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1.
Medicine (Baltimore) ; 103(6): e37128, 2024 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-38335434

RESUMEN

Early recognition of malnutrition is essential to improve the prognosis of older patients with hip fracture. The Nutritional Risk Screening 2002 (NRS-2002), the Short-Form Mini Nutritional Assessment (MNA-SF) and the Global Leadership Initiative on Malnutrition (GLIM) are widely used in malnutrition diagnosis. However, criteria for predicting postoperative hip joint motor function in older patients with hip fractures are still necessary. The objective of this study was to select the most appropriate criteria from the NRS-2002, the MNA-SF and the GLIM in predicting the postoperative hip joint motor function recovery 1 year after surgery. This retrospective observational study included 161 patients aged ≥ 65 years with hip fractures. The nutritional status of patients was determined by the NRS-2002, MNA-SF and GLIM. The Harris hip joint score (HHS), the primary outcome of this study, was used to evaluate hip joint motor function. HHS was classified as excellent (HHS > 75) or non-excellent outcomes (HHS ≤ 75). Logistic regression models for hip joint motor function recovery were constructed. Both the receiver operating characteristic curve and the decision curve analysis were used to select the most predictive criteria. The overall mean age of the 161 patients was 77.90 ±â€…8.17. As a result, NRS-2002 (OR:0.06, 95%CI [0.01, 0.17]), MNA-SF (OR:0.05, 95%CI [0.00, 0.23]) and GLIM (OR of moderate: 0.03, 95%CI [0.01, 0.11]; OR of severe: 0.02 [0.00, 0.07]) were predictive for recovery of hip joint motor function. Additionally, both the area under curve of the receiver operating characteristic curve (NRS-2002: 81.2 [73.8, 88.6], MNA-SF: 76.3 [68.5, 84.2], GLIM: 86.2 [79.6,92.8]) and the decision curve analysis showed the GLIM was better than others. Compared with NRS-2002 and MNA-SF, GLIM was a more suitable nutritional assessment criteria to predict the postoperative recovery of hip joint motor function for older patients with hip fracture 1 year after surgery.


Asunto(s)
Fracturas de Cadera , Desnutrición , Humanos , Anciano , Estado Nutricional , Estudios Retrospectivos , Recuperación de la Función , Liderazgo , Desnutrición/diagnóstico , Evaluación Nutricional , Fracturas de Cadera/cirugía
2.
Nutrients ; 16(3)2024 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-38337661

RESUMEN

BACKGROUND AND AIMS: Malnutrition in lung transplantation (LT) candidates increases postoperative morbidity and mortality. Early diagnosis of malnutrition could attenuate adverse prognostic factors. This study aimed to assess the prevalence of nutritional risk and malnutrition using GLIM criteria in LT candidates and clinically characterize those with malnutrition. METHODS: A prospective longitudinal study was conducted from 2000 to 2020 of LT candidates who underwent complete nutritional assessment (nutritional screening, anthropometry, bioelectrical impedance, blood laboratory tests and malnutrition diagnosis using GLIM criteria). RESULTS: Obstructive diseases (45.6%), interstitial diseases (36.6%) and cystic fibrosis/non-cystic fibrosis bronchiectasis (15.4%) were the main conditions assessed for LT. Of the 1060 candidates evaluated, 10.6% were underweight according to BMI, 29% were at risk of malnutrition and 47% were diagnosed with malnutrition using GLIM criteria. Reduced muscle mass was the most frequent GLIM phenotypic criterion. Malnutrition was more prevalent in patients with cystic fibrosis/non-cystic fibrosis bronchiectasis (84.5%) and obstructive (45.4%) and interstitial (31.3%) diseases. GLIM criteria detected some degree of malnutrition in all diseases requiring LT and identified patients with higher CRP levels and worse respiratory function, anthropometric measurements and visceral protein and lipid profiles. CONCLUSIONS: LT candidates present a high prevalence of malnutrition using the GLIM algorithm. GLIM criteria detected malnutrition in all diseases requiring LT and defined patients with worse clinical-analytical profiles.


Asunto(s)
Bronquiectasia , Fibrosis Quística , Trasplante de Pulmón , Desnutrición , Humanos , Fibrosis Quística/complicaciones , Fibrosis Quística/cirugía , Liderazgo , Estudios Longitudinales , Evaluación Nutricional , Estudios Prospectivos , Estado Nutricional , Bronquiectasia/complicaciones , Bronquiectasia/diagnóstico , Bronquiectasia/epidemiología , Desnutrición/diagnóstico , Desnutrición/epidemiología
4.
BMC Health Serv Res ; 24(1): 219, 2024 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-38368329

RESUMEN

BACKGROUND: As coproduction in public services increases, understanding the role of leadership in this context is essential to the tasks of establishing relational partnerships and addressing power differentials among groups. The aims of this review are to explore models of coproduction leadership and the processes involved in leading coproduction as well as, based on that exploration, to develop a guiding framework for coproduction practices. METHODS: A systematic review that synthesizes the evidence reported by 73 papers related to coproduction of health and welfare. RESULTS: Despite the fact that models of coleadership and collective leadership exhibit a better fit with the relational character of coproduction, the majority of the articles included in this review employed a leader-centric underlying theory. The practice of coproduction leadership is a complex activity pertaining to interactions among people, encompassing nine essential practices: initiating, power-sharing, training, supporting, establishing trust, communicating, networking, orchestration, and implementation. CONCLUSIONS: This paper proposes a novel framework for coproduction leadership practices based on a systematic review of the literature and a set of reflective questions. This framework aims to help coproduction leaders and participants understand the complexity, diversity, and flexibility of coproduction leadership and to challenge and enhance their capacity to collaborate effectively.


Asunto(s)
Liderazgo , Humanos
5.
J Prof Nurs ; 50: 35-42, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38369369

RESUMEN

The intricacies of the unique educational and leadership development trajectories of Black PhD-prepared nurse scientists are largely invisible in nursing faculty development literature. A broadened understanding of nursing leadership development and science mentorship can facilitate support for the next generation of Black nurse scientists. Historically Black Colleges and Universities (HBCUs) can serve as formative launch pads for nurse scientist development. However, the role of HBCUs and strategies for supporting robust educational and mentor/training opportunities for Black PhD-prepared nurse scientists require thoughtful description and application. Incorporating an intrapersonal, interpersonal, and integrative leadership framework, we describe and synthesize four Black nurse scientists and HBCU graduates' experiences to highlight early science mentorship and leadership resilience through the excellent educational foundations provided at HBCUs.


Asunto(s)
Negro o Afroamericano , Liderazgo , Humanos , Universidades , Mentores , Docentes de Enfermería
6.
J Prof Nurs ; 50: 61-65, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38369373

RESUMEN

BACKGROUND: Professional identity is a relatively new concept in the nursing and health care literature. Using the definition of Professional Identity in Nursing (PIN) as its main construct, the authors developed and tested the second iteration of the Professional Identity in Nursing Scale (PINS 2.0) used to measure PIN from two perspectives, self and environment. PURPOSE: The purpose of this study was to evaluate the psychometric properties of the PINS 2.0. METHODS: To assess psychometric validity and reliability, a split-sample analysis was conducted. An exploratory factor analysis (EFA) was conducted on one half of the sample (n = 322) and a confirmatory factor analysis (CFA) was conducted on the other half of the sample (n = 312). Descriptive statistics were also performed and analyzed. RESULTS: According to the EFA pattern of parameter coefficients and CFA fit statistics (PINS-self: χ2(399) =1059.495, p < .001, CFI = 0.934, RMSEA = 0.072, SRMR = 0.032; PINS-environment: χ2(399) =929.019, p < .001, CFI = 0.946, RMSEA = 0.065, SRMR = 0.029), the PINS 2.0 shows adequate psychometric properties for measuring the concept of PIN with the following 4 constructs: 1) values and ethics, 2) knowledge, 3) leadership, and 4) professional comportment. Cronbach's alpha coefficients were: PINS 2.0-self = 0.97 and PINS 2.0-environment =0.98. CONCLUSION: We further advance the assessment of the psychometric properties of the PINS 2.0 to measure PIN from the perspective of self and environment.


Asunto(s)
Liderazgo , Enfermeras y Enfermeros , Humanos , Psicometría , Reproducibilidad de los Resultados , Análisis Factorial , Encuestas y Cuestionarios
7.
Stud Health Technol Inform ; 312: 30-34, 2024 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-38372307

RESUMEN

Ontario is shifting to a Precision Medicine (PM) model, which emphasizes tailored patient care, an initiative reflected in the formation of Ontario Health Teams. However, this shift faces significant data governance, policy formulation, and technology integration hurdles. To overcome these barriers, we advocate for a comprehensive PM framework to orchestrate collaboration among healthcare providers, policymakers, and technologists. This framework enhances data management, propels digital health innovations, and uphold ethical standards in AI applications. Effective deployment of this framework is crucial for actualizing PM's promise in Ontario, potentially revolutionizing healthcare delivery.


Asunto(s)
Liderazgo , Medicina de Precisión , Humanos , Ontario , Atención a la Salud , Políticas
8.
Stud Health Technol Inform ; 312: 35-40, 2024 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-38372308

RESUMEN

The surge of AI-driven technologies in the digital health market demands a concurrent evolution in evaluation standards, a pace currently lagging behind innovation. This paper explores the pivotal inadequacies within existing evaluation models, highlighting the necessity for refined methodologies that align with the unique complexities of digital health. We critically examine the initiatives of key entities such as Health Canada, CADTH, and CNDHE, pinpointing the deficiencies in addressing the volatility and intricacies of AI applications. To bridge these gaps, we advocate for a nuanced evaluation paradigm, proposing the establishment of an oversight body, implementing detailed category-specific criteria, and a robust six-step evaluation framework tailored for AI health solutions. The paper culminates by underscoring the indispensable role of strategic leadership and agile policymaking in cultivating a resilient digital health environment that prioritizes patient care without compromising the ingenuity of technological advances.


Asunto(s)
Resiliencia Psicológica , Humanos , Canadá , Liderazgo , Formulación de Políticas
9.
BMC Health Serv Res ; 24(1): 199, 2024 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-38355546

RESUMEN

Leadership styles have often been proven to support employees in performing their duties better and with more efficiency while enabling them to have extended organizational tenures. Staff nurses are an essential resource of hospitals to ensure proper administration and quality patient health care. The study aims to determine how transformational and authentic leadership styles affect the staff nurses' turnover intention in private hospitals. In addition, it also finds the moderating effect of perceived organizational support. An explanatory quantitative research design with a cross-sectional investigation and a stratified sampling strategy was used for the study. Data from 296 nurses from the eight chosen private hospitals in the Kingdom of Bahrain were gathered using a questionnaire with 24 items. Smart-PLS was employed to conduct PLS-SEM (partial least squares structural equation modeling) to measure direct and indirect effects. The result indicates that transformational, authentic leadership styles and perceived organizational support significantly negatively affect nurses' turnover intention. The study confirms the negative moderating effect of perceived organizational support between transformational leadership and turnover intention and the positive moderating effect of perceived organizational support between authentic leadership and turnover intention. Managers should concentrate on the leadership style to avoid its impact on turnover intention. By considering human resource practices such as communication and training strategies to cope with the negative effect of turnover intention, organizations can enhance employee engagement, improve job satisfaction, and foster a more stable and productive work environment. The present research revealed the adverse impact of turnover intention within hospitals by examining its association with leadership styles. The research made a significant contribution to the existing literature by delving into the impact of leadership styles on turnover intention, focusing on the moderating effect of perceived organizational support. The study's findings shed light on the intricate relationship between leadership practices and employee turnover, providing valuable insights for both scholars and practitioners in the field. The study used a cross-sectional design to collect data and ensured the absence of standard method variance. The research enhanced the social dominance theory (SDT) by examining how perceived organizational support moderates the relationship between leadership styles and turnover intention.


Asunto(s)
Personal de Enfermería en Hospital , Reorganización del Personal , Humanos , Liderazgo , Estudios Transversales , Intención , Encuestas y Cuestionarios , Hospitales Privados , Satisfacción en el Trabajo
10.
BMC Public Health ; 24(1): 476, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38360605

RESUMEN

BACKGROUND: The COVID-19 pandemic has necessitated many employees to work from home with immediate effect for several months, regardless of their workplace preference or situation at home. Against this backdrop, this study explores perceived job demands and resources as well as the role of leadership and coping strategies of employees and managers with little or no prior experience with working from home in the altered work environment. METHODS: Based on the job demands-resources model, we developed an interview guide and conducted thirty-four semi-structured interviews. The interviews were transcribed and analyzed deductively-inductively using qualitative content analysis. RESULTS: Experienced job demands include, e.g., challenging, insufficient digital communication, and lack of social exchange, while greater flexibility and work-life balance were identified as valuable resources. Regarding the role of leadership, signaling trust, keeping regular contact, and supporting employees are important. To cope with the unforeseen yet persistent work situation, participants applied creative strategies by setting up offices at home with what they had at disposal. Differences were observed between employee and managerial perceptions as well as over time during the pandemic. CONCLUSIONS: The results expand our knowledge about healthy remote work by adding specific demands, resources, and coping strategies employees and managers experienced during the extreme situation of the COVID-19 pandemic to the picture as well as specifying the role of leadership. Moreover, our findings provide a foundation for guidelines for healthy remote work design and collaboration in times of abrupt change and crises.


Asunto(s)
COVID-19 , Estrés Laboral , Humanos , COVID-19/epidemiología , Teletrabajo , Pandemias , Liderazgo
11.
PLoS One ; 19(2): e0295239, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38363759

RESUMEN

The World Health Organization (WHO) is committed to empowering countries by implementing a gender, equity, and human rights approach in the health sector. The objective of this gender and inclusion analysis is to assess potential gender disparities of health sector management in the Kyrgyz Republic. The employed mixed-method approach takes advantage of data triangulation. Besides information from the literature and policy documents available at the international and national levels, the analysis includes interviews and data from the self-assessment of health services managers in the Kyrgyz Republic. A convenience sample of 75 health managers was taken and after up to three reminders a commendable response rate of 80% was achieved which resulted the final sample size of N = 60. A factor analysis using quartimax orthogonal rotation was applied to investigate the correlation between Teaching Qualification, Digitalization, Training Usefulness, Computer Workplace, and Gender Equality. In 2021, the Kyrgyz Republic adopted a new Constitution, which provides a sound legal framework to support gender equality and promote women's empowerment. However, according to a survey, only 42.9% of the respondents felt that equal rights and opportunities were integrated into their job descriptions. Similarly, only 40.7% believed that their institutions' written documents reflected a commitment to equal rights and opportunities for both genders. Two factors were identified as influencing gender equality: (1) personal and (2) technical aspects. Regarding personal aspects, gender equality, teaching qualification, and training usefulness were found to be significant. Regarding technical aspects, the computer workplace was related. In recent years, the Kyrgyz Republic has been developing a culture of gender equality. Political will is essential to promote and make organizational change possible. It is important to create a written mid-term policy that affirms a commitment to gender equality in organizational behavior, structures, staff, and management board compositions. Healthcare institutions need to prepare strategic and operational plans that incorporate gender equality principles.


Asunto(s)
Liderazgo , Derechos de la Mujer , Humanos , Femenino , Masculino , Kirguistán , Derechos Humanos , Políticas
12.
Clin Nurse Spec ; 38(2): 75-79, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38364067

RESUMEN

PURPOSE/OBJECTIVES: The purpose of this article was to describe how a National Association of Clinical Nurse Specialists affiliate partnered with a local university to engage clinical nurse specialist (CNS) students, enhance its mission and activities, and create succession planning opportunities, while providing mentorship and professional growth opportunities. DESCRIPTION OF THE PROJECT: Academic preparation of CNS students endeavors to instill professionalism. A 3-pronged partnership incorporating the inclusion of a student liaison on the board, presentation of student clinical work at the affiliate's annual conference, and development of a student scholarship was implemented. OUTCOMES: Membership in professional nursing organizations for a CNS student provides exposure and access to professional development resources, socialization to the role, rewarding networking opportunities with peers and colleagues, and leadership development. Anecdotal feedback demonstrated a better understanding of the CNS role, increased confidence, and enhanced knowledge on topics such as legislative advocacy as well as experiences of sharing clinical challenges with CNS colleagues. CONCLUSION: Partnership with the local university allowed the affiliate to maintain the influx of new CNSs, which sustains membership, nurtures the growth of new CNSs, and ensures the influx of new ideas. Furthermore, membership in professional nursing organizations is imperative to address the opportunities that exist in healthcare.


Asunto(s)
Enfermeras Clínicas , Humanos , Enfermeras Clínicas/educación , Atención a la Salud , Estudiantes , Liderazgo
13.
Clin Nurse Spec ; 38(2): 91-97, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38364069

RESUMEN

PURPOSE/OBJECTIVES: The purpose of this article is to guide the clinical nurse specialist in constructing a scorecard to track clinical outcomes and identify the associated financial impact. DESCRIPTION OF THE PROJECT/PROGRAM: Creation of a scorecard highlighting the financial impact of the clinical nurse specialist team was used to disseminate financial outcomes to hospital executive stakeholders, allowing the clinical nurse specialist team to demonstrate its clinical and financial value. OUTCOME: During development and ongoing maintenance of the scorecard, the clinical nurse specialist team cultivated skills to identify the financial impact of projects. The team also utilized financial implications of individual and group projects to prioritize work. At the end of fiscal year 2022, the clinical nurse specialist team demonstrated revenue generation of $29 890 and cost avoidance of $2 854 807.30. The clinical nurse specialist scorecard was presented quarterly to the chief nursing officer, who shared with executive leadership. CONCLUSION: Clinical nurse specialists are positioned to make significant and positive financial impact to organizations. A scorecard presented to executive leadership offers a clinical nurse specialist team a tool to capture and disseminate a clinical nurse specialist team's unique financial contribution at the system level.


Asunto(s)
Enfermeras Clínicas , Humanos , Rol de la Enfermera , Donaciones , Hospitales , Liderazgo
14.
Clin Nurse Spec ; 38(2): 80-90, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38364068

RESUMEN

PURPOSE/OBJECTIVES: The aim of the project was to discern whether a collaborative, consultative-rich, clinical nurse specialist-led project could increase completion rates of a patient health questionnaire for depression and a generalized anxiety disorder questionnaire with appropriate referrals in adult patients in the ambulatory and hospital settings of a robust cardiovascular surgery practice before cardiovascular surgery. DESCRIPTION OF PROJECT: The Define, Measure, Analyze, Improve, Control implementation methodology guided this quality improvement project. The workflow was analyzed in collaboration with stakeholders, and barriers to and facilitators of questionnaire completion were identified. Interpreter services partnerships were enhanced and used for patients with a preferred language other than English. Weekly data analysis assessed ongoing questionnaire completion rates. OUTCOME: Documented completion rates of questionnaires improved across ambulatory and hospital settings by 15%. Patients with a preferred language other than English had an 80-percentage-point increase in documented questionnaire completion. CONCLUSION: Clinical nurse specialists are poised to lead projects because of their use of the collaborative and consultative core competencies. A formal electronic health record report was established for monitoring outcomes. Embedding questionnaire administration within the standard workflow of ambulatory and hospital staff makes administering questionnaires preoperatively a sustainable practice in both settings.


Asunto(s)
Enfermeras Clínicas , Adulto , Humanos , Enfermeras Clínicas/psicología , Liderazgo , Salud Mental , Encuestas y Cuestionarios
16.
Am J Public Health ; 114(S2): 162-166, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38354355

RESUMEN

We assessed how hospitalists frame workplace safety, health, and well-being (SHW); their perception of hospital supports for SHW; and whether and how they are sharing leadership responsibility for each other's SHW. Our findings highlight the important role of local support for hospitalist SHW and reveal the systemic, hospital-wide problems that may impede their SHW. We believe that positioning hospitalists as leaders for SHW will result in systems-wide changes in practices to support the SHW of all care team members. (Am J Public Health. 2024;114(S2):S162-S166. https://doi.org/10.2105/AJPH.2024.307573).


Asunto(s)
Médicos Hospitalarios , Estados Unidos , Humanos , Liderazgo , Lugar de Trabajo
17.
Leadersh Health Serv (Bradf Engl) ; ahead-of-print(ahead-of-print)2024 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-38345072

RESUMEN

PURPOSE: Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of leadership cannot be overstated. This paper aims to present novel findings from a rapid realist review of ICS leadership in England. The overall review question was: how does leadership in ICSs work, for whom and in what circumstances? DESIGN/METHODOLOGY/APPROACH: Development of initial programme theories and associated context-mechanism-outcome configurations (CMOCs) were supported by the theory-gleaning activities of a review of ICS strategies and guidance documents, a scoping review of the literature and interviews with key informants. A refined programme theory was then developed by testing these CMOCs against empirical data published in academic literature. Following screening and testing, six CMOCs were extracted from 18 documents. The study design, conduct and reporting were informed by the Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) training materials (Wong et al., 2013). FINDINGS: The review informed four programme theories explaining that leadership in ICSs works when ICS leaders hold themselves and others to account for improving population health, a sense of purpose is fostered through a clear vision, partners across the system are engaged in problem ownership and relationships are built at all levels of the system. RESEARCH LIMITATIONS/IMPLICATIONS: Despite being a rigorous and comprehensive investigation, stakeholder input was limited to one ICS, potentially restricting insights from varied geographical contexts. In addition, the recent establishment of ICSs meant limited literature availability, with few empirical studies conducted. Although this emphasises the importance and originality of the research, this scarcity posed challenges in extracting and applying certain programme theory elements, particularly context. ORIGINALITY/VALUE: This review will be of relevance to academics and health-care leaders within ICSs in England, offering critical insights into ICS leadership, integrating diverse evidence to develop new evidence-based recommendations, filling a gap in the current literature and informing leadership practice and health-care systems.


Asunto(s)
Prestación Integrada de Atención de Salud , Liderazgo , Humanos , Inglaterra
18.
PLoS One ; 19(2): e0297559, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38346041

RESUMEN

The financial performance of Chinese public and private sector banks is changing over time. There is no stability in the financial performance of Chinese banks which hurts businesses and the market. The purpose of current research was to determine the influence of corporate social responsibility (CSR) on driving the sustainable financial performance of Chinese banks. From methodological perspective, data was collected from 329 banking sector employees from China to partial least square-structural equation model (PLS-SEM) is employed for data analysis. The research used SPSS 24 and Smart PLS 4 as statistical analysis tools. This research confirmed that achieving sustainability in financial performance for Chinese banks can be achieved with CSR influenced by technological innovation, ethical leadership, and government regulations. This research has statistically confirmed that transformational leadership leading to CSR with technological innovation, ethical leadership, and government regulations can make significant improvements in financial performance. The framework developed by current research is a novel contribution to the literature. The findings of this research improve the literature on the banking sector and advanced performance. Furthermore, this research has highlighted significant ways that can help the banking sector employees to improve their financial performance with sustainability.


Asunto(s)
Regulación Gubernamental , Invenciones , Humanos , Liderazgo , Pueblo Asiatico , China , Responsabilidad Social
19.
BMJ Open ; 14(2): e083806, 2024 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-38346888

RESUMEN

INTRODUCTION: Infection prevention and control (IPC) teams are routinely confronted with intense emotions in their daily work, as they are involved in many change processes with front-line medical staff, for example, when promoting compliance with basic IPC measures. In addition, they are confronted with challenges due to their role as intermediaries. Based on former research, this study aims to empower IPC teams to promote clinicians' compliance through interventions focusing on the IPC teams' leadership skills. METHODS AND ANALYSIS: The IP-POWER study (Infection Prevention with head and heart: Psychological empowerment of IPC teams), a multicentre, two-arm, non-blinded, cluster-randomised controlled trial with a parallel waiting control group, is planned to be conducted in Germany as of February to November 2024. A group of 10 voluntary hospitals is going to participate in a multistage intervention programme, including 2 days of intense psychological training; 5 hospitals will be randomly assigned to the waiting control group. After the workshops, there will be a 12-week follow-up period during which the contents learnt within the workshops can be applied and internalised into IPC practice. The proposed outcomes (both self-assessed and other-assessed leadership competencies of IPC team members and their task profiles, perceived workload, motivation to act in order to implement IP measures and goal attainment) are going to be collected with an online questionnaire, followed by an analysis with IBM SPSS (Statistics 29 (or later)) using descriptive analyses and multiple linear regressions. Additionally, as external data sources, hand hygiene compliance rates from the study hospitals' monitoring systems will be analysed using χ² tests. ETHICS AND DISSEMINATION: This study was reviewed and approved by the ethics committee of the University of Leipzig (184/23-ek; vote from 4 July 2023). Findings will be disseminated via peer-review publications, and national and international conference presentations. TRIAL REGISTRATION NUMBER: DRKS00031879.


Asunto(s)
Higiene de las Manos , Liderazgo , Humanos , Motivación , Control de Infecciones , Empoderamiento , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Multicéntricos como Asunto
20.
BMJ Open ; 14(2): e076625, 2024 02 08.
Artículo en Inglés | MEDLINE | ID: mdl-38331861

RESUMEN

OBJECTIVES: The literature presents complex inter-relationships among individual-factors and organisational-factors and barriers to seeking mental health support after deployment. This study aims to quantify longitudinal associations between such factors and barriers to mental health support. DESIGN: A longitudinal online survey of Canadian Armed Forces (CAF) personnel collected data at 3 months post-deployment (T1), 6 months post-deployment (T2) and 1 year post-deployment (T3). SETTING: In 2020, as part of Canada's response to the COVID-19 pandemic, 2595 CAF personnel deployed on Operation LASER to support civilian long-term care facilities in Québec and Ontario. PARTICIPANTS: All Operation LASER personnel were invited to participate: 1088, 582 and 497 responded at T1, T2 and T3, respectively. Most respondents were young, male, non-commissioned members. MAIN OUTCOME MEASURES: Barriers to mental health support were measured using 25 self-reported items and grouped into theory-based factors, including eight factors exploring care-seeking capabilities, opportunities and motivations; and two factors exploring moral issues. Logistic regressions estimated the crude and adjusted associations of individual and organisational characteristics (T1) with barriers (T2 and T3). RESULTS: When adjusting for sex, military rank and mental health status, increased meaningfulness of deployment was associated with lower probability of endorsing barriers related to conflicts with career goals and moral discomfort in accessing support at T2. Higher scores in trust in leadership were associated with lower probability of endorsing four barriers at T2, and five barriers at T3. CONCLUSIONS: We identified several modifiable organisational-level characteristics that may help reduce perceived barriers to mental health support in military and other high-risk occupational populations. Results suggest that promoting individuals' sense of purpose, instilling trust in leadership and promoting relatedness among team members may improve perceptions of access to mental health supports in the months following a domestic deployment or comparable occupational exposure.


Asunto(s)
Trastornos Mentales , Servicios de Salud Mental , Personal Militar , Humanos , Masculino , Personal Militar/psicología , Trastornos Mentales/epidemiología , Estudios Longitudinales , Liderazgo , Pandemias , Confianza , Ontario
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