BACKGROUND: There is an increasing demand for comprehensive geriatric care. Nurse practitioners (NPs), who undergo specialized training, are situated to provide such care. In Israel, the role of a geriatric nurse practitioner was introduced in the health care system 10 years ago. However, little is known about the rate of professional satisfaction and realization of full potential among these nurses. PURPOSE: The aims of this study are (1) to describe the geriatric NP workforce in Israel, (2) to measure the current geriatric scope of practice, and (3) to measure the geriatric NP satisfaction from their working environment. METHODOLOGY: For this cross-sectional study, a survey, comprising three sections relating to demographics, professional qualifications and scope of practice, and career satisfaction, was sent to 53 geriatric nurse practitioners in Israel who currently work as geriatric nurse practitioners. RESULTS: Forty-seven nurses participated in the survey. Almost 64% reported that they are satisfied with their position, and 72% reported that they are able to fulfill their full scope of practice. The mean score for scope of practice was 68.31 out of a possible score of 100. CONCLUSIONS: A number of qualifications were correlated with satisfaction at work, indicating that nurses tend to be more satisfied at work when they are able to fulfill their potential. IMPLICATIONS: Ensuring nurse practitioners' ability to realize their full potential should be a goal of the health care system. Interventions should be in place to encourage nurses to perform tasks related to their work, for which they are trained.
Job Satisfaction , Nurse Practitioners , Humans , Israel , Nurse Practitioners/statistics & numerical data , Nurse Practitioners/psychology , Cross-Sectional Studies , Female , Surveys and Questionnaires , Adult , Male , Middle Aged , Scope of Practice , Geriatric Nursing/methods
AIM: The aim of this study was to evaluate the incorporation of an educational tour into the curriculum for master's nursing students. BACKGROUND: Experiential learning is an educational approach that emphasizes hands-on experiences outside the classroom. In a two-kilometer radius in Jerusalem are historical health institutions, established beginning in the 1830s through the British Mandate, from which much can be learned about the state of public health then and how it shaped modern institutions. DESIGN: This was a cross-sectional study. METHODS: This study utilized the feedback received by students through an evaluation survey sent out after the tour. The survey had questions on overall satisfaction, how the tour contributed to their knowledge, and the appropriateness of the tour as part of the course. Additionally, students were asked if the tour added to their experience and how in an open-ended question. RESULTS: High scores were given for overall satisfaction, contribution to knowledge and the appropriateness of the tour. Additionally, four points were raised in the open-ended question: national pride in healthcare leadership, socio-political aspects and conflicts, the role of funding, and personal inspiration and professional development. CONCLUSIONS: The tour evaluation emphasized the advantages of experiential learning, enabling a deep understanding of the healthcare system's historical development in a multicultural city, as well as lessons for the future.
Problem-Based Learning , Students, Nursing , Humans , Cross-Sectional Studies , Public Health , Learning , Curriculum
Demands for whole blood (WB) and COVID-19 convalescent plasma (CCP) donations during the SARS-CoV-2 (COVID-19) pandemic presented unprecedented challenges for blood services throughout the world. This study aims to understand the motivating factors that drive WB and CCP donations in the context of the pandemic. This cross-sectional study is based on data extracted from surveys of the two volunteer donor cohorts. The findings reveal that when compared to CCP donors, WB donors were more likely to view donation as a form of social engagement (97.7% vs. 87.1%, p < 0.01), advantageous in the workplace (46.4% vs. 28.6%, p < 0.01), advantageous in their social network (58.6% vs. 47.0%, p = 0.01), and view their donation in the context of positive self-satisfaction (99% vs. 95.1%, p = 0.01). The average age of CCP donors was 7.1 years younger than those who donated WB (p < 0.01). Motivational factors were also analyzed by sex and religiosity. In conclusion, whereas both donor groups showed a high motivation to partake in these life-saving commitments, WB donors were more likely to be motivated by factors that, when better-understood and implemented in policies concerning plasma donations, may help to increase these donations.
Background: Breast cancer is the leading cause of cancer death in Israeli women. Previous studies found socioeconomic status and other risk factors impact breast cancer outcomes. The ultra-orthodox community is characterized by a longer life expectancy, lower rates of mammography performance, higher fertility rates and other sociodemographic variables that may be related to breast cancer mortality. This study examined disparities in breast cancer mortality between ultra-Orthodox and non-ultra-Orthodox Israeli women. Methods: This retrospective cohort study for breast cancer mortality included the all Jewish Israeli citizens women born between 1940 and 1960 and lived in communities with over 20,000 residents (n = 628,617). Data was collected from various sources, monitoring a period of 31 years; for each participants, their sociodemographic characteristics were compiled from the population registry, the tax authority, the education registry, and the Central Bureau of Statistics (CBS). Variables included religiosity, age, marital status, children, origin, education, and income. Multivariable Cox models evaluated predictors of mortality. Results: Of the 628,617 women in the study, 29,611 were ultra-Orthodox. Ultra-Orthodox women had higher marriage rates, more children, and lower secular education and income. Mortality was 108.8/100,000 overall, lower among ultra-Orthodox (83.4/100,000) than non-ultra-Orthodox women (110.1/100,000) despite their risk factors. Using a multivariate model to evaluate the association between ultra-Orthodoxy and breast cancer mortality, the study found higher breast cancer mortality rate among non-ultra-Orthodox women compared to ultra-Orthodox women (HR = 1.491; 99% CI = 1.232, 1.804). Associations with sociodemographic variables were different for each group. Conclusions: Although ultra-Orthodox women have socioeconomic risk factors, breast cancer mortality was lower than non-ultra-Orthodox women. Further research on potential cultural and religious factors influencing mortality is warranted. These findings highlight the importance of evaluating predictors within specific populations.
Introduction: For healthcare workers, good work-related well-being positively affects enthusiasm, efficiency, and job satisfaction. Conversely, poor well-being is associated with burnout and negative patient outcomes. During times of crises, it is difficult to balance professional responsibilities with well-being. Objective: This study aimed to evaluate the degree of well-being among nurse practitioners in Israel who worked in COVID-19 units or allied units during the delta wave. Methods: This was a web-based, cross-sectional study. Nurse practitioners who worked within the COVID-19 units in Israeli hospitals were asked to complete several questionnaires: a sociodemographic questionnaire, the Subjective Happiness Scale, the Mental Health Continuum-Short Form, and the Center for Epidemiologic Studies-Depression. Results: Forty-nine nurse practitioners participated in the survey. Scores from the Subjective Happiness Scale and the Mental Health Continuum-Short Form indicate that most nurses have relatively positive mental health. Conversely, scores on the Center for Epidemiologic Studies indicated that participants are at risk for clinical depression. There was a positive moderate association between the number of years worked as a nurse practitioner and depression and a moderate negative association between the number of years worked as a nurse practitioner and happiness. Conclusions: Understanding how nurses' mental health is impacted during crises can provide healthcare systems with tools to prevent negative outcomes. This, in turn, may contribute to a lower burnout rate, higher satisfaction from work, and better patient outcomes.
AIM: To evaluate Alzheimer's disease (AD) knowledge and attitudes among Israeli nursing students and nurses with different educational backgrounds working in varied geriatric settings BACKGROUND: Alzheimer's disease (AD) management and treatment relies on multidisciplinary care, providing comprehensive treatment to these patients. Nurses are vital to treatment provision. However, less nursing students are expressing interest to work with the geriatric population, including those with dementia. DESIGN: This was a cross-sectional study. METHODS: Participants were 231 nursing students and nurses of various educational backgrounds and from varied geriatric settings. Study measures included sociodemographic characteristics, the Alzheimer's disease Knowledge Scale, and the Dementia Attitude Scale. Participants were recruited via social media, nursing administrations in medical facilities, and snowballing methods. Overall scores by educational background and correlations between the measures and select sociodemographic variables were evaluated. RESULTS: The overall knowledge and attitudes towards dementia among Israeli nurses is moderate to high. The mean knowledge score was 23.32/30. The highest scores (for knowledge and attitude) were found among geriatric nurse practitioners. The lowest knowledge scores were found among registered nurses without a degree, while the lowest attitude scores was found among nursing students. CONCLUSIONS: Despite relatively high scores, there is still a need to minimize the gap in specific knowledge and attitude domains. There is a need for domain-specific training, such as risk factors related to dementia, and providing nurses of all educational backgrounds with the tools they need to feel comfortable in caring for AD patients.
Alzheimer Disease , Students, Nursing , Humans , Aged , Cross-Sectional Studies , Surveys and Questionnaires , Attitude of Health Personnel , Educational Status , Health Knowledge, Attitudes, Practice
BACKGROUND: Nutrition therapy plans (NTPs) in discharge summaries of tube-fed patients transferred from acute-care hospitals to rehabilitation centers are fundamental for continuity of care. This study examined the presence and quality of NTPs in discharge summaries of tube-fed patients. METHODS: This cross-sectional study was based on data retrieved from electronic medical records. The outcome measures were the presence of NTPs in discharge summaries, the presence of key elements of the NTPs, and the level of compatibility between multiple NTPs per discharge summary prepared by different health professionals. Descriptive statistics were used to assess the number of NTPs, the presence of key elements, and the degree of compatibility between NTPs for the same patient. RESULTS: A total of 100 discharge summaries of tube-fed patients admitted to a rehabilitation hospital during 2015-2017 were identified. The majority (91%) of discharge summaries included at least one NTP; 57 included more than one. Variance in the presence of key elements was observed in 165 NTPs prepared by physicians, nurses, and dietitians. Water amount and nutrition route were least reported by dietitians (6.3% and 9.4%, respectively), compared with physicians (77.6% and 81%) and nurses (77.3% and 62.7%). However, nutrition details were reported more frequently by dietitians (65.6%) than physicians (20.7%) and nurses (32%). Low compatibility was observed between dietitians and both nurses and physicians, in the range of 0%-26%. CONCLUSION: Large discrepancies were found between NTPs for the same patient prepared by dietitians, physicians, and/or nurses, and a portion of patients arrived without any NTP.
Hospitalization , Nutritional Support , Humans , Cross-Sectional Studies , Hospitals , Delivery of Health Care
Breast cancer is a leading cause of death. There are a number of risk factors for breast cancer mortality including parity, age, ethnicity, genetic history, and place of residence. This study examined the disparities in breast cancer-related mortality rates among women from urban areas compared to rural areas in Israel. This was a retrospective, follow-up study on mortality from breast cancer among 894,608 Israeli women born between the years of 1940 and 1960. Data was collected from the Israeli Central Bureau of Statistics, the Population Authority, the Education Ministry, and the Health Ministry. Over 80% of women lived in urban areas. A higher incidence of mortality from breast cancer in Israel was found among urban women compared to rural women (1047.8/100,000 compared to 837/100,000, respectively). Even after adjusting for sociodemographic variables, higher mortality rates were found among women from urban areas in Israel compared to women from rural areas in Israel. It is believed that environmental factors can partially explain the geographic variation of breast cancer incidence, and that breast cancer incidence is likely a complex interaction between genetic, environmental, and health factors.
Breast Neoplasms , Female , Humans , Urban Population , Retrospective Studies , Breast Neoplasms/epidemiology , Follow-Up Studies , Rural Population
The COVID-19 pandemic has imposed barriers to a healthy lifestyle, especially for older adults who are considered to be at a high-risk of infection. This study examined the associations between negative changes and the self-classification to COVID-19 risk level among physically active older adults who are members of a nationwide health club chain. A cross-sectional digital survey was sent to 19,160 older adults (age ≥ 65). The data collected included information on the subjects' self-classification to the COVID-19 high-risk group (HRG) and changes in physical activity (PA), body weight, and smoking habits since the outbreak. Logistic regression models were used to investigate the associations between the dependent variables of 'experienced a negative change' and the independent variables. Of the 1670 survey respondents, 78.3% classified themselves as COVID-19 HRG. Over half of the respondents reported a reduction in PA hours, 26.6% reported weight gain, and 17.7% of smokers increased their amount of smoking. A self-classification to the HRG was associated with 1.46 (95%CI 1.10−1.93, p < 0.009) and 1.67 (95%CI 1.21−2.31, p < 0.002) greater odds for reduced hours of exercise and weight gain compared to the not high-risk group, respectively. Decision makers should consider how policies may cause barriers to a healthy lifestyle and develop risk communication strategies to encourage positive health-related behaviors, even during a pandemic.
COVID-19 , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Life Style , Pandemics , Weight Gain
BACKGROUND: Respiratory cancers, including lung, tracheal and bronchus cancers, are a leading cause of cancer-related mortality in Israel; however, incidence can differ among demographic groups. Despite the importance of sociodemographic characteristics and the interactions between them to incidence and mortality, this topic is understudied. This study analyzes sociodemographic disparities by sex and ethnicity among Jews and Arabs to understand cancer outcome differences stratified by SES, marital status, and number of children as potential contextual factors. METHODS: This retrospective cohort study analyzed respiratory cancer-related mortality rates among Israelis born between 1940 and 1960 over 21-years. The follow up period was between January 1, 1996 and 12.31.2016. Mortality rates for Jews and Arabs were calculated. Using a Cox Regression, a multivariate model was constructed to determine the association between ethnicity and respiratory cancer mortality. The study population was then divided into four groups, by sex and ethnicity, to determine the association between marital status, number of children, and SES with respiratory cancer mortality for each subgroup. RESULTS: The overall mortality rate was 0.6%. Arabs had higher mortality rates compared to Jews, even after adjusting for demographic factors including age, sex and SES (Adjusted Hazard Ratio (AHR) = 1.442, 99% confidence intervals (CI) = 1.354,1.546). Among men, a higher mortality rate was found among Arabs (AHR = 1.383, 99%CI = 1.295,1.477), while among women, Arabs had lower mortality rates (AHR = 0.469, 99%CI = 0.398,0.552). Significant mortality rate differences were observed by ethnicity and sex for each sociodemographic variable. CONCLUSIONS: This study highlights the importance and implications of understanding differences in respiratory cancer mortality between Jews and Arabs, a minority group in Israel, and is relevant for minority groups in general. There is a need to tailor interventions for these groups, based on differing underlying causes and contextual factors for these cancers. Cancer outcomes among these groups should also be studied separately, by sex, to better understand them.
INTRODUCTION: The coronavirus pandemic has disproportionately negatively affected the ultraorthodox in Israel. Their unique characteristics and slow adoption of preventative health guidelines resulted in a significant increase in morbidity and mortality. To lower these rates, health and government authority figures employed methods to change the ultraorthodox community health behaviors. METHODOLOGY: This study utilizes the ACCESS model for transcultural nursing to analyze the response by authorities to high infection rates in the large ultraorthodox community in city of Beit Shemesh during the first wave of the outbreak (through early May). RESULTS: The authorities employed all model components to varying degrees and found moderate success in changing health behaviors of the ultraorthodox. DISCUSSION: Employing the ACCESS model as a response to the health care crisis among the ultraorthodox community in Beit Shemesh led to some success in increased compliance, thus lowering morbidity rates. However, not establishing strong respect and rapport hindered the process.
COVID-19/psychology , Communication , Health Behavior/ethnology , Jews/psychology , COVID-19/epidemiology , COVID-19/prevention & control , Culture , Delivery of Health Care , Humans , Models, Nursing , Pandemics , SARS-CoV-2 , Transcultural Nursing
BACKGROUND: Previous studies have shown that minorities and immigrants have low levels of trust in healthcare systems (HCSys), which might present a barrier in access to and utilization of healthcare services. We compared the levels of trust in Israel's HCSys among the Arab minority, immigrant Jews, and non-immigrant Jew sand draw on the integrative model of organizational trust to explore factors that can explain differences in the trust level within and between the study groups. METHOD: We obtained cross-sectional census data from the 2017 Social Survey of the Israel Central Bureau of Statistics. We studied levels of trust based on a survey question: "Do you have trust in the HCSys?" We used logistic regression models to compare levels of trust in HCSys among the study groups, adjusting for components of the integrative model: characteristics (sex, age, education, religiosity, and healthcare service use), abilities (private health insurance ownership), integrity (discrimination, trusting the justice system and government), and perceived risk (self-reported health). RESULTS: Our findings revealed that Arabs (odds ratio (OR) = 4.20, 95% confidence intervals (CI) = 4.17, 4.23) and immigrant Jews (OR = 2.54, 95% CI = 2.51, 2.58) had more trust in the HCSys compared to non-immigrant Jews, even after adjusting for all the component variables. Different components of the integrative model explained trust in each population group. CONCLUSION: Minority and immigrant groups had greater trust in the HCSys compared to the non-immigrant group. These findings may indicate different expectations with respect to patient-caregiver relations and HCSys utilization and raise questions regarding access to HCS and quality of care among minority and immigrant groups.
Emigrants and Immigrants , Jews , Arabs , Cross-Sectional Studies , Humans , Israel , Trust
