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1.
Introduction
Transgender and gender non-conforming (TGNC) people in the United States face disproportionate rates of mental health disorders, including suicidality, depression, anxiety, and substance use disorders than the general population. Patients' experiences utilizing mental healthcare is a determinant in their care-seeking behaviors and treatment success.Aim/question
The purpose of this integrative review is to better understand the firsthand mental healthcare experiences of TGNC persons.Method
The authors sought to locate recent English-language articles that described the mental healthcare experiences of TGNC persons. To do so, only articles that conducted data collection with a TGNC sample were considered for review.Results
Seven articles met criteria for review. Four themes emerged that depicted experiences of health promotion (welcoming environments, staff knowledge and response) and health prevention (enacted stigma, racial disparities and intersectional insensitivity).Discussion
Themes indicated that TGNC persons have mixed experiences (excellent to harmful/damaging) when receiving mental healthcare. There is room for healthcare provider growth in skills to increase TGNC cultural competency.Implications for practice
Mental healthcare providers and nurses would benefit from interventions to promote TGNC culturally competent care, including in-service training or continuing education for the current work force as well as incorporating TGNC content into pre-licensure educational curricula. 相似文献2.
3.
K. Innes-Walker C.N. Parker K.J. Finlayson M. Brooks L. Young N. Morley D. Maresco-Pennisi H.E. Edwards 《Collegian (Royal College of Nursing, Australia)》2019,26(1):62-68
Background
Wound management is frequently performed in the community and forms a large part of daily activities of General Practice health professionals. However, previous research has acknowledged a need for further education and training on evidence based wound management for these health professionals.Aim
The aim of this project was to develop and trial a Cooperative Wound Clinic model of care in General Practices, using a nurse led, interdisciplinary, holistic approach; including training and coaching to increase the wound management expertise and capacity of health professionals working in the primary healthcare environment.Methods
A longitudinal, pre-post design was used. Four Cooperative Wound Clinic pilot sites and nine wound clinics were established in General Practices across three Australian states with the intervention of the study being the model care and incorporating a local wound expert employed to provide the training and coaching. Pre and post survey data were collected on wound management practices, health professional confidence in evidence based wound management, patient health, wellbeing and healing outcomes. Longitudinal patient data were collected for 24 weeks.Findings
Results included an increase in the confidence of health professionals to manage wounds. Utilisation of a repetitive coaching model over a six month period empowered the decision making process and assessment knowledge for a variety of wound types. A positive impact on patient outcomes for a variety of wound types was also observed.Conclusion
The potential for expanding this model will bring many benefits including: empowerment of nurses’ confidence in managing wounds, promoting the role of nurse led clinics; improved wound related capability and confidence of health professionals; improved wound management, patient knowledge and better patient satisfaction and outcomes. 相似文献4.
Kasey B. Jackman Jordon D. Bosse Michele J. Eliason Tonda L. Hughes 《Nursing outlook》2019,67(1):21-38
Background
Sexual and gender minorities (SGMs) experience substantial health disparities. Evidence suggests nurses may be unprepared to work with these populations. A previous literature review of top-ranked nursing journals found that 0.16% of published articles addressed SGM health.Purpose
To evaluate changes in coverage of SGM health in the top-ranked nursing journals since the earlier review using a scoping approach.Methods
Electronic search of articles published between December 2009 and December 2017 in 20 nursing journals with the highest 5-year impact factors.Findings
Thirty-three articles (0.19%) in the top-ranked nursing journals focused on SGM health. There is increasing attention to SGM health recently, evidenced by the numbers of empirical and nonempirical research articles published, as well as nonresearch articles about SGM health.Discussion
In light of well-documented health disparities affecting SGM people, it is essential that nurses continue to conduct and disseminate research related to the health of these populations. 相似文献5.
Gloria McKee-Lopez Leslie Robbins Elias Provencio-Vasquez Hector Olvera 《Journal of Professional Nursing》2019,35(2):112-119
Background
Research evidence strongly suggests that Adverse Childhood Experiences (ACEs) predispose individuals to development of an increased sensitivity to stress and negative physical and mental health outcomes in adulthood.Purpose
To determine if there was a relationship between the number of ACEs reported by first semester BSN students and their reported level of Burnout and Depression.Methods
211 students enrolled in the first semester of upper division courses of their BSN program completed self-report questionnaires which measured the number of ACEs, the level of Depression and the level of Burnout.Results
The number of reported ACEs by participants had a significant relationship on the levels of burnout and severity of depressive symptoms. Female students with a higher number of ACEs were more likely to report higher levels of Burnout A (Emotional Exhaustion) and Burnout B (Depersonalization), and higher depression severity scores compared to males.Conclusion
Nursing programs should educate faculty concerning the frequency and range of adverse experiences that students may have had prior to admission to the nursing program, and the possible relationship with Burnout and Depression. Faculty can provide early information on counseling and support services. 相似文献6.
Problem
Throughout the world people who are homeless experience high rates of hospitalisation. Nurses who work in hospitals have the potential to improve outcomes for this group. To date, a review of qualitative literature pertaining to hospital-based nursing for people who are homeless has been lacking.Aim
To synthesize findings of contemporary qualitative studies related to hospital-based nursing care for people who are homeless in Organisation for Economic Cooperation and Development (OECD) nations.Design
A systematic database search was conducted in mid-2017 using search terms: homeless*, hospital* and nurs*, combined by the Boolean operator ‘AND’. Inclusion and exclusion criteria that mandated publication year, language, method, quality, participants, and setting were applied. 341 abstracts were screened for relevancy resulting in the final inclusion of 8 qualitative and 2 mixed method studies.Findings
Three overarching themes emerged; (1) Homelessness challenges rigid approaches to hospital-based care (2) Stigma impedes healthcare for people who are homeless (3) Hospitals can provide a platform to address homelessness.Discussion
Delivering flexible, non-stigmatising nursing in a way that empowers people experiencing homelessness challenges hospitals around the globe. Research is needed to explore local approaches and subgroups within the homeless population.Conclusion
Experiences of homelessness vary across nations and between cities necessitating local solutions. Within hospitals, if nurses can provide flexible, non-stigmatising care, they have potential to make a huge difference both the lives of individuals who are homeless and in the wellbeing of society as a whole. 相似文献7.
8.
Objective
The purpose of this study was to examine the relationship between spirituality and health status outcome in nursing home (PSTW Khusnul Khotimah) in Pekanbaru, Riau-Indonesia.Method
This study methods was a cross-sectional study with 36 elderly people as samples and it was taken by total sampling technique. JAREL Spiritual Well-Being Scale was used to assess elderly people spirituality level. Univariate and bivariate use non-parametric analysis were performed to determine the relationship between elderly people spirituality and self-reported health status.Results
Majority marital status of respondent (85.8%) were divorce with their couple. Seventy two point two percent elderly health status was not good and 52.8% (the results spiritual statement of indicates: When I was sick, I reduced spiritual welfare 33.3%, I cannot accept changes in my life 27.8%) of them have less spirituality. This study also found that the elderly people who has low spirituality level more likely have health problems. There was significant correlation between spirituality and elderly health status in nursing home (p = 0.035).Conclusion
It was important to increase the elderly people spirituality to prevent health status degradation in elderly people in nursing home. 相似文献9.
Objective
To determine factors that influence the nurses’ performance in family nursing care in public health centers in Jambi City.Method
A cross-sectional study was conducted from April to October 2016 using questionnaire with public health nurses as participants. The survey included questions on knowledge, attitude, self-confidence, motivation, personality, and nurses’ performance in family nursing care, and was completed by 114 nurses. Data analyses used for this study were chi-square test and logistic regression.Results
The factors affecting the nurses’ performance in family nursing care were attitudes (p 0.003; 95% CI 1.583–9.823), motivation (p 0.002; 95% CI 1.672–9.972), and personality (p 0.005; 95% CI 1.466–8.830).Conclusions
Need efforts to improve the attitude, motivation, and personality of nurses in providing family nursing care, such as training, supervision, and rewards. 相似文献10.
Amy J. Spooner Natasha Booth Tai-Rae Downer Louisa Gordon Adrienne P. Hudson Natalie K. Bradford Chris O’Donnell Alanna Geary Robyn Henderson Cherie Franks Aaron Conway Patsy Yates Raymond J. Chan 《Collegian (Royal College of Nursing, Australia)》2019,26(1):103-109
Background
Effective coordination and integration of care between health care providers is critical to manage complex, chronic medical conditions.Aim
Describe the advanced practice profile and activities of nurse navigators who provide a service for patients with chronic health conditions.Design
An observational study was conducted in four health services, in Queensland, Australia.Methods
In part one, nurse navigators completed a survey incorporating the Advanced Practice Role Delineation tool. In part two, nurse navigators completed a work activity diary, capturing the time spent performing daily activities, modes of communication and referral sources.Findings
Twenty-three and 18 nurse navigators participated in the survey and diary, respectively. Participants were experienced nurses, working full-time. Participants reported spending a great extent of time performing direct comprehensive care, support of systems and education in surveys. The diaries captured a mean of 20 working days per participant, a total of 5,748 work activities. including care of 615 patients. The majority of nurse navigator activities were performed within the direct comprehensive care domain. Communication predominantly occurred with patients, families, hospital health professionals either in person, at a healthcare facility or via phone.Discussion
Our research identified three focus areas of nurse navigator activities: direct comprehensive care, support of systems and education. Further work is required to extend the nurse navigators’ unique contribution to research and publication and professional leadership.Conclusions
This study established baseline knowledge regarding advanced practice profiles and work activities of nurse navigators, which can be utilised to improve current processes and future enhancement of the role. 相似文献11.
Tessa Hart John Whyte Monica Vaccaro Amanda R. Rabinowitz 《Archives of physical medicine and rehabilitation》2019,100(5):987-989
Objective
Determine agreement between self-reported dose and dose reflected in administrative records of outpatient physical, occupational, and speech therapies at 6 and 12 months after severe traumatic brain injury (TBI), for the purpose of examining accuracy and predictors of accuracy of self-reported health care utilization in this population.Design
Secondary analysis of survey used in a larger study; participants were queried about therapy doses using a structured interview, either alone or assisted by relatives if they so chose, with responses compared to administrative records.Setting
Rehabilitation center providing outpatient TBI therapies.Participants
Sixty-five people with severe TBI living in the community provided 6-month data (N=65); 54 provided 12-month data.Interventions
Not applicable.Main Outcome Measures
Degree of agreement with administrative records of scheduled and billed therapy appointments, measured using intraclass correlation coefficients (ICCs), with linear regression used to predict accuracy from demographic variables and cognitive status.Results
ICCs were in the moderate range at 6 months, but were more variable, with some in the poor range, at 12 months. Agreement was higher for scheduled than for billed (attended) appointments. Assisted and unassisted patients provided comparable agreement with records. No demographic factors were associated with accuracy, but lower cognitive FIM scores, as hypothesized, tended to predict lower agreement at 6 months.Conclusions
People with severe TBI can provide reasonable estimates of commonly prescribed outpatient therapy doses at 6 months postinjury. Accuracy may be improved by inviting patients to request assistance from relatives and by asking them to consider attended (vs scheduled) sessions. 相似文献12.
13.
Background
Stigmatization and bias toward the obese population has been studied globally in a variety of professional groups, supporting the existence of negative attitudes and weight bias against this population. Attitudes fostering the prevalence of stigmatization undermine the effectiveness and quality of health care. Studies have not compared attitudes and beliefs of graduate and undergraduate students from professional schools within the same university. As an exemplar, this study compared nursing students' attitudes and beliefs toward obese individuals with students' attitudes in other professional schools.Methods
The Attitudes Toward Obese Persons and Beliefs About Obese Persons scales were administered to undergraduate and graduate nursing students and graduate education and social work students at a US northeastern university.Results
Analyses indicated students who were younger; in nursing programs; and reported not having a friend or family member who is overweight had significantly worse attitudes than others. Gender, location of residence, perceptions of own body weight, and participating in an exercise regimen were not significant.Conclusion
Understanding attitudes toward obese people may guide educators as they train nursing, education, and social work students. Reducing negative attitudes, beliefs, and stigmatization is an important starting point in the battle against this growing public health concern. 相似文献14.
Background
Within nursing education research, protection of students as human subjects must be the highest priority. This protection can be provided via student anonymity. A subject-generated identification code, comprised of responses to a series of questions, can link data across time points while protecting student anonymity.Method
Two studies, focused on palliative care education, used a subject-generated identification code to link student data across multiple time points. Refinements to the code were made between studies to further enhance anonymity and response consistency.Results
The subject-generated identification code fostered linking of student responses across three time points in study one and two time points in study two.Conclusion
There are many benefits to utilizing a subject-generated identification code in nursing education studies. Researchers must consider the need for a data management expert and balancing transposition errors and the power to differentiate between responses. 相似文献15.
Garrison Nord Kristin L. Rising Roger A. Band Brendan G. Carr Judd E. Hollander 《The American journal of emergency medicine》2019,37(5):890-894
Introduction
Claims data raises the possibility that on demand telemedicine programs might increase new utilization, offsetting the cost benefits described in some retrospective analyses.We prospectively evaluated the cost of a synchronous audio-video on-demand telemedicine taking into account both what patients would have done instead of the telemedicine visit as well as the care patients received after the visit.Materials and methods
We conducted a prospective observational study of patients who received care from an on-demand telemedicine program. At the time of the visit, we surveyed patients about the alternative care that would have been requested, if they had not done the telemedicine visit. We also obtained information following the visit about what further care was received. Using cost data derived from the literature we performed a sensitivity analysis to determine the cost impact of the on-demand telemedicine visit.Results
There were 650 patients enrolled with a mean age of 37 who were 68% female; 74% had their care concerns resolved on the telemedicine visit; only 16% would have “done nothing” if they had not done the telemedicine visit, representing possible new utilization. Net cost savings per telemedicine visit was calculated to range from $19–$121 per visit.Conclusions
In our on-demand telemedicine program, we found the majority of health concerns could be resolved in a single consultation and new utilization was infrequent. Synchronous audio-video telemedicine consults resulted in short-term cost savings by diverting patients from more expensive care settings. 相似文献16.
17.
Ieva Stupans Katherine Baverstock Merv Jackson 《Collegian (Royal College of Nursing, Australia)》2019,26(1):146-150
Background
An understanding of determinants of health is critical for nurses to be able to develop effective care plans for their patients; however little work has been published which evaluates learning opportunities for students around the determinants of health.Aim
To gain an understanding of students’ experiences of a newly designed assessment task which focused on the determinants of health—a photo-essay.Methods
A mixed methods approach was adopted. Students undertaking the course were asked to complete a reflective thinking questionnaire both pre- and post- course. Data from individual students was matched and differences in responses to the questionnaire determined. Students were also asked to briefly describe their impressions of the photo-essay assessment task. A thematic analysis of the students’ impressions of the photo-essay task was completed.Results
An analysis of pre- and post- course questionnaire results identified that there were statistically significant differences regarding the constructs (or proxies) for the levels of students’ understanding and critical reflection. A thematic analysis of the students’ impressions of the photo-essay assessment task indicated four main themes — the challenge, the enjoyment, learning, and the connection of theory to their local environment.Discussion
Findings indicate that this assessment task provided opportunity for students to learn about the determinants of health. Benefits to students included the changes in the constructs for levels of understanding and critical reflection. These changes aligned with the themes identified in students’ free text comments.Conclusions
Based on this project, it is concluded that photo-essays may be an innovative assessment approach of the determinants of health which may be used in nursing education to enhance understanding and critical reflection. 相似文献18.
Jenna Garlock Leborah Lee Michaelia Cucci Lawrence A. Frazee Chanda Mullen 《The American journal of emergency medicine》2019,37(5):884-889
Background
In the ED, patients are treated empirically for suspected gonorrhea and/or chlamydia (GC). Limited studies have evaluated the treatment of sexually transmitted diseases (STDs) in conjunction with predictor variables. This study will allow providers to better identify patients with potential GC to streamline antibiotic treatment.Objectives
The primary objective was to determine the incidence of positive assay in patients that underwent GC screening. The secondary objectives included the proportion of patients assayed that received empiric therapy and the predictive value of risk factors to identify positive assays.Methods
This retrospective cohort study included adult patients who presented to the health-system EDs and underwent GC screening. Subjects were excluded if they were victims of sexual assault, left AMA or eloped.Results
A total of 490 assayed patients were included, of which 84 (17%) were found to be positive for GC assay. Of the 278 patients treated empirically, 74% had a negative assay. Of the entire sample (n?=?490), risk factors found to predict a positive assay (p?<?0.05) included male, women <25?years of age, concomitant bacterial vaginosis, pelvic inflammatory disease or trichomonas, penile discharge, inconsistent condom use, previous/coexisting STDs, and uninsured.Conclusions
Compared to previous reports, this study found a higher incidence of positive GC assays for patients with suspected infection. This is the first study to evaluate GC testing in both men and women in the ED, and risk factors not previously reported by the CDC were identified. 相似文献19.
Cheryl Ross Cath Rogers Christine King 《Collegian (Royal College of Nursing, Australia)》2019,26(1):1-7
Background
Nursing workload remains an issue in current health care contexts. The use of quantitative methodologies, methods and tools to measure workload has not produced adequate data to inform workforce policy to resolve workforce concerns about workload.Objective
This study aimed to identify the influence of both culture and climate as factors in nursing workload.Methods
This research used an overall critical ethnographic methodology to investigate the real lifeworkload issues of nurses. Methods included fieldwork observations and informal discussions over a 3 year period and 11 in-depth interviews.Results
The study identifies the impact of safety mandates on nursing workload as an invisible phenomenon within current workload methodologies. Such mandates add to nursing roles and routines, and become a ‘taken-for-granted’ activity that is not always directly related to patient care, nor is a visible factor in workload measurement.Conclusion
Given that workload measurements are formulated on direct patient care activities, indirect and unrecognised activities may create additional nursing workload. 相似文献20.
James S. Krause David Murday Elizabeth H. Corley Nicole D. DiPiro 《Archives of physical medicine and rehabilitation》2019,100(5):938-944
