RESUMO
AIM: Develop evidence-based recommendations for managers to support primary healthcare nurses to thrive at work. DESIGN: A mixed-methods sequential explanatory design. METHODS: National data were collected in 2020 via an e-survey based on a meta-analysis of antecedents of thriving from 213 primary healthcare nurses across New Zealand. Structural equation modelling analysis identified the key factors supporting primary healthcare nurses to thrive. This informed a second open-ended e-survey in 2022 of 19 nurses from one primary healthcare organization. The thematic analysis provided recommendations for improving management strategies to support thriving primary healthcare nurses. RESULTS: The vitality component of thriving significantly reduced burnout and intention to leave organization and profession. In contrast, the learning component of thriving had a significant positive effect on burnout. The key factors that support thriving at work are empowering leadership and perceived organizational supports (decreases burnout and intention to leave organization and profession through enhanced vitality). Recommendations for improving thriving were made in eight key areas: communication, effective management, professional development, scope of practice, autonomy, effective orientation, reward and work-life balance. CONCLUSIONS: Vitality is important in reducing burnout and turnover intentions. While learning was identified as increasing burnout, professional development and training for managers were identified as essential. Hence, the vitality dimension of the thriving at work construct should be studied at the dimension level, but more research is needed into the impact of learning on thriving over time. Primary healthcare nurses have identified that empowering leadership and perceived organizational support are critical factors in supporting them to thrive, and they provide specific recommendations for managers to improve these factors in the clinical setting. NO PATIENT OR PUBLIC CONTRIBUTION: This study collected data from Registered Nurses only. WHAT IS ALREADY KNOWN: A plethora of existing research focuses on resilience in nurses rather than thriving at work. Enabling employees to thrive at work contributes to improved well-being and sustainable organizational performance. WHAT THIS PAPER ADDS: Empowering leadership and perceived organizational support are the key factors that support primary healthcare nurses to thrive at work. The vitality dimension of the thriving at work construct should be studied at the dimension level, and further research is needed into the impact of learning on thriving over time. Primary healthcare nurses recommend that managers focus on improving communication, management efficiency, professional development, scope of practice, autonomy, orientation, reward and work-life balance.
Assuntos
Esgotamento Profissional , Satisfação no Emprego , Humanos , Esgotamento Profissional/psicologia , Esgotamento Profissional/prevenção & controle , Adulto , Feminino , Masculino , Nova Zelândia , Pessoa de Meia-Idade , Atenção Primária à Saúde , Inquéritos e Questionários , Reorganização de Recursos Humanos , Liderança , Enfermagem de Atenção Primária/psicologiaRESUMO
Objetivo: Analisar a implicação profissional de enfermeiras(os) da Estratégia Saúde da Família (ESF). Métodos:Estudo descritivo, de abordagem qualitativa realizado com 19 enfermeiras(os) da ESF durante o primeiro trimestre de 2020. Foram realizadas entrevistas semiestruturadas, procedendo-se com a análise a partir das dimensões ideológica, libidinal e organizacional da implicação profissional, conforme referencial teórico da Análise Institucional. Resultados:Nas dimensões ideológica, libidinal e organizacional da implicação profissional foram identificados: a amplitude do trabalho da(o) enfermeira(o) na ESF; a sobrecarga de trabalho; a assistência de enfermagem e o trabalho em equipe; o vínculo com os(as) usuários(as); a falta de apoio da gestão e a ausência de articulação da rede de atenção à saúde. Conclusão: O trabalho em equipe corresponde ao vetor essencial para a prática profissional, o vínculo como principal motivador e a falta de apoio da gestão e da articulação em rede como dificultadores do exercício da enfermagem na ESF.
Objective: To analyze the professional involvement of nurses in the Family Health Strategy (FHS). Method:Descriptive study with a qualitative approach carried out with 19 nurses in the FHS during the first quarter of 2020. Semi-structured interviews were carried out, proceeding with the analysis from the ideological, libidinal and organizational dimensions of professional involvement, according to the theoretical framework of Institutional Analysis. Results:It was identified in the ideological, libidinal and organizational dimensions of professional involvement: the breadth of the nurse's work in the FHS; work overload; nursing care and teamwork; the bond with the users; the lack of management support and the lack of articulation of the health care network. Conclusion: Teamwork corresponds to the essential vector for professional practice, the bond as the main motivator and the lack of support from management and networking as obstacles to the exercise of nursing in the FHS.
Assuntos
Enfermagem de Atenção Primária/psicologia , Atenção Primária à Saúde , Estratégias de Saúde NacionaisRESUMO
The objective of this study is twofold: first, to analyze whether the daily level of energy in terms of vigor at work could explain the way in which workers psychologically detach from their work, relax, practice challenging activities, and have the feeling of having control over their leisure time when arriving home. Second, to check if the daily emotional job demands could hinder that relationship, reversing the positive effect of vigor in recovery. For this purpose, a multilevel study with a diary methodology was designed. In total, 94 nurses from various hospital and primary care centers in Madrid and Basque Country (Spain) participated in this study. They completed daily questionnaires twice a day (in the afternoon after work and at night before going to bed) for five consecutive workdays from Monday to Friday (N = 94*5 = 470). The results revealed that on days that vigor at work was high, nurses experienced more psychological detachment, relaxation, feelings of mastery, and time control at home. Moreover, on days that emotional job demands were high, vigor was more negatively related to psychological detachment and time control at home. Additionally, vigor was more positively related to all recovery experiences at home in days that emotional demands were low. Therefore, daily vigor can act as an energy resource that helps the worker to recover. However, this effect can occur in situations in which stressors are not present in high intensity. These results have clear practical implications for both health organizations and workers.
Assuntos
Emoções , Recursos Humanos de Enfermagem , Estresse Ocupacional , Humanos , Análise Multinível , Recursos Humanos de Enfermagem/psicologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Estresse Ocupacional/psicologia , Enfermagem de Atenção Primária/psicologia , Espanha , Inquéritos e Questionários , Equilíbrio Trabalho-VidaRESUMO
This paper reports on a study that aimed to understand how remote area nurses implemented primary health care principles in the Australian remote health care setting. Twenty-four Registered Nurses and Nurse Practitioners who worked in remote health services without inpatient facilities were interviewed using constructivist grounded theory methods. Findings revealed that nurses in this study aimed to practice in a way that was guided by Indigenous empowerment and social justice. However, some nurses questioned elements of their practice such as 'chasing' people for appointments or routine screening required by clinical guidelines that may not reflect the values of Indigenous peoples. Nurses expressed concern that they may be reinforcing past colonising practices and their actions may be considered paternalistic rather than empowering. Nurses in this study wanted to develop partnerships and provide nursing care that aligned with the health and wellbeing expectations of communities. However, ways of communicating the needs of communities and the development of partnerships between health providers and communities need to be developed. The present study calls for further research from the perspective of remote community members in order to develop ways of sharing knowledge about health and wellbeing between remote area nurses and communities.
Assuntos
Atitude do Pessoal de Saúde , Papel do Profissional de Enfermagem/psicologia , Enfermeiras e Enfermeiros/psicologia , Enfermagem de Atenção Primária/psicologia , Serviços de Saúde Rural , Enfermagem Rural/métodos , Austrália , Humanos , Entrevistas como Assunto , Havaiano Nativo ou Outro Ilhéu do Pacífico , Profissionais de Enfermagem/psicologia , Satisfação do Paciente , Enfermagem de Atenção Primária/métodosRESUMO
Dementia is now a global health priority. With no known cure, the best way to reduce the number of people who will be living with dementia is by promoting dementia risk reduction (DRR). However, despite evidence-based guidelines, DRR is not yet routinely promoted in Australian general practice. Previously, we proposed a preliminary conceptual model for implementing DRR in primary care based on our scoping review of practitioners' views. The present study aimed to refine this model for the Australian context by incorporating the current perspectives of Australian general practitioners (GPs) and general practice nurses (GPNs) about DRR. Interviews with 17 GPs and GPNs were analysed using the framework method, underpinned by the Consolidated Framework for Implementation Research (CFIR). We identified 12 barriers to promoting DRR in Australian general practice, along with five facilitators. Using the CFIR-Expert Recommendations for Implementing Change (ERIC) Matching Tool to select prioritised implementation strategies from the ERIC project, the findings were incorporated into a refined conceptual model. The refined model points to an implementation intervention that uses educational materials and meetings to reach consensus with GPs and GPNs on the importance of promoting DRR and an appropriate approach. Champion GPs and GPNs should be prepared to drive the agreed implementation forward, and general practices should share successes and lessons learned. This model is a crucial step in bridging the gap between DRR guidelines and routine practice.
Assuntos
Atitude do Pessoal de Saúde , Demência/psicologia , Medicina Geral/métodos , Clínicos Gerais/psicologia , Enfermagem de Atenção Primária/psicologia , Comportamento de Redução do Risco , Austrália , Feminino , Humanos , Entrevistas como Assunto , Masculino , AutoeficáciaRESUMO
General practice is arguably the ideal setting to initiate advance care planning (ACP), but there are many barriers. This pilot study was designed to assess the feasibility, acceptability and perceived utility of a nurse-facilitated screening interview to initiate ACP with older patients in general practice. Patients were recruited from four general practices in Sydney, Australia. General practice nurses administered the ACP screening interview during routine health assessments. Patients and nurses completed a follow-up questionnaire consisting of questions with Likert responses, as well as open-ended questions. Descriptive statistics and content analysis were used to analyse the data. Twenty-four patients participated; 17 completed the follow-up questionnaire. All patients found the ACP screening interview useful and most felt it would encourage them to discuss their wishes further with their family and general practitioner. Several patients were prompted to consider legally appointing their preferred substitute decision-maker. All six participating nurses found the screening interview tool useful for initiating discussions about ACP and substitute decision-making. This nurse facilitated screening tool provides a simple, acceptable and feasible approach to introducing ACP to older general practice patients during routine health assessments.
Assuntos
Planejamento Antecipado de Cuidados , Medicina Geral/métodos , Relações Enfermeiro-Paciente , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Feminino , Humanos , Entrevistas como Assunto , Masculino , New South Wales , Projetos Piloto , Enfermagem de Atenção Primária/psicologia , Inquéritos e QuestionáriosRESUMO
The objective of the study was to evaluate the prevalence and factors associated with Burnout Syndrome (BS) in Primary Health Care (PHC) nursing professionals from the state of Bahia, Brazil. A multicentre, cross-sectional population-based study was conducted in a cluster sample among 1125 PHC Nursing professionals during the years 2017 and 2018. We used a questionnaire that included sociodemographic, labor and lifestyle variables and the Maslach Burnout Inventory scale to identify BS. The associations were evaluated using a robust Poisson regression with the hierarchical selection of the independent variables. The prevalence of BS was 18.3% and the associated factors were ethnicity (prevalence ratio (PR) = 0.62, confidence interval (CI) 95% = 0.47-0.83), residence (PR = 2.35, CI 95% = 1.79-3.09), economic situation (PR = 1.40, CI 95% = 1.06-1.86), satisfaction with current occupation (PR = 1.75, CI 95% = 1.31-2.33), (PR = 1.60, CI 95% = 1.23-2.08), rest (PR = 1.83, 95% CI = 1.41-2.37), technical resources and equipment (PR = 1.37, CI 95% = 1.06-1.77), night shift (PR = 1.49, CI 95% = 1.14-1.96), physical activity practice (PR = 1.72; CI 95% = 1.28-2.31), smoking (PR = 1.82, CI 95% = 1.35-2.45), and satisfaction with physical form (PR = 1.34, CI 95% = 1.01-179). Strategies are needed to prevent BS, with an emphasis on implementing worker health programs in the context of PHC.
Assuntos
Esgotamento Profissional/epidemiologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Enfermagem de Atenção Primária/psicologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
AIMS AND OBJECTIVES: To understand clinical reasoning and decision-making of triage nurses during telephone conversations with callers suspected of having acute cardiac events, and support from a computer decision support system (CDSS) herewith. BACKGROUND: In telephone triage, nurses assess the urgency of callers' conditions with clinical reasoning, often supported by CDSS. The use of CDSS may trigger interactional workability dilemmas. DESIGN: Qualitative study using principles of a grounded theory approach following COREQ criteria for qualitative research. METHODS: Audio-stimulated recall interviews were conducted amongst twenty-four telephone triage nurses at nine out-of-hours primary care centres (OHS-PC). RESULTS: Telephone triage nurses use clinical reasoning elements for urgency assessment. Typically in telephone triage, they interpret the vocal-but not worded-elements in communication (paralanguage) such as tone of voice and shortness of breath and create a mental image to compensate for lack of visual information. We confirmed that interactional workability dilemmas occur. Congruence, established when the CDSS supports the triage nurses' decision-making, is essential for the CDSS' value. If congruence is absent, triage nurses may apply four working strategies: (a) tinker to make CDSS final recommendation align with their own assessment, (b) overrule the CDSS recommendation, (c) comply with the CDSS recommendation or (d) transfer responsibility to the GP. CONCLUSION: Triage nurses who assess urgency may experience absence of congruence between the CDSS and their decision-making. Awareness of how triage nurses reason and make decisions about urgency and what aspects influence their working strategies can help in achieving optimal triage of callers suspected of acute cardiac events at OHS-PC. RELEVANCE TO CLINICAL PRACTICE: Triage nurses' reasoning and their working strategies are vital for outcome of triage decisions. Understanding these processes is essential for CDSS developers and OHS-PC managers, who should value how triage nurses interact with the CDSS, while they have the benefit of callers in mind.
Assuntos
Tomada de Decisões , Sistemas de Apoio a Decisões Clínicas/normas , Enfermagem de Atenção Primária/métodos , Triagem/métodos , Plantão Médico/métodos , Humanos , Infarto do Miocárdio/enfermagem , Infarto do Miocárdio/psicologia , Relações Enfermeiro-Paciente , Enfermagem de Atenção Primária/psicologia , Pesquisa Qualitativa , TelefoneRESUMO
BACKGROUND: High-quality nutrition education is recommended as an essential component of diabetes care. In the UK, there has been a gradual shift of inter-professional boundaries with respect to providing nutritional care for people with type 2 diabetes. Only a minority now regularly receive advice from a dietitian. Instead, increased demands for nutrition education are being absorbed by practice nurses. The present study seeks to explore this situation through the views of practice nurses on the services that they provide and the issues they face. METHODS: A qualitative approach using semi-structured interviews was employed. Practice nurses were recruited using purposive sampling, and nine were interviewed. Data were analysed using the Framework Method. The Theoretical Domains Framework from the COM-B ('capability', 'opportunity', 'motivation' and 'behaviour') model of behaviour change, as increasingly employed to explore the behaviour of healthcare professionals, was used to further frame the findings. RESULTS: Practice nurses reported that ongoing diabetes nutrition education only took place at annual review appointments and was limited to 5-10 min. They described how they are expected to take on a more advanced role in diabetes nutrition education than they can provide and are becoming increasingly isolated in this role as a result of a lack of time, practical and informational support, and training standards and provision. CONCLUSIONS: A range of service improvements led by dietitians, which focus on strengthening the working environment and enhancing professional support available for practice nurses who provide diabetes nutrition education, could improve quality of care and health outcomes in people with diabetes within current time restraints.
Assuntos
Diabetes Mellitus Tipo 2/enfermagem , Papel do Profissional de Enfermagem/psicologia , Educação de Pacientes como Assunto/métodos , Enfermagem de Atenção Primária/psicologia , Atenção Primária à Saúde/métodos , Adulto , Atitude do Pessoal de Saúde , Dietética , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Reino UnidoRESUMO
OBJECTIVE: Professional engagement is an indicator of the relationship between a nurse and the work environment and is an important factor in performance and productivity. The goal of this study was to evaluate levels of engagement among nurses in primary health care units. METHODS: Cross-sectional study in a city of São Paulo state, Brazil, in 2017, using an instrument containing sociodemographic variables and the Utrecht Work Engagement Scale (UWES). RESULTS: In the sample of 75 nurses, the majority were female (94.7%), aged between 29 and 39 (52.0%), specialists (81.3%), married (57.3%), permanent employees (68.0%), working 40 hr per week (98.7%), and working in primary health care for 3-10 years (42.7%). Engagement levels were classified as high in all dimensions. Nurses who worked as managers presented a very high level of dedication; professionals aged 40 years or older presented very high levels in all dimensions (Dedication: 5.2; Absorption: 5.0; Vigor: 5.3; and Overall score: 5.1); and professionals with more than 10 years of experience in primary health care had very high levels in all dimensions (Dedication: 5.0; Absorption: 5.0; Vigor: 5.0; and Overall score: 5.0). CONCLUSIONS: Nurses working in Brazil's primary health care system have high engagement and ability to act; they enhance team performance and quality and effectiveness of care provided.
Assuntos
Enfermagem de Atenção Primária/psicologia , Atenção Primária à Saúde/organização & administração , Engajamento no Trabalho , Adulto , Brasil , Cidades , Estudos Transversais , Feminino , Humanos , Masculino , Enfermagem de Atenção Primária/estatística & dados numéricosRESUMO
OBJECTIVE: to evaluate the quality of life of primary care nurses in the climacteric. METHOD: A cross-sectional descriptive-analytic study, performed with 98 female nurses, aged 40-65 years, using the WHOQOL-Bref questionnaire. RESULTS: the worst level of quality of life was observed for professionals aged 50-59 years, non-white, specialists, divorced or widowed, with children, a lower income, with another employment relationship, a weekly workload of more than 40 hours, who consumed alcoholic beverages weekly, with chronic disease, in continuous use of medications, sedentary, who did not menstruate and did not receive hormonal treatment, and who went through menopause between the ages of 43-47 years. CONCLUSION: Although the variables "physical activity" and "age" have a statistically significant association with quality of life, other variables seem to interfere in these professionals' lives, indicating the need for a more critical and deep reflection on these relations.
Assuntos
Enfermeiras e Enfermeiros/psicologia , Enfermagem de Atenção Primária/normas , Qualidade de Vida/psicologia , Adulto , Fatores Etários , Idoso , Climatério/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Menopausa/psicologia , Pessoa de Meia-Idade , Enfermagem de Atenção Primária/métodos , Enfermagem de Atenção Primária/psicologia , Grupos Raciais/estatística & dados numéricos , Inquéritos e Questionários , Carga de Trabalho/psicologia , Carga de Trabalho/normasRESUMO
BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) receiving primary care regularly visit their practice nurses (PNs). By actively participating during medical consultations, patients can better manage their disease, improving clinical outcomes and their quality of life. However, many patients with T2DM do not actively participate during medical consultations. To understand the factors affecting engagement of patients with T2DM, this study aimed to identify factors that help or hinder them from actively participating in consultations with their primary care PNs. METHODS: Two semi-structured focus groups and 12 semi-structured individual interviews were conducted with patients with T2DM (n = 20) who were undergoing treatment by primary care PNs. All interviews were transcribed verbatim and analyzed using a two-step approach derived from the context-mapping framework. RESULTS: Four factors were found to help encourage patients to actively participate in their consultation: developing trusting relationships with their PNs, having enough time in the appointment, deliberately preparing for consultations, and allowing for the presence of a spouse. Conversely, four factors were found to hinder patients from participating during consultations: lacking the need or motivation to participate, readjusting to a new PN, forgetting to ask questions, and ineffectively expressing their thoughts. CONCLUSION: Patients lacked the skills necessary to adequately prepare for a consultation and achieve an active role. In addition, patients' keen involvement appeared to benefit from a trusting relationship with their PNs. When active participation is impeded by barriers such as a lack of patient's skills, facilitators should be introduced at an early stage. TRIAL REGISTRATION: Current Controlled Trials NTR4693 (July 16, 2014).
Assuntos
Diabetes Mellitus Tipo 2/enfermagem , Relações Enfermeiro-Paciente , Participação do Paciente/psicologia , Diabetes Mellitus Tipo 2/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Profissionais de Enfermagem , Enfermagem de Atenção Primária/psicologia , Pesquisa Qualitativa , Qualidade de Vida , Encaminhamento e ConsultaRESUMO
BACKGROUND: Job satisfaction is generally considered to be an important element of work quality and workplace relations. Little is known about levels of job satisfaction among hospital and primary-care midwives in the Netherlands. Proposed changes to the maternity care system in the Netherlands should consider how the working conditions of midwives affect their job satisfaction. AIM: We aimed to measure and compare job satisfaction among hospital and primary-care midwives in the Netherlands. METHODS: Online survey of all practising midwives in the Netherlands using a validated measure of job satisfaction (the Leiden Quality of Work Questionnaire) to analyze the attitudes of hospital and primary-care midwives about their work. Descriptive and inferential statistics were used to assess differences between the two groups. RESULTS: Approximately one in six of all practising midwives in the Netherlands responded to our survey (hospital midwives n = 103, primary-care midwives n = 405). All midwives in our survey were satisfied with their work (n = 508). However, significant differences emerged between hospital and primary-care midwives in terms of what was most important to them in relation to their job satisfaction. For hospital midwives, the most significant domains were: working hours per week, workplace agreements, and total years of experience. For primary-care midwives, social support at work, work demands, job autonomy, and the influence of work on their private life were most significant. CONCLUSION: Although midwives were generally satisfied, differences emerged in the key predictors of job satisfaction between hospital and primary-care midwives. These differences could be of importance when planning workforce needs and should be taken into consideration by policymakers in the Netherlands and elsewhere when planning new models of care.
Assuntos
Satisfação no Emprego , Enfermeiros Obstétricos/psicologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Enfermagem de Atenção Primária/psicologia , Adulto , Feminino , Maternidades/estatística & dados numéricos , Humanos , Masculino , Serviços de Saúde Materna , Tocologia/estatística & dados numéricos , Países Baixos , Satisfação Pessoal , Gravidez , Inquéritos e Questionários , Local de Trabalho/psicologiaRESUMO
BACKGROUND: Mental Health problems are one of the leading disabilities worldwide. Individuals seeking help for their mental illness expect nurses to be cognisant of their needs without prejudice and discrimination. Existing evidences suggest a growing number of patient referral from primary healthcare to psychiatric consultations. This study aimed to explore primary healthcare nurses' knowledge and attitude towards mental illness and people with mentally illness. METHODS: A cross-sectional study using the Mental Health Problem Perception and the Community Attitudes to Mental Illness questionnaires. Descriptive and multivariate regression using maximum likelihood procedures were applied. RESULTS: Regression analysis showed significantly high correlation between knowledge and authotarianism (ßâ¯=â¯0.775, pâ¯=â¯0.007) and moderate inverse correlation with social restrictiveness (ßâ¯=â¯-0.517, pâ¯<â¯0.001). However, no significant correlation with benevolence (ßâ¯=â¯-0.057, pâ¯=â¯0.181) was detected. Nurses with higher educational level were significantly associated with authotarianism attitude. CONCLUSIONS: This is the first study examining knowledge and attitude of primary healthcare nurses in Brunei. The relationship between the study variables as well as demographic factors, in comparison to other countries, were discussed. Overall, negative attitude among nurses is still a challenging issue; therefore, developing re-education initiatives and increase contact time, especially for healthcare front liners with negative attitudes regardless of education level, to favour change of attitude, is important to foster holistic care to people with mental illness and promote mental health in the population.
Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais/psicologia , Enfermagem de Atenção Primária/psicologia , Adulto , Autoritarismo , Brunei , Estudos Transversais , Feminino , Humanos , Masculino , Enfermagem de Atenção Primária/estatística & dados numéricos , Estigma SocialRESUMO
OBJECTIVES: To assess nurses' knowledge and perceptions towards mental illness. METHODS: This was a cross-sectional descriptive study conducted among 126 randomly selected nurses those are working under District Mental Health program in Karnataka (India). The data was collected through self-reported questionnaires Using the modified version of Public perception of mental illness questionnaire and Attitude Scale for Mental Illness. RESULTS: The findings revealed that majority of the subjects were women (74.4%), Hindus (92.1%) and were from rural background (69.8%). The mean Knowledge score 10.8±1.6 adequate knowledge (maximum possible =12) among 91% of the subjects, and 52% of them hold negative attitudes towards people with mental illness (88.9±13.6). While majority of the subjects hold negative attitudes in 'Separatism' (53.5%), 'Stereotyping' (73%), 'Benevolence' (54%), 'Pessimistic prediction' (53%) domains, they hold positive attitudes in 'Restrictiveness' (88%) and 'Stigmatization' (72%) domains. Women than men endorsed positive attitudes towards persons with mental illness in Stereotyping' (p<0.001), 'Restrictiveness' (p<0.01), 'Benevolence' (p<0.001) and 'Pessimistic prediction' (t= 2.22, p<0.05) domains. Similarly, Auxiliary Nursing Midwifery found to be less restrictive (p<0.05), more benevolent (p<0.001) and less pessimistic (p<0.05) compared to nurses with higher education (General Nursing and Midwifery and Bachelor of Science in Nursing). CONCLUSIONS: The present study showed adequate knowledge on mental illness among nurses. Yet they hold stigmatizing and negative attitudes towards mental illness. Hence, it is an urgent priority to develop and implement educational programs to inculcate positive attitudes towards people with mental illness to provide optimal care to this vulnerable population.
Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais/enfermagem , Enfermagem de Atenção Primária/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Enfermagem de Atenção Primária/psicologia , Fatores Sexuais , Estereotipagem , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Researchers have found that many primary care providers are not following developmental screening recommendations. Few studies exist on the screening behaviors of advanced practice nurses. METHODS: A qualitative descriptive study explored the screening behaviors, skills, and environmental facilitators/constraints of 24 family nurse practitioners (FNPs) who cared for pediatric patients from birth to 5 years of age in primary care settings. An inductive approach to content analysis was used to interpret the data. RESULTS: Five main themes emerged: (a) Developmental Screening Behaviors During Well-Child Visits, (b) Developmental Screening Behaviors When a Concern Was Raised, (c) Need for Additional Developmental Screening Skills, (d) Factors That Support Developmental Screening, and (e) Factors That Limit Developmental Screening. Sixteen subthemes supported the main themes. DISCUSSION: Most FNPs were not using standardized tools. Behaviors mainly consisted of actions that were informal. FNPs were not familiar with current recommendations, and they had difficulty describing most instruments.
Assuntos
Competência Clínica , Deficiências do Desenvolvimento/diagnóstico , Enfermeiros de Saúde da Família , Programas de Rastreamento/métodos , Enfermagem de Atenção Primária/métodos , Adulto , Pré-Escolar , Enfermeiros de Saúde da Família/psicologia , Enfermeiros de Saúde da Família/normas , Feminino , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Enfermagem de Atenção Primária/psicologia , Enfermagem de Atenção Primária/normas , Pesquisa Qualitativa , Adulto JovemRESUMO
ABSTRACT Objective: to evaluate the quality of life of primary care nurses in the climacteric. Method: A cross-sectional descriptive-analytic study, performed with 98 female nurses, aged 40-65 years, using the WHOQOL-Bref questionnaire. Results: the worst level of quality of life was observed for professionals aged 50-59 years, non-white, specialists, divorced or widowed, with children, a lower income, with another employment relationship, a weekly workload of more than 40 hours, who consumed alcoholic beverages weekly, with chronic disease, in continuous use of medications, sedentary, who did not menstruate and did not receive hormonal treatment, and who went through menopause between the ages of 43-47 years. Conclusion: Although the variables "physical activity" and "age" have a statistically significant association with quality of life, other variables seem to interfere in these professionals' lives, indicating the need for a more critical and deep reflection on these relations.
RESUMEN Objetivo: evaluar la calidad de vida de enfermeras en el climaterio que actúan en la atención primaria. Método: estudio descriptivo y de análisis, de cohorte transversal, realizado con 98 enfermeras, de entre 40 y 65 años de edad, en que se utilizó el cuestionario WHOQOL-Bref. Resultados: presentaron un peor nivel de calidad de vida las profesionales: de entre 50 y 59 años de edad, no blancas, con especialización, divorciadas o viudas, con hijos, con menor renta familiar, que tenían otro vínculo de empleo, con carga laboral semanal superior a 40 horas, que consumían alcohol semanalmente, portadoras de enfermedad crónica, en el uso continuo de medicamentos, sedentarias, que no menstruaban y no estaban bajo tratamiento hormonal, y cuya menopausia empezó entre 43 y 47 años de edad. Conclusión: a pesar de la variable "realización de actividad física" y de la variable "edad" haber presentado una asociación estadísticamente significativa con la calidad de vida, otras variables parecen afectar la calidad de vida de esas profesionales, lo que demanda una reflexión crítica y más profundizada sobre esas relaciones.
RESUMO Objetivo: avaliar a qualidade de vida de enfermeiras no climatério atuantes na atenção primária. Método: estudo descritivo-analítico, de corte transversal, realizado com 98 enfermeiras, com idade entre 40 e 65 anos, utilizando-se o questionário WHOQOL-Bref. Resultados: apresentaram pior nível de qualidade de vida as profissionais com idade entre 50 e 59 anos, não brancas, especialistas, divorciadas ou viúvas, com filhos, com menor renda, possuidoras de outro vínculo empregatício, carga horária de trabalho semanal acima de 40 horas, que ingeriam bebida alcoólica semanalmente, portadoras de doença crônica, em uso contínuo de medicamentos, sedentárias, que não menstruavam e não faziam tratamento hormonal, e que apresentaram a menopausa entre 43 e 47 anos. Conclusão: apesar das variáveis "realização de atividade física" e "idade" terem uma associação estatisticamente significante com a qualidade de vida, outras variáveis parecem interferir na dessas profissionais, indicando a necessidade de uma reflexão crítica e mais aprofundada sobre essas relações.
Assuntos
Humanos , Masculino , Feminino , Adulto , Qualidade de Vida/psicologia , Enfermagem de Atenção Primária/normas , Enfermeiras e Enfermeiros/psicologia , Enfermagem Primária/métodos , Climatério/psicologia , Menopausa/psicologia , Estudos Transversais , Inquéritos e Questionários , Fatores Etários , Carga de Trabalho/normas , Carga de Trabalho/psicologia , Grupos Raciais/estatística & dados numéricos , Enfermagem de Atenção Primária/psicologia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Clinical practice guidelines risk having little impact on healthcare if not effectively implemented. Theory informed, targeted implementation may maximise their impact. Our study explored barriers to and facilitators of guideline implementation and use by South African primary care nurses and allied healthcare workers in four provinces in South Africa. We also proposed interventions to address the issues identified. METHODS: We used qualitative research methods, comprising focus group discussions using semi-structured topic guides. Seven focus group discussions were conducted (48 providers) in four South African provinces (Eastern Cape, Western Cape, Kwazulu-Natal, Limpopo). Participants included mostly nurses, dieticians, dentists, and allied health practitioners, from primary care facilities in rural and peri-urban settings. The analysis proceeded in three phases. Firstly, two analysts conducted inductive thematic content analysis to develop themes of data. This was followed by fitting emergent themes to the Theoretical Domains Framework and finally to the associated Behaviour Change Wheel to identify relevant interventions. RESULTS: Participants are knowledgeable about guidelines, generally trust their credibility and are receptive and motivated to use them. Guidelines are seen by nurses to provide confidence and reassurance, as well as professional authority and independence where doctors are scarce. Barriers to guideline use include: inadequate systems for printed book distribution, insufficient and substandard photocopies, linguistic inappropriateness (e.g. complicated language, lack of summaries, unavailable in local languages), unsupportive auditing procedures, limited involvement of end-users in guideline development, and patchy training that may not filter back to all providers. Future aspirations identified include: improving the design features of guidelines, accessible places to find guidelines, making digitally-formatted versions available, more supplementary materials (e.g. posters) to support patient engagement, accessible clinical support following training, and in-facility training for all professional cadres to ensure fair access, similar levels of capability and interdisciplinary consistency. CONCLUSIONS: South African primary care nurses and allied health practitioners have high levels of motivation to use guidelines, but face many systemic barriers. We used the Behaviour Change Wheel to suggest relevant, implementable interventions addressing identified barriers. This theory-informed approach may improve clinical guideline implementation and impact healthcare for South Africa.
Assuntos
Pessoal Técnico de Saúde/estatística & dados numéricos , Motivação , Guias de Prática Clínica como Assunto , Enfermagem de Atenção Primária/estatística & dados numéricos , Atenção Primária à Saúde/normas , Pessoal Técnico de Saúde/psicologia , Pessoal Técnico de Saúde/normas , Atenção à Saúde/normas , Grupos Focais , Fidelidade a Diretrizes , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Humanos , Enfermagem de Atenção Primária/psicologia , Enfermagem de Atenção Primária/normas , Atenção Primária à Saúde/estatística & dados numéricos , Prática Profissional/normas , Pesquisa Qualitativa , Melhoria de Qualidade , Saúde da População Rural , África do SulRESUMO
RESUMEN Introducción: El trastorno por déficit de atención con hiperactividad, es un trastorno del desarrollo neurológico de alta prevalencia en edad pediátrica. Los cuidadores de estos pacientes son el eslabón fundamental para garantizar su adecuada evolución y su incorporación a la sociedad. Objetivo: Diseñar un programa psicoeducativo enfermero para cuidadores primarios de infantojuveniles con trastorno por déficit de atención con hiperactividad. Métodos: Se realizó un estudio de intervención cualitativo-cuantitativo; descriptivo, longitudinal y prospectivo, en áreas de salud del municipio Santa Clara, entre enero de 2016 y abril de 2017. La población estuvo constituida por 49 cuidadores primarios de infantojuveniles con trastorno por déficit de atención con hiperactividad que asisten a la consulta multidisciplinaria de trastornos del neurodesarrollo del Policlínico Chiqui Gómez Lubián, de los cuales se seleccionó una muestra de 19 cuidadores por muestreo aleatorio simple. Se evaluaron los datos de estructura, proceso y resultado, los cuales fueron procesados con frecuencias y porcentaje. Resultados: El 52,63 por ciento de los cuidadores mostró una mediana capacidad de adaptación y afrontamiento. Entre las dimensiones más afectadas de calidad de vida se identifican afectaciones en las emociones, conductas y en el descanso /sueño. El 68,42 por ciento de los cuidadores no estaban satisfechos con la preparación recibida para brindar cuidados a su familiar. Conclusiones: Basado en el modelo de adaptación y afrontamiento de Callista Roy, se diseñó un programa psicoeducativo enfermero para cuidadores de infantojuveniles con trastorno por déficit de atención con hiperactividad, a partir de la identificación de estrategias de afrontamiento y dimensiones afectadas de su calidad de vida(AU)
ABSTRACT Introduction: Attention-deficit hyperactivity disorder is a neurodevelopmental condition of high prevalence in pediatric age. The caregivers of these patients are the fundamental link for ensuring their proper advancement and their incorporation into the society. Objective: To design a psychoeducational nursing program for primary caregivers of children and adolescents with attention-deficit hyperactivity disorder. Methods: A qualitative-quantitative, descriptive, longitudinal and prospective intervention study was conducted, in health areas of Santa Clara Municipality, between January 2016 and April 2017. The study population consisted of 49 primary caregivers of children and adolescents with attention-deficit hyperactivity disorder attending the multidisciplinary consultation of neurodevelopmental conditions of Chiqui Gómez Lubián Polyclinic, among which a sample of 19 caregivers was selected by simple random sampling. The structure, process and result data were evaluated, and later on processed with frequencies and percentage. Results: 52.63 percent of the caregivers showed a medium capacity of adaptation and coping. Among the most affected dimensions of quality of life, we identified affectations in emotions, behaviors and in rest or sleep. 68.42 percent of the caregivers were not satisfied with the preparation received to provide care to their relative. Conclusions: Based on Callista Roy's Adaptation Model of Nursing, a psychoeducational nursing program was designed for caregivers of infants and adolescents with attention-deficit hyperactivity disorder, from the identification of coping strategies and affected dimensions of their quality of life(AU)
Assuntos
Humanos , Criança , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Cuidadores/educação , Enfermagem de Atenção Primária/psicologia , Epidemiologia Descritiva , Estudos Prospectivos , Estudos LongitudinaisRESUMO
BACKGROUND: burnout syndrome is a significant problem in nursing professionals. Although, the unit where nurses work may influence burnout development. Nurses that work in primary care units may be at higher risk of burnout. The aim of the study was to estimate the prevalence of emotional exhaustion, depersonalization and low personal accomplishment in primary care nurses. METHODS: We performed a meta-analysis. We searched Pubmed, CINAHL, Scopus, Scielo, Proquest, CUIDEN and LILACS databases up to September 2017 to identify cross-sectional studies assessing primary care nurses' burnout with the Maslach Burnout Inventory were included. The search was done in September 2017. RESULTS: After the search process, n = 8 studies were included in the meta-analysis, representing a total sample of n = 1110 primary care nurses. High emotional exhaustion prevalence was 28% (95% Confidence Interval = 22-34%), high depersonalization was 15% (95% Confidence Interval = 9-23%) and 31% (95% Confidence Interval = 6-66%) for low personal accomplishment. CONCLUSIONS: Problems such as emotional exhaustion and low personal accomplishment are very common among primary care nurses, while depersonalization is less prevalent. Primary care nurses are a burnout risk group.