Background:
Adherence to self-care recommendations is associated with improved patient outcomes and improved quality of life for people living with heart failure. The Home-Heart-Walk (HHW) is an ...intervention to promote physical activity adapting the elements of a six minute walk test, a reliable and valid measure. This adaptation was designed to support self-monitoring of physical functioning and promote the self-care of people with heart failure. The primary outcome of the Home-Heart-Walk was perceived physical functioning and the secondary outcomes were six-minute walk test distance, health related quality of life, self-care behaviour, self-efficacy and physical activity level.
Methods:
A multicentre randomized controlled trial. Participants (N=132) were recruited from three academic hospitals in Sydney, Australia. Participants were randomized to either the Home-Heart-Walk group or the control group. Perceived physical functioning, health related quality of life, self-care behaviour, exercise self-efficacy and physical activity level were measured at baseline and at three- and six-month follow-up.
Results:
After adjusting for baseline scores, there were no statistically significant between-group differences in perceived physical functioning, six-minute walk test distance, health related quality of life and exercise self-efficacy at follow-up. The intervention group had improvement in self-care behaviour (F(1,129) = 4.75, p = 0.031) and physical activity level (U = 1713, z = −2.12, p = 0.034) at the six-month follow-up compared with the control group.
Conclusion:
The Home-Heart-Walk did not improve the perceived physical functioning of the intervention group. Although the feasibility and acceptability of this strategy to support self-monitoring and improve self-care behaviour was demonstrated, self-reported adherence was unreliable; newer technologies may offer better assessment of adherence.
Background: As a third-world country experiencing a rise in the elderly population and changes to traditional family structures, improving psychological health is critical to improving quality of ...life (QoL) in the older adults living in residential care facilities in Jordan. Purpose: This study aimed to (a) estimate the prevalence of depression among nursing home (NH) residents in Jordan; (b) measure perceived QoL in these NH residents in the dimensions of mobility, self-care, usual activity, pain and discomfort, and anxiety/depression; and (c) assess the influence of depression on each of these QoL dimensions. Methods: This cross-sectional study recruited a convenience sample of 155 participants living in a residential care facility in Jordan. The instruments used included a sociodemographic and clinical questionnaire, the Mini-Mental State Examination, a Geriatric Depression Scale (GDS), and the EuroQol, which is a five-dimension, five-level questionnaire. The data were presented as means, standard deviations, and percentages as well as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results: A high prevalence of depression was found in the study population, with 72.3% having a score between 6 and 9 on the GDS, which is suggestive of depression. Moreover, 18.1% scored ≥ 10 on the GDS, which is indicative of a nearly continual state of depression. With regard to the QoL dimensions, 84.5% of the participants reported experiencing pain, 81.9% reported anxiety/depression, 80.6% reported problems performing usual activities, 75.5% reported problems with self-care, and 63.2% reported mobility difficulties. Pain, anxiety, and depression were found to be significantly associated with level of depression (AOR = 2.78 and 95% CI 1.18, 6.57, AOR = 5.81 and 95% CI 2.14, 15.78, and AOR = 4.75 and 95% CI 1.87, 12.07, respectively). Conclusions: Depression is common among NH residents in Jordan and is associated significantly with poor QoL. This study yielded empirical data that may be used to develop strategies to enhance or promote the mental health status and QoL of NH residents in Jordan.
To develop an oral healthcare educational intervention for undergraduate nursing students using a codesign framework and to evaluate the process.
A six-step codesign framework by Dietrich et al. ...(2017) was used to develop an oral healthcare educational intervention for nursing students. Five academic staff and three nursing students participated in two workshops conducted on Zoom™ to codesign learning activities to be used in the classroom to deliver the oral healthcare learning material. Evaluation of the codesign process was undertaken through focus groups and a hybrid content analysis approach was used to analyse the data. Ethical approval was received from the Western Sydney University Human Research and Ethics Committee (H14177).
A multifaceted oral healthcare educational intervention was developed using a range of approaches which included podcasts, dental models, and picture guides. While students were apprehensive about participating alongside faculty staff, good facilitation supported inclusive practices, giving equal voice and respect for all innovative ideas. Critical to the codesign process was adequate resourcing and preparation of participants prior to the workshops to promote robust discussions and meaningful engagement.
Codesign facilitated the development of a novel oral healthcare educational intervention for undergraduate nursing students within an Australian nursing education context. The approach was useful in the design of tailored teaching and learning activities that best suited student learning. Each participant brought unique experiences and expertise to the discussion, which led to collaboration between nursing students and academic staff. Good facilitation of the codesign workshops was paramount to the success of the development of the intervention.
Attrition from nursing programs is common, costly and burdensome to individuals, nursing faculties and the health care system. Increasingly, nursing faculties are requested to monitor attrition rates ...as a measure of performance, but little is known of the influence of career choice on program completion.
The aim of this study was to assess the impact of nursing as a first choice for study on attrition in a baccalaureate nursing program.
A longitudinal, cohort design was used in this study, which involved undergraduate nursing students enrolled at a university in Australia. Of the 357 participants who completed a baseline survey in 2004 at entry to their Bachelor of Nursing program, 352 were followed up over a six-year period to the end of 2009.
Students who selected nursing as their first choice for study were nearly twice as likely (OR: 1.99 95% CI: 1.07–3.68) to complete their nursing program compared to those who did not. These students were also more likely to be older (mean age: 26.8 vs 20.1years, P<0.001), and employed in nursing-related work (35% vs 2%, P<0.001). In addition, the study revealed that male students (OR: 1.93 95% CI: 1.07–3.46) and those who worked more than 16h per week during semester (OR: 1.80 95% CI: 1.09–2.99) were less likely to complete than their counterparts.
These data assist in generating realistic projections of completion and entry to the workforce. Understanding patterns of attrition and individuals' motivations to be a nurse is important not only for supporting nursing students to help them complete their studies but also for developing more targeted strategies directed toward student recruitment and retention.
Periodontal disease is a risk factor for atherosclerotic cardiovascular disease and it is recommended internationally that patients with cardiovascular disease should engage in preventative oral ...health practices and attend regular dental care visits. This study aimed to explore the oral health status, behaviours and knowledge of patients with cardiovascular disease.
A cross-sectional questionnaire containing 31 items was administered to patients with cardiovascular disease from cardiac rehabilitation and outpatient clinics in Sydney Australia in 2016-2017.
Of the 318 patients surveyed, 81.1% reported having at least one oral health problem. Over a third (41.2%) of participants had not seen a dentist in the preceding 12 months and 10.7% had received any oral healthcare information in the cardiac setting. Those with valvular conditions were more likely to have received information compared to those with other cardiovascular conditions (40.6% versus 7.4%, p < 0.001). Only half of the participants had adequate oral health knowledge.
Despite a high incidence of reported oral health problems, many patients lacked knowledge about oral health, were not receiving oral health information from cardiac care providers and had difficulty accessing dental services. Further research is needed to develop oral health strategies in this area.
During a pandemic, dentists face enormous challenges due to restrictions placed on their practice and the need to comply with biosafety measures. This study aimed to explore the impact of the ...COVID-19 pandemic and infection control measures on dentists and their practice in Jordan and the global implications for other primary healthcare workers. A qualitative exploratory study employing face-to-face or telephone interviews, was conducted with ten dentists from the 9
May to 20
September 2020. An inductive thematic approach to analysis was used identifying three themes, each with two accompanying subthemes: (1) Response to COVID-19 pandemic: (1a) Government response and (1b) People's response; (2) The effects of the pandemic and response measures: (2a) Impact on work and practice and (2b) Impact on personal and social life; (3) The unanticipated gains: (3a) Altruism and (3b) Leadership and change. Stringent infection control measures were implemented to slow the spread of the virus, however limited government support made implementation unsustainable and caused financial hardship. Lack of clear guidelines, changes in practice, social distancing measures, and altered social interactions, adversely impacted daily life, triggering mental distress. Misinformation influenced response to COVID safety measures. Despite the negatives, working during the pandemic reaffirmed dental professionals' roles and purpose, with strong leadership boosting morale. Education, adequate biosafety resources and clear guidelines or policies to support and sustain stringent infection control procedures are crucial in ensuring that measures are implemented to meet the safety requirements of the pandemic response. Promoting the well-being of the healthcare workforce is equally important. Finally, altruism and strong leadership among healthcare workers can contribute to a meaningful and humane pandemic response.
Promoting self-management and monitoring physical activity are important strategies in chronic heart disease (CHD) management. The six-minute walk test (6MWT) is a commonly used sub-maximal exercise ...test for measuring physical functional capacity.
The aim of this paper is to review the current literature on 6MWT relating to methodological issues as well as exploring the potential of the protocol to be adopted as a self-administered exercise test.
The Medline, CINAHL, Science Direct and the World Wide Web using the search engine Google, were searched for articles describing the administration, reliability and validity of the 6MWT. Findings of the integrative literature review The 6MWT is a simple, safe and inexpensive sub-maximal exercise test. The 6MWT distance is strongly associated with functional capacity, and it is a useful prognostic tool. To date, the capacity for self-administration of the 6MWT has not been investigated.
Adapting the 6MWT as a patient-reported outcome measure may enhance the capacity, not only for clinicians to monitor functional status, but also promote self-management by enabling individuals to monitor changes in their functional capacity.
Connecting students with learning activities to promote academic engagement has been a focus of higher education over the past decade, partly driven by an increasing rate of student participation in ...part-time employment, and a growing concern about the quality of the student experience. Using a prospective survey design, this study selected three elements of academic engagement (homework completion, lecture attendance, and study hours) and academic disengagement (part-time work), to identify predictors of academic performance in a pathophysiology subject in 126 second year nursing students. Homework completion emerged as the strongest positive predictor of academic performance, followed by lecture attendance; however, time spent studying was not a significant predictor of academic performance. Of concern was the finding that the amount of part-time work had a significant and negative impact on academic performance. Combining all elements of academic engagement and disengagement, and controlling for age and ethnicity, the multiple regression model accounted for 34% of the variance in the academic performance of second year nursing students studying pathophysiology. Results from these findings indicate the importance of active learning engagement in influencing academic success, and provide some direction for nursing academics to design effective learning approaches to promote academic engagement of nursing students.
Attrition from undergraduate nursing programs continues to warrant investigation particularly in the climate of nursing shortages and fiscal reflection on academic institutional programs. This ...three-year study used a prospective longitudinal survey design to determine entry characteristics of students, attrition, progression and completion in an undergraduate program. Students were surveyed in the first three weeks of commencing their program and gave permission for academic grades to be collected during their six session, three year Bachelor of Nursing program. Of the 740 students enrolled 48% (357 students) were surveyed and 352 students (99%) gave consent for their grades to be collected. One-third of the student cohort graduated in the expected three-year timeframe, one-third had dropped out and one-third was still completing their studies. A higher Grade Point Average and being a native English speaker were most predictive of students completing their course in the minimum expected timeframe.
Interprofessional education (IPE), where two or more professions learn with, from, and about each other to improve collaboration and the quality of care, has been proposed as a curriculum strategy to ...promote mutual understanding between professions, thus helping to prepare health professionals to work in challenging contemporary health systems. Although there is support for IPE initiatives within health professional education, differences in student motivation and learning strategies are likely to contribute to the success of these initiatives.
To explore self-regulated learning strategies used by first year medical and nursing students, and to determine if these strategies were different among nursing students who were high achievers.
A comparative survey design.
Nursing and medical nursing schools in a large university in the western region of Sydney, Australia.
Six hundred and sixty-five first year nursing (
n
=
565) and medical (
n
=
100) students in a large university in the western region of Sydney were surveyed to assess motivational and learning strategies using The Motivated Strategies for Learning Questionnaire (MSLQ). Data relating to sociodemographic characteristics and academic performance were also collected.
Nursing students were significantly older than medical students (mean age: 24.4 years versus 19.4 years;
p
<
0.001), and there were also more females in the nursing student group (82% versus 56%;
p
<
0.001). Although nursing students had a higher mean score for extrinsic goal orientation compared to medical students (
p
<
0.001), medical students had higher mean scores for the other four learning strategies measured: peer learning (
p
=
0.003), help seeking (
p
=
0.008), critical thinking (
p
=
0.058), and time and study environment management (
p
<
0.001). Similarly, the grade point average (GPA) of medical students at the end of their first year was significantly higher (4.5, S.D. 1.4 versus 3.6, S.D. 1.3;
p
<
0.001) compared to that of nursing students.
While interprofessional education is seen to have many benefits for students, this study demonstrates differences in motivational and learning strategies between nursing and medical students that may impact on the success of interprofessional programs.
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