There is a growing emphasis on evaluating discharge readiness, particularly for those involved in the care of patients in transition. Caregivers supporting individuals with traumatic brain injury are ...a specific focus due to the potential impact of adequate discharge preparation on patient recovery and post-discharge outcomes.
This research aimed to evaluate the preparedness of caregivers for the discharge of patients with moderate or severe traumatic brain injury from the hospital.
This cross-sectional study was carried out in a tertiary hospital in Indonesia from January to April 2023 using the Indonesian adaptation of the Preparedness for Caregiving Scale. The study comprised seventy-four caregivers of individuals with traumatic brain injury, chosen through a purposive sampling approach based on pre-established inclusion and exclusion criteria. Data collection involved a questionnaire covering caregiver information (gender, age, education level, income, and psychological status) and discharge readiness. Descriptive statistics and correlation analyses, employing Pearson and chi-square, were conducted.
Most caregivers were female (83.8%), spouses of patients (50%), and had a moderate education level (52.7%). The average age of caregivers was 43.7 ± 8.7 years, with an average duration of patient care of 4.22 ± 1.2 days and a monthly income of 220 US dollars. The mean score for readiness for hospital discharge was low (10.08 ± 1.91), indicating that caregivers were not adequately prepared for discharge. Age and education were significant factors (
<0.05) related to hospital discharge readiness.
This study emphasizes the importance of assessing caregiver readiness for the discharge of patients with traumatic brain injury from the hospital. Findings indicate a concerning trend of inadequate preparedness among caregivers, with factors such as age and education level significantly influencing readiness. The predominance of female caregivers, often spouses of patients, indicates the need for tailored support strategies. Prioritizing caregiver preparation and support, especially by nurses, is crucial for optimizing patient recovery and post-discharge outcomes.
Discharge planning is vital to preventing hospital readmission, and nurses play a key role. The COVID-19 pandemic has posed challenges to hospital services that may persist or recur. Therefore, ...exploring nurses' experiences with discharge planning practices before and during this pandemic is crucial.
This study aimed to describe the experiences of discharge planning practices among nurses at an Indonesian tertiary hospital before and during the COVID-19 pandemic.
A qualitative descriptive study design was used. Telephone interviews were conducted to collect data among ten nurses from March 2019 and continued between December 2020 and August 2021. Content analysis was done for data analysis.
Two main themes emerged: 1) Challenges in discharge planning practices and 2) Perceived discharge planning as a professional responsibility. Implementing the inpatient ward fusion policy as part of the hospital's pandemic response presented greater challenges to nurses in coordinating care and performing discharge planning. Fear of COVID-19 infection, social distancing measures, and using personal protective equipment also affected how nurses delivered discharge education during the pandemic. However, the nurses sensed a greater responsibility to ensure the maintenance of essential components of discharge planning procedures to guarantee the patient's capability to perform self-care at home.
Nurses viewed discharge planning practices as their responsibility and continued them during the pandemic despite facing various challenges. In addition to recognizing the significance of nurses' roles in discharge planning practices and overall patient care, it is crucial to anticipate and address the diverse working patterns and styles among healthcare professionals in unified wards, ensuring effective coordination.
Background: Nurses face a high risk of experiencing excessive fear while caring for patients with COVID-19. However, to our knowledge, no study has yet explored the factors associated with nurses’ ...fears when caring for patients with COVID-19.Aim: The present study aimed to analyze the factors associated with nurses’ fears when caring for COVID-19 patients in Indonesia.Method: This cross-sectional study was conducted on 591 nurses caring for COVID-19 patients. The nurses were recruited from 26 provinces in Indonesia using a purposive sampling method in April 2020. The instruments consisted of a sociodemographic characteristics form and a valid instrument to explore nurses’ fears. Data were analyzed using SPSS software (version 23).Results: In total, 86.8% of the nurses felt fear when caring for COVID-19 patients. Moreover, despite using personal protective equipment, 83.8% of participants answered that they feared getting infected with the virus while caring for patients, and 87.5% of the participants feared that their families might become infected with the virus. Among the nurses who cared for COVID-19 patients, 91.2% feared they might pass the disease on to their families at home. Age, marital status, infection prevention control training, and nurses’ education level were significantly related to nurses’ fears (P<0.05, CI 95%).Implications for Practice: The excessive fear in nurses who care for COVID-19 patients is a major issue for nursing managers. Provision of viral transmission prevention and control programs, self-esteem improvement activities, and having pandemic course subjects in the nursing education curricula can help nurses become more aware and ready to face a pandemic.
Effective nursing interventions for caring for patients with moderate to severe traumatic brain injury are still challenging during a transition from hospital to home. Since traumatic brain injury ...has deep-rooted sequelae, patients and their caregivers require better arrangement and information on the condition to achieve improved outcomes after discharge.
This study aimed to assess transitional care programs to improve outcomes of patients with traumatic brain injury and their caregivers.
A systematic review and meta-analysis were performed on studies retrieved from ProQuest, PubMed, Science Direct, CINAHL, and Google Scholar from January 2010 to July 2021. RevMan 5.4.1 software was used for meta-analysis.
Nine studies were systematically selected from 1,137 studies. The standard approaches of interventions used in patients with traumatic brain injury and their caregivers were education, mentored problem-solving, home-and community-based rehabilitation, counseling, skill-building, and psychological support. We observed that there was significant evidence indicating beneficial effects of intervention in increasing the physical functioning of patients with traumatic brain injury (
= -0.44, 95%
-0.60 to -0.28,
<0.001), reducing the psychological symptoms among caregivers (
= -0.42, 95%
-0.59 to -0.24,
<0.001), and increasing the satisfaction (
= -0.35, 95%
-0.60 to -0.11,
= 0.005).
Education, skill-building, and psychological support should be the main components in transitional care nursing programs for patients with traumatic brain injury and their caregivers.
Background: Postoperative hypoxia (POH) is a complication that often occurs in patients after Coronary Artery Bypass Grafting (CABG). Breathing exercises are considered effective in overcoming POH ...after CABG. However, this intervention has not been implemented using the dynamic nurse-patient relationship model from Ida Jean Orlando. The dynamic nurse-patient relationship model is expected to improve the quality of nursing care after cardiac surgery.Purpose: This study aimed to describe the application of breathing exercises in postoperative hypoxia after CABG using the dynamic nurse-patient relationship model.Methods: This study was the summary of the case presentation along with the interventions on three patients after CABG through the dynamic nurse-patient relationship model approach with the main intervention focusing on breathing exercises.Results: After three days of implementing the intervention, most patients showed improvement in POH. This condition was evidenced by an increase in the PaO2/FiO2 ratio from less than 200 to above 200, with an average increase of 89.3. The blood gas analysis results supported the results from a respiratory alkalosis condition to a normal PH and a PaCO2 value from <35 mmHg to the normal range (35-45 mmHg). Also, X-rays of the patients showed pulmonary atelectasis improvement.Conclusion:Applying breathing exercises in postoperative hypoxia after CABG using the dynamic nurse-patient relationship model can improve POH in post-cardiac surgery patients. We recommend using the model theory approach because this theory can see patients’ psychological and physical changes dynamically in post-CABG patients.
Background: The quality of life of patients with primary brain tumor in Indonesia is poorly understood. Therefore, this study aimed to investigate the health‐related quality of life of patients ...admitted to the Neurosurgery Department of Dr. Hasan Sadikin Hospital, Bandung, Indonesia, up to 3 months after discharge. Methods: Baseline data were collected from patients aged ≥18 years who were admitted to the hospital between October 9, 2015, and February 17, 2016. In‐person interviews were then conducted 1–2 days pre‐discharge (n = 65) and follow-up telephone interviews were made 1, 2, and 3 months post-discharge (n = 58, 55, and 54, respectively) to collect socio-demographic data, clinical characteristics, and EQ‐5D‐5L data. Results: Prior to discharge, one‐third or less of the 65 patients interviewed reported “no problems” with mobility (32%), self‐care (32%), usual activities (18%), and pain/discomfort (43%), whereas 74% reported “no problems” with anxiety/depression. By contrast, at 3 months post-discharge, an increased proportion of patients reported “no problems” with mobility (61%), self‐care (67%), usual activities (56%), and pain/discomfort (76%), with little change in anxiety/depression (“no problems” 70%). Conclusions: While there was improvement, many patients were still reporting problems at 3 months post-discharge, highlighting the need for ongoing support and care to ensure the best possible outcomes.
Caring for patients with traumatic brain injury (TBI) during the transition from hospital to home can be psychologically challenging to caregivers. This study aimed to assess the effectiveness of a ...novel mobile health (m-health) transitional care intervention to reduce stress and burden of caregivers of patients with TBI and to reduce readmissions.
A randomized controlled trial was conducted with 74 caregivers of adult patients with moderate or severe TBI admitted to a referral hospital in Indonesia. An m-health application for Android mobile phones was designed including education and information for caregivers. The application included an online chat feature with weekly monitoring. The m-health transitional care intervention also included face-to-face education before hospital discharge. Primary outcomes were caregivers' stress and burden. Outcomes were measured at 3 time points: at hospital discharge, 2 weeks postdischarge, and 4 weeks postdischarge. Random Allocation Software was used for randomization of study participants.
Final analysis included data of 37 caregivers in the intervention group and 37 caregivers in the control group. Stress within the intervention group decreased over time (P < 0.001, mean difference = 11.05). Between both groups, stress was significantly different at 2 weeks and 4 weeks postdischarge (P < 0.001). Caregiver burden showed similar results (2 weeks postdischarge P < 0.001 and 4 weeks postdischarge P < 0.001). Only 1 patient in the control group was readmitted to the hospital.
The m-health transitional care intervention reduced stress and burden of caregivers of patients with moderate or severe TBI. Nurses should consider using m-health technologies to support caregivers in the transition from the hospital into the community.
Traumatic brain injury (TBI) is a crucial public health problem that causes disability, and social and economic problems world wide. TBI patients in West Java are increasing every year which poses ...various problems in quality of life. Most patients receive follow-up and rehabilitation after hospitalization, but some cannot attend due to cost and transportation difficulties since they are scattered in various areas across the island. Nursing teleconsultation is the provision of nursing services that can be administered to patients electronically in remote areas. In practice, nursing teleconsultation must be supported by qualified nursing knowledge, supportive communication technologies, and strategies to protect patient confidentiality, system and information security. Innovations in nursing teleconsultation can potentially be applied in West Java to provide continuous nursing service to TBI patients without being constrained by the problems associated with distance and cost.
Traumatic brain injury (TBI) is a crucial public health problem that causes disability, and social and economic problems world wide. TBI patients in West Java are increasing every year which poses ...various problems in quality of life. Most patients receive follow-up and rehabilitation after hospitalization, but some cannot attend due to cost and transportation difficulties since they are scattered in various areas across the island. Nursing teleconsultation is the provision of nursing services that can be administered to patients electronically in remote areas. In practice, nursing teleconsultation must be supported by qualified nursing knowledge, supportive communication technologies, and strategies to protect patient confidentiality, system and information security. Innovations in nursing teleconsultation can potentially be applied in West Java to provide continuous nursing service to TBI patients without being constrained by the problems associated with distance and cost.
Acute Coronary Syndrome (ACS) is a cardiovascular disease that causes significant deaths in most countries. No study assessed the directly how this psychological well-being is related to Cardiac Diet ...Self-Efficacy (CDSE). This study aimed to identify the relationship between psychological well-being and cardiac diet self-efficacy in ACS patients after treatment. This cross-sectional study involved 150 patients at two hospitals in Jambi Province that treated heart disease, especially ACS. We used Cardiac Diet Self-Efficacy (CDSE) Scale and Psychological Well-Being questionnaire. The associations between psychological well-being a cardiac diet self-efficacy were confirmed by the Pearson Correlation test using SPSS 26.0. The correlation test showed a p-value of 0.018, indicating a relationship between psychological well-being and cardiac diet self-efficacy. Furthermore, the value of r obtained at 0.41 shows a reasonably strong relationship between psychological well-being and cardiac diet self-efficacy. Therefore, it is necessary to prepare for improving psychological well-being in ACS patients both from the discharge planning stage and post-hospital intervention so that ACS patients can have good cardiac diet self-efficacy after treatment.
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