Doctoral programmes in the nursing discipline: a scoping review.

BACKGROUND: This study aimed to map and summarise the state of the research regarding doctoral programs in nursing, as well as the issues debated in the context of nursing doctoral education. A Scoping Review in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension scoping reviews statement (PRISMA-ScR) was conducted. Three electronic bibliographic data bases were searched: Cumulative Index to Nursing and Allied Health Literature Complete, Medline (on EBSCO Host) and SCOPUS to identify empirical studies published between January 2009 and December 2019. The review process was based on framework identified by Arksey and O'Malley and further revised by Levac and colleagues. Analysis was performed with the use of the Donabedian framework regarding the structure of the doctorate programmes, the process, and the outcomes. RESULTS: The review included 41 articles, mostly originating in the United States (n=26) and Europe (n=8), mainly by collecting the perceptions of students and faculty members with descriptive studies. The following issues were investigated at the (a) structure level: Prerequisite for doctoral candidates, Qualifications of faculty members, Mission of doctoral programs; (b) process level: Doctoral programs contents, Doctoral programs resources and quality, Mentoring and supervision, Doing doctorate abroad; and (c) outcome level: Academic performance outcomes in doctoral programs, Doctoral graduates' competences, Doctoral students/graduates' satisfaction, Doctoral graduates' challenges. CONCLUSIONS: Doctoral programs have mainly been investigated to date with descriptive studies, suggesting more robust research investigating the effectiveness of strategies to prepare future scientists in the nursing discipline. Doctorates are different across countries, and there is no visible cooperation of scholars internationally; their structure and processes have been reported to be stable over the years, thus not following the research development in nursing, discipline and practice expectations. Moreover, no clear framework of outcomes in the short- and long-term have been established to date to measure the quality and effectiveness of doctorate education. National and global strategies might establish common structure, process and outcome frameworks, as well as promote robust studies that are capable of assessing the effectiveness of this field of education.

Religiosity and Attitudes towards Health, Disease, Death and the Use of Stimulants among Jehovah's Witnesses.

Religiosity is considered as one of the many factors shaping an individual's health consciousness. The aim of the study is an analysis of the correlation between the religiosity of Jehovah's Witnesses and their attitudes towards health and disease. A cross-sectional study was performed on the convenience sample of 171 Jehovah's Witnesses from eastern Poland with the use of two research tools: the author's questionnaire, focusing on attitudes towards health, disease, death and the use of stimulants, and the Duke University Religion Index (DUREL). The research involved 99 females (57.9%) and 72 males (42.1%), with an average age of 37.25 (SD = 12.59) years. On average, they have been a Jehovah's Witness for 29.21 (SD = 13.22) years and are characterised by a high ratio of organisational religious activity (ORA) (M = 5.60; SD = 0.62) and intrinsic religiosity (IR) (M = 4.81; SD = 0.37). Those who had never smoked before becoming one of Jehovah's Witnesses had a higher IR (Z = -2.822; p = 0.005), similarly to those respondents who smoked cigarettes before they became Jehovah's Witnesses (Z = -2.977; p = 0.003) and those who did not abuse alcohol before they became Jehovah's Witnesses (Z= -1.974; p = 0.048). Jehovah's Witnesses are a group characterised by a high degree of consistency when it comes to religiosity, attitudes regarding health and disease and health behaviours. This means that they follow the teachings of their religion with regard to health issues. Knowledge about the association between religiosity and health behaviours is important to provide effective health education, health promotion and development of health prevention policy, specifically when dealing with more religious groups of clients.

The role of doctoral-educated nurses in the clinical setting: Findings from a scoping review.

AIMS AND OBJECTIVES: To map and summarise published studies on the career opportunities and roles of doctoral-educated (PhD and DNP) nurses in the clinical setting; to collate actions as proposed in the literature to promote career opportunities and roles for PhD and DNP nurses in the clinical setting. BACKGROUND: To improve healthcare outcomes and strengthen leadership in nursing practice, there is the need to place nurses with a doctorate in clinical settings. However, available evidence has never been summarised to map the state of the science in this field. DESIGN: A scoping review, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for scoping reviews statement (PRISMA-ScR). METHODS: An electronic database of literature was searched by accessing CINAHL Complete and Medline (on EBSCO Host) and SCOPUS to identify studies published between January 2009-December 2019. A thematic analysis was performed by identifying emerging patterns in the research questions. RESULTS: Ten studies were found with three types of clinical engagement: (a) a practice influencer/developer; (b) a clinical leader; and (c) a clinical teacher for students. Working in clinical areas, doctoral-educated nurses might influence several outcomes at the patient, research, staff and organisational levels. CONCLUSIONS: Clinical roles for doctoral-educated nurses are still uncommon. However, in the last ten years, a debate has started to identify the possible careers in clinical settings, the needs and the challenges encountered while developing clinical academic roles, as well as the outcomes and actions that should be undertaken. RELEVANCE TO CLINICAL PRACTICE: Academic nursing bodies, working with professional bodies and healthcare institutions at different levels, are called on to develop career frameworks, allowing the opportunity for doctoral-educated nurses to be involved in clinical practice and to influence its quality and performance; this might in turn lead to an increase in the quality of research.

Female sexuality at reproductive age as an indicator of satisfaction with life - descriptive cross-sectional survey.

INTRODUCTION: Life satisfaction is the result of valuing one's own life, and it is higher when the individual situation is closer to the general norm. It is characterized by dynamic and subjectivity and the way it is perceived is regulated by internal and external factors. Life satisfaction can be described in subjective and objective categories, by various indicators. OBJECTIVE: The aim of the study was to evaluate the determinants of satisfaction with life in selected aspects among women of reproductive age. MATERIAL AND METHODS: The study was conducted on 280 women, selected according to the following criteria: age range 18-45, at least one sexual intercourse per month, lack of chronic diseases or cancer, and consent to participate in the research. The research instruments used were: Satisfaction With Life Scale (SWLS), Sexual Satisfaction Questionnaire (SSQ), Female Sexual Function Index (FSFI). RESULTS: Life satisfaction increased with age (p<0.0001), higher life satisfaction was reported by women with higher education (p<0.001), married, (p<0.01), talked with their partner about their sexual expectations (p=0.03) and did not want to change anything in their sexual life (p<0.001). Analysis revealed a positive correlation between life satisfaction and sexual satisfaction (p < 0.0001). CONCLUSIONS: Higher level of sexual satisfaction and sexual health is related to better satisfaction with life. Factors affecting sexual satisfaction include residence, having children, discussing one's sexual expectations with their partner, feeling no need to change one's sex life, and frequency of sexual activity.

Place of Residence and Marital Status as Variables Differentiating a Sense of Self-Efficacy in the Elderly-A Descriptive Cross-Sectional Survey.

Background: Studies on the self-efficacy of the elderly are still being conducted to a very limited extent. Nevertheless, they can provide relevant information for specialists to use in many disciplines of science, as well as for practitioners, especially gerontologists, geriatricians, psychologists and other people associated with prophylaxis and health promotion. The aim of the study is to assess the impact of the place of residence and marital status on the self-efficacy in the elderly. Methods: A diagnostic survey method was used for the study and within the method, the authors' sociodemographic data questionnaire and the generalized self-efficacy scale (GSES) were applied. The study was carried out in a group of 171 females and 130 males under nursing care in the home environment or in nursing-home care in Poland. Results: The average level of generalized sense of self-efficacy in the research cohort was M = 26.69, SD = 8.49. A relatively high percentage of the group (48.9%) showed a sense of self-efficacy at a high level. The level of a sense of self-efficacy was low in 38.2% of the cohort, while its average intensity in the remaining ones constituted 12.9% of the total. A statistically significant impact of a place of residence (Z = -2.940; p = 0.003) and marital status (H = 12.000; p = 0.007) on the sense of efficacy in the research cohort was proven in favor of those from the rural environment and the respondents having spouses. Conclusions: On the scale of the studied group, the results of a sense of self-efficacy are optimistic, as older people with high levels predominated. However, the results of the cohort whose self-efficacy is insufficient to cope with their old age should be considered carefully, especially in the case of lonely people living in the urban environment and NHC (nursing-home care) residents.

The Correlation between Social Support and Quality of Life of Seniors without Cognitive Disorders from an Institutional Environment-A Descriptive Cross-Sectional Survey.

The aim of this study was to confirm the correlation between social support and the quality of life of seniors who live without cognitive disorders, but are living in an institutional environment. The measurement of variables was based on a cross-sectional survey method. A representative sample of 957 seniors participated in the survey. The study covered public nursing homes (NHs) and residential care homes (RCHs) selected for the study by stratified sampling. The results confirmed a linear correlation between social support and the quality of life of seniors (p < 0.001). It was also confirmed that there were differences in the range of studied variables depending on the type of institution (NH versus RCH; p < 0.001). Social support is a significant component, and at the same time, a modifier of the perception of the quality of life for older people. Its variable level determines the subjective assessment of functioning in particular domains of quality of life. RCH as an institution of a social nature satisfies the needs for support at a higher level than NH, which translates into a better perception of older people's quality of life.

Health Evaluation in the Context of Satisfaction with Medical Services among Patients with Osteoarthritis: Descriptive Cross-Section Survey.

Osteoarthritis (OA) is one of the most common causes of rehabilitation benefits and senior disability. It generates high costs of treatment and increasing demand for medical staff and care of geriatric profile. The aim of the study was to determine the relationship between health evaluation and satisfaction with medical services among individuals with OA in rehabilitation outpatient clinics. The survey was carried out from June 2017 to May 2018, among patients being provided with services of five outpatient rehabilitation clinics in Lublin. The surveyed group comprised 328 respondents. The following tools were utilized: the List of Health Criteria (LHC), the Multidimensional Health Locus of Control Scale (version B) (MHLC), the authors' own questionnaire compiled for the study, and the Servperf Method. According to the respondents, the most important health criterion is "not to experience any ailments" (M = 1.56). In an assessment of a clinic, the respondents rated neatness (cleanliness) of the staff highest (M = 4.38) and the appearance of a building where a clinic is located lowest (M = 3.42). The better the evaluation of medical services in an outpatient rehabilitation clinic in comparison to other settings, the better the evaluation of the quality of service (rho S = 0.593; p < 0.000). The study conducted in outpatient rehabilitation clinics showed great demand for outpatient specialist care of geriatric profile. Undoubtedly, there is need for continuation and expansion of studies on patients with OA in other rehabilitation settings.

Electrical bioimpedance in patients after ischemic stroke, a civilization disease.

INTRODUCTION: Ischemic stroke is caused by artery blockage, resulting in damage to brain tissue. A significant factor in the further treatment of a patient is not only the time to reach a specialist centre, but also the state of hydration of the organism. Clinical situations involving the excess or deficiency of water can have extremely serious consequences for the functioning of the body and subsequent stroke-related disorders. One of the increasingly common methods of evaluating the composition of the human body is by electrical bioimpedance. OBJECTIVE: The aim of the study was to assess the state of human body hydration measured by bioimpedance in patients with an early stage of ischemic stroke. MATERIAL AND METHODS: The examination involved 81 patients with ischemic stroke in the Neurology Department, Subdivision of Stroke Treatment at the Province Specialist Hospital in Lublin, Poland, in 2015. Measurement of the composition and outer and intracellular space of the human body by the Whole Body Bioimpedance (WBIA) method was performed using the Body Composition Monitor (BCM) (Fresenius Medical Care GmbH, Bad Homburg, Germany). RESULTS: A group of patients were been examined with the use of the BIA apparatus three times: on the first, seventh, and tenth day of hospital stay, to determine the level of body hydration. Comparative analysis of data showed that on the first day of hospitalization all the measurements of electrical bioimpedance parameters in the patients were significantly different from those of the control group. In the case of TBW, ECW, ICW, the patients' scores were significantly higher than those of the control group. Only with respect to the over-hydration index, the patients achieved a significantly lower score than the control group. CONCLUSIONS: Assessment of hydration status in patients with a diagnosed stroke indicates a slight dehydration in relation to the control group, but falling within the scope of normovolaemia, according to bioimpedance measurement standards.

Differences in the quality of life dependent on family status of the elderly living in rural areas - a cross-sectional survey.

INTRODUCTION: A factor that conditions the perception of the quality of life (QoL) is having a social network and relationships within it. The quality of life of seniors is assumed to be at a higher level if they are surrounded by those close to them in comparison to those living alone. The aim of the study was to assess differences in the quality of life of elderly rural residents depending on their family status. MATERIAL AND METHODS: Due to the random and mixed selection of respondents, the study comprised a group of 588 representatives living in rural areas of Eastern Poland. The differentiated criterion of the groups of senior respondents was their family situation: living with a family or living alone. Assessment of the quality of life was conducted by means of the WHOQoL-bref questionnaire. The Mann-Whitney tests and Kruskal-Wallis tests were used to carry out statistical analysis of the data. RESULTS: The respondents who lived with their families differed statistically to a significant extent (p<0.005) from those who lived alone. The former gave a better assessment of the majority of the QoL domains: physical, psychological and social. Obtaining higher mean values for the environmental domain among the respondents living alone (M=14.31) seemed to be an atypical and interesting phenomenon because seniors living with their relatives usually assessed that dimension better than those living alone. CONCLUSIONS: The family situation of seniors affected the level of quality of life. Living with their relatives may be expected to be favourable for seniors because it translates into better performance in physical, psychological and social domains. Loneliness, which frequently accompanies old age, leads to the deterioration of the quality of life.

Differences in the Perception of Social Support Among Rural Area Seniors-A Cross-Sectional Survey of Polish Population.

Introduction and objective: Social support constitutes an important determinant of an elderly person’s health and of functioning in his or her living environment. It depends on available support networks and the type of help received. Measurement of social support should encompass both its structure and the functions it fulfills, which enables detailed assessment of the phenomenon. The aim of the study was to compare the perception of social support among rural area seniors provided with institutional care with those living in a home setting. Material and method: Using the diagnostic survey method and the technique of the distribution of a direct questionnaire, 364 respondents from rural areas were examined: those living in an institutional environment (n = 190) and those living in their home (natural) environment (n = 174). The respondents were selected on the basis of a combined sampling method: proportionate, stratified, and systematic. Variables were measured with the following questionnaires: Courage Social Network Index (CSNI) and Social Support Scale (SSS). Results: The living environment has been proved to differentiate average values of support both in the structural and functional dimensions in a statistically significant way (p < 0.001). An untypical phenomenon was higher average values pertaining to emotional bonds, frequency of direct contacts, and help received in the group of respondents living in an institutional environment. Conclusions: The living environment and demographic variables affect the perception of social support among elderly people. Full-time institutional care of a senior citizen leads to the deterioration of social support; therefore, keeping an elderly person in a home environment should be one of the primary goals of the senior policy.

Psychosocial aspect of quality of life among working and unemployed nurses and midwives.

OBJECTIVE: The objective of the study was to explain differences in the subjective evaluation of the psychological and social aspects of quality of life in a group of working and unemployed nurses and midwives. MATERIAL AND METHODS: The survey was conducted in a group of 620 professionally-active and inactive people (315 nurses and 305 midwives), selected by random stratified-systematic sampling. The tool used to gather empirical material was the standardized questionnaire WHOQoL-100. RESULTS: Professionally-active nurses evaluated the mental domain less favourably (M=12.33), compared with unemployed nurses (M=12.73), and the difference between average values was statistically significant (p=.043). It is also worth noting that in the group of midwives there were significant differences in each discussed domain. The unemployed respondents evaluated more positively the overall quality of life (M=14.29; p=.005) and the mental domain (M=12.85; p=.009), while the social domain was evaluated less favourably by the professionally-active midwives (M=12.73; p=.022). CONCLUSIONS: Paradoxically, those who were unemployed made slightly more positive evaluations in comparison with the professionally active. Professional work is not a factor preferably affecting the quality of life and its psychosocial dimension. The higher quality of life of the unemployed respondents may result from the buffering impact of social support.

Psychosocial aspect of quality of life of Polish women with breast cancer.

INTRODUCTION AND OBJECTIVE: Breast cancer is one of the most frequently occurring malignant tumours among women in Poland. The highest incidence of the disease is registered among women aged 50 and more. Cancer imposes a considerable psychological strain on a woman. It causes a sense of uncertainty about one's health and further life, as well as frequent problems with accepting the image of one's own body. It often results in low self-esteem and a feeling of embarrassment, accompanied by symptoms of apathy and detachment. The aim of the study was to determine mental and social life quality of Polish women treated for breast cancer. MATERIALS AND METHODS: The research encompassed 107 women aged between 45 and 65 (SD=6.11) undergoing treatment for breast cancer. The WHOQOL-Bref scale was applied in the research. RESULTS: The social field was better evaluated in comparison with the mental sphere. There was a statistical correlation between place of residence and social sphere of quality of life (p=,036), with higher ratings assigned by respondents residing in rural areas (M=15.36) compared with residents of towns (M=14.15). CONCLUSIONS: Given the fact that respondents were coping with cancer or its consequences, paradoxically, perception of the overall quality of life and examined areas was generally good, especially among women with higher education, those who were single and those living in rural areas. Along with age, there decreases at the respondents the experienced quality of life, however a rise of evaluations of the mental sphere is accompanying the rise in the education level.

[Synthetic endovascular prostheses in the treatment of the aortic dissection]. / Syntetyczne protezy wewnatrznaczyniowe stosowane w leczeniu rozwarstwienia aorty.

Endovascular technique using endovascular prostheses called stent-grafts offers less invasive new method of the aortic dissection. Assessment of endovascular aortic dissection type B treatment effectiveness, complications and mortality frequency associated with this technique. Among 33 patients (24 men -- 73% and 9 women -- 27%, aged 19-76 years (average [+/- SD]. Underwent endovascular stent-grafts implantation procedures using 3 types of grafts: Zenith (2 prostheses -- 13,3%), Talent (11 prostheses -- 73,3%) and Valiant (2 prostheses --13,3%). The diameter of proximal end of stent-graft ranged from 34 to 42 mm (mean 37,6 +/- 3,44 mm), length -- from 130 to 230 mm (mean 183,6 +/- 37,42 mm). Endovascular technique is promising strategy of aortic dissection type B treatment. Stent-graft application faces up to general aspiration to minimize extension and traumatization of surgical procedures, to reduce peri- and postoperative complications, decrease hospitalization and convalescence period. Endovascular technique is the only available method that interferes in the elementary mechanism of the aortic dissection pathogenesis. Through the initiation of natural repair process (thrombosis of the false lumen), as a result of coverage of the primary entry tear, ensures remodeling and stabilization of the aortic wall.