Comparison of student nurses' expectations and newly qualified nurses' experiences regarding clinical practice: A secondary analysis of a cross-sectional survey.

AIM: To compare student nurses' expectations and newly qualified nurses' experiences regarding clinical practice in Switzerland 1 year after graduation. DESIGN: A secondary explorative analysis of a cross-sectional survey. METHODS: The data were sourced from the Swiss National Graduate Survey of Health Professionals covering six universities of applied sciences between 2016 and 2019, with information on three cohorts of bachelor student nurses, with a 1-year follow-up between each year. The participants were 533 bachelor-prepared nursing graduates. RESULTS: The student nurses' overall expectations included the following top two prioritized aspects: 'contributing to something important' and 'adequate time to spend with patients'. Newly graduated nurses' clinical practice experiences demonstrated that not all expectations were met 1 year after graduation. The largest gaps were found in 'adequate time to spend with patients', 'work-life balance' and experiencing 'good management'. CONCLUSION: The most crucial expectation gaps are related to having sufficient time to spend with patients and a good work-life balance. The most important result is whether there is a shortage of places for nurses to work rather than the oft-cited shortage of nurses. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The expectations of Swiss newly qualified nurses can be better met by an assessment in the first year about which individual perceptions of workplace characteristics cause them to make choices to change something about their work, affect their job satisfaction or influence their intention to stay. IMPACT: Few of the student nurses' expectations were met 1 year after graduation, therefore Swiss healthcare institutions should improve needs assessments to strengthen the nurse workforce starting early in employment. The results underscore the importance of a constructive management culture, such as that in magnet hospitals in the United States which underpins the philosophy of changing in nursing. The results can be used internationally as a benchmark and as a basis for introducing potential interventions for nurse retention. REPORTING METHOD: This study was reported following the Standardized Reporting of Secondary Data Analyses Checklist. PATIENT OR PUBLIC CONTRIBUTION: There were no patient or public contributions. TRIAL AND PROTOCOL REGISTRATION: This study has not been registered.

Evaluation of knowledge about gestational diabetes mellitus among postpartum women and its connection with women's sociodemographic and clinical characteristics: a quantitative cross-sectional study.

OBJECTIVE: to define the knowledge level among postpartum women affected by gestational diabetes and identify its association with women's sociodemographic and clinical characteristics. DESIGN AND SETTING: a cross-sectional comparative study was conducted. Data collection took place in a single university hospital in the German speaking part of Switzerland. PARTICIPANTS: a total of 107 postpartum women diagnosed with gestational diabetes in the current pregnancy completed a gestational diabetes mellitus specific knowledge questionnaire (GDMKQ) in German or English in their postpartum period. Further, sociodemographic and clinical characteristics were collected. RESULTS: Women were between 24 and 45 years old, 56.1% had an academic degree, 60.7% were migrant women coming mainly from other European countries, 17.8% had a previous history of gestational diabetes, and 31.8% had a family history of diabetes. As measured with the GDMKQ, women with a higher educational level obtained higher scores and therefore showed a better knowledge level about gestational diabetes compared to women with primary and secondary educational levels (M 13.3 vs M 11.1 and 12.5; χ2 (2) = 13.003, p = .002). In addition, women with a previous history of gestational diabetes also reached higher scores compared to women with no history of gestational diabetes (M 13.6 vs M 12.5, Z = - 2.278, p = .023). CONCLUSION AND IMPLICATION FOR PRACTICE: Even if the knowledge status among women attending this single Swiss hospital is presently very good, a lower educational level was associated with a lower knowledge level and identified as the main factor to hinder women's comprehension of gestational diabetes. More individually tailored consultations by health care professionals may serve to meet women's needs more adequately and support them better in the understanding of their condition.

Integrated Palliative Outcome Scale for People with Dementia: easy language adaption and translation.

BACKGROUND: In this article, we report the cultural adaption and translation of the Integrated Palliative Care Outcome Scale for People with Dementia (IPOS-Dem) into a Swiss-German easy language version for proxy assessment of people with dementia living in Swiss nursing homes. The Swiss-German easy language version of the IPOS-Dem was developed and culturally adapted in a six-phase process from the German IPOS-Dem using recommended guidelines. With nursing home staff and laypeople, the conceptual definition and relevance of IPOS-Dem items were established during phase I. Phase II encompassed the completion of forward translations. Independent native speakers blind to the original scale translated and back-translated the Swiss-German easy language version. The resulting IPOS-Dem version was then blindly back-translated in phase III. Experts reviewed all resulting translations in phase IV to produce a pre-final IPOS-Dem version. Finally, the phase V cognitive debriefing involved two focus groups assessing the pre-final IPOS-Dem version. Phase V included cognitive interviews with laypeople (n = 2), family members of those with dementia (n = 4) and staff from different care contexts (n = 12). RESULTS: Using easy language specialists yielded a clinically relevant, comprehensive and understandable translation. In addition, face and content validity for the easy language version were established in the cognitive interviews. CONCLUSIONS: With an easy language IPOS-Dem, all frontline staff and family members can be empowered to communicate their observations after caring interactions. Enhanced clinical communication with easy language tools shows the potential for research and clinical applications. In addition, attentive use in scales of easy language communication may foster increased engagement with untrained laypeople in clinical and care research.

Identifying research gaps: A review of virtual patient education and self-management.

BACKGROUND: Avatars in Virtual Reality (VR) can not only represent humans, but also embody intelligent software agents that communicate with humans, thus enabling a new paradigm of human-machine interaction. OBJECTIVE: The research agenda proposed in this paper by an interdisciplinary team is motivated by the premise that a conversation with a smart agent avatar in VR means more than giving a face and body to a chatbot. Using the concrete communication task of patient education, this research agenda is rather intended to explore which patterns and practices must be constructed visually, verbally, para- and nonverbally between humans and embodied machines in a counselling context so that humans can integrate counselling by an embodied VR smart agent into their thinking and acting in one way or another. METHODS: The scientific literature in different bibliographical databases was reviewed. A qualitative narrative approach was applied for analysis. RESULTS: A research agenda is proposed which investigates how recurring consultations of patients with healthcare professionals are currently conducted and how they could be conducted with an embodied smart agent in immersive VR. CONCLUSIONS: Interdisciplinary teams consisting of linguists, computer scientists, visual designers and health care professionals are required which need to go beyond a technology-centric solution design approach. Linguists' insights from discourse analysis drive the explorative experiments to identify test and discover what capabilities and attributes the smart agent in VR must have, in order to communicate effectively with a human being.

Couples living with type 1 diabetes: An integrative review of the impacts on health and wellbeing.

Impacts of type 1 diabetes and relationship factors on health and wellbeing of both persons with diabetes and partners (T1D partners) have not been investigated. Integrative review methods evaluated the evidence. From 323 titles, we included 24 studies involving 16,083 persons with diabetes and 1020 T1D partners. Studies were quantitative (n = 13), qualitative (n = 9) and mixed methods (n = 2). Maintaining resilient, good quality, intimate relationships optimises physical and psychological outcomes for persons with diabetes. Partners experience disturbed sleep and while general psychological health is maintained, distress surrounding hypoglycaemia is overwhelming for over a third of partners. Nurturing quality relationships could reap significant health benefits.

Characteristics of patients treated for severe hypoglycaemia in emergency care settings - Analysis of routinely collected data.

OBJECTIVE: Severe hypoglycaemic events (SHE) commonly require emergency care. This study investigates the presentation of patients with SHE to a single Swiss emergency service, including pre-hospital care with emergency medical services (EMS) and emergency department (ED) presentations. METHOD: Retrospective analysis of routinely collected data by the EMS and ED during 2014. All adult patients with diabetes type 1 or type 2 with SHE were included in the analysis. RESULTS: 43 SHE were recorded in 38 patients with diabetes. Mean age of all patients was 65 years (SD ±â€¯17.51), 54% (n = 23) were men, 55.8% (n = 24) were living in a relationship, and 54.8% (n = 23) were diagnosed with type 2 diabetes. Of the 43 episodes, 65% (n = 28) of the presentations used EMS and were then taken to the ED, 28% (n = 12) involved contact with the EMS only, and 7% (n = 3) were seen by the ED but did not use EMS. Patients seen by the EMS only (n = 12) were younger compared to those admitted to ED (n = 28); Md 54 years vs Md 72 years; U = 98; p = .039. The same age difference was similar between patients in the ED setting discharged home (n = 11) and with in-patients (n = 20); Md 61 years vs. Md 79 years; U = 51; p = .013. CONCLUSIONS: People most likely to suffer a SHE were men, those living with a partner, over 65 years old, and living with type 2 diabetes. Younger patients treated by EMS at home tended to remain at home, in contrast to the older patients who were admitted to hospital. This was also true for the ED where older people in particular became in-patients after such an event. Elderly care specialist brief interventions conveyed by EMS and ED healthcare professionals might be of value to prevent further SHE. Validating these findings in multiple emergency settings is warranted to support the delivery of targeted interventions.

Hypoglycaemia and brief interventions in the emergency department - A systematic review.

OBJECTIVE: For people with diabetes, severe hypoglycaemia is the most common reason for emergency service usage and emergency department (ED) presentations. Brief interventions (BI) are a recognised intervention strategy in the ED for other conditions but to date, they have not been applied to those with hypoglycemia. This review aims to identify components and outcomes of BI for people with diabetes mellitus to inform the development of BI in the ED. METHOD: A systematic review of randomized controlled trials was undertaken in MEDLINE, CINAHL, PsychINFO and EMBASE. Studies that examined brief interventions for people with diabetes were considered. Eligible studies were critically appraised and included in a narrative synthesis. RESULTS: A total of 2475 citations were identified, 171 full papers were reviewed and four articles were included for review. The components 'advice' and 'assistance' from the five A Framework were the most frequently used BI components. Statistically significant improvements were achieved in psychological, functional, and satisfaction outcomes. However, clinical outcomes were not improved and economic outcomes like costs of BI were not evaluated. CONCLUSIONS: The literature review demonstrated a lack of evidence related to BI in diabetes within the emergency setting despite the ED being an ideal environment. Future research needs to be conducted to investigate the effectiveness of BI for patients with diabetes.