RESUMEN
Objetivo: elaborar, validar y evaluar un video educativo sobre estrategias de comunicación enfermero-paciente para estudiantes de la carrera de enfermería. Método: se trata de un estudio metodológico, con diseño longitudinal y análisis cuantitativo. El público objetivo cumplió las etapas de preproducción, producción, postproducción y evaluación del video. Resultados: cinco enfermeras evaluaron el storyboard del video y consideraron que la comprensión del tema, los tópicos abordados y el lenguaje utilizado eran apropiados y relevantes para el tema. Otras cinco enfermeras consideraron que la calidad de la técnica audiovisual utilizada, el ambiente simulado, la caracterización de los personajes y el desarrollo de las estrategias de comunicación enfermero-paciente estaban presentes y eran adecuados. La versión final del video fue evaluada por nueve estudiantes de enfermería que tuvieron un nivel de comprensión de los ítems igual o superior al 96%. El video presenta las siguientes estrategias: Estrategias Generales de Comunicación, Comunicación Intercultural, NURSE, Tell me more, Ask-Tell-Ask, Comunicación Terapéutica y Comunicación de Malas Noticias. Conclusión: este estudio describe la creación de un video, la validación que realizaron del mismo los expertos y la evaluación del público objetivo, quienes consideraron que es un recurso educativo importante para el proceso de enseñanza-aprendizaje de las estrategias de comunicación. Los jueces y el público objetivo consideraron que el video era un instrumento válido para enseñar las estrategias de comunicación enfermero-paciente.
Objective: to create, validate and evaluate an educational video on nurse-patient communication strategies for undergraduate Nursing students. Method: this is a methodological study with a longitudinal design and quantitative analysis. The following stages were conducted: pre-production, production, post-production and evaluation of the video by the target population. Results: five female nurses evaluated the video storyboard and indicated understanding of the subject matter, the topics addressed and the language used as adequate and pertinent to the theme. Another five female nurses considered the following as present and desirable elements: quality of the audiovisual technique employed, simulated environment, characterization of the characters, and development of the nurse-patient communication strategies The final version of the video was evaluated by nine Nursing students that presented a level of item understanding of at least 96%. The video presents the following strategies: General communication strategies, Intercultural Communication, NURSE, Tell me more, Ask-Tell-Ask, Therapeutic Communication and Communicating Bad News. Conclusion: this study portrays the creation of a video, its validation by experts and its evaluation by the target population, which indicated it as a relevant educational resource for the teaching-learning process regarding communication strategies. Both the evaluators and the target population considered that the video is a valid instrument to teach content about the nurse-patient communication strategies.
Objetivo: construir, validar e avaliar um vídeo educativo sobre estratégias de comunicação enfermeiro-paciente para estudantes da graduação em enfermagem. Método: trata-se de um estudo metodológico, com delineamento longitudinal e análise quantitativa. Foram percorridas as etapas de pré-produção, produção, pós-produção e avaliação do vídeo pelo público-alvo. Resultados: cinco enfermeiras avaliaram o storyboard do vídeo e apontaram a compreensão do tema, os tópicos abordados e a linguagem utilizada como adequadas e pertinentes à temática. Outras cinco enfermeiras consideraram presentes e desejáveis: qualidade da técnica audiovisual empregada, ambiente simulado, caracterização das personagens e desenvolvimento das estratégias de comunicação enfermeiro-paciente. A versão final do vídeo foi avaliada por nove estudantes de enfermagem que apresentaram nível de compreensão dos itens igual ou acima de 96%. O vídeo apresenta as seguintes estratégias: Estratégias gerais de comunicação, Comunicação Intercultural, NURSE, Tell me more, Ask-Tell-Ask, Comunicação Terapêutica e Comunicação de Más Notícias. Conclusão: este estudo retrata a criação de um vídeo, sua validação por peritos e sua avaliação pelo público-alvo, que manifestaram tratar-se de um recurso educativo relevante para o processo de ensino-aprendizagem de estratégias de comunicação. Os juízes e o público alvo consideraram o vídeo como um instrumento válido para ensinar sobre as estratégias de comunicação enfermeiro-paciente.
Asunto(s)
Humanos , Femenino , Estudiantes de Enfermería , Comunicación , Película y Video Educativos , Bachillerato en Enfermería/métodos , Lenguaje , Aprendizaje , Relaciones Enfermero-PacienteRESUMEN
Community nurses remain understudied in research on interactional power, especially in China where community healthcare is an emerging practice. Grounded in French & Raven's typology of social power, this article conceptualises the power of community nurses in a Chinese urban context. Through thematic analysis of textual data from 26 semi-structured interviews and two additional focus group discussions with community nurses in Shenzhen, we identified six power varieties, i.e. indirect reward, indirect coercion, legitimate position, peer reference, field expertise, and caring information. We classified these powers trichotomously, as nurse-to-doctor, nurse-to-nurse, and nurse-to-patient, to show the potential influences nurses bring to healthcare relationships. Our analysis indicated nurses' exercise of some powers was constrained by two elements, i.e. doctor-nurse power polarity and patient prejudices against nursing, which together contributed to nurses' adverse power loss. These power adversities permeated the community health environment, contributing to healthcare delivery dysfunctions by undermining nurses' self-improvement, self-assurance, enthusiasm, and cooperation in care. Our analysis, using the insights of social power, develops a novel reading of community nursing delivery in urban China. We argue that nurse empowerment could promote community healthcare delivery. Role enhancement and pro-nursing policy development would reduce adverse power scenarios for community nurses and help convert their potential power resources into practical powers in support of patients' needs.
Asunto(s)
Relaciones Enfermero-Paciente , Enfermeras y Enfermeros , Humanos , Poder Psicológico , ChinaRESUMEN
A nurse imagines a startling and oddly comforting perspective during a code.
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Comunicación , Relaciones Enfermero-Paciente , HumanosRESUMEN
Presence remains a fundamental aspect of nursing practice and theory and yet remains poorly defined. The author describes Watson's phenomenon of authentic presence in both the nursing and interdisciplinary literature. The emerging themes are applied to Watson's theoretical and philosophical perspectives of human caring science.
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Empatía , Teoría de Enfermería , Humanos , Relaciones Enfermero-PacienteRESUMEN
Background: The comorbidity of anxiety and drug use disorders complicates treatment prognosis, and one of the greatest challenges is to address the environmental and behavioral factors involved. The aim of this study was to describe the uses of intervention mapping in the design of a theory and evidence-based complex intervention to develop skills around the management of anxiety for cocaine users in outpatient addiction treatment. Methods: The six steps of the intervention mapping approach, which are needs assessment, creation of matrices of performance objectives, selection of methods and practical strategies, program development, adoption and implementation, and evaluation were applied to develop the Interpersonal Theory of nursing to Anxiety management in people with Substance Use Disorders (ITASUD) intervention. The theory used for the conceptual model was interpersonal relations theory. All theory-based methods and practical applications were developed at the individual level, acting in behavioral, interpersonal, organizational and community environments. Results: The intervention mapping provided a broad overview of the problem and outcome expectations. The ITASUD intervention consists of five consecutive sessions of 110-min targeting individual determinants of anxiety (knowledge, triggers, relief behaviors, self-efficacy and relations), delivered by a trained nurse using Peplau's concepts of interpersonal relations. Intervention Mapping is a multi-step process that incorporates theory, evidence, and stakeholder perspectives to ensure that implementation strategies effectively address key determinants of change. Conclusions: The intervention mapping approach increases the effectiveness of the intervention since the matrices provide a broad view of all factors that affect the problem and facilitate replication through transparency of the determinants, methods, and applications used. ITASUD addresses all factors that play an important role in substance use disorders based on a theoretical basis, which provides the translation of evidence from research into effective practice, policy, and public health improvements.
Asunto(s)
Relaciones Enfermero-Paciente , Trastornos Relacionados con Sustancias , Humanos , Ansiedad , Trastornos de Ansiedad/terapia , Modelos Teóricos , Trastornos Relacionados con Sustancias/terapiaRESUMEN
This article summarizes the current state of nurses' implicit bias and discusses the phenomenon from Levinas' face of the Other and ethics of belonging, Watson's human caring and unitary caring science, and Chinn's peace and power theory. Nurses' implicit bias is a global issue; the primary sources of nurses' implicit bias include race/ethnicity, sexuality, health conditions, age, mental health status, and substance use disorders. The current research stays at the descriptive level and addresses implicit bias at the individual level. This article invites nurses to go beyond "the face of the Other" and revisit the ethics of belonging and power.
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Enfermeras y Enfermeros , Teoría de Enfermería , Humanos , Sesgo Implícito , Empatía , Relaciones Enfermero-PacienteRESUMEN
AIM: To illuminate the meaning of newly graduated registered nurses' experiences of caring for patients in emergency departments during the COVID-19 pandemic. DESIGN: A phenomenological hermeneutical study guided by Lindseth and Norberg. METHODS: In-depth one-on-one interviews with 14 nurses from five hospitals were conducted from March to November 2020 and analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) were used as the reporting guideline. RESULTS: The findings comprise one main theme Caring through barriers and three themes with sub-themes. In the first theme, having intention to care, participants revealed their dedication to care for patients during the pandemic despite extensive stress, little experience and skills. The second theme, with tied hands in human suffering, illuminates experiences of being disconnected from the patient, overwhelmed by responsibility and unable to relieve suffering. The third theme, feeling inadequate, reveals experiences of lack of support and doubts meaning less space to develop into the nurse one wants to be. CONCLUSION: Findings reveal a new understanding of new nurses' experiences during times of crisis. The essence of caring in the emergency department during the pandemic can be explained as mediated through spatial, temporal and emotional barriers preventing new nurses from providing holistic care. IMPACT: The results may be used as anticipatory guidance for new nurses and inform targeted support interventions to support new nurses entering the profession in crisis conditions. PUBLIC CONTRIBUTION: This study involved new nurses in semi-structured interviews.
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COVID-19 , Enfermeras y Enfermeros , Humanos , COVID-19/epidemiología , Pandemias , Relaciones Enfermero-Paciente , Investigación Cualitativa , Servicio de Urgencia en HospitalRESUMEN
Humans are continuously storying and re-storying themselves through language and socially organizing language into narratives to create meaning through experiences. Storytelling through narrative inquiry can bridge world experiences and co-create new moments in time that honor human patterns as wholeness and illuminate the potential for evolving consciousness. This article aims to introduce narrative inquiry methodology as a caring and relational research approach aligned with the worldview grounding Unitary Caring Science. This article uses nursing as an exemplar to inform other human science disciplines interested in using narrative inquiry in research, while defining essential components of narrative inquiry through the theoretical lens of Unitary Caring Science. By exploring research questions through this renewed understanding of narrative inquiry informed by the ontological and ethical tenets of Unitary Caring Science, healthcare disciplines will be knowledgeable and prepared to facilitate knowledge development to contribute to the sustainment of humanity and healthcare beyond eliminating the cause of illness and into the experience of living well with illness. The co-creative process of narrative inquiry as a caring and healing inquiry can guide collective wisdom, moral force, and emancipatory actions by seeing and valuing human experiences through an evolved holistic and humanizing lens.
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Comunicación , Narración , Humanos , Lenguaje , Conocimiento , Relaciones Enfermero-PacienteRESUMEN
Building trust in the nurse-patient relationship.
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Personal de Enfermería , Humanos , Confianza , Relaciones Enfermero-Paciente , Recursos HumanosRESUMEN
AIM: The aim of this study is to investigate the effects of "The Training of Presence in Care-TPinCare" of nurses working with oncology patients on care-oriented patient-nurse interaction and caring behaviors. BACKGROUND: Helping the individual to realize, protect and maintain his/her existence can be considered as the basis of "good nursing care". Presence is a way of care for the nurse and patient that fosters human-to-human bonding and deep contact experience and healing. DESIGN: This is a randomized controlled study. METHOD: Data were collected between January 2019 and May 2019. The sample selection consisted of 52 nurses working with oncology patients, 26 interventions and 26 controls in accordance with the criteria of inclusion, exclusion and exemption by randominization and blinding. The data were collected by using the "Nurses Introductory Features Form", "Caring Behaviors Scale - 24 " and "Caring Nurse-Patient Interaction Scale". The training was applied to nurses in the intervention group. In data analysis used SAS 9,4 program; statistically Mean score, t test, Repeated Measures ANOVA. In the context of these effect sizes, the power of the study was calculated to be 0.99 for each scale. This study was conducted in line with the principles of the Declaration of Helsinki. RESULTS: According to the control group of nurses in the intervention group, there were no statistically significant differences in the mean scores of caring behaviors at different measurement times. A statistically significant difference was found in favor of the intervention group for caring nursing patient interaction general, sub-dimensions of "importance", "competence" and "practicality", in nursing interventions (p < 0.05). Although the pretest mean scores of the nurses in the intervention group were lower compared with the control group, it was found that the posttest mean scores increased and the level of follow-up was maintained by a little increasing or decreasing. It was determined that there was no significant change in the posttest and follow-up scores of the nurses in the control group according to the pre-test mean scores. CONCLUSIONS: This study showed that TPinCare has a positive effect on nurses working with oncology patients with respect to care quality perception and viewing "importance", "competence" and "practicality", of attitude and behaviours related to care-focused patient nurse interactions. In this context, it can be suggested to continue the trainings which will contribute to caring behaviors and patient-nurse interactions of nurses and to support them with institutional contribution.
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Neoplasias , Personal de Enfermería en Hospital , Humanos , Masculino , Femenino , Actitud del Personal de Salud , Pacientes , Competencia Clínica , Relaciones Enfermero-Paciente , Encuestas y CuestionariosRESUMEN
BACKGROUND: A standard of practice in psychiatric nursing pertains to the ability to maintain professional boundaries within a nurse-patient relationship. Nursing students are inexperienced in maintaining nurse-patient relationships and are at risk of crossing professional boundaries. Research regarding boundary instruction and available resources is needed to guide educators. METHOD: Psychiatric nurse educators (n = 11) and psychiatric nurses (n = 9) were interviewed to determine what resources psychiatric nursing educators use to teach professional boundaries to undergraduate students. Following the interviews and preliminary analysis, eight participants also attended a focus group. RESULTS: Participants reported resources such as textbooks were useful for defining professional boundaries. Participants also described case studies as a resource available to help operationalize boundaries in psychiatric nursing practice. CONCLUSION: Resources should be developed to address changes in care provision and technology to include cultural competence and guidelines for the use of social media. [J Nurs Educ. 2023;62(2):97-100.].
Asunto(s)
Bachillerato en Enfermería , Enfermería Psiquiátrica , Medios de Comunicación Sociales , Estudiantes de Enfermería , Humanos , Estudiantes de Enfermería/psicología , Relaciones Enfermero-Paciente , Grupos Focales , EnseñanzaRESUMEN
AIM: Nurse-led care aims to optimize the discharge preparation with a focus on increasing patients' independency and self-care abilities. This study compared patients' improvements of self-care abilities and frequency of readmission rate between nurse-led care and regular nursing care within the acute hospital setting. DESIGN: A quasi-experimental design within a real-world setting was used for this work. METHODS: We included a pool of 2501 patients from a control group (medically stable in usual care) and 420 patients from an intervention group (nurse-led care). After propensity score matching, the study cohort consisted of 612 patients. RESULTS: From admission to discharge, nurse-led care patients showed superior improvements of total self-care abilities compared to usual care patients. In particular, we found improvements in the following categories: mobility, grooming and excretion. Patients with nurse-led care were furthermore less frequently readmitted to hospital compared with the control group patients. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
Asunto(s)
Rol de la Enfermera , Autocuidado , Humanos , Readmisión del Paciente , Relaciones Enfermero-Paciente , Alta del PacienteRESUMEN
WHAT IS KNOWN ON THE SUBJECT?: Psychiatric and/or mental health nurses are struggling to measure the outcomes of the nurse-patient relationship. Collecting nurse-sensitive patient outcomes is a strategy to provide outcomes of a nurse-patient relationship from patients' perspectives. Because there was no validated scale, the Mental Health Nurse-Sensitive Patient Outcome-Scale (six-point Likert-scale) was recently developed and psychometrically evaluated. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study using the Mental Health Nurse-Sensitive Patient Outcome-scale to measure nurse-sensitive patient outcomes of the nurse-patient relationship in psychiatric hospitals. Moderate to good average scores for the MH-NURSE-POS total (4.42) and domains scores (≥4.09). are observed. Especially outcomes related to 'motivation' to follow and stay committed to the treatment received high average scores (≥4.60). Our results are consistent with the patient-reported effect(s) of relation-based nursing in qualitative research. The scores generate evidence to support the outcomes of the nurse-patient relationship and implicates that further investment in (re)defining and elaborating nurse-patient relationships in mental healthcare is meaningful and justified. More comparative patient-reported data can determine how nurse-sensitive patient outcomes are affected by the patient, nurse, and context. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Demonstrating patient-reported outcomes of the nurse-patient relationship can be important to enhance the therapeutic alliance between nurses and patients, organize responsive nursing care, and create nursing visibility in mental healthcare. Further nursing staff training on interpersonal competencies, such as self-awareness and cultural sensitivity, can be pivotal to achieving the patient-reported outcomes for inpatients with mental health problems. ABSTRACT: INTRODUCTION: Identifying patient-reported outcomes of the nurse-patient relationship is a priority in inpatient mental healthcare to guide clinical decision-making and quality improvement initiatives. Moreover, demonstrating nurse-sensitive patient outcomes can be a strategy to avoid further erosion of the specialism of psychiatric and/or mental health nursing. AIM/QUESTION: To measure nurse-sensitive patient outcomes of the nurse-patient relationship. METHOD: In a multicentred cross-sectional study, 296 inpatients admitted to five psychiatric hospitals completed the recently developed and validated Mental Health Nurse-Sensitive Patient Outcome-Scale (MH-NURSE-POS). The MH-NURSE-POS consists of 21 items (six-point Likert-scale) in four domains: 'growth', 'expression', 'control', and 'motivation'. RESULTS: Participants displayed moderate to good average scores for the MH-NURSE-POS total (4.42) and domain scores (≥4.09). Especially outcomes related to 'motivation' to follow and stay committed to the treatment received high average scores (≥4.60). DISCUSSION: The results demonstrate that patients perceive the nurse-patient relationship and the care given by psychiatric and/or mental health nurses as contributing to their treatment. IMPLICATIONS FOR PRACTICES: Patient-reported outcomes can guide nurses and managers to provide and organize nursing care and to build a nurse-patient relationship that has a positive impact on these outcomes. Additionally, outcomes can create nursing visibility as a profession in- and outside mental healthcare.
