bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of institutional care of older people as evaluated by nursing staff
Authors: Isola Arja , Backman Kaisa , Voutilainen Päivi , Rautsiala Tarja 
Published: February 2008

Aims.  The aim of this paper was to report on the quality of institutional nursing of older people as evaluated by nursing staff in 2001 and to compare the responses with those obtained in 1998.Background.  The healthcare division of one Finnish city authorised an outside survey of long‐term geriatric care in the hospitals providing such care in 1998. Based on the results, recommendations concerning the development of care of older people were issued. A re‐survey was conducted in 2001, using the same criteria of quality assessment.Methods.  A survey research method was used. All the seven institutions providing long‐term geriatric care, including a total of 53 wards, participated. In 1998, a total of 607 questionnaires was returned. The response percentage was 78·6%. In 2001, a total of 573 questionnaires was returned. The response percentage was 76·8%.Results.  The staff considered their possibilities to help geriatric patients best in the domain of physical care and slightly less good in the domain of psychosocial care. The differences in staff estimates between the two years were very small. More than 90% of the respondents considered their knowledge of physical care adequate. The nursing staff's evaluations were roughly similar in 1998 and 2001. More than 98% of the respondents considered the helping of older people important or moderately important in the other subdomains except sexual expression. According to the nursing staff, intentional or unintentional negligence in care was more common than physically or psychically offensive conduct. Observations concerning maltreatment had increased from 1998 to 2001. The staff reported both physical and mental fatigue. Nevertheless, the nursing staff appeared to be quite content with their current workplaces.Relevance to clinical practice.  The findings indicated that geriatric care mostly aims to respond to the physical needs of older people. Nursing should, therefore, be developed and improved because mere satisfaction of physical needs is not enough to guarantee a good quality of life for older people in long‐term institutional care.
A systematic review of peer teaching and learning in clinical education
Authors: Secomb Jacinta 
Published: February 2008

Aims and objectives.  The purpose of this review is to provide a framework for peer teaching and learning in the clinical education of undergraduate health science students in clinical practice settings and make clear the positive and negative aspects of this teaching and learning strategy.Background.  The practice of using peers incidentally or purposefully in the clinical education of apprentice or undergraduate health science students is a well‐established tradition and commonly practiced, but lacks definition in its implementation.Method.  The author conducted a search of health science and educational electronic databases using the terms peer, clinical education and undergraduate. The set limitations were publications after 1980 (2005 inclusive), English language and research papers. Selection of studies occurred: based on participant, intervention, research method and learning outcomes, following a rigorous critical and quality appraisal with a purposefully developed tool. The results have been both tabled and collated in a narrative summary.Results.  Twelve articles met the inclusion criteria, representing five countries and four health science disciplines. This review reported mostly positive outcomes on the effectiveness of peer teaching and learning; it can increase student's confidence in clinical practice and improve learning in the psychomotor and cognitive domains. Negative aspects were also identified; these include poor student learning if personalities or learning styles are not compatible and students spending less individualized time with the clinical instructor.Conclusions.  Peer teaching and learning is an effective educational intervention for health science students on clinical placements. Preclinical education of students congruent with the academic timetable increases student educational outcomes from peer teaching and learning. Strategies are required prior to clinical placement to accommodate incompatible students or poor student learning.Relevance to clinical practice.  The findings from this systematic review, although not statistically significant, do have pragmatic implications for clinical practice. It can increase clinical placement opportunities for undergraduate health students, assist clinical staff with workload pressures and increase clinician time with clients, while further developing students’ knowledge, skills and attitudes.
Self‐care management of sleep disturbances and risk factors for poor sleep among older residents of Taiwanese nursing homes
Authors: Tsai Yun‐Fang , Wong Thomas KS , Ku Yan‐Chiou 
Published: February 2008

Aims.  To explore self‐care management strategies for sleep disturbances and risk factors for poor sleep among older residents of nursing homes in Taiwan.Background.  With the deterioration of health that accompanies ageing, sleep quality becomes poorer, making it a significant issue in geriatric care. However, little is known about self‐care strategies for management of sleep disturbances among elders worldwide.Design.  A cross‐sectional design was used.Methods.  Residents (n = 196) were recruited from nine nursing homes chosen by stratified sampling across Taiwan. The Pittsburgh Sleep Quality Index, a self‐care management of sleep disturbance questionnaire and a demographic form were used to collect data.Results.  The prevalence of poor sleep in these older nursing home residents was 46·4%. Only 48·5% of participants used self‐care strategies to manage sleep disturbances. The most frequently used strategy was ‘take prescribed medicines’. Self‐learning was the main information source for self‐care strategies. Logistic regression analysis indicated that having no spouse and a low educational level significantly predicted poor sleep.Conclusions.  This study revealed a high prevalence of poor sleep quality among older residents of nursing homes in Taiwan. Older residents’ inability to get relief from sleep disturbances may have been because of their limited use of strategies to manage sleep disturbances.Relevance to clinical practice.  As health care providers play an important role in helping older people to manage sleep disturbances in nursing homes, it is crucial to train nursing home staff to perform sleep assessments and provide current knowledge about sleep disturbance management. It is also necessary to pay more attention to the sleep problems of elders without spouses and with little education.
Comparison of homecare costs of local wound care in surgical patients randomized between occlusive and gauze dressings
Authors: Ubbink Dirk Th , Vermeulen Hester , Van Hattem Jarne 
Published: February 2008

Aims and objectives.  To study the material and nursing costs and outcome of wound care at home comparing two dressing groups (occlusive vs. gauze‐based) in surgical patients after hospital dismissal.Background.  The large variety in dressing materials and lack of convincing evidence make the choice for optimum local wound care at home cumbersome. Occlusive wound dressings require a lower change frequency than gauze‐based dressings, which appears especially useful for homecare patients and could save costs.Methods.  We investigated a consecutive series of 76 patients with wounds, included in a randomized trial comparing occlusive vs. gauze dressings. Daily dressing change frequency, consumption of dressing materials and need for district nursing visits were recorded until wound closure by means of diaries and at outpatient visits. Costs were expressed as means and 95% confidence intervals (CI) after calculation using non‐parametric bootstrapping.Results.  Patient groups were similar regarding age, wound size and aetiology. Dressing change frequency in the occlusive group (median: 0·6/day) was significantly (p = 0·008) lower than in the gauze group (1·1/day). Mean daily material costs of modern dressings were €5·31 vs. €0·71 in the gauze group. Mean difference; €4·60 (95% CI, €2·68–€6·83) while daily total (material plus nursing) costs showed no difference between the groups; mean €2·86 (95% CI, €−6·50–€10·25). Wound healing in the gauze‐treated group tended to be quicker than in the occlusive dressing group (medians: 30 vs. 48 days, respectively; log‐rank p = 0·060).Conclusions.  The use of occlusive dressings does not lead to a reduction in costs and wound healing time as compared with gauze dressings for surgical patients receiving wound care at home.Relevance to clinical practice.  District nurses should reconsider using gauze‐based dressings, particularly in surgical patients with exudating wounds.
Can venous and arterial leg ulcers be differentiated by the characteristics of the pain they produce?
Authors: Closs S José , Nelson E Andrea , Briggs Michelle 
Published: February 2008

Aim.  To explore the characteristics of venous and arterial leg ulcer pain among people cared for in the community.Background.  There is little information available concerning the different characteristics of pain resulting from venous and arterial leg ulcers. The identification of clear differences in pain experience might aid recognition of arterial deterioration and provide a useful adjunct for existing diagnostic procedures.Design.  This was a prospective interview‐based survey.Method.  Structured interviews were conducted with each of the participants in their home. Ulcer history, pain (McGill pain questionnaire and verbal rating scale) and factors influencing pain were assessed.Results.  Fifty‐two women and 27 men aged 77·7 (SD 8·9) took part. Pain scores for least, average, worst and present pain varied widely, and arterial ulcers were associated with the highest average pain scores. Pain tended to be worst at night and least in the afternoon; arterial ulcers were more painful than venous ulcers on lying down. Venous leg ulcers were frequently described as throbbing, burning and itchy, while arterial ulcer pain tended to be described as sharp and hurting.Conclusions.  Some characteristics of pain appeared to be suggestive of the leg ulcer type. Differences were found in the words chosen to describe the pain as well as the temporal and postural aspects of arterial and venous leg ulcer pain. More research is needed to confirm these preliminary findings.Relevance to clinical practice.  Patients’ descriptions of pain have the potential to supplement other methods of differentiating between types of leg ulcer and provide an early‐warning indicator for transition from venous to arterial ulceration.
Effects of self‐efficacy, self‐care behaviours on depressive symptom of Taiwanese kidney transplant recipients
Authors: Weng Li‐Chueh , Dai Yu‐Tzu , Wang Yi‐Wen , Huang Hsiu‐Li , Chiang Yang‐Jen 
Published: February 2008

Aims.  The aim of this study was to examine the effect of self‐efficacy on depression and to consider the mediating effect of self‐care behaviour.Background.  Depression is a problem for kidney transplant recipients and can compromise their quality of life. From other studies on chronic illnesses, self‐efficacy and self‐care behaviour have been considered to be potential determinants for depressive symptoms. However, none of these previous studies have investigated the relationships among these variables in kidney transplantation recipients.Design.  A cross‐sectional survey employing correlation design and purposive sampling was used.Methods.  One hundred and seventy‐seven persons who had received a kidney transplant participated. A self‐administrated questionnaire and a medical record audit were used to collect data. The data were analysed using correlation and hierarchical linear regression methods.Results.  The average score of depressive symptoms was 8·61 SD 7·64. Among the participants in the study, 32·8% had scores of depressive symptoms higher than 11 (indicating mild to severe symptoms of depression). Self‐efficacy and self‐care behaviour had direct negative effects on depressive symptoms. Self‐care behaviour had partial mediating effect on the relationship between self‐efficacy and depression. Total variance explained was 23%.Conclusion.  Depressive symptoms are still a problem that need to be addressed among kidney transplantation patients. Patients who have higher self‐efficacy and higher self‐care behaviour will have lower depressive symptoms. Our results support that self‐efficacy is the significant predictor of depressive symptoms.Relevance to clinical practice.  Self‐efficacy is a powerful and modifiable determinant of depressive symptoms. We should design interventions that focus not only on the skill aspects of self‐care behaviour but also on those that have a strong connection with self‐efficacy. We could incorporate the self‐efficacy‐enhanced strategies as proposed by social cognitive theory into the kidney transplantation care programme.
Nursing information: users’ experiences of a system in Taiwan one year after its implementation
Authors: Lee Ting‐Ting 
Published: February 2008

Aim and objective.  The purpose of this study was to explore nurses’ experiences during the first year of the installation of a nursing information system (NIS). The objective was to identify the major issues that emerged regarding the users’ concerns of this technology in their daily practice.Background.  The success of the implementation of an information system depends mostly on the users’ acceptance of this technology; however, nurses’ experience of a system installation for a particular length of time, as in this study, has seldom been explored. This is a report on a qualitative study that explored nurses’ experiences of a NIS use during the first year of its installation.Design.  Descriptive qualitative interviews with nurse participants were used to collect data at a medical centre in Taiwan.Method.  Four focus groups were conducted with the 23 nurse participants in November 2005. The interview guide included questions about the impact of computer use on the nurses’ workflow and the electronic documentation process.Results.  Six major themes emerged regarding the nurses’ NIS use, including their dissatisfaction with insufficient personal computers and printers, the slow system response time, workflow change, poor content design, decreased charting quality and the impact on their interpersonal relationships.Conclusions.  Organizations may need to redesign the computer interface, to provide better hardware and to maintain a more reliable network function to meet the nurses’ needs during the adoption process, as well as to modify or devise appropriate documentation regulations.Relevance to clinical practice.  As they continue to use electronic documentation, nurses may become accustomed to the technology and use it more easily as it becomes the required documentation method. However, understanding the barriers and difficulties they encountered could maximize their technology use and improve both the nursing efficiency and the documentation quality.
Effectiveness of psychoeducation intervention on post‐traumatic stress disorder and coping styles of earthquake survivors
Authors: Oflaz Fahriye , Hatipoğlu Sevgi , Aydin Hamdullah 
Published: February 2008

Aims and objectives.  The aim of the study was to examine the effectiveness of a psychoeducation intervention based on Peplau's approach, including problem‐solving compared with intervention with medication on post‐traumatic stress disorder (PTSD) symptoms and coping of earthquake survivors.Background.  Post‐traumatic reactions and recovery are the result of complex interactions among biological, personal, cultural and environmental factors. Both psychosocial and psychopharmacological methods have been advised to treat PTSD. The general goal of treatment is to decrease the anxiety and to support these patients in regaining normal daily functions.Design.  The study used a pretest to posttest quasi‐experimental design with three comparison groups.Methods.  The sample of the study included 51 survivors of the Marmara Earthquake who met diagnostic criteria for PTSD. Comparison groups were made up as psychoeducation only, medication only and psychoeducation with medication (PEM). Six semi‐structured psychoeducation sessions were conducted individually. Patients in the ‘medication only’ group did not participate in these sessions. The Clinician Administered PTSD Scale, Hamilton Depression Scale and Coping Strategies Scale were used for the measurements.Results.  There was a significant difference between the ‘PEM’ group and the ‘medication only’ group with the first group showing greater relief of symptoms. Generally, there were no differences between the ‘medication only’ and ‘psychoeducation only’ groups. Avoidance as a coping strategy had significant positive correlations with PTSD and depression outcomes.Conclusions.  Patients with PTSD seem to take more advantage from the combined treatment model. Nurses can help the patients with PTSD by teaching them to cope with the symptoms.Relevance to clinical practice.  The number and variety of catastrophic events in the world are increasing. Psychiatric nurses should therefore take responsibility regarding the effects of trauma and investigate the ways of working with people who experienced trauma in more detail and develop interventions based on scientific evidence.
The influence of patient acuity on satisfaction with emergency care: perspectives of family, friends and carers
Authors: Ekwall Anna , Gerdtz Marie , Manias Elizabeth 
Published: February 2008

Aims and objectives.  To investigate the factors that influence satisfaction with emergency care among individuals accompanying patients to the emergency department and explore agreement between the triage nurse and accompanying person regarding urgency.Background.  Many patients seeking treatment in hospital are escorted by an accompanying person, who may be a friend, family member or carer. Several factors influence patient satisfaction with emergency care, including waiting time and time to treatment. It is also influenced by provision of information and interpersonal relations between staff and patients. Research on satisfaction has focused on the patient perspective; however, individuals who accompany patients are potential consumers. Knowledge about the ways accompanying persons perceive the patient's medical condition and level of urgency will identify areas for improved patient outcomes.Design and methods.  A prospective cross‐sectional survey with a consecutive sample (n = 128 response rate 83·7%) was undertaken. Data were collected in an Australian metropolitan teaching hospital with about 32,000 visits to the emergency department each year. The Consumer Emergency Satisfaction Scale was used to measure satisfaction with nursing care.Results.  Significant differences in perceptions of patient urgency between accompanying persons and nurses were found. Those people accompanying patients of a higher urgency were significantly more satisfied than those accompanying patients of a lower urgency. These results were independent of real waiting time or the accompanying person's knowledge of the patients’ triage status. In addition, older accompanying persons were more satisfied with emergency care than younger accompanying persons.Discussion.  Little attention has been paid to the social interactions that occur between nurses and patients at triage and the ways in which these interactions might impact satisfaction with emergency care.Relevance to clinical practice.  Good interpersonal relationships can positively influence satisfaction with the emergency visit. This relationship can contribute to improved patient care and health outcomes.
Depressive symptomatology and the prevalence of cardiovascular risk factors among older men and women from Cyprus; the MEDIS (Mediterranean Islands Elderly) epidemiological study
Authors: Panagiotakos Demosthenes B , Kinlaw Mallory , Papaerakleous Natasa , Papoutsou Stalo , Toutouzas Pavlos , Polychronopoulos Evangelos 
Published: February 2008

Aims.  The purpose of this paper is to explore the link between symptoms of depression and the prevalence of cardiovascular risk factors in older adults.Methods.  During 2005, 136 older men and 164 women from various parts of Cyprus agreed to participate in the study. The sampling was random and multistage (according to age–sex distribution of the referent population). All participants were living in the community and not in institutions. Among several socio‐demographic, bioclinical, lifestyle and dietary characteristics, depressive symptoms were assessed using the short version of the Geriatric Depression Scale (GDS).Results.  Participants without signs of depression, typically, have fewer cardiovascular risk factors (i.e. hypertension, hypercholesterolemia, diabetes and obesity) than those with moderate or severe symptoms. Even when behavioural variables (e.g. diet, smoking, exercise) are statistically controlled, participants that are higher than others on depression are more likely to have hypertension and/or hypercholesterolemia than those with lower scores. Every one‐unit increase in GDS score (range 0–15) is associated with a 12% higher likelihood of having an additional cardiovascular disease risk factor.Conclusions.  Symptoms of depression are positively associated with the number of cardiovascular risk factors in ‘healthy’ older adults, irrespective of lifestyle behaviours (e.g. smoking, dietary intake and physical activity).Relevance to clinical practice.  Healthcare providers should consider the implications of both the presence and nature of this relationship in their continuing care of older adults.
Effect of an interactive computerized psycho‐education system on patients suffering from depression
Authors: Lin Mei‐Feng , Moyle Wendy , Chang Hsiu‐Ju , Chou Mei Hsien , Hsu Mei‐Chi 
Published: February 2008

Aims.  The aim of this study was to examine the effect of an Interactive Computerized Psycho‐Education System on patients suffering from depression and to compare the use of an Interactive Computerized Psycho‐Education System vs. traditional pamphlet education approach.Background.  Depression management depends on pharmacological treatment and psychotherapy and on appropriate and timely patient education. Whilst multimedia learning concepts have been applied in areas such as education, this approach has not been widely used in psychiatric outpatient departments.Design and method.  A preliminary pre and post quasi‐experimental design with patients with depression was employed at an hospital. Participants in the experimental group (n = 19) received an Interactive Computerized Psycho‐Education System intervention programme (Interactive Computerized Psycho‐Education System and the educational manual). Participants in the control group (n = 13) were exposed only to the traditional pamphlet education approach (consultation from psychiatrists and information sheets). Primary outcome was depression knowledge scores. Secondary outcomes were scores on the Compliance Behaviour Assessment Scale.Results.  In the experimental group (n = 19), the time spent working on the Interactive Computerized Psycho‐Education System was about 30–180 minutes per session, with an average of 67 minutes. Participants in the experimental group had a considerably decreased incidence of medication non‐compliance compared with participants in the control group. Knowledge scores of the experimental group ranged from 30–100, with an average score of 74.7.Conclusion.  The Interactive Computerized Psycho‐Education System is acceptable and may be as more effective than a traditional education approach to achieve adherence to medications for depression.Relevance to clinical practice.  Compared with a traditional approach, the combination of the Interactive Computerized Psycho‐Education System and a nursing‐consulting clinic may assist patients with depression to achieve and maintain better medication compliance in addition to improving their knowledge of depression.