The person of the therapist: therapists' personal characteristics as predictors of alliance and treatment outcomes.

Objective Studies examining the unique contribution that the therapist has on outcomes (i.e., "therapist effects") have increased in recent years. Therapist effects are believed to occur via how the therapist's interpersonal and intrapersonal qualities influence the therapeutic relationship, which in turn influences outcomes. The current study focused on the extent to which professional self-doubt, counseling self-efficacy, and humility are therapist qualities that influence treatment outcomes. Methods: Data were collected from 46 therapists at a multi-site community behavioral health organization. Therapists completed measures of therapist characteristics. Therapists' responses were matched with de-identified archival client data (N = 1, 817) that contained an outcome and alliance measure administered every session. Multilevel modeling was used to determine the extent to which therapists' personal characteristics predicted client outcomes. Results: Results of the unconditional model for the alliance measure indicated a lack of growth in alliance scores across treatment. Approximately 5% of the variance in rate of growth for treatment outcome was between therapists. When controlling for the effects of counseling self-efficacy, professional self-doubt was marginally significant. When counseling-self-efficacy was removed from the model, professional self-doubt was no longer marginally significant. Conclusion: The findings highlight the complexity of therapist effects and the need for future research on this topic.

The Baptist Health Lexington Nursing Orientation Progression Tool: A Methodological Study.

OBJECTIVE: The purpose of this study was to develop and test a tool to monitor a nursing orientee's progress to competence. BACKGROUND: The literature suggests that, during orientation, consistent documentation and communication among educators, preceptors, and nurse leaders facilitate a timely progression to independent practice for new nurses. METHODS: A 2-phase methodological study was conducted. Nurse educators clarified goals, identified essential competencies, and developed the Baptist Health Lexington Nursing Orientation Progression Tool (OPT). The tool was used to monitor orientees' progression through orientation. RESULTS: Content validity assessment of the OPT (content validity index = 0.98) demonstrated strong validity. Testing of the tool revealed 31 nurses completed orientation early, 12 completed orientation on time, and 18 nurses required extended orientation time. All requiring an extension were new graduates. CONCLUSION: The OPT guided preceptors to facilitate timely completion of orientation among newly hired nurses. Findings suggest that new graduates may need more assistance than experienced nurses.

Effect of a Parent Empowerment Program on Parental Stress, Satisfaction, and Length of Stay in the Neonatal Intensive Care Unit.

Parental stress is high when infants are admitted to a neonatal intensive care unit in community-based hospital. This quasi-experimental study explored the effect of implementing the "Creating Opportunities for Parent Empowerment" (COPE) program on parental stress, postpartum depression, parental satisfaction with care, and length of stay in a community-based hospital. A cohort of nurses completed a 1-day "COPE for HOPE" parent empowerment training session. A nurse implemented the COPE parent training at the bedside soon after birth and extended throughout hospitalization. The following instruments were used to collect data: a demographic data sheet, Parental Stress Scale: Neonatal Intensive Care Unit, Edinburgh Postnatal Depression Scale, and an investigator-designed parent satisfaction survey. Forty-nine parent sets participated in the study (29 in the intervention group, 20 in the comparison group). A significant difference was found between the groups related to lower parental stress. There was no difference in terms of parental depression scores or length of hospital stay. However, clear trends revealed that parents in the COPE group exhibited lower depression scores. Parents in both groups reported being greater than 95% satisfied with care across all items. These findings may motivate administrators in other community-based hospitals to implement this intervention.

The effect of education on nursing personnel's knowledge and attitudes regarding the use of integrative care techniques with hospice and palliative care patients.

PURPOSE: To examine the effect of education on nursing personnel's knowledge and attitudes regarding the use of hand massage, breathing techniques, and essential oils with hospice and palliative care patients. BACKGROUND: Unrelieved, end of life pain is common among hospitalized patients on hospice and palliative care units. Integrative care techniques such as hand massage, breathing techniques, and essential oils can be available to use with these individuals. Nursing personnel are often unaware of other techniques that are not a traditional pharmacology approach to pain. METHODS: A quasi-experiment was conducted to evaluate the effect of an educational intervention on nursing personnel's knowledge and attitudes regarding the use of three integrative care techniques (hand massage, breathing techniques, and essential oils) with hospice and palliative care patients in an acute care setting. Data on knowledge and attitudes were collected pre- and postintervention. RESULTS: Following the intervention, improvements in nursing personnel's attitudes and knowledge toward the use of the three techniques were found. CONCLUSION: Results of this study suggest that education of nursing personnel may positively influence knowledge and attitudes toward providing hand massage, breathing techniques, and essential oil for end of life patients.

The Effect of Hospital-Based Childbirth Classes on Women's Birth Preferences and Fear of Childbirth: A Pre- and Post-Class Survey.

The purpose of this study was to examine the effect of a hospital-based childbirth class on fear of childbirth, anticipation regarding the birth experience, birth preferences and perception of the birth experience among first-time mothers. Expectant mothers (N = 207) completed an investigator-designed questionnaire before and after attending a prenatal hospital-based childbirth class held in the hospital where they intended to give birth. Statistically, significant changes postintervention included a decrease in fearfulness and an increase in birth anticipation. Shifts also occurred in birth preferences. Data collected from an open-ended question revealed the participants' increased excitement about birth. Findings provide evidence that attending hospital-based childbirth classes may influence women's perceptions and preferences regarding birth.

Developing a Research Friendly Hospital-Based Environment: A Fellowship Model Focused on Graduate Students.

Magnet designation requires that nurses be actively involved in activities that lead to obtaining evidence through conducting research. Unfortunately, several barriers limit nurses' ability to engage in research activities, including insufficient resources. This article explains how a community-based hospital implemented a fellowship model to circumvent some of these barriers. Two fellowship positions are described, 1 in research and 1 in library sciences. The method, outcomes, and cost of the fellowship model are discussed.