propose with final uncertainty of about 20 kJ mol-1 standard enthalpies of formation of TBP, HDBP, and H2MBP which amounts to -1281.7 ± 24.4, -1229.4 ± 19.6, and -1176.7 ± 14.8 kJ mol-1, respectively, in the gas phase. In the liquid phase, the predicted values are -1367.3 ± 24.4, -1348.7 ± 19.6, and -1323.8± 14.8 kJ mol-1, to which we may add about -22 kJ mol-1 error from the COSMO-RS solvent model. From these data, the complete hydrolysis of TBP is predicted as an exothermic phenomena but showing a slightly endergonic process.

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