Role Of Nurses Research Articles

O IMPACTO DA DOR CRÔNICA NA QUALIDADE DE VIDA DAS CRIANÇAS O PAPEL DO ENFERMEIRO NO MANEJO DA DOR

The impact of chronic pain on children's quality of life and the role of nurses in pain management is the central approach of this study, which was carried out through a literature review. The aim is to analyze how chronic pain affects children's physical, emotional and social development, as well as to assess the importance of nurses in identifying and treating this pathology. The review aims to strengthen the improvement of nursing practices and enhance the multidisciplinary approach in the hospital environment. Scientific articles and recent publications on the subject were used to support the discussions. The main results indicate that the proper management of chronic pain in children, led by nurses, is indispensable for minimizing the negative impacts on the child's quality of life, and that continuous and personalized interventions are necessary. The research also highlights the importance of adequate training for professionals and the implementation of protocols that consider both the physical and emotional aspects of pain, reinforcing the need for a holistic, effective, interdisciplinary approach guided by nurses.

A national job profile for infection control nurses in public health: the development and content

Abstract Background The COVID-19 pandemic emphasized the crucial role of infection control nurses (ICNs) in public health. ICNs working in multidisciplinary infection control teams face challenges, such as new infectious disease outbreaks and vaccination hesitancy. Recognizing the complexity in this domain, Dutch ICNs in municipal public health services expressed the need for a national job profile describing their tasks and responsibilities. Methods A mixed methods approach was used to develop a job profile. National and international documents on infection control professionals were studied by desk research. Insights from Dutch infection control professionals and experts were collected through a survey (n = 171), two interactive discussion meetings (18-22 participants) and meetings with an advisory group of stakeholders, including representatives of the Dutch nurses’ association. Descriptive statistics and deductive content analysis were used to analyze the data. Results The diverse methods facilitated the development of a job profile for Dutch ICNs. The profile describes that, within infection control teams, ICNs play a key role in coordinating and monitoring infection control measures. They facilitate collaboration among (at-risk) individuals, the infection control team, and the collaborating partners. Additionally, ICNs identify emerging risks for infection control and coordinate infection prevention activities in collaboration with the infection control team. During large-scale outbreaks, ICNs take a leading role and, where appropriate, delegate tasks such as contact tracing to crisis workers. Conclusions We developed the first job profile that outlines the tasks and responsibilities of ICNs in Dutch public health services. It contributes to strengthening infectious control services to face future challenges. Findings emphasize the ICNs’ pivotal role in coordinating and monitoring infection control efforts, while enhancing collaboration, even during large outbreaks. Key messages • In close collaboration with infection control professionals a robust job profile was developed, describing the tasks and responsibilities of infection control nurses in the Netherlands. • The new job profile contributes to strengthening the position of infection control nurses working in municipal public health services and infection control teams.

Addressing deficits in malnutrition care in northern Sierra Leone; an educational intervention

Abstract The 2017 Sierra Leone National Nutrition Survey reported poor practice regarding the medical management of severe acute malnutrition and the provision of emergency food to patients, particularly in the northern city of Makeni. We developed a training package for paediatric nurses, aiming to design an easily reproducible format which could be utilised nationally. Our aims were to empower and educate staff to provide more consistent care by challenging the negative cultural perception of malnourished patients and increasing knowledge of key guidelines. A two-day course based around UNICEF guidance on malnutrition was developed with the financial support of the Sierra Leonean office of the World Health Organisation. We sought the advice of local staff on issues impacting the quality of malnutrition care, including cultural barriers, educational limitations and supply issues. Lectures and practical sessions were devised covering recognition, assessment and management. Communication skills were taught using role play, focussing on the key role of nurses in parental education, and nursing skills were reinforced using practical tasks. Local staff identified for their strong teaching and leadership were recruited as instructors and to provide feedback on session design and content. 21 candidates attended from across the region, with the majority based in inpatient feeding units. Candidates completed a pre- and post-course written examination and a qualitative feedback form. Pre-course exam results ranged from 35%-85% with an average of 65%; post-course results showed improvement with a range of 55%-100% and an average of 88%. Candidates rated the course on average 9.7 out of 10 and the written feedback was positive. We subsequently observed positive changes in clinical practice in the inpatient feeding units across the region. Based on these assessments the course achieved its aims. Further study is needed to know if noted clinical improvements were sustained. Key messages • Challenging local cultural perceptions of malnourished patients is crucial to establishing improvement in medical care for this group. • Sustainable educational intervention requires local instructors who can independently deliver teaching, and establishing this cohort at the course inception is critical to its ongoing success.

Essential public health competencies in nursing during the COVID-19 pandemic: A Delphi study

Background & Aim: Nursing practice, characterized by its multifaceted nature, encompasses diverse settings and situations in public health, making it difficult to clearly define the role of nurses in this setting. The study aimed to determine the applicability and relevance of the Regional Core Competency Framework for Public Health in nursing practice during the COVID-19 pandemic. Methods & Materials: Study based on the Delphi methodology, a structured approach to the systematic collectión of expert opinions, to obtain group agreements. Twenty-one nurses working in public health areas during the pandemic participated. Results: The competencies most applied by the nurses were in the domain of health situation analysis and surveillance and risk and damage control. 95% of the nurses were involved in care actions to prevent contagion; 71% analyzed social determinants of health, 100% were involved in the domain of policies, planning, regulation, and control, and 86% in the domain of health promotion. 89% made decisions to favor access to preventive and health care services. 78% valued social participation actions and 76% implemented immediate responses to COVID-19. Conclusion: The main public health competencies used by nursing for dealing with the COVID-19 pandemic are the management of educational processes, health promotion, primary health care, analysis of social determinants, management of health policies, information analysis, and management of immediate responses to challenges generated by COVID-19.

A worldwide bibliometric analysis on euthanasia

Introduction: Euthanasia, which allows individuals with an incurable disease to end their lives in an honourable way, is a long-debated practice. It is related to various issues such as culture, philosophy, religion, ethics, public value, and efficient use of health resources. While some advocate for the right of individuals to choose euthanasia, others criticize it on ethical, legal, and religious grounds. Methods: In this study bibliometric analysis was used and the data were obtained from the Web of Science Core Collection database on July 26, 2024. Only English publications and articles were included using keywords such as "euthanasia," "end-of-life decisions," "medical assistance in dying," "physician-assisted death," and "physician-assisted suicide" without time restrictions. VOSviewer software was used to create network and density graphs, and SciMAT software was used to create strategic diagrams. Results: A total of 2,230 studies published between 1980 and 2024 were analyzed. The author with the most publications is Deliens, L, with 86 studies. The majority of studies were published in the USA, Netherlands, and Canada (692, 336, 225 respectively). The most frequently used keywords are euthanasia, palliative care, and ethics. The highest number of publications (149) was in the year 2021. In the strategic diagram for the first period (between 1980 and 2001), the themes of care and ethics were prominent, while for the second period (between 2002 and 2024), the clusters of nurse and shared decision-making were notable. Conclusion: After its legalization in the Netherlands, euthanasia has been accepted and implemented in some countries over the years, with variations in scope. Some countries, like the Netherlands and Belgium, also accept health problems related to old age and mental illness as euthanasia requests. The discussion around euthanasia often revolves around the principles of medical ethics, including autonomy, beneficence, non-maleficence, and justice. Studies have focused on the role of physicians and nurses in the process, as well as end-of-life decision-making by patients. Recently, Canada defined the role of nurses in the euthanasia process, marking a significant development.

Nurses’ perceptions regarding the establishment of clinical education and training units in public hospitals in the North-West Province: a qualitative study

BackgroundA Clinical Education and Training Unit is defined as a unit in which the clinical orientation, teaching, learning, and assessment, mentoring and support of student nurses are coordinated to achieve the outcomes of their learning programmes in the health establishment. In South Africa, Clinical Education and Training Unit was developed to reconstruct and revitalise nursing education and training. The clinical education is crucial to enable nursing students to put what they learn in the classroom into practice as they direct patient care, practise therapeutic communication, hone technical skills, demonstrate caring behaviours, investigate ethical dilemmas, and take on the roles of nurses. The clinical teaching unit is one of the models that show potential in advancing clinical education. Since the proposed clinical education and teaching model concluded that Clinical Education and Training Units should be established in 2012, to the researcher’s knowledge, no research study has been conducted to explore and describe the nurses’ perceptions regarding the establishment of Clinical Education and Training Units, particularly in the North-West Province. This has resulted in the scarcity of literature on their perceptions. Thus, the researcher believed that it was essential to explore and describe the perceptions of professional nurses regarding the establishment of Clinical Education and Training Units in the North-West Province of South Africa, so that their perceptions may be known and understood.AimThe study aimed to explore and describe the perceptions of professional nurses regarding the establishment of Clinical Education and Training Units in public hospitals in the North-West Province.MethodsA qualitative-exploratory-descriptive and contextual research design was used. This method was used because it is known to unearth a wide range of views, opinions, thoughts, and feelings of the participants thus enabling a deeper understanding concerning perceptions of professional nurses regarding the establishment of Clinical Education and Training Units at the hospitals of interest. Participants were recruited using pamphlets and flyers. A non-probability convenience and purposive sampling techniques were used to select participants based on an inclusion criterion. From 09 September 2023 to 07 December 2023, the researcher used face-to-face group discussions to collect data and it was analysed using six steps of inductive thematic data analysis as outlined by Braun and Clarke.ResultsFour focus groups discussions were conducted with a total of 19 participants who were professional nurses. Responses were categorised into three domains: advantages of the Clinical Education and Training Unit, challenges of the Clinical Education and Training Unit, and recommendations for the Clinical Education and Training Unit. Subsequently, a total of three main themes with eight sub-themes were determined for advantages of the Clinical Education and Training Unit, two themes with six subthemes for challenges of the Clinical Education and Training Unit, and one theme with two sub-themes for recommendations for the Clinical Education and Training Unit respectively.ConclusionThe need to establish functional Clinical Education and Training Units is therefore very important not only to student nurses but also to health care professionals. Most of the participants emphasised that if Clinical Education and Training Units were fully established they would be beneficial in developing health care professionals, especially in terms of in-service training where nursing standards are emphasised as outlined by the South African Nursing Council. The research study results might contribute to the full establishment of CETUs in the hospitals of the North- West Province, South Africa.Trial registrationnot applicable to the study.

Building a Consortium to Address Graduate Nursing Student Academic Preparedness.

The demand for nurses in advanced practice roles is expected to grow by 38% by 2032. The nationwide faculty shortage is also a concern, as it correlates to the nursing shortage. Successful retention strategies for graduate nursing students can strengthen the rising demand of specialized nursing roles. The transition from clinical practice to the graduate student environment can be daunting to some practicing nurses who may struggle with program completion. It is well documented that graduate nursing students lack academic preparation for the rigorous scholarly work. A national onboarding consortium of graduate nursing faculty was formed to meet regularly and utilize a model onboarding program to address graduate nursing students' academic preparedness. Structured onboarding programs show promising results. The programs were easily adopted to support students from various backgrounds and regions within the United States. Benefits of forming a consortium to address a national issue were evident.

Nursing Roles in Extracorporeal Membrane Oxygenation

ABSTRACT Extracorporeal membrane oxygenation (ECMO) is a type of mechanical circulatory support that is increasingly utilized in the United States for severe respiratory and/or cardiac failure refractory to conventional therapies. It is an expensive and complex life support modality. Moreover, patients on ECMO are critically ill and require a strong multidisciplinary care team. A successful ECMO program involves a trained team consisting of physicians, perfusionists, nurses, and respiratory therapists. This article discusses the multiple roles of ECMO nurses, the various ECMO delivery care models, and the potential cost savings of an RN ECMO specialist staffing model—and introduces the novel role of the ECMO lead.

The negative impacts of secondary traumatic stress and mutual suffering: considerations in the hospital setting.

Nurses and other health professionals may be at an increased risk of experiencing emotional disturbance associated with caring for people who are experiencing distress, illness or disease or who are at the end stage of their life. This was a particular problem during the COVID-19 pandemic. This article seeks to explore how working closely with individuals who are experiencing ill health may impact negatively on the nurse as a care provider. This exposure to trauma, illness and death can result in a vicarious experience of trauma that may result in a sense of shared experience with the patient. The emotional burden this places on the nurse can lead to increased anxiety, stress and a need to detach from the patient. This can have a detrimental effect on patient care and nurses must remain vigilant to their susceptibility to, and experience of, mutual suffering through secondary trauma. Although nursing offers many positive experiences, this article is focused on highlighting the negative impacts of secondary traumatic stress. This article briefly outlines the literature relating to secondary traumatic stress and mutual suffering in the acute hospital setting and does not consider mental health settings or patients. The aim of the article is to close the theory-practice gap while also encouraging personal reflection on nurses' experiences of mutual suffering in practice. The author recognises the loaded nature of the term 'mutual suffering'; however, this is an established phrase used to explain the phenomena of interest. Although the term 'suffering' may imply a passive sick role for nurses, in this context the term should be seen as a shared sense of the experience of the patients and health staff.

Antimicrobial Stewardship in Healthcare: Exploring the Role of Nurses in Promoting Change, Identifying Barrier Elements and Facilitators—A Meta-Synthesis

Antimicrobial Stewardship in Healthcare: Exploring the Role of Nurses in Promoting Change, Identifying Barrier Elements and Facilitators—A Meta-Synthesis

Exploring Implementation of Reasonable Adjustments in Hospitals for People With Intellectual Disability: Using a Realist Lens.

To explore the factors influencing the implementation of reasonable adjustments in hospitals for people with intellectual disability: using a realist lens. A qualitative study using a realist lens. Data collection involved one focus group interview and three semi-structured interviews with healthcare professionals working in hospital or community settings in September 2023. Data were analysed using qualitative content analysis and findings were mapped to the Context and Implementation of Complex Interventions (CICI) framework across the dimension's context, implementation and setting. Healthcare professionals support the provision of reasonable adjustments in acute hospitals as a person-centred approach to caring for people with intellectual disability. While reasonable adjustments are evident in practice, they are mostly individual-level cases with little evidence of strategic system-level implementation. The factors influencing the implementation of reasonable adjustments in practice were conceptualised using the CICI framework. Context factors spanned the domains of epidemiological (e.g., ageing population), socio-cultural (e.g., historical healthcare), political (e.g., lack of integrated care pathways) and ethical (e.g., provision of person-centred care). Implementation factors spanned the domains of strategies (e.g., leadership strategies), agents (e.g., liaison and advocacy roles) and outcomes (e.g., individual-level reasonable adjustments). The setting for the complex intervention was the acute hospital. System-level indicators for successful implementation include intellectual disability specific policies/procedures for integrated care pathways, education and awareness training for hospital staff, and leadership strategies such as the development of liaison nursing roles and the appropriate allocation of physical and human resources. A radical change is needed where implementation of reasonable adjustments in acute hospitals are broadened beyond isolated individual-level cases to system-level healthcare. This research highlights the importance of exploring the integrated dimensions of context, implementation and setting in complex interventions such as reasonable adjustments and sets foundation for further implementation research in this area. Reasonable adjustments at the system-level within acute hospitals would promote person-centred care and help address the inequities and health disparities experienced by people with intellectual disability. This research uses a realist lens to explore the factors influencing the implementation of reasonable adjustments in acute hospitals for people with intellectual disability. The factors influencing the implementation of reasonable adjustments in practice were conceptualised using the CICI framework across the dimensions of context (domains epidemiological, socio-cultural, political and ethical), implementation (domains strategies, agents and outcomes) and setting. System-level indicators for successful implementation include intellectual disability specific policies/procedures for integrated care pathways, education and awareness training for hospital staff, and leadership strategies such as the development of liaison nursing roles and the appropriate allocation of physical and human resources. This research highlights the importance of exploring the integrated dimensions of context, implementation and setting of complex interventions such as reasonable adjustments and sets a foundation for further implementation research in this area. This research adhered to the Equator research reporting guideline: standards for reporting qualitative research. A parent of a child with intellectual disability was involved in the conduct of this research, specifically in the design, data collection and preparation of the manuscript.

Nurse Practitioners' Experiences of Transitioning to and Working in the Pioneering Nursing Role: An Interview Study.

Nurse practitioners (NPs) play a crucial role in healthcare by providing person-centred and high-quality care. Their contributions encompass enhanced accessibility to healthcare and reduced hospital admissions and cost-effectiveness. They usually hold a master's degree in nursing, incorporating expanded clinical skills to manage patients in different settings and address both nursing and medical needs. Despite the global development of the role, its implementation varies, presenting challenges related to role clarity, regulation and acceptance by other healthcare professionals. To explore how nurses who are or have been employed as NPs describe their experiences of transitioning to and working in the NP role in Sweden. A qualitative interview study. This study explores the experiences of 15 NPs in Sweden, using a snowball sampling strategy and semi-structured interviews. The data were collected through interviews in April and May 2022 and analysed with inductive content analysis. The present study explores the experiences of NPs as they transition from experienced nurses to NPs, emphasising motivations, educational challenges, acceptance and autonomy. Transitioning into the NP role initially brought isolation that evolved into acceptance. They recognised their strength in integrating medical and nursing competencies for holistic care. Leadership was pivotal, with managerial support crucial for the successful implementation of the role. Autonomy-related challenges, such as prescription rights and dependency on physicians, underscored the need for a protected professional title and national guidelines. This study enriches the evolution of the NP role in Sweden, offering vital insights into the ongoing national-level dialogues on NP role development in Sweden. The paper's relevance extends globally by providing valuable perspectives on NPs practicalities and fostering international understanding and advancement. Standards for reporting qualitative research. Not applicable.

The Role of the Public Health Nurse in Collaborative Efforts to Manage COVID-19 in a Rural Hispanic Population: A Qualitative Inquiry.

While local health departments (LHDs) recognize the need to provide culturally congruent care to rural Hispanic populations, the COVID-19 pandemic tested their capacity to leverage available knowledge, skills, and resources to integrate effective transcultural collaborations to improve health outcomes. Twelve semi-structured interviews of community leaders were conducted and interpreted using qualitative thematic analysis. The role of the LHD's Public Health Nurse (PHN) in the pandemic response was examined using the Public Health Intervention Wheel (2019), specifically collaboration, coalition-building, and community organizing components. The PHN directed the community response to the pandemic. Four pivotal themes emerged from the data: identifying gaps, forming alliances, putting boots on the ground, and moving forward. The need to provide culturally congruent care to the Hispanic population required the development of transcultural knowledge through multi-faceted strategies. Sustaining relationships borne out of the pandemic is important to enhance community response to future disasters.

Assessing the Association of Pain Intensity Scales on Quality of Life in Elderly Patients with Chronic Pain: A Nursing Approach.

Chronic pain is prevalent among the elderly and significantly affects their quality of life (QoL). Pain intensity scales are crucial tools in evaluating the severity of pain and tailoring management strategies. This study investigates the relationship between various pain intensity scales and QoL among elderly patients with chronic pain, highlighting the implications for nursing practice. A cross-sectional study was conducted with 150 elderly patients (aged 65 and above) in Riyadh, Saudi Arabia. Participants were assessed using the Numeric Rating Scale (NRS), Visual Analog Scale (VAS), and McGill Pain Questionnaire (MPQ) alongside the 36-Item Short-Form Health Survey (SF-36) to evaluate QoL. Data analysis involved Pearson correlation and multiple regression to explore the association of pain intensity on QoL. All pain scales showed significant negative correlations with QoL. The MPQ exhibited a significant association, suggesting its comprehensive nature captures the multidimensional association of pain more effectively. Regression analysis identified pain intensity, age, and duration of chronic pain as significant predictors of reduced QoL. The findings emphasize the importance of selecting appropriate pain assessment tools that reflect the complex nature of pain in elderly patients. Implementing comprehensive pain assessments like the MPQ can enhance individualized care strategies and potentially improve the QoL in this population. This study underscores the role of nurses in optimizing pain management approaches tailored to the elderly.

Unveiling the Core Competencies in Neuroscience Nursing Within the Context of Italy: A Qualitative Phenomenological Analysis.

Background: In 2008, the European Association of Neuroscience Nursing (EANN) initiated the NeuroBlend™ project, which aimed to delineate the roles and competencies of neuroscience nurses across Europe. This project resulted in the development of the European Competence Profile (ECP), intended to standardize educational pathways and professional recognition for this specialized field. Aim: This study examines the relevance of neuroscience nursing practices to the competencies outlined in NeuroBlend™ across different Italian care settings, including multiple sclerosis, pediatric neurosurgery, pediatric neurology, Alzheimer's disease, and substance addiction. Methods: A phenomenological approach was employed, utilizing focus groups to gather the perspectives of nurses on the competencies defined by the NeuroBlend™ model. The focus groups were conducted from May 2022 to September 2022. The data collected from the focus groups were analyzed using thematic analysis. Results: Thirty nurses participated in the focus groups. Thematic analysis revealed the core competencies, such as communication, empathy, flexibility, and reflective skills, as critical in all care settings. The main themes that emerged were relationships with patients and families, personalized care, and continuity of care. Conclusions: The competencies outlined in the NeuroBlend™ framework are vital to the role of neuroscience nurses in the settings studied and remain highly relevant in the context of Italian healthcare.

Sustainability and dialysis: the 4 main points for a green dialysis

Dialysis represents a big challenge for the environmental sustainability, because it is bound to high consumption of water and electricity, hazardous waste incineration and subsequent greenhouse gas emissions. In recent years, it has been recognized the urgent need to preserve our environment together with the people’s health, starting from making dialysis greener. This awareness has led to a new paradigm in the history of dialysis, the concept of Green Nephrology. The Italian Society of Nephrology published 10 affordable actions in the Position Statement with the aims to increase awareness, propose joint actions and coordinate industrial/social interactions. Starting from these, there are four key points to pave the way for environmental sustainability: 1) Sustainable technologies (i.e., machines, filters, water treatment systems, acid concentrates, lighter materials, electronic patient record); 2) Green dialysis centers; 3) Environmental improvement project, using tools to define targets and their monitoring; 4) Nurse role, as he is the main environmental sustainability promoter. To achieve Green Nephrology it’s necessary a partnership between all the stakeholders of the healthcare system. Since the growing awareness of the problem and the existence of ways to solve it, it’s time to act and the effective way to do it is to implement all the solutions provided in this article in an immediate future.

Is it worth it? A comparison study of medical students’ aspirations for gaining the Health Care Certificate following employment as Healthcare Assistants

Background Medical students seek early patient contact but their curriculum starts with scientific knowledge. We integrated the Healthcare Assistant (HCA) course into semester one for early patient-facing clinical contact. This study compares students’ aspirations for this learning with the realities of employed work as HCAs. Methods This sequential mixed-methods study used pre-post-scored questionnaire data, followed by post-course focus groups, and interviews a year later. The quantitative data were analysed using SPSS and the qualitative data using thematic analysis. Results The learning was highly valued with early perceptions challenged. The learning both accelerated and advanced their medical skills. Their naivety of nurses’ work within team-based practice quickly eroded; they symbiotically linked their clinical and non-clinical learning; they acclimatised to the hospital environment while future gazing in preparation for clinical learning. Early anxieties for starting employment were overcome, building resilience. Conclusions HCA training offers a practical patient-facing set of competencies on which to build medical capability. Student text-book scientific knowledge was validated through their experiences with recognition of the importance of empathetic patient-centred care. They quickly learnt and absorbed ward function; experienced good and poor teamworking; highly valued the nursing role; and experienced the every-day stresses of being a front-line practitioner.

Experiences of Indonesian nurses as Hajj health personnel in caring for Hajj pilgrims: A qualitative study.

Investigating the experiences and roles of nurses during Hajj is vital due to the unique public health challenges posed by the mass gathering of diverse pilgrims. Nurses play a crucial role in disease surveillance, infection control, and managing emergencies like heat stroke and injuries. Their insights can improve emergency preparedness and public health management. This study aimed to explore the experiences of Indonesian nurses as Hajj health personnel caring for Hajj pilgrims during the 2023 Hajj season. This study employed a qualitative descriptive design and selected participants through purposive sampling from hospitals, public healthcare centers, and clinics in Yogyakarta, Indonesia. Nine nurses participated in the research, and data were collected through a focus group discussion in December 2023. Thematic analysis was used to analyze the data. Six themes emerged, including practicing ethical principles in providing health care during the hajj process, competency qualifications as a health worker, the health care process during Hajj, legal Requirements for Hajj, the importance of therapeutic communication skills to establish cooperation with various parties, and recognizing the role of duties and responsibilities during the hajj process. The study emphasizes the importance of competencies, ethics, communication, and strategic planning in Hajj healthcare. Effective online communication, especially via WhatsApp, was crucial for coordination. The findings emphasize the need for strategic workforce planning, resource allocation, and continuous training to enhance care quality for pilgrims, informing better planning and policy development for future Hajj seasons.

Feasibility of a nurse-led, mHealth-assisted, and team-based collaborative care model for heart failure care in India: Findings from a multi-stakeholder qualitative study

Background Heart failure (HF) management is often challenging due to poor adherence to GDMT and self-care. Continuous monitoring of patients by a dedicated care manager may enhance adherence to self-care and treatment and prevent hospitalisations. For the adoption and acceptance of a collaborative care model (CCM) for HF management in Indian settings, understanding the perspectives of all stakeholders regarding its various components and feasibility is needed. Therefore, we aimed to obtain perceptions of potential challenges to care and suggestions on multiple components of the proposed CCM in managing HF and its feasibility. Methods In-depth interviews were done among HF patients, caregivers, nurses, and cardiologists from private, co-operative, and public sector tertiary care hospital settings that cater to HF patients in Kerala, India. An in-depth interview guide was used to elicit the data. Data were analysed using Python QualCoder version 2.2. We used a framework method for the analysis of data. Results A total of 22 in-depth interviews were conducted. We found that the existing care for HF in many settings was inadequate for continuous engagement with the patients. Non-adherence to treatment and other self-care measures, was noted as a major challenge to HF care. Healthcare providers and patients felt nurses were better at leading collaborative care. However, various barriers, including technical and technological, and the apprehensions of nurses in leading the CCM were identified. The stakeholders also identified the mHealth-assisted CCM as a potential tool to save money. The stakeholders also appreciated the role of nurses in creating confidence in patients. Conclusions A nurse-led, mHealth-assisted, and team-based collaborative care was recognised as an excellent step to improve patient adherence. Effective implementation of it could reduce hospitalisations and improve patients' ability to manage their HF symptoms.

Promoting Health for a vulnerable Family with Relationship Challenges. Exploring the Community Nurse's Role

Background: In today's dynamic social landscape, families often encounter a myriad of challenges that can impact their overall health and well-being. Among these challenges, relationship difficulties within the family unit stand out as a significant concern, with potential repercussions for the physical, emotional, and psychological health of its members. Aim: This case study article delves into the intricate dynamics of promoting health within a vulnerable family facing significant relationship challenges. The focus of this study is to explore the pivotal role of the community nurse in addressing the unique needs of such families. Materials and Methods: A qualitative research approach was employed to comprehensively investigate the experiences of a vulnerable family navigating relationship challenges. Data collection involved in-depth interviews, direct observations, and document analysis. Thematic analysis was used to extract meaningful patterns and insights from the collected data. Results: The findings underscored the crucial influence of the community nurse in fostering the health and well-being of the vulnerable family. Through tailored interventions, collaborative support, and sensitive communication, the community nurse played a pivotal role in addressing the family's relationship challenges and promoting their overall health. Conclusions: This study sheds light on the significance of the community nurse's involvement in enhancing the health outcomes of families facing relationship challenges. The role of the community nurse emerges as an essential component in fostering resilience and facilitating positive changes within the family unit.