Aims and objectives
To gain greater understanding of which personal and professional demands novice nurses are confronted with and what can be done to improve the transition from novice to ...professional staff nurse.
Background
Novice nurses are confronted with a lot of physical, emotional and intellectual changes in the role‐transition process from student nurse to professional staff nurse, which are often related to feelings of confusion, uncertainty and stress. Few studies have investigated, on a longitudinal basis, the lived experiences of novice nurses in the clinical setting.
Design
The study adopted a qualitative longitudinal approach to investigate the described experiences of novice nurses during their first 2 years after graduation. Written diaries were selected for optimal data collection.
Methods
A sample of eighteen novice nurses was recruited from several wards at a University Medical Center in the Netherlands. The inclusion criteria were a Bachelor's degree in nursing, aged under 30, and no more than 1 year's work experience. Data were collected from weekly measurements from September 2013–September 2014.
Results
Eight major themes emerged from the diaries (n = 580): relatedness, competence, development, organisational context, existential events, goals, autonomy and fit. This study revealed that the need for relatedness was by far the most reported theme. Support and positive feedback from colleagues appeared to be crucial for novices starting work in a highly complex environment.
Conclusion
This study showed that one of the strategies novice nurses use to deal with challenging and existential situations is to share their experiences with colleagues. Therefore, novice nurses should always work in a safe environment which enables this.
Relevance to clinical practice
Identification of key issues around understanding novice nurses’ first clinical experiences may help to improve their transition from novice to professional staff nurse. The presence and support from supervisors and mentors are inevitable to keep novice nurses motivated for the profession.
Aim
To assess the effects of family nursing conversations on family caregiver burden, patients’ quality of life, family functioning and the amount of professional home health care.
Design
A ...controlled before‐and‐after design.
Methods
Intervention group families participated in two family nursing conversations incorporated in home health care; control group families received usual home health care. Patients and family members completed a set of questionnaires on entering the study and 6 months later to assess family caregiver burden, family functioning and patients’ quality of life. The amount of home health care was extracted from patient files. Data were collected between January 2018–June 2019.
Results
Data of 51 patients (mean age 80; 47% male) and 61 family members (mean age 67; 38% male) were included in the results. Family caregiver burden remained stable in the intervention group whereas it increased in the control group. Family functioning improved significantly compared with the control group for patients and family members in the intervention group. No significant effects on patients’ quality of life emerged. The amount of professional home health care decreased significantly in the intervention group whereas it remained equal in the control group.
Conclusion
Family nursing conversations prevented family caregiver burden, improved family functioning, but did not affect patients’ quality of life. In addition, the amount of home health care decreased following the family nursing conversations.
Impact
Countries with ageing populations seek to reduce professional and residential care and therefore encourage family caregiving. Intensive family caregiving, however, places families at risk for caregiver burden which may lead to increased professional care and admission into residential care. This study demonstrates that family nursing conversations help nurses to prevent family caregiver burden and improve family functioning while decreasing the amount of home health care.
摘要
目标
探讨家庭护理交谈对家庭照料人员负担、患者生活质量、家庭功能及专业家庭保健服务量的影响。
设计
前后对照研究。
方法
干预组家庭在家庭护理服务中加入两次家庭护理交谈;对照组家庭接受常规的家庭护理服务。患者和家属在研究期间和6个月后完成一组问卷调查,以评估家庭照料人员的负担、家庭功能和患者生活质量。从患者档案中提取家庭护理服务量。收集2018年1月至2019年6月之间的数据。
结果
结果中包含51名患者(平均年龄80岁;47%为男性)和61名家庭成员(平均年龄67岁;38%为男性)的数据。家庭照料人员的负担在干预组中保持稳定,但在对照组中呈现增长。与对照组相比,干预组患者和家庭成员的家庭功能明显改善。对患者生活质量无显著影响。在干预组中,专业家庭护理量显著减少,而在对照组中保持不变。
结论
家庭护理交谈能避免造成家庭照料人员的负担,改进家庭功能,且不影响患者的生活质量。此外,家庭护理交谈后,家庭护理量有所减少。
影响
人口老龄化国家寻求减少专业护理和住院护理,鼓励家庭护理。然而,密集的家庭护理使家庭照料人员面临负担增加的风险,可能导致专业护理和住院护理增加。本研究显示,家庭护理交谈有助于护士在减少家庭护理量的同时,减轻家庭照料人员的负担,以及改善家庭功能。
Gain insight into the process of shared decision-making (SDM) in daily hospital care for patients with dementia from nurses' perspectives.
Explorative qualitative design.
In-depth digital interviews ...were conducted with 14 registered nurses between June and November 2022. A phenomenological approach was applied using Colaizzi's seven-step method.
Five themes were identified in the data: (1) SDM in daily care: How shared decision-making is applied; (2) Nurses' perceptions and competence: How nurses perceive and manage SDM; (3) Nurses' roles and advocacy: The evolving roles of nurses and their advocacy efforts, (4) Recognition of dementia and its impact: How nurses recognize and manage dementia; and (5) Interventions to support SDM: Strategies and interventions to facilitate SDM.
This study highlights the complexity of SDM in patients with dementia. It demonstrates the importance of the involvement of relatives, omission of patient goals in discussions and perceived deficiencies of nurses. The early identification of dementia, evaluation of nuanced capacity and targeted communication are essential. Further research and enhanced training are required to improve care in this context.
Potential areas for further research on SDM in nurses involving patients with dementia include investigating the effects of integrating goal discussions into SDM training for nurses, overcoming barriers to SDM competence, and challenging the idea that SDM is solely the responsibility of physicians. These findings highlight the need for policies that encourage interdisciplinary collaboration, address misconceptions and recommend training programmes that focus on applying SDM to the daily care of patients with dementia, thereby improving the overall quality of patient care.
The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used for reporting.
No patient or public contribution.
To explore content validity of the ICF core set for Diabetes Mellitus from nurses' perspective.
A two-round Delphi study was conducted with nurses specialized in diabetes care, who were recruited by ...purposive sampling. Level of agreement on relevance of ICF categories was calculated using Item-level Content Validity Index.
Twenty-seven nurses judged 147 second-level ICF categories on relevance for people with Diabetes Mellitus. Agreement was reached on 65 (44.2%) categories, of which 46 were from the ICF core set for Diabetes Mellitus, 17 were from previous validation studies, and two were additional categories that were mentioned as relevant. Forty-six out of the 65 categories were derived from the component body functions and structures. No agreement was reached on 82 (55.8%) categories, of which 33 were derived from the component environmental factors.
Content validity of the ICF core set for Diabetes Mellitus was partially supported by specialized nurses. Agreement was predominantly reached on biomedical categories. Content validity of categories derived from environmental factors received little support.
The nursing profession should be aware of a gap between the current biomedical focus and the desired biopsychosocial approach; the latter of which is recommended in chronic care.
IMPLICATIONS FOR REHABILITATION
The International Classification of Functioning, Disability and Health (ICF) encourages a biopsychosocial approach in health care, and ICF core sets, such as the core set for Diabetes Mellitus, are useful in identifying the needs of patients.
Content validity of the ICF core set for Diabetes Mellitus was partially supported by nurses specialized in diabetes care; agreement was predominantly reached on biomedical categories.
The nursing profession should be aware of a potential gap between the current biomedical focus and a desired biopsychosocial approach, which is particularly recommended in chronic care.
It is recommended that nurses take part in future revisions of ICF core sets; a multidisciplinary approach enables members to learn from each other's perspectives, including from those of patients.
This study describes nurses’ perspectives about their experience of being involved in a 6-day educational intervention which focused on the development of competency in family nursing practice with a ...particular emphasis on family nursing conversations. The foundational knowledge of the educational intervention was based on the Calgary Family Assessment Model (CFAM) and the Calgary Family Intervention Model (CFIM). A research design incorporating quantitative and qualitative measurement was used. Before and after the family nursing educational intervention, nurse participants (n = 18) completed the Families’ Importance in Nursing Care–Nurses’ Attitudes (FINC-NA) instrument. The outcomes were analyzed using paired-samples t tests. FINC-NA scores increased by 6.94 points (SD = 5.66, p < .001). To complement the quantitative findings, in-depth interviews were conducted with all of the participants. Participants reported increased awareness of the importance of families in nursing care. In addition to an increase in positive attitudes about families, participants perceived that their knowledge and skills regarding family nursing conversations were more comprehensive. A 6-day educational intervention with a focus on reflection appears useful in helping nurses to “think family” and encouraging perceptions of increased competence in family nursing conversations.
Aims and objectives
Overall, this study aimed to describe nursing care for patients with dementia in acute hospitals, with the objectives of describing the provided nursing care (a), nurses’ ...attitudes and perceptions in caring for patients with dementia (b), and exploring how nurses deal with challenging behaviour (c). Additionally, we determined background variables associated with caring for people with dementia.
Background
Due to comorbidities, people with dementia are frequently admitted to acute care hospitals. Here, they are at high risk of complications. Nurses strive for good care but regularly experience insufficient knowledge and skills regarding caring for people with dementia.
Design
A cross‐sectional survey study design.
Methods
Data were collected in seven Dutch acute hospitals and through social media. In total, 229 hospital nurses completed the questionnaire. We used the Geriatric In‐Hospital Nursing Care Questionnaire and two subscales of Hynninen on managing challenging behaviour. This report followed the STROBE checklist.
Results
Nurses express that they often apply general preventive interventions not explicitly related to dementia care. In general, nurses have mixed feelings about the nursing care provided in their department. For challenging behaviour, a variety of approaches, including restrictive measures and medication, is applied. The nurses’ attitudes and perceptions are influenced by the type of hospital where the nurses work, the level of education, the number of hours nurses work, and if the nurses completed a course on dementia in the last year.
Conclusions
Despite a positive attitude, nurses do not have the specific knowledge and skills needed to provide proper care. Nurses who recently completed a course on dementia had more positive attitudes and perceptions towards caring for patients with dementia.
Relevance to clinical practice
The results of this research can be used to improve the quality of nursing care for patients with dementia in acute hospitals.
Organ and tissue donation can also involve children. Because of its sensitivity, this topic requires careful decision making. Children have the ability to carefully reflect on this subject and enjoy ...participating in family discussions about it. Therefore, what children need is proper information. When schools are used to educate children about this subject, information about teacher support for this type of lesson along with its effects on the depth of family discussions is important.
A questionnaire was sent to all 7,542 primary schools in the Netherlands. The goal was to gather information on teachers' perspectives about a neutral lesson devoted to organ and tissue donation, and also on the best age to start giving such a lesson. The second part of our study examined the effects of a newly developed lesson among 269 primary school pupils. The school response was 23%. Of these, 70% were positive towards a lesson; best age to start was 10-11 years. Pupils reported 20% more family discussions after school education and enjoyed learning more about this topic. There is significant support in primary schools for a school lesson on organ and tissue donation. Educational programs in schools support family discussions.
Problem: For an increasing group of children with chronic conditions worldwide, there is growing evidence that spiritual care from healthcare professionals is important to help them cope with illness ...and disability. As there is yet little known of which needs should be addressed with this pediatric spiritual care, this synthesis of the literature aims to clarify these needs. Eligibility criteria: all nursing, education and psychology peer-reviewed research studies, published in English between 2000 and 2017, focussing on spirituality or spiritual needs of children between 0 and 18 years old with a physical chronic condition, from their own perspective were eligible. Sample: Twenty articles of which were two reviews and eighteen single studies were included reporting on children between 0 and 21 years. Included chronic conditions were type 1 diabetes mellitus, Duchene muscular dystrophy, HIV/aids, asthma, sickle cell disease, cystic fibrosis and cancer. Results: Children's spirituality seemed to be shaped by a search for identity focusing on normalcy and expressed their beliefs mainly in their relationship with a supportive God, using mostly religious language. Relational aspects, contextual aspects and spiritual/religious coping can generate spiritual issues or needs which influence health and adjustment to living with chronic conditions. Conclusions: Spirituality is an integral aspect of life and child development, requiring spiritual care from healthcare professionals when children face a physical chronic condition.
Implications: More research among younger children and/or non-religious children from various countries should be performed to complement the existing – mostly American – evidence.
•Spirituality can help children with a chronic condition cope when faced with illness and disabilities.•This synthesis shows what we know about children's spirituality and their spiritual needs almost exclusively concerns children from the United States and mostly Christian or at least religious children.•Spirituality of children appears to involve a search for a unique identity and relationship with God and identifies three spiritual issues specific for children with a chronic condition requiring spiritual care: relational aspects, contextual aspects and spiritual/religious coping.
Aim
This study explored the effects of contextual, relational and cognitive factors derived from novice nurses’ work experiences on emotions and affective commitment to the profession.
Background
...With an increasing demand for well‐trained nurses, it is imperative to investigate which work‐related factors most affect their commitment to develop effective strategies to improve work conditions, work satisfaction and emotional attachment.
Design
A repeated measures within subjects design.
Methods
From September 2013–September 2014 eighteen novice nurses described work‐related experiences in unstructured diaries and scored their emotional state and affective commitment on a scale. The themes that emerged from the 18 diaries (with 580 diary entries) were quantified as contextual, relational and cognitive factors. Contextual factors refer to complexity of care and existential events; relational factors to experiences with patients, support from colleagues, supervisors and physicians; cognitive factors to nurses’ perceived competence.
Results
The first multilevel regression analysis, based on the 18 diaries with 580 entries, showed that complexity of care, lack of support and lack of competence were negatively related to novice nurses’ affective commitment, whereas received support was positively related. The next multilevel regression analyses showed that all contextual, relational and cognitive factors were either related to negative or positive emotions.
Conclusion
To retain novice nurses in the profession, it is important to provide support and feedback. This enables novice nurses to deal with the complexity of care and feelings of incompetence and to develop a professional commitment.
Students living with a chronically ill family member may experience significant pressure, stress, and depression due to their caregiving situation. This may also lead to them delaying or dropping out ...of school when the combination of being a caregiver and their education program are too demanding. This survey study aims to explore the consequences for students of bachelor or vocational education programs when they are growing up with a chronically ill family member and the influence of various background characteristics and risk factors.
A survey was sent to 5997 students (aged 16-25 years) enrolled in bachelor or vocational education programs in the north of the Netherlands. The content of the survey was based on a literature study and consultation with experts. Descriptive statistics, Chi-square tests, and logistic regression analyses were performed.
A total of 1237 students (21%) responded to the survey. A sub group of 237 (19%) students (mean age 21(2.2); 87% female) identified themselves as growing up with a chronically ill family member. More than half (54.9%) of these students indicated that they experienced negative consequences in daily life. A significant association (OR .42, p < .02) was found for these consequences and the level of education for which attending vocational education yields a higher risk. In addition, growing up with a mentally ill family member was associated with a 2.74 (p = .04) greater risk of experiencing negative consequences in daily life compared to students living with a family member with a physical disorder or multiple disorders.
Since a substantial number of students growing up with a chronically ill family member indicate serious physical, mental, and social consequences as a result of this care situation, awareness for this specific age-group is needed. Students with a mentally ill family member and students undertaking vocational education appear to be especially at risk. Further research is required in order to gain insight that is more in-depth into the exact type of problems that these students encounter and the specific needs that they have regarding support.
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