Level Of Confidence In Ability Research Articles

Implementation of the Champions for Skin Integrity model to improve leg and foot ulcer care in the primary healthcare setting.

To facilitate evidence-based leg and foot ulcer management through implementation of the Champions for Skin Integrity model to education in primary health care in Australia. Leg and foot ulcers are frequently seen wounds in general practice and wound care the most frequently performed activity by practice nurses. The literature reports the lack of evidence-based leg and foot ulcer assessment, management and prevention strategies in this setting, and previous research in regard to confidence and knowledge has indicated that general practice health professionals have the greatest need for education in wound care. Pre-post, nonequivalent group research design. The Champions for Skin Integrity model of evidence-based wound management utilised strategies including workshops, development of Champions and use of resources. Pre- and post-implementation health professional surveys and patient clinical audits were completed. Descriptive statistics were calculated for all variables. Paired t tests identified statistically significant differences between the pre/post staff survey data. STROBE guidelines for reporting were followed (See Appendix S1). One hundred nine general practice healthcare professional staff attended the workshops. Significant outcomes were noted in increased levels of confidence in ability to assess, manage and prevent all types of leg and foot ulcers, as well as to apply evidence-based practice and change management following workshops. Pre- and post-skin audits also indicated an increase in evidence-based practices. Implementation of Champions for Skin Integrity strategies in this sample of primary healthcare professionals in general practice fostered a positive change in evidence-based wound management, assessment and prevention. The Champions for Skin Integrity model has supported increases in evidence-based practices in treatment and management of wounds in primary healthcare professionals, similar to the positive outcomes gained in the aged care setting. This is likely to lead to positive outcomes for those with wounds in this setting.

Educating undergraduate general nursing students to conduct Mental State Assessments using high fidelity video simulations that develops learning in the affective domain

Nursing students require a range of clinical skills to contribute as part of the mental health care team, we would argue that one of the quintessential skills is the ability to complete and accurately record a Mental State Assessment (MSA). Teaching students how to complete a MSA using high fidelity video simulations (HVFS) prepares them for the reality of clinical practice including cognitive skill development and emotional readiness for clinical practicum in acute mental health care settings. In this study, three HVF simulations were created to facilitate students learning, based on well documented evidence supporting the use of video content as a learning media. However our focus is not only on cognitive skill development in conducting mental state assessments, but in distinguishing the approach to learning in the affective domain. Using this method, students learn to confront and manage their own feelings, beliefs and attitudes and in turn regulate their emotional responses in clinical situations. Pre and post workshop evaluations completed by students for the past three years has resulted in consistently high levels of confidence in ability to conduct a MSA after the workshop. The paired t test was used to calculate the difference between pre and post workshop confidence scores, revealing the two-tailed p value of less than .0001 which is considered to be extremely statistically significant. Therefore, it can be concluded that students completing the 3-day workshop had a significant increase in confidence and competence in performing MSA’s.

Development and Validation of the Self-Efficacy Regarding Vaginal Birth Scale

ObjectivesThe purpose of this study was to develop a scale to measure self-efficacy regarding a vaginal birth (SEVB) during pregnancy and to assess its reliability and validity among nulliparous Chinese women. DesignA panel study. SettingFive hospitals in Northern Taiwan. ParticipantsThe analysis included 700 (second trimester), 637 (third trimester), and 585 (before birth) women who did not have medical indications for cesarean births at the indicated time points. MethodsThe SEVB scale was used to measure the level of confidence in ability to carry the pregnancy to term and give birth vaginally. The scale included nine items, and each was scored on a numeric rating scale from 0 to 10. A higher score indicated a higher level of self-efficacy. ResultsFactor analysis confirmed the one-factor structure, which explained 62.77% and 67.08% of the variance, with Cronbach's alphas for the scale of 0.93 and 0.94 during the second and third trimesters, respectively. The test–retest reliability was 0.73 as determined by the intraclass correlation coefficient. Contrasted group validity supported that those women who preferred cesarean births had significantly lower SEVB scores than women who preferred vaginal births during the second and third trimesters. Those women who tried vaginal births had higher SEVB scores than women who had cesareans without trying vaginal births. ConclusionThe scale showed acceptable reliability and validity. Health professionals could use the scale to screen women with low self-efficacy during pregnancy and provide appropriate intervention to increase their willingness to try vaginal births.

Knowledge Gaps in the Management of Hemophilia Among Hematologists/Oncologists

Hemophilia is an orphan disease whose management requires specialized knowledge of complications and treatments, which adds to the challenge of caring for patients. Knowledge gaps among hematologists, hematologist-oncologists and pediatric oncologists regarding management of hemophilia could negatively impact patient outcomes.Utilizing the National Hemophilia Foundation and the World Federation of Haemophilia guidelines and best practices, a global, hemophilia-specific continuing medical education-accredited clinical practice assessment survey was developed and completed by unselected hematologists and oncologists in order to define current education gaps and assess areas of deviation from guideline and best practices. The assessment included both knowledge- and case -based, multiple-choice questions that healthcare providers completed confidentially on-line between March 21, 2014 and July 2, 2014. Topics ranging from hemophilia severity to management/prevention of bleeds were assessed. Responses from clinicians were de-identified and aggregated prior to analyses.354 hematologist (51%), hematologist/oncologist (34%) or pediatric oncologists (14%) completed the survey, from the following locales: North America (30%), Europe (25%), Asia (18%), Central/South America (9%), Middle East (7%), Africa (8%), and Australia (2%). Practice settings of participants were academic (53%), community hospital (22%), private practice (12%), hemophilia treatment center (HTC) (5%), community clinic (3%), and other (5%). Respondents demonstrated knowledge (> 88% correct responses) in topics such as: definition of severe hemophilia, identifying life-threatening bleeds, primary prophylaxis dose/schedule, adolescence transitioning, and monitoring after initiating prophylaxis. In contrast, knowledge gaps included: prophylaxis duration; incidence of inhibitors; role of physiotherapy; managing joint bleeds (Table 1). For most responses, the proportion of correct responses appeared to be consistent regardless of physician specialty (hematologists (Group A) versus hematologists/oncologists + pediatric oncologists (Group B)) or practice setting (academic + HTC (Group C) versus community (Group D)). A low level of confidence in ability to identify when to use prophylaxis was reported among 20% [95% CI: 16.74% to 23.26%] of all respondents.Knowledge gaps permeate clinical practice in the care of persons with hemophilia. Most significant gaps were related to incidence of inhibitor development, continuance of prophylaxis, and use of physiotherapy for hemophiliac joint disease. These data support the development and implementation of educational tools for clinicians involved in hemophilia care across a range of practice settings.Abstract 4831. Table 1Hemophilia Knowledge Gaps for Hematologists, Hematologist/Oncologists, Pediatric Oncologists (% Correct Responses)Survey Assessment TopicAllGroup AGroup BGroup A vs Group B p-valueGroup CGroup DGroup C vs Group D p-valueProphylaxis Duration35.9%34.8%38.3%0.5542.0%28.4%0.03Incidence of Inhibitors48.3%51.4%44.0%0.2043.4%54.3%0.08Physiotherapy for Joint Disease47.4%50.4%45.2%0.4051.0%43.3%0.27Managing Joint Bleeds74.2%73.1%75.6%0.6475.8%72.2%0.60 DisclosuresVan Laar:Medscape LLC: Employment. Warren:Medscape LLC: Employment. Desai:Medscape LLC: Employment. Fogarty:CSL Behring: Research Funding; Biogen Idec Inc.: Research Funding; Baxter: Research Funding; Pfizer Inc: Consultancy; Chugai Pharma USA: Consultancy; Biogen Idec Inc.: Consultancy; Baxter: Consultancy; Bayer HealthCare Pharmaceuticals: Consultancy; Amgen Inc: Consultancy; Pfizer Inc: Research Funding; Medscape LLC: Honoraria; VindicoMed: Honoraria.

Recreational Use of Erectile Dysfunction Medications and Its Adverse Effects on Erectile Function in Young Healthy Men: The Mediating Role of Confidence in Erectile Ability

Oral erectile dysfunction medications (EDMs) have become an increasingly popular drug of abuse among young men without a medical indication. In addition to being associated with increased sexual risk behaviors, recreational EDM use may adversely impact psychological aspects of sexual function, primarily by affecting one's confidence in pharmacologically unaided erectile ability. To date, these associations have not been investigated empirically. This study examined the mediating role of confidence in erectile ability on the concurrent relationship between recreational EDM use and erectile function among young healthy men. A secondary aim was to examine erectile function characteristics among recreational users, prescribed users, and nonusers to control for the possibility that recreational users were using EDMs to treat ED. The sample comprised 1,207 sexually active men (mean age = 21.9 years; standard deviation = 4.48) who were recruited from undergraduate institutions within the United States. Participants completed an online survey assessing frequency of EDM use, as well as levels of sexual function (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall sexual satisfaction) and levels of confidence in ability to gain and maintain erection, as per the International Index of Erectile Function. Recreational users (N = 72) reported similar erectile function levels compared with nonusers (N = 1,111), and both groups differed from prescribed users (N = 24). Recreational users also reported lower erectile confidence and lower overall satisfaction compared with nonusers. Results were consistent with mediation, in that more frequent EDM use was inversely associated with erectile confidence, which in turn showed negative relations with erectile function. Confidence in erectile abilities mediates the inverse relationship between recreational EDM use and erectile function. Results underscore the possibility that recreational EDM use among healthy young men may lead to psychogenic ED. Additional longitudinal research is necessary to establish a causal link between these variables.

Outcome of Dialectical Behaviour Therapy for Concurrent Eating and Substance Use Disorders

The current study examined the preliminary efficacy of dialectical behaviour therapy (DBT) adapted for concurrent eating disorders (EDs) and substance use disorders (SUDs). A matched randomized controlled trial was carried out with 25 female outpatients diagnosed with concurrent ED and SUD. Participants randomized to the intervention condition received DBT, whereas those randomized to the control condition received treatment as usual (TAU), both for a period of 1 year. A series of measures related to disordered eating, substance use and depression were administered to the participants at the beginning of treatment and at 3, 6, 9 and 12 months into treatment, followed by 3-month and 6-month follow-up assessments. Participants randomized to the DBT condition evidenced a superior retention rate relative to their counterparts in the TAU condition at various study time points, including post-treatment (80% versus 20%) and follow-up (60% versus 20%). Due to the unexpected elevated dropout rates and the worsening of ED-SUD symptomatology in the TAU condition, recruitment efforts were terminated early. Results from the DBT condition revealed that the intervention had a significant positive effect on behavioural and attitudinal features of disordered eating, substance use severity and use, negative mood regulation and depressive symptoms. Finally, increases in participants' perceived ability to regulate and cope with negative emotional states were significantly associated with decreases in emotional eating and increases in levels of confidence in ability to resist urges for substance use. Results suggest that the adapted DBT might hold promise for treating individuals with concurrent ED and SUD. The current study is the first study to report positive effects of DBT on individuals with concurrent eating and substance use disorders. Although the results require replication and extension, they suggest that the DBT may be promising for this population. The results suggest that clinicians treating individuals with concurrent eating and substance use problems should be particularly cautious of poor treatment retention and treatment complications. The results bear upon the highly salient and important issue of whether individuals with concurrent substance use need to be excluded from research studies and treatment programmes.

Toddler parents training, understanding, and perceptions of CPR

Background Little is known about parent CPR skills and their perceptions of its use, especially in the context of drowning incidents among young children where parents are often the first responder. The primary objective of the study was to examine parental understanding of child and adult CPR, extent of CPR training, and parental confidence to perform CPR. Method Survey research using a self-complete questionnaire was used to gather data from parents ( n = 1716) whose 2–4-year-old toddlers were either attending early childhood centres ( n = 781) or enrolled in swim schools ( n = 935). Differences in parental CPR training, knowledge, levels of confidence in ability to perform CPR, and perceptions were measured by frequency, with regression tests used to discern differences by institution, gender, ethnicity, length of residency, and recency of CPR training. Results Almost two-thirds (64%) of parents reported that they had received formal CPR training in the past, yet few correctly reported the current ratios for either adult CPR (19%) or child CPR (12%). Most parents correctly agreed that, in child CPR, you must always give initial breaths before starting compressions (74%), but the majority incorrectly believed you should seek help before starting CPR (61%) and continue CPR for 5 min before stopping (59%). Most parents (56%) felt anxious about their ability to perform CPR on an adult, and even more (62%) felt anxious about their ability to perform child CPR. Conclusion Our findings highlight the need for education interventions to address the substantial gaps in knowledge of CPR for all parents of young children.

Variables impacting on patients' perceptions of discharge from short-stay hospitalisation or same-day surgery.

The paper presents components of a study (n = 929) that was designed to examine, at one specific point in time, the hospital experience of the patient and the patient's corresponding recovery at home. Variables that captured the hospitalization and recovery experience relate to the degree of patient involvement in decisions about their treatment and discharge plans. Levels of health and recovery-related information reported by patients and their level of confidence in ability to resume regular activities once home were also measured. In general, individuals reported what many would consider having received less than optimal levels of information about their illness and recovery at home. Many patients also reported that they neither participated, nor were consulted on their needs or perceptions during their hospitalization. Expectations were that problems that patients might experience once home would have their origins in problems from within the community. However, the community resources were found to be less implicated and hospital resources more so. This suggests the importance of examining institutional issues even when one is focusing on the delivery of community services.

The impact of inservice teacher education on mathematics teachers' subject-matter confidence, and competency

Two inservice courses designed to strengthen teachers' subject-matter competencies while introducing them to mathematics curricula for Grades 7 and 8 were investigated. In a pretest-posttest quasi-experimental design, participants were given a confidence measure and knowledge test. After the inservice training, teachers manifested greater self-confidence in knowledge of curricular material, a corresponding increase in mathematics skills, and high levels of confidence in ability to teach the curriculum. Results suggest that when knowledge tests are not feasible, measurement of confidence in solving problems may be sufficient to evaluate the cognitive impact of an inservice program.