Monday, 27 March 2017

A ten year study of childhood asthma

Roger Watson, Editor

It seems obvious that the incidence of childhood and adolescent asthma is increasing. Certainly, asthma is a major health problem worldwide with up to 300 million people suffering. In children, asthma lowers health status and this effect may be worse in girls than in boys. Asthma leads to feelings of being left out and anger.

This study from Sweden by Stridsman et al. (2017) titled: ‘Asthma inadolescence affects daily life and school attendance – Two cross-sectionalpopulation-based studies 10 years apart’ and published in Nursing Open aimed: ‘to study the impact of asthma on daily life, school absenteeism and physical education. In addition, to describe asthma triggers at school.’ The study was carried out in 2003 and 2013 and involved over 3000 adolescents in the first round and over 2000 in the second round.

The authors report: ‘The prevalence of current asthma in 2003 was 8% (girls 8% vs. boys 8% p = .864) and in 2013, 11% (girls 12% vs. boys 11% p = .337). The proportion of adolescents who reported that their respiratory symptoms/asthma had an impact on daily life increased from 64% in 2003, to 70% in 2013 (test for trend, p = .008) (Figure 1). In 2013, the proportion reporting that asthma had an impact on daily life was higher among girls than boys (86% vs. 71%; test for trend p = .039). However, no differences according to sex were found in 2003. In conclusion, the authors say: ‘this study showed that still in 2013, asthma affects adolescents’ daily lives in school and both school attendance and physical education are negatively affected by the disease and its symptoms.’

Reference

Stridsman C, Dahlberg E, Zandrén K, Hedmann L (2017) Asthma in adolescenceaffects daily life and school attendance – Two cross-sectional population-basedstudies 10 years apart Nursing Open doi: 10.1002/nop2.77

Monday, 2 January 2017

How best to deliver education to nurses?

Roger Watson, Editor

The debate continues about how best to deliver education to nurses and, perhaps due to the professional and interpersonal aspects of nursing, there are concerns about whether or not the teaching requires face-to-face interaction between teacher and learner. This is the topic of a study from the USA by Soper (2016) titled: 'Knowledge into learning: comparing lecture, e-learning and self-study take-home packet instructional methodologies with nurses' and published in Nursing Open. 

The aim of the study was: 'to examine which of three instructional methodologies of traditional lecture, online electronic learning (e-learning) and self-study take-home packets are effective in knowledge acquisition of professional registered nurses.' An experiment invovled 87 nurses receiving a package on coronary care by the various mehtods and then being given the same knowlegde questionnaire. There was no significant difference bewteen the methods of delivery in the knowlegde of the nurses.

The author concluded: 'The study was able to determine that there were no significant differences in knowledge acquisition of nurses between the three instructional methodologies. The study also found that all groups scored at the acceptable level for certification. It can be concluded that all of these instructional methods were equally effective in knowledge acquisition, but they are not equally cost- and time-effective. Therefore, hospital educators may wish to formulate policies regarding a choice of instructional method that takes into account the efficient use of nurses’ time and institutional resources.

Reference

Soper T (2016) Knowledge into learning: comparing lecture, e-learning and self-study take-home packet instructional methodologies with nurses Nursing Open DOI: 10.1002/nop2.73

Friday, 25 November 2016

Taking a baby home from neonatal intensive care

Roger Watson, Editor

Having a new born baby in neonatal intensive care must be a very stressful experience for parents.  However, the period immediately after taking the baby home, while a considerable relief, must also be stressful. Parents need to be adequately prepared as this study from Sweden by Larsson et al (2016) titled: ‘Parentsexperiences of discharge readiness from a Swedish neonatal intensive care unit’ and published in Nursing Open shows.

The aim of the study was: ‘to describe how parents experienced the support at, and preparation for discharge from, the NICU and how they experienced the first time at home.’ Parents of 93 neonatal infants were approached and given a questionnaire about their experiences. Some were answered by mothers, some by fathers and some by both parents. The results were very positive: ‘When asked if the parents felt adequately prepared for discharge home, 55 (83%) responded “yes,” three (5%) responded “no,” and eleven (17%) answered the question in free text. When asked if they felt they received sufficient support from the NICU for the first few days at home, 49 (74%) responded “yes,” no parent answered “no,”’. Nevertheless, some parents did express worries: ‘The first few days at home were a little bit scary without the NICU staff near as we were used to. We checked frequently that he was breathing!’ and ‘I don’t think you can really be sufficiently prepared; it’s something so totally new in your life, so you will never be prepared enough.’

The authors concluded: ‘Factors favouring the parents’ sense of being prepared for going home and affecting their experience of the first period at home were being present during, and involved in, the infant’s care at theNICU; the infant’s being medically examined and declared healthy;the parents getting sufficient medical and practical information; and the transition to home occurring gradually. At discharge, several parents wished they had had more information about breastfeeding, tube feeding, and the infants’ food intake; they also would have liked emotional support and follow-up counselling after discharge.’

Reference

Larsson C, Wägström U, Normann E, Thernstrom Blömqvist Y (2016) Parents experiences of discharge readinessfrom a Swedish neonatal intensive care unit Nursing Open DOI: 10.1002/nop2.71 

Friday, 28 October 2016

Nursing home resident transfer to emergency care

Roger Watson, Editor

The aim of this study was: 'To explore possible factors in the organization of nursing homes that could be related to differences in the rate of transfer of residents from nursing homes to emergency department.'  The study is from Sweden by Kirsebom et al. (2106) titled: 'Transfer of nursing home residents to emergency departments: organizational differences between nursing homes with high vs. low transfer rates' and published in Nursing Open.

Five nursing homes were studied and, as explained by the authors: 'All of the nursing homes’ websites, where the facilities are described, were read to establish whether they expressed some sort of care philosophy or theory.'  Other aspects of care were also studied such as nurse training in care of older people with dementia and years of caring for people with dementia. Nurisng homes were also classified as private for-profit or public. There was an association between being a high transfer to emergency care home and being private for-profit. In the low transfer homes more nurses had training in caring for older people with dementia and had worked longer with people with dementia. 

The authors concluded: 'Taken together, the present findings indicate that organizational factors could be related to differences in transfer rates between nursing homes. Our data reveal that nursing homes identified with the highest transfer rates to ED (emergency departments) were run by for-profit providers to a higher extent and had updated ACPs (advanced care plans) for their residents to a lower extent than did nursing homes with the lowest transfer rates. Further, RNs’ level of competence may be related to transfer rates. Improved use of ACPs in nursing homes needs to be in focus if the care provided is to conform to the wishes of residents and their families. Better adherence to ACPs could enhance the care and outcome for residents, thereby possibly reducing transfers to the ED. This needs to be further explored.'

Reference



Monday, 27 June 2016

Socialising new graduates

Roger Watson, Editor

As explained by the authors of this Canadian study: 'The purpose of this study was to explore the relationships between preceptor characteristics (emotional intelligence, personality and cognitive intelligence) and new graduate nurse socialization outcomes regarding turnover intent, job satisfaction, role conflict and ambiguity during a preceptorship programme.'  The authors are Lalonde and McGillis Hall (2016) and the articel is titled: 'Preceptor characteristics and the socialization outcomes of new graduate nurses during a preceptorship programme' and is published in Nursing Open.  

The authors used a sample of 41 preceptors and 44 new graduate nurses and used a rnage of validated questoinnaires to measure intelligence, emotional intelligence and personality.  Some characteristics of preceptors and nurses were related as follows: 'Three preceptor personality traits were related to new graduate nurse outcomes. First, preceptor openness was positively correlated with new graduate job dissatisfaction and role conflict. This indicates that the more open the preceptor, the higher the job dissatisfaction among new graduate and the higher their perception of role conflict. This cohort of new graduate nurses, with an average age of 24, is considered part of Generation Y, or the millennial generation, that is, individuals born between 1979 and 1994' and 'Second, preceptor conscientiousness was positively related to new graduate turnover intent. Specifically, the more conscientious the preceptor, the higher the intent to turnover among the new graduate participants. This implies that new nurses paired with more conscientious preceptors are more likely to want to leave their current job. As the preceptors provide the technical information surrounding their new role, along with important social cues, the new nurse assesses these social cues and the people surrounding them.'

The authors conclude: 'This study provides additional support to the existing literature that examines how preceptor characteristics may be worthy of consideration. However, further research is required to determine whether or not preceptor personality traits impact the socialization outcomes of new graduate nurses.'

Reference

Lalonde M, McGillis Hall L (2016) Preceptor characteristics and the socialization outcomes of
new graduate nurses during a preceptorship programme Nursing Open doi: 10.1002/nop2.58

Sunday, 26 June 2016

Psychological care of miitary veterans

Roger Watson, Editor

According to the authors: 'Each year, a proportion of personnel leave military service, which may place strain on their mental and physical well-being as well as their successful reintegration into society. Returning from war zones into civilian life can precipitate stress or further exacerbate existing mental health problems.'  The aim of this study from the UK by Clarkson et al. (2016) was 'To evaluate the outcomes of participants attending a psychological therapies service for military veterans.'

The study investigates the Military Veterans’ Improving Access to Psychological Therapies
Service (North West) (MV IAPT) and, as described by the authors: 'We undertook an observational, prospective cohort study of veterans accessing the MV IAPT service for a pilot period of 20 months from September 2011–April 2013. Data were collected anonymously from the clinical information system of general IAPT services, where standardized measures of depression, anxiety and social adjustment were administered to patients at each session and scores entered into the computerized system.'

Quoting directly from the article: 'Data were available on pre-(assessment) and post-treatment
(last available session) standardized measures for the 505 veteran patients accessing the service and receiving some form of treatment. Overall, across the whole sample, there were highly significant improvements on all measures. For the different types of service conclusion, there were highly significant improvements on all measures. These findings have implications for nurse therapists and others, working with this vulnerable patient group. In contrast to countries like the United States, where a dedicated infrastructure exists for veterans’ healthcare needs, the lack of specifically tailored help in the UK has been problematic. Many veterans have been confused by the different services on offer, their acceptance criteria and referral routes.'

The authors conclude: 'The findings reported here have much to offer in the context of providing
salient evidence, in particular to those commissioning mental health services, against the backcloth of an increased commitment to the veteran population, such as that in the Military Covenant, now enshrined in law.'

Reference

Clarkson C, Giebel CM, Challis D, Duthie P, Barrett A, Lambert H (2016) Outcomes from a pilot psychological therapies service for UK military veterans Nursing Open doi: 10.1002/nop2.57

Tuesday, 14 June 2016

Mindfulness and resilience in nursing students

Roger Watson, Editor

Dispositional mindfulness - a phenomenon that includes 'observing, acting with awareness, non-judging, self-compassion and non-reactivity or acceptance' - is related to resilience in nursing students as this study from Australia by Chamberlain et al. (2016) titled: 'Dispositional mindfulness and employment status as predictors of resilience in third year nursing students: a quantitative study' and published in Nursing Open shows.  According to the authors: 'Nursing students will graduate into stressful workplace environments and resilience is an essential acquired ability for surviving the workplace. Few studies have explored the relationship between resilience and the degree of innate dispositional mindfulness, compassion, compassion fatigue and burnout in nursing students, including those who find themselves in the position of needing to work in addition to their academic responsibilities.'

As the authors explain: 'The aim of this study was to observe the predictors of resilience in third year nursing students as a strategy for dealing with or managing study and workplace related stress. Specifically assessed were, innate dispositional mindfulness, professional quality of life and employment during study enrolment to determine if these psychological and workload states were predictive of personal resilience.'  Using questionnaires to measure mindfulness and resilience the authors showed that: 'resilience correlated positively with dispositional mindfulness'.  The authors conclude: 'The strongest predictors of resilience were dispositional mindfulness and its subset of acceptance.'  This study could contribute to helping nursing students to develop good coping strategies to deal with the stress of being a nurse.

Reference

Chamberlain D, Williams A, Stanley D, Mellor P, Cross W, Siegloff L (2016) Dispositional mindfulness and employment status as predictors of resilience in third year nursing students: a quantitative study Nursing Open doi: 10.1002/nop2.56