Émotions des infirmières au chevet des malades hospitalisés pour la COVID-19. Recherche qualitative consensuelle.

The COVID-19 pandemic has created unprecedented working conditions, with repercussions on the daily lives of nurses. The events experienced positively or negatively in their clinical practice have aroused a variety of emotions for them. The objective of this research is to describe and categorize the events that provoked emotions in nurses who volunteered to accompany COVID-19 victims in a Belgian academic hospital during the first wave of the pandemic by identifying what these emotions were. The researchers used Hill's Consensual Qualitative Research method. Nineteen semi-structured individual interviews were conducted. After the full transcription of the recordings, the data were analyzed by the research team. The results show that the emotions felt by the participants were caused by thirty-seven types of events (categories) grouped into nine families (domains). COVID-19 is viewed negatively by the participants who express fear of this serious and contagious disease. When they talk about the experiences of patients and their families, their discourse alternates between joy at having been able to provide help and care and sadness at not having been able to be effective in all circumstances. Participants share a positive experience and express joy in recalling the COVID-19 outbreak as an exceptional event that they coped with through their personal and professional experience and resources, their relationships with colleagues on the interprofessional team, and the responses of the nursing department and hospital.

Effects of an educational intervention to strengthen humanistic practice on haemodialysis nurses' caring attitudes and behaviours and quality of working life: a cluster randomised controlled trial.

BACKGROUND: Nurses are trained to establish a trusting relationship with patients to create an environment promoting patients' quality of life. However, in tech-heavy care settings, such as haemodialysis units, dehumanising practices may emerge and take root for various reasons to the potential detriment of both patients and nurses. For patients, this may lead to a deterioration of quality of life and, ultimately, of health status. For nurses, it may cause a deterioration of the work environment and, in turn, of quality of working life. Based on Watson's Theory of Human Caring, we developed a brief educational intervention for haemodialysis nurses to strengthen their humanistic practice in the aim of improving the nurse-patient relationship and nurse quality of working life.. The intervention was tested by way of an experimental design. METHODS: One hundred and one haemodialysis nurses, recruited in ten hospitals in French-speaking Switzerland, were randomised into an experimental group that received the intervention and a control group. The nurse-patient relationship was measured with the Caring Nurse-Patient Interaction Scale (EIIP-70) and nurse quality of life at work was measured with the Quality of Work Life Questionnaire at four time points: pre-intervention, intervention completion, and six-month and one-year follow-ups. Random intercept regression analysis was used to evaluate change over time in the two variables under study. RESULTS: The intervention appeared to reinforce nurse attitudes and behaviours geared to a more humanistic practice. The effect seemed to fade over time but, 1 year post-intervention, six dimensions of the nurse-patient relationship (hope, sensibility, helping relationship, expression of emotions, problem solving, teaching) scored above baseline. Nurse quality of working life, too, seemed positively impacted. The cultural dimension of nurse quality of working life, that is, the degree to which everyday work activities attune with personal and cultural values, seemed positively impacted, as well, with improvement stable throughout the year following the intervention. CONCLUSIONS: Results support a positive effect of the intervention over both the short term and the medium-to-long term. A brief intervention of the sort may constitute an effective means to improve the nurse-patient relationship by preventing or reducing dehumanising practices. TRIAL REGISTRATION: NCT03283891 .

Effects on nurses' quality of working life and on patients' quality of life of an educational intervention to strengthen humanistic practice among hemodialysis nurses in Switzerland: a protocol for a mixed-methods cluster randomized controlled trial.

BACKGROUND: Humanistic nursing practice constitutes the cornerstone of the nursing profession. However, according to some authors, such practice tends to fade over time in favour of non-humanistic behaviours. To contrast this tendency, an educational intervention (EI) based on Watson's Theory of Human Caring was developed and tested in two pilot studies involving, respectively, rehabilitation nurses in Quebec (Canada) and haemodialysis (HD) nurses in Switzerland. In light of the positive results obtained in these, another study is being undertaken to examine more in depth the EI's effects on both HD nurses and patients in French Switzerland. The EI is expected to have positive effects on quality of nurse-patient relationship (NPR), team cohesion, nurse quality of working life (QoWL), and patient quality of life (QoL). METHODS/DESIGN: The study described in this protocol will use a mixed-method cluster randomised controlled trial design. For the quantitative component, nurse and patient data will be collected through questionnaires. The accessible population of 135 nurses and 430 patients will be clustered into 10 HD units. These units will be randomised into an experimental group (EG) and a waiting-list control group (WLCG). Measurements will be taken at baseline (pre-intervention) and repeatedly over time (post-intervention): immediately at EI completion and six and 12 months thereafter. For the qualitative portion of the study, 18 semi-structured interviews will be conducted with EG nurses picked at random two months after EI completion to explore perceived changes in nurse humanistic practice. Qualitative data will be analysed through the relational caring inquiry method, a phenomenological approach. Descriptive and inferential statistics will be computed from the quantitative data. DISCUSSION: The study described in this protocol will determine if and how the proposed EI promotes humanistic nursing practice and how this practice affects quality of NPR, nurse QoWL, and patient QoL. Moreover, it will lay the groundwork for offering the EI to nurses in other healthcare sectors. TRIAL REGISTRATION: This clinical study was registered with ClinicalTrials.gov [NCT03283891, 14/09/2017].

[Evidence of lack of agreement between hemodialysis patients and nurses on presence and severity of symptoms.] / Évidence d'un manque de concordance entre les patients hémodialysés et les infirmières sur la présence et la sévérité des symptômes.

Hemodialysis patients constitute a vulnerable population whose quality of life is affected by the many symptoms (e.g., pain, fatigue) they experience. The presence and severity of these symptoms are significantly under-assessed by health professionals. The purpose of this study was to describe and compare the symptoms perceived by hemodialysis patients versus those detected by nurses. A total of 123 patients and 70 nurses working in six hemodialysis centers were included in the study. The results show that participating nurses detected less than 50% of the symptoms perceived by patients. Agreement between hemodialysis patients and nurses regarding symptom presence and severity was slight to fair at best (kappa < 0.47). This suggests that improving the knowledge and skills of hemodialysis nurses for detecting the symptoms of the patients in their care could go a long way toward intervening more efficiently and improving the quality of the care they offer.

Relationship among symptoms, quality of life, and complementary and alternative medicines use among patients undergoing hemodialysis in French-speaking Switzerland.

BACKGROUND: Chronic renal disease is considered a main public health problem due to its high prevalence in the population. The solution of choice currently available is kidney transplantation but when this option is not available, blood purification treatments, notably haemodialysis (HD), are necessary. The presence of chronic renal disease combined with this demanding medical procedure leads to a hard symptomatology. To face this situation, HD patients often resort to complementary and alternative medicines (CAM) as they perceive that the healthcare professionals aren't paying enough attention to their quality of life. Given this background, we aim to describe the prevalence and the type of the CAM used among HD patients and their possible relations with patients' symptomatology and quality of life. METHODS: We interviewed 88 patients, undergoing hemodialysis in three hemodialysis centers in French-speaking Switzerland, about the presence of symptoms, their quality of life, and the possible use of CAM. Cluster analysis was used to create patients' profiles about CAM use and regression analysis to explore the links between symptoms' presence, patients' quality of life, and CAM use. RESULTS: Our results show a large use of CAM: almost two HD patients out of three uses at least one CAM. Using cluster analysis, we were able to identify five patients' profiles: non-users (37.5% of our sample), users of herbal medicine (20.5%), users of prayer-based practices (18.2%), people mainly using massages (9.1%), and a residual group including the users of other CAMs, with a predominance of meditation (14.8%). As expected, we observe a negative relation between the number of declared symptoms and patients' quality of life. Contrarily, we observe no relation between the use of CAM and the presence of symptoms. Our results show a positive relationship between the use of CAM and patients' overall perception of health as well as the psychological dimension of their quality of life. No relationship is observed with other dimensions of quality of life, notably the physical dimension. CONCLUSIONS: Our results suggests that CAMs aren't used as a substitute of official medicine but as a parallel support to HD patients' quality of life.

Assessing Resources in a Population of Hemodialysis Patients: A New Approach to Improve Quality of Care.

Hemodialysis patients constitute a vulnerable population. Their health needs are considerable and they often present psychological symptoms such as depression and anxiety. Empirical studies have demonstrated the efficacy of positive psychology interventions to enhance the well-being of patients and alleviate their depressive symptoms. One such intervention consists in identifying and mobilizing patient resources to activate their recovery. An intervention of the sort was implemented in Switzerland with hemodialysis nurses using AERES, a novel self-assessment instrument. AERES covers 31 domains under three dimensions: personal characteristics/qualities, hobbies/passions, and social/environmental resources. The aim of this qualitative study was to explore hemodialysis nurse perceptions of the use of this instrument. Sixteen hemodialysis nurses were recruited in six hospitals in French-speaking Switzerland and interviewed after delivering the intervention. A consensual qualitative research method was used to analyze the data. Results showed that the resources instrument was easy to administer and beneficial to patients and health professionals. Patient wellbeing became the top priority for the nurses and new interventions centered on patient resources were undertaken. Quality of patient care was improved. Nurses perceived this positive psychology instrument as a means of creating a positive relationship with patients and supporting them emotionally. Assessing the resources of this vulnerable population can provide health professionals with a powerful tool to understand patient intact resources, which can be used to alleviate symptoms and foster wellbeing.

Workplace Wellbeing and Quality of Life Perceived by Portuguese Nurses during the COVID-19 Pandemic: The Role of Protective Factors and Stressors.

During the COVID-19 pandemic, nurses were exposed to many stressors, which may have been associated with some mental health problems. However, most of the studies carried out on nurses' quality of life and workplace wellbeing during the COVID-19 pandemic took a pathogenic approach. Given that current scientific knowledge in this field presented too many gaps to properly inform preventive and therapeutic action, the aim of this study was to explore whether protective factors (resilience, perceived social support, and professional identification) and stressors (perceived stress and psychosocial risks in the workplace) influenced the quality of life and workplace wellbeing perceived by Portuguese nurses during the COVID-19 pandemic. Data for this cross-sectional study was collected through online self-administered questionnaires. Linear regression models were used to analyze the relationships between variables. Results showed that perceived stress, resilience and job satisfaction were associated with quality of life and workplace wellbeing among Portuguese nurses. The study's findings could serve to inform health policy and should draw the attention of nursing managers to the needs and difficulties reported by nurses, to the importance of providing them with emotional support, and to the relevance of promoting a good work environment.

Transformation of Clinical Nursing Practice Following a Caring-based Educational Intervention: A Qualitative Perspective.

Introduction: Hemodialysis (HD) patients experience numerous physical and psychological symptoms on a daily basis. These symptoms have a heavy impact on their quality of life, which is a key indicator of their survival in the short term. Numerous empirical studies have shown that the quality of the nurse-patient relationship (NPR) is essential in promoting positive outcomes for patients. When patients receive caring, their autonomy and independence grows, their sense of hope increases, their quality of life improves, and their sense of satisfaction with nursing care received rises. Inversely, the presence of dehumanizing practices in hemodialysis settings can contribute to delay healing for patients. In light of the importance of the quality of the relationship between nurses and HD patients and of the benefits to be had from a quality relationship, an educational intervention based on Watson's Theory of Human Caring was delivered to HD nurses. Objective: The purpose of this study was to explore qualitatively the perceptions of nurses working with HD patients in French-speaking Switzerland regarding changes to their clinical practice after receiving an educational intervention intended to reinforce caring attitudes and behaviors towards patients. Methods: The method used was that of consensual qualitative research (CQR). Sixteen semi-structured interviews were conducted with hemodialysis nurses post-intervention. Results: The results evidence a transformation of clinical nursing practice illustrated by three core ideas: (1) caring practice was reinforced; (2) new practices emerged; and (3) some limitations appeared. Conclusion: In these times of global pandemic where the issue of the humanization of nursing care is front and center, this professional development activity helped reinforce caring-based practice. This practice needs to be developed within the various care units in order to guarantee and promote quality of care and patient safety.

Comparing feeling of competence regarding humanistic caring in Belgian nurses and nursing students: A comparative cross-sectional study conducted in a French Belgian teaching hospital.

Aim: The aim of the study was to describe and compare feeling of competence regarding humanistic caring in Registered Nurses (RN) and nursing students (NS). Design: A quantitative comparative cross-sectional research design was used. Methods: A convenience sample of 196 RN and 47 NS in a teaching hospital in Belgium completed a self-administered questionnaire composed of a sociodemographic survey and the Caring Nurse-Patient Interactions Scale (CNPI-23) developed by Cossette et al. Results: The four dimensions of the CNPI-23 were compared using the Skillings-Mack test. Both groups scored higher on "humanistic" and "comforting" than on "clinical" and "relational" care and both scored lowest on this last dimension. Linear regressions showed that none of the variables had a statistically significant influence on the CNPI-23 scores, except for NS "state of health," which influenced their feeling of competence regarding "relational care."

Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol.

BACKGROUND: The clinical decisions of emergency department triage nurses need to be of the highest accuracy. However, studies have found repeatedly that these nurses over- or underestimate the severity of patient health conditions. This has major consequences for patient safety and patient flow management. Workplace distractors such as noise and task interruptions have been pointed to as factors that might explain this inaccuracy. The use of a serious game reproducing the work environment during triage affords the opportunity to explore the impact of these distractors on nurse emergency triage accuracy, in a safe setting. METHODS/DESIGN: A pilot study with a factorial design will be carried out to test the acceptability and feasibility of a serious game developed specifically to simulate the triage process in emergency departments and to explore the primary effects of distractors on nurse emergency triage accuracy. Eighty emergency nurses will be randomized into four groups: three groups exposed to different distractors (A, noise; B, task interruptions; C, noise and task interruptions) and one control group. All nurses will have to complete 20 clinical vignettes within 2 h. For each vignette, a gold standard assessment will be determined by experts. Pre-tests will be conducted with clinicians and certified emergency nurses to evaluate the appeal of the serious game. DISCUSSION: Study results will inform the design of large-scale investigations and will help identify teaching, training, and research areas that require further development.

A comparative descriptive analysis of perceived quality of caring attitudes and behaviours between haemodialysis patients and their nurses.

Aim: Despite its importance in nursing, perceived quality of the nurse-patient relationship has seldom been researched. This study sought to examine and compare the quality of caring attitudes and behaviours as perceived by haemodialysis patients and their nurses. Design: This comparative descriptive study involved 140 haemodialysis patients and 101 nurses caring for them in ten haemodialysis units in the French-speaking part of Switzerland. Methods: Participants completed a sociodemographic questionnaire and the Caring Nurse-Patient Interaction Scale (CNPI-70). Results: Both nurses and patients reported a high frequency of caring attitudes and behaviours. Patients gave higher ratings than nurses did on all the caring dimensions, except spirituality. Implications are discussed.