The aim of the study was to assess hypertensive patients' self-care agency and any correlation with the patient's lifestyle changes and the nurse's degree of patient centeredness after counseling training.
Nurses in the intervention group (IG; n = 19) working at nurse-led clinics at health centers were trained in patient centeredness (motivational interviewing) and the stages of change model and included 137 patients. Nurses in the control group (CG; n = 14) included 51 patients. The Exercise of Self-Care Agency (ESCA) instrument was used. There was a significant difference from baseline to the 2-year follow-up in the ESCA score (IG, p = .0001). An increase in ESCA score was correlated with an increased level of physical activity after 2 years (IG, p = .0001; CG, p = .040).
The counseling training gave an increase in the patients' self-care agency scores, which was significantly correlated with increased physical activity.
In clinical practice it is important for nurses to be patient centered in their counseling to affect patients' self-care agency in a positive direction.
With a focus on sexual health and rights, this study describes how transgender people experience meetings with health care professionals.
Transgender people face prejudice and discrimination worldwide. Little is known of their experiences in sexual health-promoting settings.
Within a descriptive design, 20 persons aged 18-74 and identifying as transgender and nonbinary were interviewed. The results were analysed with constructivist grounded theory.
Disrespect among health care professionals is the core category connected to the experiences in the result; transgender people experience estrangement, expectations and eviction in different sexual health-promoting settings.
Transgender knowledge needs to be increased in general, in both specialised transgender health care and many other health care settings, to prevent transgender peoples' experiences of estrangement. Moreover, an increased knowledge of, and respect for, sexual health and rights is needed to prevent transgender peoples' exposure to gender binary, cis- and heteronormative expectations. In addition, access to sexual health care is essential following gender-confirmatory care as well to avoid transgender peoples' experiences of eviction from the health care system.
Nurses have an important role to play in striving for equity and justice within health care. This study describes how health care professionals appear to be disrespectful and suggestions of how this can be avoided are made.
Previous research has revealed nurses' knowledge gaps in venous leg ulcer (VLU) nursing care, and continuing education is needed. The closer nurses' perceived knowledge is to their evidence-based theoretical knowledge, the better possibilities they have to conduct evidence-based VLU nursing care.
To assess the congruence between nurses' perceived and theoretical knowledge about VLU nursing care before and after an internet-based education about VLU nursing care (eVLU).
Quasi-experimental study with intervention and comparison groups and pre- and post-measurements.
Home health care in two Finnish municipalities.
Nurses (n?=?946) working in home health care were invited to participate. In the intervention group, 239 nurses and 229 nurses in the comparison group met the inclusion criteria, and they were all recruited to the study.
Nurses were divided into intervention and comparison groups with lottery between the municipalities. Nurses in both groups took care of patients with VLU according to their organizations' instructions. In addition to this, nurses in the intervention group received a 6-week eVLU while those in the comparison group did not. Data were collected with a questionnaire about perceived and theoretical knowledge before education, at six weeks, and at 10?weeks. The percentages of congruence were calculated at every measurement point, and the McNemar test was used to detect statistical significance of changes between measurements.
The increase of congruence was more often statistically significant in the intervention group than in the comparison group.
The results support the hypothesis that the congruence between perceived and theoretical knowledge will be higher among nurses receiving eVLU. Because of the low participation and drop-outs, the results should be interpreted with caution.
The population of Japan has become multi-cultural, and there is more demand for culturally competent nursing care. The purpose of this study was to explore cultural characteristics of nursing practice in Japan focusing on behaviour. We interviewed 25 professionals with experience in or knowledge of nursing practice both in Japan and either the United States, the United Kingdom, Sweden, Thailand or South Korea. Qualitative content analysis has yielded three themes for cultural characteristics of nursing practice in Japan: practice expectations, communication and relationships with patients. Practice expectations for nurses in Japan involved various aspects; nurses conducted a wide range of basic nursing tasks, including bed baths and toileting. They often relied on non-verbal communication to deliver thoughtfulness and perceptiveness. They typically show deference to doctors and colleagues, emphasizing building and maintaining harmony with them. This emphasis on a multifaceted, non-verbal, and harmonious approach seemed characteristic of practice among Japanese nurses.
Adverse event reporting is a frequently used mechanism to establish a learning cycle to avoid future errors. However a precondition is that the potential - as well as the occurred adverse events is reported. This study explores two comparable internal medicine departments to find possible explanations on a differing frequency of adverse event reporting. Ethnographic methods - observation and interviews - are applied to collect data. The analysis reveals specific, but common ways of doing task prioritization and rating of adverse event severity. The interpesonal relationships, however, show significant differences in the two departments and can be the most plausible explanation of the difference in adverse event reporting.
Midwives have a significant impact on the clinical outcome and the birthing experience of women. However, there has been a lack of research focusing specifically on clinical midwives' learning and development of professional competence.
The objective of the study was to describe how midwives reflect on learning and the development of professional competence and confidence.
A qualitative study based on focus groups with midwives employed in maternity services.
Four categories describe the results: (1) Feelings of professional safety evolve over time; (2) Personal qualities affect professional development; (3) Methods for expanding knowledge and competence; and (4) Competence as developing and demanding. The meaning of competence is to feel safe and secure in their professional role. There was a link between the amount of hands-on intrapartum experience and increasing confidence that is, assisting many births made midwives feel confident. Internal rotation was disliked because the midwives felt they had less time to deepen their knowledge and develop competence in a particular field. The midwives felt they were not seen as individuals, and this system made them feel split between different assignments.
External factors that contribute to the development of knowledge and competence include the ability to practise hands-on skills in an organisation that is supportive and non-threatening. Internal factors include confidence, self-efficacy, and a curiosity for learning.
Midwives working within an organisation should be supported to develop their professional role in order to become knowledgeable, competent and confident.
To describe district nurses' (DNs') prescribing practice and examine associations between DNs' self-reported prescribing frequency, opinions about prescribing, and structural conditions/empowerment.
A cross-sectional and correlational design was employed. Data were collected during 2012 using questionnaires and a prescribing register. A random sample of 150 DNs from 32 primary care centers in Sweden was invited.
DNs' ability to prescribe is used to a relatively small extent and access to "opportunities" and "informal power" seems to be the most important structural empowerment conditions for increased prescribing frequency and positive opinions about prescribing. The results support Kanter's theory of structural empowerment.
This article regarding restricted prescribing shows how important structural conditions/empowerment is to DNs' prescribing and employers have to enhance nurses' access to especially the structures "opportunities" and "informal power" to increase nurse prescribing. More targeted support and training are needed in different prescribing areas to make use of DNs' prescription qualification to a greater extent.
To explore nurses' strategies that may support the sense of coherence in people with dementia.
People with dementia are often described as people with no resources, people who need support from family or from healthcare personnel to function in everyday life. Despite the disease, some people still have the resources needed to cope well with parts of their lives and experience coherence. To date, no research has explored any nurses' strategies that may support the sense of coherence in people with dementia.
The design of the study is qualitative and exploratory.
Data were collected by participant observation and focus group interviews. Sixteen registered nurses from two different Norwegian nursing homes were recruited and participated in the study. Qualitative content analysis was used to analyse the data.
The empirical material consisted of field notes from participant observation and transcripts from focus group interviews. Three generic categories were identified as strategies that may support sense of coherence in people with dementia: 'Finding and nurturing the individual's resources', 'Customising meaningful activities' and 'Finding creative solutions'. These categories were identified as strategies that may support and possibly enhance the sense of coherence in people with dementia.
The findings provide an empirical base for assuming that with support and help from nurses, people with dementia may experience and strengthen their sense of coherence, therefore, the nurses need to be aware of the activities that may support and possibly enhance the sense of coherence in people with dementia.
Despite the contextual limitations, this study highlights the need to identify and nurture resources in people with dementia, thus supporting their sense of coherence. The findings may contribute in enhancing the quality of care for people with dementia.
To describe facilitators and barriers in relation to the growth of nurse prescribing competence from the perspective of the nurses studying in a prescribing programme.
The number of nurses enrolled in a nurse prescribing programme is rapidly increasing in Finland. However, few studies on nurse prescribing education are available and therefore research is needed, particularly from the point of view of nurses studying in the programme.
The descriptive, qualitative study used the text of student online learning diaries as data during a 14-month prescribing programme. The sample consisted of 31 nurses, public health nurses or midwives enrolled in a prescribing programme at a university of applied sciences. The data were analysed using the inductive analysis method.
The growth of nurses' prescribing competence was facilitated by learning clinical examination of the patient, networking with peers, receiving support from the workplace and supervisors, doctors' positive attitude towards nurse prescribing and being able to apply competencies directly to nursing practice. The barriers to the growth of nurses' prescribing competence were unclear job description, incomplete care plans and concerns about how consultation with doctors will be organised and realised.
The results show that, for the purpose of developing the new role and position of nurse prescribers, educators and nursing managers must invest more in staff awareness of nurse prescribing education and also offer more support to nurse prescribers in their workplaces.
The results of this study can be used especially in countries where nurse prescribing education is only in the process of being planned or has just been started. Heads of nursing and educators in prescribing education will benefit from the results when creating expanded job descriptions for nurses and supporting networking between students during the period of training.