Nursing Skills Research Articles

An Exploratory Study to Assess the Communication Pattern, Skills, Style and Problems of Communication among the Professional Nurses

Background: Effective communication is the key element in providing comprehensive high-quality nursing care to the patients. Aim: Aim of the study was to explore the pattern, skills, and style of communication among the professional nurses and the problems faced by the nurses during communication. Methodology: A quantitative research approach with exploratory descriptive design was used in this study. This study was done at selected hospitals of Saudi Arabia. Professional nurses were the population of the study. Proportionate stratified random sampling technique was used in this study. The investigators randomly selected the subjects proportionately from different hospitals of Arar Province. Nurses from selected hospitals of Arar Province were the sample of this study with the sample size of 100. Before starting the data collection process written permission was taken from the ethical committee and administrators of the hospitals. Informed written consent was taken from all the participants of the study. Through the structured questionnaire, the researchers collected the data from the subjects regarding socio-personal variables of professional nurse, pattern of communication, skills of the professional nurses needed for the communication, style of communication and the problems faced by the professional nurses during communication. The data were obtained from the sample through observation and interview. Throughout the study, the researchers maintained the confidentiality and anonymity of the subjects. Results: Analysis of the study depicts that 38 percent of the subjects were belongs to the age group of 20-30 years, but 16 percent of the samples were between the age group of 51-60 years. Majority (78 percent) of the samples were females whereas 22 percent of the subjects were males. About 46 percent of the subjects were Saudis, but 30 percent of the subjects were Indian nurses. Majority (79 percent) of the samples were B.Sc. nurses and 88 percent of the samples were staff nurses / nurse technicians. Majority (84 percent) of them were working under ministry of health hospitals of Saudi. Around 41 percent of the subjects were having the experience of 1-5 years, whereas 8 percent of the staffs were newly joined, they have no experience. Regarding pattern of communication, 39 percent of the Nurses were having very good pattern of communication, whereas 28 percent of the subjects were maintaining excellent pattern of communication with their clients. About 19 percent of the Nurses were having excellent skill in communication. More than fifty (57%) percent of the Nurses were having very good style of communication. About 25 percent of the participants were facing the communication problems of incivility and rude behaviour, whereas 19 percent were suffering from intimidation. Around 22 percent of the participants were the victims of humiliation. About 16 percent were suffering from physical violence but 18 percent nurses were the victims of bullying. There was a significant association between socio-personal variables and pattern, skills, style, and problems of communication among professional nurses, P<0.05*. Hypothesis of the study revealed that there was a significant positive correlation between socio-personal variables and style of communication and problems faced by the professional nurses during communication. Correlation is significant at 0.05* level. Conclusion: This study recommends that effective communication improves productivity and promotes team-building among professional nurses.

Barriers to Effective Communication Between Nurses and Patients from the Perspective of Emergency Nurses at Educational-Therapeutic: A Cross-Sectional Study

Background: Effective communication between nurses and patients is essential for delivering quality patient care, particularly in high-pressure settings such as emergency departments. Objectives: This study aimed to assess the barriers hindering effective nurse-patient communication, as perceived by emergency nurses employed at the teaching hospitals associated with Mazandaran University of Medical Sciences in Iran in 2023. Methods: This cross-sectional study recruited 184 emergency nurses from five university hospitals using a census method. The sample population consisted of nurses working in emergency departments affiliated with Mazandaran University of Medical Sciences from May to August 2023, in Iran. Data were collected using demographic and the Barriers to Nurse-Patient Communication questionnaires, a validated and reliable instrument that assesses four domains hindering effective communication between nurses and patients. The data were analyzed using SPSS version 22. Results: According to the calculations, 65.2% of the participants were female, with ages ranging from 23 to 54 years and work experience between 1 and 27.5 years. Additionally, 92.4% held a bachelor's degree, and 7.6% had a master's degree. The results showed that, according to the emergency nurses, the barriers to communication between nurses and patients in the four investigated areas, ranked from highest to lowest score, were occupational characteristics, environmental factors, personal-social factors, and patient’s clinical conditions. The highest obstacles identified were: In the field of personal-social factors, patient’s excessive expectations (4.05 ± 0.88); in the field of occupational characteristics, heavy workload (4.32 ± 0.90); in the field of patient’s clinical conditions, presence of a companion (3.17 ± 1.29); and in the field of environmental factors, lack of appreciation of nurses by officials (3.96 ± 1.09). The barrier scores did not significantly correlate with nurses’ demographic variables. Conclusions: According to the results, the biggest obstacles were in the field of job characteristics of the emergency nurses. Therefore, the findings of this research can help nursing managers identify and adjust communication barriers between nurses and patients to adopt more effective strategies for teaching and evaluating nursing communication skills, ultimately fostering effective communication between nurses and patients.

Nurses’ Awareness and Practice Toward Pain Assessment and Management as Fifth Vital Sign in Sudan: A Cross-sectional Study

Background: Pain is globally prevalent, affecting quality of life and driving most people to seek medical care. Nurses are essential for pain assessment and treatment. Adequate nursing awareness, attitudes, and skills are vital for optimal management. This study investigates nurses’ awareness and practice toward pain assessment and management as the fifth vital sign in Sudan. Methods: This study was a cross-sectional, hospital-based study. Convenience sampling was performed to collect information from nurses working at four government hospitals using a self-administered questionnaire 24 November 2020 and 18 April 2021. The study utilized descriptive and inferential statistics for data analysis. Results: A total of 393 registered nurses participated in this study. Most (66.7%) were women, 46.6% were aged 20–25 years, and 69.2% had a bachelor degree. More than half of the nurses had low awareness of pain assessment (51.7%) and management practices (53.7%). A weak positive correlation was observed between awareness and practice (r = 0.280, P = 0.000). Women nurses showed a higher awareness (204.80, P = 0.048). Nurses with a high level of education showed higher awareness (249.32, P = 0.031) and higher practice (272.00, P = 0.029). Nurses working in the critical care unit performed significantly better than others (234.61, P = 0.001). Conclusion: There is a low level of awareness regarding pain assessment and management practices. This study suggests the need for more research and training programs, especially for nurses with low educational levels.

Critical thinking and artificial intelligence in tandem: A nursing perspective

The human race is forced to engage in a very rapid adaptation process whenever it is confronted with technological change in any sphere of life. The unabated progress of artificial intelligence (AI) has also impacted the field of critical thinking. It is fascinating that critical thinking, an essential component of intellectual intelligence in nursing, seems to be disrupted by an artificial brain-alike machine that can automatically analyze and synthesize a series of contexts. This has been an improvisation of ideas of intellectual intelligence for a very long time. Perspectives on both sides of the coin bring up interesting questions about the role that AI will play in the future, such as whether it will disrupt the critical thinking skills of nurses or whether it may be engaged as a tool to increase the critical thinking skills capability, especially in the fields of nursing care.

Bi-lingual content validation of the Non-Technical Skills for Operating Room Nurses (NOTSORN) tool: A Delphi study

BackgroundThe primary responsibility of the operating room nurse is to prevent adverse events and patient harm during surgery. Since most preventable adverse events are the result of breakdowns in communication and teamwork, or non-technical skills, training such skills should strengthen the operating room nurses’ error prevention abilities. Behavioural marker systems operationalise non-technical skills; however, previous systems for operating room nurses do not cover the full extent of non-technical skills used by operating room nurses. Thus, the Non-technical Skills for Operating Room Nurses (NOTSORN) behavioural marker system was developed. ObjectiveThe objective of this study was to establish face and content validity of the Non-Technical Skills for Operating Room Nurses behavioural marker system. This multi-item scale measures individual non-technical skills in operating room nursing. ParticipantsA purposive sample of operating room nursing researchers, educators, and senior clinicians from nine countries worldwide. MethodsA two round, Delphi panel with international experts in operating room nursing. The survey was administered online. Content validity index (CVI) was used to measure agreement among panel members. Results25 operating room nurse experts participated in the online Delphi study. After round 1, 56 items were accepted, 26 items were revised, and 1 item was dropped. Following round 2, all items (6 with minor revisions) were accepted. Thus, the Non-technical Skills for Operating Room Nurses tool comprise 81 items. The scale level CVI score for the final 81 item tool was 0.99. The individual item level CVI scores ranged from 0.9 to 1.0. ConclusionsThe Non-Technical Skills of Operating Room Nurses behavioural marker system is a nuanced tool with a myriad of non-technical skills operating room nurses need to undertake their work safely. The tool's intended use includes student/trainee supervision, supervision of novice operating room nurses, self-reflection for performance reports, and in operating room nursing education. Over time, use of the tool has the potential to contribute to patient safety in the operating room. Tweetable abstractThe NOTSORN tool provides a comprehensive and holistic evaluation of OR nurses' non-technical skills for safe surgical performance

Determination of the relationship between parents' health literacy and fever management of their children: Across-sectional study.

The research was conducted to determine the practices of parents regarding the fever management of their children and reveal the relationship between their health literacy (HL) and fever management of their children. Cross-sectional study was used. This study was carried out with 242 parents. The data were collected using the Parent Descriptive Information Form, Turkish HL Scale-32 and Parents' Fever Management Scale between September 2021 and September 2022. The data were evaluated with the SPSS program, using percentages, averages, Pearson's correlation and regression analysis. The mean age of the parents was 31.87 ± 6.59. The parents' mean Parents' Fever Management Scale score was 36.22. It means that parents had high fever management practice. Their mean Turkish HL Scale-32 total score was 34.43. 51.6% of the parents had a problematic or insufficient HL level. In the cases of fever, 61.2% of the parents stated that they took off the child's clothes, 69.0% measured temperature from the armpit, and 55.4% gave antipyretics according to the doctor's prescription. There is a statistically significant positive correlation between the Parents' Fever Management Scale and Turkish HL Scale-32. It is observed that 8.2% of the change in parents' fever management is explained by HL. The study found that with an increase in parents' HL, fever management of their children also increased. Emerging evidence showed that developing parents' HL knowledge and skills could be an option/approach in fever management. It should be a basic nursing skill that to provide HL support to parents. This study adhered to the relevant cross-sectional STROBE (the Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. No patient or public contribution.

Comparing educational frameworks: unpacking differences between fink's and bloom's taxonomies in nursing education

BackgroundModern healthcare's dynamic and complex nature demands that nursing education evolves. Traditional reliance on Bloom's Taxonomy, while effective for cognitive development, falls short of addressing the holistic needs of nursing education. The integration of affective and practical dimensions is crucial, making Fink's Taxonomy of Significant Learning a valuable alternative. SummaryFink's Taxonomy, introduced in 2003, extends beyond the cognitive to include the human dimension, caring, and learning how to learn. These domains are vital for preparing nurses who can apply their knowledge effectively in diverse healthcare settings. This article delves into the benefits and challenges of implementing Fink's Taxonomy in nursing education and its compatibility with the profession's evolving demands. It also underscores the scant research on its application in nursing education, advocating for comprehensive studies. Discussion and conclusionAdopting Fink's Taxonomy could enhance the competence, empathy, and adaptability of nursing professionals, better equipping them for modern healthcare challenges. To ascertain Fink's efficacy in developing nursing skills and competencies, extensive research employing varied methodologies is imperative.

Knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries: A scoping review.

Over the past three decades, research studies on nurses' engagement in evidence-based practice (EBP) have been widely reported, particularly in high-income countries, with studies from these countries dominating literature reviews. As low- and middle-income countries (LMICs) continue to join the EBP movement, primary research has emerged over the past decade about nurses' engagement with EBP. The aim of this scoping review was to identify the types and extent of published research regarding nurses' knowledge, skills, attitudes, beliefs, and implementation of EBP in LMICs. The JBI scoping review methodology was used. Eight databases were searched up to November 2023. The review included primary studies (quantitative, qualitative, and mixed methods) that reported the knowledge, skills, attitudes, beliefs, or implementation of EBP among nurses in LMICs. Included studies focused on registered nurses in all healthcare settings within LMICs. Studies published in English were included with no limit on publication date. Two independent reviewers screened titles, abstracts, and full-text articles of published studies. Data were analyzed quantitatively using frequencies and counts. Textual data from qualitative studies were analyzed using descriptive content analysis. Fifty-three publications were included, involving 20 LMICs. Studies were published between 2007 and 2023, with over 60% published in the past 7 years. Studies that evaluated familiarity/awareness of EBP showed that in general, nurses had low familiarity with or awareness of EBP. Most studies (60%) described nurses' attitudes toward EBP as positive, favorable, or high, and 31% as moderate. However, over 60% of studies described nurses' EBP knowledge/skills as moderate, low, or insufficient. Approximately 84% of studies described EBP implementation in healthcare settings as moderate, low, poor, or suboptimal. Studies on nursing EBP have been increasing in LMICs for the past two decades, with findings highlighting opportunities for advancing EBP in nursing within LMICs. Health systems and healthcare organization leaders in LMICs should equip nurses with EBP knowledge and skills while providing the needed resources and support to ensure consistent implementation of EBP to improve health outcomes.

Total Quality Management in Improving Health Services

This research aims to determine the implementation of Total Quality Management as an effective model for realizing quality health services at Ananda Hospital Makassar. This research method is of various types qualitative with a policy approach. The data source uses primary data via instrument observations and interviews as well as secondary data through reviewing various documents. The data analysis technique uses an interactive model, namely data collection, data condensation, data presentation, and verification/conclusion. The results of this research show that the implementation of the TQM model at Ananda Makassar Hospital was not implemented optimally due to the leadership aspect of manager Hospitals are less able to organize and organize all existing resources within the hospital and the inability of the head of the hospital to collaborate and communicate well with all Ananda Hospital staff to work together. set standard work procedures that are efficient and effective and the TQM implementation factors at Ananda Hospital can run well if the hospital can optimize the implementation of communication and collaboration factors where it is hoped that the Ananda Makassar Hospital will improve the quality of service by involving patient health organizations in provide education to patients as well as collaboration in exchanging necessary medical personnel resources done Ananda Makassar Hospital to develop the competency and work skills of doctors, nurses and staff administration hospitals in collaboration with other agencies and institutions that can provide training activities.

Leadership Matters: Investigating the Association Between Nursing Home Administrator Turnover and Quality.

Existing research has associated nursing home (NH) staff turnover with poor performance, yet the impact of nursing home administrator (NHA) turnover remains relatively understudied. This study aimed to explore the relationship between NHA turnover and NH quality, and to determine if this relationship was mediated by registered nurse (RN) turnover. Utilizing data from multiple secondary sources, including the Care Compare: Skilled Nursing Facility Quality Reporting Program (SNF QRP) and LTCFocus.org, this study employed a longitudinal analysis covering the period 2021-2022 (n = 19,645). The dependent variable was quality star ratings from SNF QRP, whereas the independent variable was NHA turnover, reflecting the number of administrators who left each facility annually. We used Baron and Kenny's mediation testing method, incorporating 2-way fixed effects (state and year level) with appropriate organizational and market level control variables. The results affirmed that NHA turnover negatively affected quality, decreasing the likelihood of a higher star rating by 14% with one departure and 25% with multiple departures (p = .001). Additionally, NHA turnover correlated with an increase in RN turnover by 7% and 11%, respectively, for one and multiple departures (p = .001). RN turnover fully mediated the impact of NHA turnover on quality, nullifying the direct effect of NHA turnover. The results of this study highlight the synergistic relationship between administrators and caregivers in NHs. To enhance NHA retention, NHs should improve compensation and benefits. Nonetheless, broader governmental support and interventions might be necessary to sustain these improvements.

Immersive Virtual Reality Simulation for Learning Fundamental Nursing Skills: A Mixed-Methods Study.

Literature showed that learners' perceived usability and perspective toward a technology application affected their learning experience. Fewer studies have investigated immersive virtual reality (IVR) simulation learning of fundamental nursing skills learning (FNSL). The aim of the study was to explore the perceived usability of IVR simulations for FNSL among first-year nursing students and their perspectives toward this learning modality. This study used a mixed-methods design with an educational intervention. Sixty-five first-year nursing students participated in 2 IVR simulation procedures in complementary mode. Surveys and focus groups were conducted in the postintervention period. The findings demonstrated students' positive inclinations toward IVR simulation learning. Two areas emerged: using IVR simulation as a complementary modality for FNSL and barriers affecting students' perceived usability toward this technology. With addressing the concerns from students' perceived usability, immersive virtual reality simulation could be a potential complementary modality for FNSL.

Instructional guidelines and group discussion effects on new nurses’ competency regarding nursing care of preterm infants

BackgroundPremature birth was once one of the leading causes of infant mortality. Premature infants require improved medical and nursing skills from a highly competent nursing team. PurposeThis investigation aimed to assess the effects of instructional guidelines and group discussion on new nurses’ competency in preterm infants caring at the Neonatal Intensive Care Unit (NICU). MethodsA single-anonymized, two-group pre-test and post-test study design was accompanied in 2022. The study was accompanied for 50 newly graduated nurses concerned with competence in nursing management of preterm infants at the Neonatal Intensive Care Unit (NICU) in two hospitals: Al-Namas General Hospital, KSA, and the Pediatric Hospital of Assiut University, Egypt. Two groups were randomly selected from among the nurses to be trained on preterm infant nursing care competence either through an instructional guideline or group discussion. Nursing attitudes and practices were measured before and after training using questionnaires and checklists. ResultsThere was no significant difference between the instructional guideline group and the group discussion in the mean total score of attitudes (11.72 and 14.65, P = 0.455) and practices (14.36 and 14.80, P = 0.494) towards caring for preterm infants before intervention. While mean nurses’ attitude and practice scores increased significantly in both groups after the intervention, in the discussion group, nurses' practice scores increased significantly (p = 0.001). Still, there were no significant changes in the instructional guideline group (P = 0.202). ConclusionBoth methods were effective on the newly graduated nurses' attitude; however, the instructional guidelines did not affect their practice regard nursing care of preterm infants. However, group discussion training techniques can effectively improve the nurses’ attitude and practice toward nursing care of preterm infants. Relevance to clinical practiceThe group discussion training method should be the approved and proven method for hospitals to train new nurses to increase clinical practices, especially during nursing care for premature infants, because this method has proven its worth in increasing the skill of nurses. It enables a group to talk about a specific subject and exchange personal stories. This approach involves a group leader facilitating communication and interaction between participants.

ETC 51 - Implementing Enhanced Standard Precaution (ESP) and Its Impact in a Skilled Nursing Facility

ETC 51 - Implementing Enhanced Standard Precaution (ESP) and Its Impact in a Skilled Nursing Facility

The experiences and perceptions of rural and remote nurses who provide care to pregnant women in the absence of midwives.

Maternity unit closures in rural and remote settings of Australia have left a substantial gap in services for pregnant women. In the absence of midwives, and when women are unable to attend a maternity facility, registered nurses (RNs) are required to fill the void. While maternity education can attempt to prepare RNs for such encounters, there is little documented to suggest it meets all their physical and psychological needs. The existing challenges for health professionals, practising a vast generalist scope of practice while living and working in a rural and remote location, have been well researched and documented. How nurses feel about the expectation that they work outside their scope of practice to provide maternity care in a rural and remote setting in Australia has not been asked until now. This study explores the perceptions and experiences of RNs who find themselves in this situation. The study utilised a hermeneutic phenomenological methodology to examine the experiences and perceptions of rural and remote nurses providing care for pregnant women. RNs working in rural and remote health facilities that had no maternity services were recruited by a purposive sampling method. Semistructured conversational interviews were recorded and transcribed verbatim. Data analysis was guided by van Manen's analytical approach. Eight nurses participated, and from the data three themes, each with several subthemes, emerged: 'being-in-the-world of the rural and remote nurse' - described how participants viewed rural and remote nursing as an entity with unchangeable aspects that could not be considered in isolation; 'scope of practice - unprepared or underprepared' described how, despite their existing and extensive nursing skills, participants felt ill-equipped theoretically, practically and mentally to care for pregnant women; 'moral distress' - participants expanded their feelings of unpreparedness to include inadequacy, fear, and appropriateness of care delivery. The realism of rural and remote nursing practice demonstrates that at some point in their career, rural and remote nurses will care for a labouring and/or pregnant woman at high risk for complications. Participants in this study appeared open and honest in their interviews, displaying pride at their extensive nursing skills and job satisfaction. However, they were unanimous in their discussions of what being a nurse and providing maternity care in a rural and remote setting meant to themselves and to pregnant women. They suggested care was fragmented and inadequate from a workforce that is inadequately prepared and stressed. This study has highlighted another concerning aspect of rural and remote midwifery care - the experiences and perceptions of eight nurses delivering care that has previously been overlooked. The united voice of the RNs in this study warrants a platform to speak from and deserves acknowledgement and attention from government and midwifery policy drivers. These nurses, and the women receiving their care, deserve more.

General nurse competencies in disaster: A delphi study

AimThe aim of this study is to understand the significance of a disaster-related competence framework for Portuguese general nurses and identify from ICN - Core Competencies in Disaster Nursing version 2.0 core competencies description, those that are considered crucial for a competent preparedness and response in disaster scenarios. BackgroundResearch suggests that the occurrence of disasters will be more recurrent, requiring that nurses, pillars of any health system, have knowledge, skills and preparedness to face these events. DesignAn exploratory, cross-sectional qualitative study was carried out. Delphi method was used for data collection. MethodsThe study group consisted of technical-scientific council’s presidents or coordinators/directors of nursing courses, nurses integrated in the Portuguese Council of Nurses and National Nursing Specialty Colleges and nurses with experience in the field of disasters. ResultsFindings revealed that there is consensus on sixteen competencies, considered relevant for developing general nurse knowledge and competence, both at a national or international level, in the field of disasters. ConclusionsThe development of these competencies which establishes practice standards, building nurses skills and knowledge and ultimately, influencing nursing level-entry curricula’s, conferring professional autonomy and self-regulation, in the field of disaster are fundamental. Furthermore, this study may serve as a reference for future alignment of competency frameworks between European Union countries or others.

A scale for measuring nursing digital application skills: a development and psychometric testing study

BackgroundThe adoption of digitization has emerged as a new trend in the advancement of healthcare systems. To ensure high-quality care, nurses should possess sufficient skills to assist in the digital transformation of healthcare practices. Suitable tools have seldom been developed to assess nurses’ skills in digital applications. This study aimed to develop the Nursing Digital Application Skill Scale (NDASS) and test its psychometric properties.MethodsThe Nursing Digital Application Skill Scale was developed in three phases. In Phase 1, an item pool was developed based on previous literature and the actual situation of nursing work. Phase 2 included 14 experts’ assessment of content validity and a focus group interview with 30 nurses to pretest the scale. In phase 3, 429 registered nurses were selected from March to June 2023, and item analysis, exploratory factor analysis, and confirmatory factor analysis were used to refine the number of items and explore the factor structure of the scale. Additionally, reliability was determined by internal consistency and test-retest reliability.ResultsThe final version of the NDASS consisted of 12 items. The content validity index of NDASS reached 0.975 at an acceptable level. The convergent validity test showed that the average variance extracted value was 0.694 (> 0.5) and the composite reliability value was 0.964 (> 0.7), both of which met the requirements. The principal component analysis resulted in a single-factor structure explaining 74.794% of the total variance. All the fitting indices satisfied the standard based upon confirmatory factor analyses, indicating that the single-factor structure contributed to an ideal model fit. The internal consistency appeared high for the NDASS, reaching a Cronbach’s alpha value of 0.968. The test-retest reliability was 0.740, and the split-half coefficient was 0.935.ConclusionThe final version of the NDASS, which possesses adequate psychometric properties, is a reliable and effective instrument for nurses to self-assess digital skills in nursing work and for nursing managers in designing nursing digital skill training.

From hospital to home: Analyzing the market dynamics of home health and hospital-at-home care

The home health care industry in the United States is expected to develop at a compound annual growth rate (CAGR) of 6.89% from 2023 to 2032, and is expected to reach approximately $300 billion by 2028. The aging population, rising rates of chronic illnesses, the need for post-hospitalization care, and patient preferences for at-home care are some of the factors contributing to this growth. In addition to non-medical help with everyday life activities, home health care offers medical treatments such skilled nursing and physical therapy. Large providers with the greatest patient volume, such as AccentCare, Amedisys, and Enhabit Home Health & Hospice, dominate the industry. To guarantee patient safety and high-quality care, home health agencies are subject to regulatory scrutiny. Home health care can also be a valuable source of information and respite for family caregivers. The capabilities of home health care have been increased by technological developments in telehealth and remote monitoring, which allow medical professionals to keep an eye on patients' status and interact with them from a distance. All things considered, the home health care sector is changing to accommodate the expanding and varied requirements of patients who want to receive treatment in the convenience of their own homes, offering an affordable and individualized substitute for traditional hospital settings.

가상현실(Virtual Reality)을 활용한 핵심간호술 훈련이 지식, 수행, 수행자신감, 자기효능감, 문제해결능력에 미치는 효과

가상현실(Virtual Reality)을 활용한 핵심간호술 훈련이 지식, 수행, 수행자신감, 자기효능감, 문제해결능력에 미치는 효과

Describing Psychiatric Symptoms Experienced by Older Adults in a Skilled Nursing Facility During the COVID-19 Pandemic

There is limited investigation about psychiatric symptoms experienced by older adults with mental health conditions or neurocognitive ones residing in a skilled nursing facility during the COVID-19 pandemic. The objective of this descriptive-design study was to describe the psychiatric symptoms from the year before COVID-19 pandemic to the 1st year of the pandemic for older adults with a mental health condition or a neurocognitive one residing in a skilled nursing facility. A database (n = 84) was established from the extraction of already collected data on the assessment of older adults (n = 84) with mental health conditions or neurocognitive ones living in one skilled nursing facility. The timeframe was from March 1, 2019 to February 28, 2021, eight quarters of extracted data. Psychiatric symptoms were impaired decision making, altered level of consciousness, disorganized thinking, understanding or comprehension, disruptive behaviors, delirium, delusions, hallucinations, inattentiveness, impaired cognition, and depression. Data were analyzed with descriptive statistics. Participants had a mean age of 74.2 ± 10.8. A description of the psychiatric symptoms over the 2 years was a decrease in the level of understanding along with an increase in delusions, disruptive behaviors (physical and verbal), impaired decision making, cognitive impairment, and inattentiveness. The findings focus on the description of the psychiatric symptoms associated with the COVID-19 pandemic. These findings relate to the first step to address a gap in the literature about psychiatric symptoms and COVID-19 for nursing home residents. Future longitudinal and multisite studies are warranted to expound on these findings and the described psychiatric symptoms over time.

The emotional boundary seesaw model to help cancer clinical nurse specialists work with patients who challenge them.

Receiving a diagnosis of cancer and receiving treatment can be physically and psychologically onerous for cancer patients. Alongside their nursing skills, cancer clinical nurse specialists (CCNSs) are trained to provide psychological support, assessment and intervention following a cancer diagnosis. Mental health specialists, usually clinical psychologists, provide clinical supervision to CCNSs to support them with this. One of the regular themes that comes up in clinical supervision with CCNSs is how to maintain a supportive and therapeutic relationship with 'challenging' patients. These patients may be considered challenging because they are inconsistent, demanding or ambivalent about their care, which puts a strain on the relationship with their CCNS. By using the emotional seesaw model to reflect on and attend to the emotional boundaries of the relationship, within clinical supervision, these challenging relationships can be understood and managed, and better outcomes for the patient can be achieved.