Attitudes of patients with schizophrenia spectrum or bipolar disorders towards medication self-management during hospitalisation.

BACKGROUND: Medication self-management (MSM) is defined as a person's ability to cope with medication treatment for a chronic condition, along with the associated physical and psychosocial effects that the medication causes in their daily lives. For many patients, it is important to be able to self-manage their medication successfully, as they will often be expected to do after discharge. AIM: The aim of this study was to describe the willingness and attitudes of patients with schizophrenia spectrum or bipolar disorders regarding MSM during hospital admission. A secondary aim was to identify various factors associated with patient willingness to participate in MSM and to describe their assumptions concerning needs and necessary conditions, as well as their attitudes towards their medication. METHODS: A multicentre, quantitative cross-sectional observational design was used to study the willingness and attitudes of psychiatric patients regarding MSM during hospitalisation. The study adhered to guidelines for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). RESULTS: In this study, 84 patients, of which 43 were patients with schizophrenia spectrum disorders and 41 were patients with bipolar disorders, participated. A majority of the patients (81%) were willing to participate in MSM during their hospitalisation. Analysis revealed patients are more willing to MSM if they are younger (r = -.417, p < .001) and a decreasing number of medicines (r = -.373, p = .003). Patients' willingness was positively associated with the extent of support by significant others during and after hospitalisation (Pearson's r = .298, p = .011). Patients were convinced that they would take their medication more correctly if MSM were to be allowed during hospitalisation (65%). CONCLUSION: Most of the patients were willing to self-manage their medication during hospitalisation, however, under specific conditions such as being motivated to take their medication correctly and to understand the benefits of their medication. RELEVANCE TO CLINICAL PRACTICE: From a policy point of view, our study provided useful insights into how patients look at MSM to enable the development of future strategies. Since patients are willing to self-manage their medication during hospitalisation, this may facilitate its implementation. PATIENT CONTRIBUTION: Patients were recruited for this study. Participation was voluntary, and signed informed consent was obtained from all participants prior to the questionnaire.

Cross-sectional evaluation of pharmaceutical care competences in nurse education: how well do curricula prepare students of different educational levels?

BACKGROUND: Nurses play an important role in interprofessional pharmaceutical care. Curricula related to pharmaceutical care, however, vary a lot. Mapping the presence of pharmaceutical care related domains and competences in nurse educational programs can lead to a better understanding of the extent to which curricula fit expectations of the labour market. The aim of this study was to describe 1) the presence of pharmaceutical care oriented content in nursing curricula at different educational levels and 2) nursing students' perceived readiness to provide nurse pharmaceutical care in practice. METHODS: A quantitative cross-sectional survey design was used. Nursing schools in 14 European countries offering educational programs for levels 4-7 students were approached between January and April 2021. Through an online survey final year students had to indicate to what extent pharmaceutical care topics were present in their curriculum. RESULTS: A total of 1807 students participated, of whom 8% had level 4-5, 80% level 6, 12% level 7. Up to 84% of the students indicated that pharmaceutical care content was insufficiently addressed in their curriculum. On average 14% [range 0-30] felt sufficiently prepared to achieve the required pharmaceutical care competences in practice. In level 5 curricula more pharmaceutical care domains were absent compared with other levels. CONCLUSIONS: Although several pharmaceutical care related courses are present in current curricula of level 4-7 nurses, its embedding should be extended. Too many students perceive an insufficient preparation to achieve pharmaceutical care competences required in practice. Existing gaps in pharmaceutical care should be addressed to offer more thoroughly prepared nurses to the labour market.

Perceived barriers, benefits, facilitators, and attitudes of health professionals towards type 2 diabetes management in Oujda, Morocco: a qualitative focus group study.

BACKGROUND: In Morocco, the treatment of type 2 diabetes (T2D) is mainly focused on medication and only 2% of patients are coached towards a healthier lifestyle. In Oujda, Eastern Morocco the prevalence of T2D is 10.2%, and the current trend is alarming, especially for women. Therefore, the aim of this study is to explore healthcare professionals (HCP) views on the perceived barriers and benefits of an integrated care approach in primary healthcare centers (PHCCs) to T2D management in Oujda. METHODS: A qualitative descriptive study using focus groups in 8 PHCCs. This resulted in a sample of 5 doctors and 25 nurses caring for diabetes patients. The transcripts of all conversations were coded to allow for thematic analysis. RESULTS: The participants mentioned different barriers to an integrated approach to DM management:: excessive workload; poor reimbursement policy; lack of staff and equipment; interrupted drug supply; poor working environment; limited referral; gap in the knowledge of general practitioners; health beliefs; poverty; advanced age; gender; the use of psychotropic drugs. An integrated approach could be facilitated by simplified electronic records and referrals; uninterrupted free care; staff recruitment; continuous professional development; internships. BENEFITS: structured care; promotion of care in PHCCs; empowerment of self-management. CONCLUSION: HCP views reflect the urge to strengthen the management of T2D in PHCCs. There is a need for HCP with expertise in physical activity and nutrition to solve the current gap in the multidisciplinary integrated care approach. The specific local context in this Eastern Moroccan region, with limited resources and remote hard-to-reach rural areas, can contribute to patients' reluctance to change their lifestyles, and is a challenge to provide care in an efficient and sustainable manner. More research is needed to see how a patient-centered multidisciplinary approach to T2D management can help motivate patients in Morocco to change to a healthier lifestyle.

Certified Nursing Assistants' Perspectives on Delirium Care.

The current descriptive qualitative study provides an in-depth understanding of the perspectives of certified nursing assistants (CNAs, N = 7) regarding delirium. Data were collected through interviews with seven CNAs working in a long-term care facility. Five themes emerged: Knowledge About Delirium, Caring for Residents With Delirium, Delirium Education, Psychological Burden, and Quality of Care. CNAs' care of residents with delirium was based on prior experiences and gut feelings, indicating a high need for delirium training. [Journal of Gerontological Nursing, 49(2), 43-51.].

From abstainer to current drinker: a qualitative investigation of the process of alcohol use initiation among early adolescents in Thailand.

Background: Recent evidence shows that young people started their first alcohol initiation when they were early adolescents (10-14 years of age), while there is still very little scientific understanding concerning the process of alcohol use of this age group. This study examined how adolescents in Thailand emerge to become drinkers. Method: The semi-structured interview with 10-14-year-olds (n = 61) in Chonburi, province of Thailand. Data were collected, and analysis followed the method of content analysis. Results: Our analyzes revealed three steps of alcohol initiation among early adolescents: (a) the pre-stage; (b) the initiation; and (c) the self-adjustment stage. Parent, peer, and the taste of alcohol were noteworthy as the factors that promote young people to accept alcohol sipping and consumption as part of their life. Nevertheless, law, social norms, culture, parents, and health consequences discouraged young people from emerging alcohol initiation. Conclusion: The preliminary evidence from this study recommends the interventions that address both individual-level and interpersonal circumstances as potentially being effective solutions to the provision of precautionary measures against underage alcohol use.

Factors associated with alcohol consumption among early adolescents in a province in Eastern region of Thailand: a cross-sectional analysis.

A cross-sectional study was applied to obtain factors associated with alcohol consumption since information among early adolescents in Thailand is limited. Data was collected from December 2016 to March 2017. A questionnaire was developed through a literature review and tested for validation and reliability. Multi-stage random sampling was used to recruit youths aged 10-14 years from Chonburi Province, Thailand. Descriptive statistics (mean and standard deviation), Chi-squared test, and multivariable logistic regression were used for data analysis. The mean and standard deviation (SD) for the age of participants was 12.07 years (1.42) with 50.23% being male. In total, 10.94% reported drinking alcohol in the past 12 months. Current drinking in the past year was positively associated with older youths of 14 years of age (AOR = 5.34, 95% CI = 2.91-9.81) having a positive attitude toward alcohol consumption behavior (AOR = 4.18 95% CI = 3.36-5.21), direct observation of friends' drinking (AOR = 4.21, 95% CI = 3.32-5.32), direct observation of villagers/community members' drinking (AOR = 1.99, 95% CI = 1.15- 3.48), adolescents whose parents stored alcohol at home (AOR = 1.35, 95% CI = 1.06-1.55), and being exposed to alcohol advertising (AOR = 1.60, 95% CI =1.16-2.23). The factor most inversely associated with current drinking appears to be male gender (AOR = 0.78, 95% CI =0.64-0.94). Strategies for delaying and reducing drinking among early adolescents should accompany these risk factors into any preventive programs.

The prevalence of delirium in belgian nursing homes: a cross-sectional evaluation.

BACKGROUND: Delirium is a common geriatric syndrome, but only few studies have been done in nursing home residents. Therefore, the aim of this study was to investigate (point) prevalence of and risk factors for delirium in nursing homes in Belgium. METHODS: A multisite, cross-sectional study was conducted in six nursing homes in Belgium. Residents of six nursing homes were screened for delirium. Exclusion criteria were coma,'end-of-life' status and residing in a dementia ward. Delirium was assessed using the Delirium Observation Screening Scale. RESULTS: 338 of the 448 eligible residents were included in this study. Of the 338 residents who were evaluated, 14.2 % (95 %CI:3.94-4.81) screened positive for delirium with the Delirium Observation Screening Scale. The mean age was 84.7 years and 67.5 % were female. Taking antipsychotics (p = 0.009), having dementia (p = 0.005), pneumonia (p = 0.047) or Parkinson's disease (p = 0.03) were more present in residents with delirium. The residents were more frequently physically restrained (p = 0.001), participated less in activities (p = 0.04), had had more often a fall incident (p = 0.007), had lower levels of cognition (p < 0.001; MoCA ≥ 26, p = 0.04; MoCA ≥ 25, p = 0.008) and a higher "Activities of Daily Living" score (p = 0.001). In multivariable binary logistic regression analysis, a fall incident (2.76; 95 %CI: 1.24-6.14) and cognitive impairment (OR: 0.69; 95 %CI: 0.63-0.77) were significantly associated with delirium. CONCLUSIONS: Delirium is an important clinical problem affecting almost 15 % of the nursing home residents at a given moment. Screening of nursing home residents for risk factors and presence of delirium is important to prevent delirium if possible and to treat underlying causes when present.

The effects of continuity of care on the health of mother and child in the postnatal period: a systematic review.

BACKGROUND: Continuity of care (COC) is essential for high-quality patient care in the perinatal period. Insights in the effects of COC models on patient outcomes are important to direct perinatal healthcare organization. To our knowledge, no previous review has listed the effects of COC on the physical and mental health of mother and child in the postnatal period. METHODS: A search was conducted in four databases (PubMed, Web of Knowledge, CENTRAL and CINAHL), from 2000 to 2018. Studies were included if: participants were healthy mothers or newborns with a gestational age between 37-42 weeks; they covered the perinatal period and aimed to measure breastfeeding or any outcome related to the maternal/newborn physical or mental health. At least one of the three COC types (management, informational and relationship) was identified in the intervention. The methodological quality was assessed. RESULTS: Ten articles were included. COC is mostly present in the identified care models. The effects of COC on the outcomes of mother and child in the postnatal period seem mostly to be positive, although not always significant. The relation between COC and the outcomes can be influenced by confounding factors, like the socio-economic status of the included population. Interventions with COC during pregnancy appear to be more effective for all the studied outcome factors. CONCLUSION: COC as management, relational and informational continuity starting antenatal has the most impact on the postnatal outcomes of mother and child.

Development and validation of an assessment tool for nursing workload in emergency departments.

AIMS: To develop the Workload Assessment of Nurses on Emergency (WANE) tool and to test its validity and reliability to measure nursing workload in the emergency departments. BACKGROUND: Ensuring safe nursing staffing in emergency departments is a worldwide concern. There is no valid tool to measure emergency nursing workload in order to determine the needed nurse staffing in the emergency departments. DESIGN: A two-year, cross-sectional, multicenter study. METHODS: Workload was operationalised as the time nurses spent with nursing activities, classified into direct and indirect care. A board of experts provided content validity. Construct validity was evaluated by examining the WANE's correlations and group-discriminations patterns within the network of variables known to determine nursing workload. Reliability was assessed by the tool's ability to yield consistent results across repeated measurements. Reporting of this research adheres to STROBE guidelines. RESULTS: Seven emergency departments, including 3,024 patients, were involved in the first year and 18 emergency departments and 7,442 patients in the second year. Direct care time correlated positively and significantly with patient dependency on nursing care, age and length of emergency department stay and discriminated between the categories of dependency on nursing care, age and hospitalisation. Both direct and indirect care time discriminated between the emergency departments according to different patient care profiles and unit characteristics. WANE showed consistent results across measurements. CONCLUSIONS: Results support the WANE's reliability and validity to measure emergency nursing workload. This tool could be used to determine, on patient and unit, a baseline nurse staffing and the nursing skill mix in the emergency departments. WANE is also an evidence-based management tool for benchmarking purposes. RELEVANCE TO CLINICAL PRACTICE: The use of an evidence-based workload tool in making staffing decisions in emergency departments is crucial to ensure safe patient care and prevent work overload in nursing staff.

SelfMED: Self-Administration of Medication in Hospital: A Prevalence Study in Flanders, Belgium.

BACKGROUND: Self-management is a key element in regaining and maintaining health. However, during hospitalization it becomes less obvious. Patient self-administration of medication during hospitalization is suggested to be beneficial to patient satisfaction, adherence to pharmacotherapy, and self-care competence. OBJECTIVES: This study aimed to examine the prevalence of self-administration of medication during hospitalization, and possible contributing factors. DESIGN AND SETTING: A cross-sectional observational study was conducted in 12 Belgian hospitals from February 2015 until June 2015. PARTICIPANTS: Data were collected on all hospitalized patients at 57 wards, based in 12 hospitals. DATA COLLECTION: A structured questionnaire at ward level and patient level on medication management, self-administration of medication, and rationale for prohibiting or allowing patients to self-administer their medication was conducted in consultation with the head nurse. RESULTS: Of the 1,269 patients participating in this study, 22% self-administered at least one medicine during hospitalization and 13.8% self-administered at least 50% of their total amount of medication. In the opinion of the head nurse, 40.9% of the hospitalized patients would have been able to self-administer their medication during hospitalization. Only a few wards had an available procedure and screening tool to assess the competence of the patients to self-administer their medication. This did not affect the prevalence of self-administration. Self-administration occurred significantly more at surgical short-stay wards, compared to other wards. The self-administering patients were on average younger and female and had a lower number of different medications per day before and during hospitalization. These patients had a good health status and were independent to mildly dependent on nurses on the ward. Related factors were used to provide a multivariate logistic regression model. CONCLUSIONS: Sometimes self-administration of medication was allowed. According to the surveyed nurses, however, more patients would be able to self-administer their medication during hospitalization. There seems to be a lack of procedures and screening tools to assess the competence or appropriateness of patients to self-administer their medication. CLINICAL RELEVANCE: This study provides new knowledge about the prevalence of self-administration of medication, contributing factors, the types of self-administered medications, and the organization of self-administration of medication on different wards.

A concept analysis of proactive behaviour in midwifery.

AIM: To report an analysis of the concept of proactive behaviour and apply the findings to midwifery. BACKGROUND: Proactive behaviour is a universal phenomenon generalizable to multiple professions. The purpose of this work was to establish a link with midwifery. DESIGN: Concept analysis by Walker and Avant's method. DATA SOURCES: Literature was searched in PubMed, ERIC, NARCIS, Emerald and reference lists of related journal articles with a timeline of 1990 - April 2015 in the period of November 2014 - June 2015. Next key words were combined by the use of Boolean operators: 'proactive behaviour', 'midwifery', 'midwife', 'proactivity' and 'proactive'. Fifteen studies were included. METHODS: A focused review of scientific publications in midwifery, health care, healthcare education and social sciences, which highlighted the concept of proactive behaviour. RESULTS: In the studied literature, several attributes of proactive behaviour were cited. These attributes were narrowed by applying it on a midwifery model case, borderline case and contrary case. Related concepts were elaborated and distinguished of the concept of proactive behaviour in midwifery. Proactive behaviour is triggered by different individual and contextual antecedents and has consequences at multiple levels. CONCLUSION: A midwife who behaves proactive would not look at changes as a boundary, persistently improves things she experienced as wrong, anticipates future barriers and looks for viable alternatives to carry out her work as efficiently and effectively as possible. Various individual and/or contextual antecedents trigger proactive behaviour in midwifery, and this behaviour could cause multiple future benefits for the constant evolving reproductive health care.

Resident and nurse reports of potential adverse drug reactions.

PURPOSE: Nursing home residents are at high risk for adverse drug reactions (ADR). To improve pharmacotherapeutic care for individual residents, healthcare professionals need to be aware of ADRs. In nursing homes, nurses have a central role in monitoring residents' health and informing physicians on the presence of ADRs. The aim of this study was to evaluate the value of nursing home residents' ADR reports. METHODS: Residents of a convenient sample of two nursing homes were included if their mental status and understanding of Dutch enabled them to report ADRs. In a cross-sectional design, residents and nurses were questioned about 17 potential ADRs. Reports of residents and nurses were consequently compared. Medication use was studied to describe the risk for ADRs per resident. RESULTS: Residents had a mean of eight different chronic medication prescriptions. Over 90% of the residents used medications which increase the risk of feeling somnolent/tired/sedated, arrhythmias and abdominal pain. The median number of potential ADRs reported by nurses was significantly lower compared to the number of resident reports (median [range], respectively, 1 [1-10] and 4 [1-10]). In general, residents reported the presence of more ADRs than nurses, except for confusion. The correspondence between nurse and resident reports ranged from 43% (dry mouth) till 88% (arrhythmia). CONCLUSIONS: Nurses and patients reported a lot of potential ADRs. The type of ADRs they reported was different and complementary. Questioning residents about specific potential ADRs may increase the awareness of ADRs.

Impact of role-, job- and organizational characteristics on Nursing Unit Managers' work related stress and well-being.

AIM: To study the impact of role, job- and organizational characteristics on nurse managers' work related stress and well-being such as feelings of emotional exhaustion, work engagement, job satisfaction and turnover intention. BACKGROUND: Various studies investigated role-, job- and organizational characteristics influencing nurse-related work environments. Research on nurse managers' related work environments define influencing factors, but, a clear understanding of the impact of nurse-managers' work-environment characteristics on their work related stress and well-being is limited. DESIGN: A cross-sectional design with a survey. METHODS: A cross-sectional survey (N = 365) was carried out between December 2011-March 2012. The questionnaire was based on various validated measurement instruments identified by expert meetings (e.g. staff nurses, nurse managers and executives and physicians). Hierarchical regression analyses were performed using emotional exhaustion, work engagement, job satisfaction and turnover intentions as outcome variables. RESULTS: Study results showed one out of six nursing unit managers have high to very high feelings of emotional exhaustion and two out of three respondents have high to very high work engagement. Hierarchical regression models showed that role conflict and role meaningfulness were strong predictors of nursing unit managers' work related stress and well-being, alongside with job- and organizational characteristics. CONCLUSION: Several risk factors and stimulating factors influencing nurse unit managers' work related stress and well-being were identified. Further challenges will be to develop proper interventions and strategies to support nursing unit managers and their team in daily practice to deliver the best and safest patient care.

Validation of the Delirium Observation Screening Scale in long-term care facilities in Flanders.

AIM: The aim of this study was to validate the Delirium Observation Screening Scale (DOSS) in a population of long-term care facility (LTCF) residents in Flanders. Currently there is no validated screening tool for delirium available for the population in this setting in Flanders. METHODS: A multisite, cross-sectional study was conducted in six LTCFs. A total of 338 residents aged 65 years and older were included. Sociodemographic and clinical data, including data from the Montreal Cognitive Assessment (MoCA), Confusion Assessment Method (CAM) and DOSS, were obtained by three trained nurse researchers. For the DOSS, internal consistency was determined, and inter-rater reliability was calculated. To validate the DOSS, the sensitivity, specificity, and positive and negative predictive value of the DOSS relative to the CAM were determined through receiver operating characteristic analysis. This article adheres to the Strengthening the Reporting of Observational Studies (STROBE) checklist for observational research. RESULTS: For 338 residents, delirium assessments were completed during an early or late shift. The prevalence of delirium was 14.2% as measured with the DOSS. The reliability (α) for the CAM and DOSS was assessed, as was the inter-rater reliability (κ) and the area under the curve. The sensitivity and specificity for a cut-off value of 3 on the DOSS by Youden's index were very high, as was the negative predictive value. The positive predictive value was good. CONCLUSIONS: This study showed that the DOSS is a reliable and valid instrument to screen for delirium in LTCF residents in Flanders. Geriatr Gerontol Int 2024; 24: 619-625.

Nurse-led interventions to enhance adherence to chronic medication: systematic review and meta-analysis of randomised controlled trials.

PURPOSE: Non-adherence to chronic medication remains an important problem with vast consequences and without solutions to date. Nurses are well positioned to provide adherence care, yet currently represent an underutilised force in improving adherence and outcomes. This review aims to synthesise the effect of nurse-led interventions on adherence to chronic medication. METHODS: Using Review Manager software, a meta-analysis was conducted. The search term medication adherence was combined with random* and nurse in PubMed and ISI Web of Knowledge. Retrieved articles' reference lists were hand searched. Included were randomised controlled trials on nurse-led interventions, aiming to improve chronic medication adherence. Articles were to be in English and published from 2006 to 2011. Quality was assessed using an adapted version of the CONSORT tool. RESULTS: Ten studies met the selection criteria, seven of which were on HIV-positive patients. Their quality was acceptable to high. Counselling was the intervention most frequently assessed, mostly given face-to-face, but also in groups and via electronic messages. All interventions enhanced adherence. Of the five studies reporting adherence as mean percentage of adherence, pooled mean differences were +5.39 (1.70-9.07) (short term) and +9.49 (4.68-14.30) (long term), favouring the intervention groups. Of the studies reporting adherence dichotomously, odd's ratios were 1.55 (1.04-2.29) (short term) and 1.87 (1.35-2.61) (long term). The longer counselling was effectuated, the better the results. CONCLUSIONS: Counselling appears to be an effective approach that nurses can use to supplement other methods, building a multifaceted strategy to enhance adherence. Tackling non-adherence seems to demand continuous efforts and follow-up.

A contingency perspective on team learning and innovation in nursing.

AIMS: To report a correlational study of the relation between team learning activities and implementation-effectiveness of innovations in nursing teams. BACKGROUND: Non-compliance to implementation of innovations is a problem in nursing teams. In the literature, team learning is proposed as a facilitator for change. Still, studies reporting the effects of team learning activities on the implementation of innovations in nursing teams are scarce. To address this gap in the literature, this study explored the influence of team learning on the implementation of two innovations. DESIGN: A cross-sectional survey. METHODS: The survey was conducted in 2008-2009 with a sample of 469 nurses, representing 30 nursing teams from The Netherlands and Belgium. The relationship between variables representing team learning and the use and the knowledge of an incremental (n = 14) or a radical innovation (n = 16) was examined by correlation and multiple regression analyses. RESULTS: Correlation analyses revealed positive relationships between the team learning activities handling production-oriented information and implementation-effectiveness of an incremental innovation. In addition, team learning activities about development-oriented information positively affected the implementation of a radical innovation. Multiple regression yielded models that explain 83% of the variance on the use of an incremental variable, 73% on knowledge of a radical innovation, and 80% on use of a radical innovation. CONCLUSION: In nursing teams, team learning activities that relate to the production of nursing care affect the implementation of an incremental innovation. The implementation of a radical innovation is effected by team learning activities that relate to the development of the provided nursing care.

Delirium in Home Care: A Case Report.

Delirium is a challenging medical problem, particularly in the home care setting, and greatly affects both patients and family caregivers. When delirium is not immediately detected and effectively managed, various outcomes are adversely affected. This report describes delirium in an older home-bound man and offers strategies for detecting and managing delirium in a home care setting. The patient is a frail 86-year-old man with multiple medical comorbidities and functional decline after bronchitis that was diagnosed by a general practitioner. Following the diagnosis and subsequent treatment of bronchitis, the patient suffered a major decline in cognitive and physical functioning during normal daily activities. Medical screening revealed confusion, apathy, and extreme fatigue. Using the assessment tool of the Functional Independence Measures and Delirium Observation Screening Scale (DOSS), the presence of functional decline and delirious symptoms were found. Through multidisciplinary collaboration, a treatment plan was initiated. It consisted of hydration following a fixed schedule, adapted nutrition, a temporary adapted medication schedule for pre-diabetes, and an exercise plan. No specific pharmaceuticals were given. The patient made a full recovery over time. All professional and informal caregivers should be aware of the potential presence of delirium when an older patient with a deteriorating physical or mental condition presents itself. Good diagnostics for delirium and possible underlying diseases are necessary. Adequate treatment, with the help of paramedics such as dieticians, physiotherapists, etc. must be provided when necessary.

The attitude of healthcare providers towards medication self-management in hospitalized patients diagnosed with schizophrenia or bipolar disorders.

BACKGROUND: Medication self-management (MSM) is considered an important aspect of pharmacotherapy and plays an essential role in the treatment of various illnesses. To date, research into the willingness and attitude of psychiatric healthcare providers toward MSM in patients diagnosed with schizophrenia or bipolar disorders during hospitalization is lacking. AIM: The aim of this study was to identify healthcare providers' willingness to MSM and assess their attitude, conditions, benefits, and ability toward it during hospitalization. METHODS: A multicenter, quantitative cross-sectional observational design was used to study psychiatric healthcare providers' attitude to MSM during hospitalization in patients diagnosed with schizophrenia or bipolar disorders. RESULTS: In this study, 173 healthcare providers, of which 147 were nurses and 26 psychiatrists, participated. During hospitalization, 86% of the healthcare providers were willing to MSM. Regularly evaluating patients' ability regarding MSM during hospitalization was seen as an important condition (94%). Psychiatrists were significantly less convinced that MSM during hospitalization has a positive impact on adherence when compared to nurses (respectively 54% vs. 77%, p = .009). DISCUSSION: Most healthcare providers indicated that they were willing to MSM in patients diagnosed with schizophrenia or bipolar disorders during hospitalization under specific conditions.

Digital adaptability competency for healthcare professionals: a modified explorative e-Delphi study.

AIM: To establish items of the digital adaptability competency for healthcare professionals. BACKGROUND: While the application and deployment of eHealth has continued at a rapid pace, healthcare professionals are expected to keep up and join the digital evolution. The implementation of eHealth requires a change in the healthcare professionals' competencies of which the ability to adapt to technological change is fundamental. There's more needed than just ICT skills, overall competencies to be digitally adaptable between patientcare and the use of eHealth are needed. Today, a distinct and relevant list of items for healthcare professionals related to the competency of digital adaptability is missing. DESIGN: An exploratory modified e-Delphi study. METHODS: This study was conducted in Flanders, Belgium. An expert group (n = 12) consisting of 2 policymakers of the Belgian federal government, 3 eHealth managers of large organizations in the Belgian healthcare sector, 1 nurse, 1 midwife, 2 health service users and 3 researchers specialized in eHealth research. Through a literature review an initial list of items was developed, consisting of 67 statements. A two-round Delphi survey was performed where experts could rate the relevance of each item. The third round comprised an online meeting, where the expert group discussed the remaining items until agreement was reached to retain, modify, or eliminate the item. RESULTS: In round 1, eleven items were included to the final document. In round 2, ten items were included. In round 3, the panel unanimously agreed to add six items, one item was modified into two separate items. In total, 29 items were included in the final document. CONCLUSIONS: The rather abstract concept of digital adaptability is now transformed into a more pragmatic concept of 29 items, reflecting the practical competencies of healthcare professionals necessary to be digital adaptable.