Factors affecting early career registered nurses' views of building good relationships with patients: A qualitative empirical research study.

AIM: To clarify the factors affecting early career registered nurses' (ECRNs') views on building good nurse-patient relationships. DESIGN: An exploratory qualitative research design was implemented using detailed individual semi-structured interviews. METHODS: Interview data were analysed using a thematic approach based on the systematic text condensation analysis proposed by Malterud. DATA SOURCES: Eleven consenting nurses working in four hospitals. RESULTS: Six characteristics were identified that influenced ECRNs' perceptions of building good nurse-patient relationships: finding clues through reflection, observing patients' reactions, clarifying their role as a nurse, doing their best for the patients, treating each patient as an irreplaceable individual and receiving support. CONCLUSIONS: We discovered that the factors affecting ECRNs' views could be divided into two categories: factors that contribute to ECRNs' views on developing positive relationships with patients, and factors that influence ECRNs' relationships with patients but do not directly lead to positive relationships. It is critical for ECRNs to reflect on their experiences of poor relationship-building and observe patients' reactions. ECRNs seldom recognize that they have developed good relationships with their patients. It is critical to consider organizational environment and support as variables in developing a nurse-patient relationship so that the responsibility does not fall solely on ECRNs. IMPLICATIONS: The results of this study provide clues to help ECRNs overcome difficulties in building relationships with patients. Furthermore, they can be used to develop educational programme for ECRNs. Future studies should use these findings to provide support to ECRNs and help them build relationships with patients.

Proxy evaluation of dignity expectations and satisfaction of older patients with dementia by family members and nurses.

AIM: Develop a proxy evaluation questionnaire for patients' family members and nurses to evaluate dignity expectations and satisfaction of patients with dementia. DESIGN: Cross-sectional study. METHOD: A proxy questionnaire draft was prepared with 30 items on expectations for dignity and 23 items on satisfaction with dignity. And administered to three paired groups: 81 older patients with intact cognitive function, 75 family members, and 77 nurses. RESULTS: 18 of 30 items and 21 of 23 were correlated between patients and their family members' responses on dignity expectations and satisfaction, respectively. When limited to nurses with clinical experience of ≥20 years, there were significant correlations between patients' and nurses' responses (p < .05). Exploratory factor analysis of patient's responses to significantly correlated items extracted 3 factors with 13 items of expectations for dignity but no factors of satisfaction with dignity. Using a questionnaire provides insight for proxy evaluation of expectations for dignity.

Developing a self-checklist of staff development behavior for associate nurse unit managers using the Delphi method.

The most significant influence on nurses' professional growth is through work under direct guidance in clinical settings. Associate nurse unit managers perform direct patient care with the staff, as well as assist management work of nurse unit managers. They can be excellent role models for the staff. We examined their behaviors that help promote staff development, aimed to identify effective behaviors, and created a self-checklist to evaluate them. We created 53 items to assess staff development behaviors, which were evaluated via a Delphi survey with 252 experts and a questionnaire survey with 124 associate nurse unit managers in Japan to evaluate whether the created item was appropriate. The results of the Delphi survey showed an agreement rate of over 90%, and associate nurse unit managers showed an acceptance rate of 82.6-99.2% for 40 of 53 items. Consequently, we created 40-item self-checklist of staff development behaviors for associate nurse unit managers with adequate validity. This checklist would be helpful for them to promote staff development while working in clinical settings and would contribute to enhancing the quality of nursing.

Health Information Sharing Among Muslim Women in a Japanese Mosque.

With the increase of foreign residents in Japan, most of them are suffering from inadequate health information. In reference to an ethnography, we conducted fieldwork using a participant observation and an interview with 36 foreign Muslim women. Our study clarified they especially needed health information on childcare because of a lack of such information in their native languages, and needed the support of Japanese Muslims because of problems in communication with healthcare personnel.

Development of the Inpatient Dignity Scale Through Studies in Japan, Singapore, and the United Kingdom.

PURPOSE: The importance of human dignity in care is well-recognized. Care recipients' experiences with undignified care have been reported in many countries. However, few studies have measured these situations quantitatively, especially as there are no tools applicable to inpatients receiving ordinary daily care. This study aimed to develop a valid and reliable Inpatient Dignity Scale (IPDS) that can measure inpatients' expectations of and satisfaction with dignity in daily care. METHODS: We conducted a three-phase research project: item generation and a preliminary survey with 47 items related to patients' dignity in Japan, a main survey with 36 items with deliberate translation into English in Singapore, and a confirmatory survey with 35 items in England, with 442, 430, and 500 inpatients as participants in questionnaire surveys, respectively. Data from each survey were processed using factor analysis. RESULTS: Authors obtained a scale with a four-factor structure with acceptable reliability: (F1) respect as a human being, (F2) respect for personal feelings and time, (F3) respect for privacy, and (F4) respect for autonomy. CONCLUSION: The Inpatient Dignity Scale can be periodically used by hospital administrators or nurses to preserve inpatients' dignity in daily care by monitoring inpatients' views regarding their expectations of and satisfaction with dignity.

Evaluation of Nurses' Acceptance of Screen Display Methods with Temporarily Non-Display for Privacy Protection.

The purpose of this study was to explore nurses' acceptance of a screen display method that temporarily hides patient information for privacy protection. Using a questionnaire, we asked nurses to evaluate the display method from the viewpoints of safety and efficiency with respect to 22 personal information items. The nurses were favorably interested in introducing the display method into their hospital system; however, their acceptance varied.

Examination of an Electronic Patient Record Display Method to Protect Patient Information Privacy.

Electronic patient records facilitate the provision of safe, high-quality medical care. However, because personnel can view almost all stored information, this study designed a display method using a mosaic blur (pixelation) to temporarily conceal information patients do not want shared. This study developed an electronic patient records display method for patient information that balanced the patient's desire for personal information protection against the need for information sharing among medical personnel. First, medical personnel were interviewed about the degree of information required for both individual duties and team-based care. Subsequently, they tested a mock display method that partially concealed information using a mosaic blur, and they were interviewed about the effectiveness of the display method that ensures patient privacy. Participants better understood patients' demand for confidentiality, suggesting increased awareness of patients' privacy protection. However, participants also indicated that temporary concealment of certain information was problematic. Other issues included the inconvenience of removing the mosaic blur to obtain required information and risk of insufficient information for medical care. Despite several issues with using a display method that temporarily conceals information according to patient privacy needs, medical personnel could accept this display method if information essential to medical safety remains accessible.

Patients' Opinions on Display Methods to Protect Privacy.

The purpose of this study is to ascertain if patients will accept an electronic patient record system that temporarily conceals their private information. We interviewed 11 outpatients at a core hospital in Shizuoka prefecture of Japan. Most patients agree with our idea using temporary mosaic on the screen to protect their privacy.

Display methods of electronic patient record screens: patient privacy concerns.

To provide adequate care, medical professionals have to collect not only medical information but also information that may be related to private aspects of the patient's life. With patients' increasing awareness of information privacy, healthcare providers have to pay attention to the patients' right of privacy. This study aimed to clarify the requirements of the display method of electronic patient record (EPR) screens in consideration of both patients' information privacy concerns and health professionals' information needs. For this purpose, semi-structured group interviews were conducted of 78 medical professionals. They pointed out that partial concealment of information to meet patients' requests for privacy could result in challenges in (1) safety in healthcare, (2) information sharing, (3) collaboration, (4) hospital management, and (5) communication. They believed that EPRs should (1) meet the requirements of the therapeutic process, (2) have restricted access, (3) provide convenient access to necessary information, and (4) facilitate interprofessional collaboration. This study provides direction for the development of display methods that balance the sharing of vital information and protection of patient privacy.

[Subjective physical and mental health characteristics of male family caregivers].

OBJECTIVES: Due to the increased population of elderly people requiring care and assisted living care, as well as changes in the social structure, the number of males playing a role in home care has therefore been increasing each year. The purpose of this study was to clarify characteristics related to subjective mental and physical health of male family caregivers based on a comparison with male non-caregivers. METHODS: The subjects comprised 52 male family caregivers (caregiver group) who provide care for those requiring at-home care at level 3 or above, or who provided care for people with dementia in cases at a level below 3, with an average age and standard deviation of 69.3 +/- 10.9 years old. The comparison group comprised 52 people who underwent regular health checkups in K city, whose gender and ages, by 10-year age group, were matched to the subjects on a 1:1 basis, and whose average age and standard deviation were 69.2 +/- 11.1 years old. The research was conducted over ther period from December 2005 to April 2007. The survey was conducted with a self-answering format, and subjects were asked questions about such matters as lifestyle, QOL, psychosocial stress and coping with stress. RESULTS: The average age of people requiring care was 75.7 +/- 9.5 years old, and it became apparent that elderly caregivers generally provide care for other elderly people. In a health-related QOL (SF-8), care-giver group were significantly low in "General Health" and "Bodily Pain" in the physical health domain. In the mental health domain, "Mental Health" and mental health summary score of the care-giver group were significantly low. Regarding lifestyle, it was apparent that the care-giver group had significantly fewer sleeping hours than the control group and the PSQI score was also lower. Coping scores were significantly low for the caregiver group regarding 2 items, "Evasive Thinking" and "Recreation", and this indicated a tendency toward not adopting an evasive type of coping. CONCLUSION: It became clear that male caregivers have low subjective health and experience problems about sleep and stress. In addition, they tended not to take coping of evasion type and a need of comprehensive support was suggested.