Background
Because of the COVID‐19 pandemic, health care systems worldwide are working under challenging conditions. Patients, who are seriously ill, require intensive care admission. In fighting ...COVID‐19, nurses are frontline health care workers and, as such, have a great responsibility providing needed specialized patient care in intensive care units (ICU). However, working conditions and emotional factors have an impact on the quality of the care provided.
Aim
The purpose of the present study was to explore and describe the experiences and perceptions of nurses working in an ICU during the COVID‐19 global pandemic.
Study design
Qualitative research was undertaken, using an empirical approach and inductive content analysis techniques.
Methods
The selected population consisted of ICU nurses from a tertiary teaching hospital in Spain. Data were obtained via semi‐structured videocall interviews from Apr 12th to Apr 30th, 2020. Subsequently, transcribed verbatims were analysed using the template analysis model of Brooks.
Findings
A total of 17 nurses comprised the final sample after data saturation. Four main themes emerged from the analysis and 13 subthemes: “providing nursing care,” “psychosocial aspects and emotional lability,” “resources management and safety” and “professional relationships and fellowship.”
Conclusion
Providing health care by intensive care nursing professionals, during the COVID‐19 pandemic, has shown both strong and weak points in the health care system. Nursing care has been influenced by fear and isolation, making it hard to maintain the humanization of the health care.
Relevance to clinical practice
Implications for practice include optimizing resource management (human and material), providing psychological support, and adequate training for ICU nurses, as well as high‐quality protocols for future emergency situations.
Background
Pressure injuries are a major public health problem because of their impact on morbidity and mortality, quality of life, and increased healthcare costs. The Centros Comprometidos con la ...Excelencia en Cuidados/Best Practice Spotlight Organization (CCEC/BPSO®) program provides guidelines that can improve these outcomes.
Aims
This study aimed to assess the effectiveness of the CCEC/BPSO® program in improving the care of patients at risk of pressure injury (PI) at an acute care hospital in Spain.
Methods
A quasi‐experimental regression discontinuity design in three periods was used: (1) baseline (2014), (2) implementation (2015–2017), and (3) sustainability (2018–2019). The study population was comprised of 6377 patients discharged from 22 units of an acute care hospital. The performance of the PI risk assessment and reassessment, the application of special pressure management surfaces, and the presence of PIs were all monitored.
Results
Forty‐four percent of patients (n = 2086) met the inclusion criteria. After implementing the program, the number of patients assessed (53.9%–79.5%), reassessed (4.9%–37.5%), the application of preventive measures (19.6%–79.7%), and the number of people identified with a PI in implementation (1.47%–8.44%) and sustainability (1.47%–8.8%) all increased.
Linking Evidence to Action
The implementation of the CCEC/BPSO® program achieved improved patient safety. Risk assessment monitoring, risk reassessment, and special pressure management surfaces were practices that increased during the study period and were incorporated by professionals to prevent PIs. The training of professionals was instrumental to this process. Incorporating these programs is a strategic line to improve clinical safety and the quality of care. The implementation of the program has been effective in terms of improving the identification of patients at risk and the application of surfaces.
Aims
To develop and psychometrically test the short version of the Multidimensional Scale of Dating Violence (MSDV 2.0) in Spanish‐language to detect violence perpetrated and suffered in dating ...relationships.
Design
A psychometric instrument development and validation study.
Methods
A two‐phase approach was used: Phase (1) the items of the original instrument were revised and new items related to online violence and sexual violence were incorporated. Content validation by a Delphi panel with 25 psychometric and dating violence experts were performed. Next, a face validity was performed in 32 students followed by a pilot study in another 74 participants. Phase (2) Psychometric validation, the instrument was tested in a sample of 1091 university students, analysing the psychometric properties based on construct validity and internal consistency. The study was conducted from September to November 2020 in the context of the Andalusian Public University System.
Results
In phase (1) 42 items for each subscale (perpetration, victimization) were accepted by the Delphi panel, and acceptable values were obtained for the criteria of clarity, coherence, and relevance. In phase (2) the MSDV 2.0 showed acceptable psychometric properties. Confirmatory factor analysis showed a five‐dimensional structure with 18 items for each subscale with excellent fit rates. Reliability analysis indicated adequate internal consistency (α = .879–.802) and correlations with the Depression, Anxiety, and Stress Scale (ρ = .418–.225) and the self‐perceived health item (ρ = .380–.179), providing evidence of its convergent validity. Cut‐off points were also calculated for each dimension, with their corresponding sensitivity and specificity, indicating to be a good instrument for detecting possible cases of dating violence.
Conclusion
The MSDV 2.0 is the only short instrument published to date that measures the dating violence suffered and perpetrated taking into account all its dimensions. Its use would serve as support in prevention programs and design of public policies.
Impact
The short version of the MSDV 2.0 could be a comprehensive enough instrument to enable a detection and evaluation of dating violence in the educational setting.
Objective
Further research is needed on parenting practices among parents of children with attention‐deficit/hyperactivity disorder (ADHD), as these practices impact children's development and ...outcomes. This study analyzes these practices, distinguishing between parents’ and children's gender.
Method
Parental warmth (affection–communication and criticism–rejection responses) and control (inductive, strict, and indulgent discipline styles) were assessed in both parents of 81 children diagnosed with ADHD (aged 6–17 years).
Results
Mothers reported greater affection–communication responses and use of inductive disciplinary practices than fathers. Higher use of maternal strict practices was associated with female children, regardless of their age, subtype, medication, or comorbidities. However, parental practices used with male children were affected by children's age and subtype.
Conclusions
Warmth levels and discipline styles used by parents of children with ADHD may differ depending on the gender of both parents and children. The implications of these findings for understanding gender differences associated with ADHD are discussed.
Purpose
To estimate the worldwide pooled prevalence of inadequate work ability among hospital nursing personnel using the Work Ability Index (WAI).
Design
Systematic review and meta‐analysis.
Methods
...A systematic search was conducted on Medline/PubMed, Scopus, Web of Science, Scielo, PsychInfo, CINAHL, Nursing and Allied Health, LILACS, and Google Scholar from inception to July 2021 to identify observational studies on work ability among hospital nursing personnel using the WAI. Two researchers independently completed the study selection, quality assessments, and data extraction on the prevalence of inadequate work ability that was pooled using the random effects model. Finally, subgroup analyses were performed to explore sources of heterogeneity.
Findings
A total of 42 studies were included, consisting of 24,728 subjects worldwide from 14 countries. Of these, 35 studies were included in the meta‐analytical analyses. The worldwide pooled prevalence of inadequate work ability among hospital nursing personnel was 24.7% (95% CI = 20.2%–29.4%). High levels of heterogeneity were detected in all studies. Prevalence was higher in studies where samples were composed of nurses and nursing assistive personnel (26.8%; 95% CI = 22.4%–31.5%) than in those of nurses alone (22.2%; 95% CI = 13.1%–32.9%) and in studies where the sample was over 40 (28.1%; 95% CI = 19.5%–37.5%) than in those with a sample under that age (22.4%; 95% CI = 15.8%–29.7%).
Conclusions
Almost one in four members of hospital nursing staff in the world has inadequate work ability and therefore are at risk of several negative outcomes during their working life. These prevalence data correspond to the pre‐pandemic period, so new studies should also be especially useful in quantifying the impact of the COVID‐19 pandemic on work ability in the hospital nursing workforce.
Clinical relevance
The above findings justify the launch of initiatives that include annual assessment for the early identification of inadequate work ability, offering the possibility of anticipated corrective measures. Nursing workforce older than 40 years and those belonging to the professional category of nursing assistive personnel should be priority target groups for screening and intervention to improve work ability.
Purpose
Heart failure is a highly prevalent chronic health problem associated with poor quality‐of‐life and negative outcomes. Self‐care is a cornerstone in patients suffering from heart failure. ...Nurses are commonly engaged in enhancing patients’ self‐care behaviors, but the specific condition of deficit on self‐care is not clearly identified by nurses. No nursing diagnoses focused on self‐care of heart failure patients is currently available. This study aimed to develop a new nursing diagnosis that focuses on self‐care in heart failure patients.
Data sources
A concept and content analysis were used. Some steps of the concept analysis were performed through an integrative literature review conducted searching in PUBMED and CINAHL databases to identify attributes, antecedents, and consequences of the diagnosis. Forty‐five articles were selected from the 1450 studies found. Then, the content analysis was performed by an international panel of 29 experts. Two Delphi rounds were used to achieve consensus and an item content validity index was calculated for each diagnostic element.
Data synthesis
Integrative review proposed four diagnostic labels, two definitions, 15 defining characteristics, and 44 related factors. After the two Delphi rounds a consensus was reached for each diagnostic indicator with a content validity index ranging from 82.8% to 100%. The nursing diagnosis—labeled heart failure self‐care deficit—was validated with a definition, eight defining characteristics, 15 related factors, and five at‐risk populations.
Conclusions
This diagnosis allows nurses to document patients’ self‐care in daily clinical practice through a standard nursing terminology, by naming this health problem, describing its etiology, and clinical manifestations.
Implications for nursing practice
This new diagnosis is expected to assist nursing clinicians, educators, and students in clinical reasoning with the aim to improve diagnostic accuracy in identifying patients with a heart failure self‐care deficit, to select the most appropriate interventions and pursue better outcomes.
To examine and map the consequences of chronic pain in adulthood.
Documents addressing the impact of chronic pain on the psychological and social spheres of people suffering from chronic pain, ...published in Spanish and English between 2013 and 2018, were included. Those who addressed pharmacological treatments, chronic pain resulting from surgical interventions or who did not have access to the full text were excluded. Finally, 28 documents from the 485 reviewed were included.
Studies show that pain is related to high rates of limitation in daily activities, sleep disorders and anxiety-depression spectrum disorders. People in pain have more problems to get the workday done and to maintain social relationships. Chronic pain is also associated with worse family functioning.
This review shows that limitations in the ability to perform activities of daily living, sleep, psychological health, social and work resources and family functioning are lines of interest in published articles. However, knowledge gaps are detected in areas such as the influence of having suffered pain in childhood or adolescence, the consequences of non-fulfillment of working hours and gender inequalities.
Purpose
To identify which patient and hospital characteristics are related to nurse staffing levels in acute care hospital settings.
Design
A cross‐sectional design was used for this study.
Methods
...The sample comprised 1,004 patients across 10 hospitals in the Andalucian Health Care System (southern Spain) in 2015. The sampling was carried out in a stratified, consecutive manner on the basis of (a) hospital size by geographical location, (b) type of hospital unit, and (c) patients’ sex and age group. Random criteria were used to select patients based on their user identification in the electronic health record system. The variables were grouped into two categories, patient and hospital characteristics. Multilevel linear regression models (MLMs) with random intercepts were used. Two models were fitted: the first was the null model, which contained no explanatory variables except the intercepts (fixed and random), and the second (explanatory) model included selected independent variables. Independent variables were allowed to enter the explanatory model if their univariate association with the nurse staffing level in the MLM was significant at p < .05.
Results
Two hierarchical levels were established to control variance (patients and hospital). The model variables explained 63.4% of the variance at level 1 (patients) and 71.8% at level 2 (hospital). Statistically significant factors were the type of hospital unit (p = .002), shift (p < .001), and season (p < .001). None of the variables associated with patient characteristics obtained statistical significance in the model.
Conclusions
Nurse staffing levels were associated with hospital characteristics rather than patient characteristics.
Clinical Relevance
This study provides evidence about factors that impact on nurse staffing levels in the settings studied. Further studies should determine the influence of patient characteristics in determining optimal nurse staffing levels.
The nurse-patient relationship involves complex attitudes and behaviours with ethical and deontological implications. It has been linked to improvements in patient health outcomes, although there is ...still no consensus in the scientific literature as to the definition and characterisation of the concept. This article aim to define the concept of the nurse-patient relationship. A concept analysis was conducted using the Walker and Avant method to identify the attributes defining the nurse-patient relationship. An integrative review of the literature was conducted using the PubMed, Web of Science, Scopus, and Cumulative Index to Nursing & Allied Health Literature databases. A review of the grey literature and other minor non-indexed publications on the topic was also conducted. A total of 36 articles were included in the review. A model case, a contrary case, a related case, and empirical references were produced to clarify the concept and identify its essential attributes. The concept is defined as a helping relationship involving interaction between different players. It is the basis of nursing care and is intended to meet the healthcare needs of the individual receiving this care. It is also viewed as an intervention in itself, requiring a specific training process just like any other nursing skill. The essential attributes of the relationship are empathy, presence, contact, authenticity, trust, and reciprocity. In conclusion, the nurse-patient relationship is a helping relationship established with the patient and/or their family based on interaction, communication, respect for ethical values, acceptance, and empathy in order to encourage introspection and behavioural change. Key components include communication, active listening, and respect. Bioethical values and confidentiality must also be present to ensure that the relationship is built on equality and intimacy.
The aim of this systematic review and meta-analysis was to identify and evaluate the impact of interventions to improve or reduce insomnia in the workforce through randomized clinical trials. ...Following the recommendations of the PRISMA and MARS statement, a systematic literature search was carried out on the PubMed, Web of Science, CINHAL, and PsycINFO databases, with no restrictions on the language or publication date. For the meta-analysis, a random-effects model and the
were used as outcome measures. To assess the risk of bias and the quality of evidence, the Cochrane Collaboration tool and the GRADE method were used, respectively. Twenty-two studies were included in the systematic review and 12 studies in the meta-analysis, making a total of 14 intervention groups with a sample of 827 workers. Cognitive behavioral therapy was the most widely used intervention. According to the estimated difference between the means, a moderate effect for the reduction of insomnia symptoms after the intervention (MD -2.08, CI 95%: -2.68, -1.47) and a non-significant degree of heterogeneity were obtained (
= 0.64; I
= 0%). The quality of the evidence and the risk of bias were moderate. The results suggest that interventions on insomnia in the workplace are effective for improving workers' health, and that improvements in the quality of sleep and a decrease in the symptoms of insomnia are produced, thanks to an increase in weekly sleeping hours and a reduction in latency at sleep onset. As regards work, they also led to improvements in productivity, presenteeism, and job burnout.
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