Ranking Of Statements Research Articles

What are the research needs for the field of disaster nursing? An international Delphi study.

Internationally there is an increasing amount of peer-reviewed literature pertaining to disaster nursing. The literature includes personal anecdotes, reflections, and accounts of single case studies. Furthermore, issues such as the willingness of nurses to assist in disasters, the role of nurses in disasters, leadership, competencies, and educational preparedness for nurses have been the focus of the literature. The aim of this research was to determine the international research priorities for disaster nursing. This research used a three-round Delphi technique. The first round used a face-to-face workshop to generate research statements with nursing members of the World Association for Disaster and Emergency Medicine (WADEM). The second and third rounds included the ranking of statements on a 5-point Likert scale with nursing members of WADEM and the World Society of Disaster Nursing (WSDN). Statements that achieved a mean of four or greater were considered a priority and progressed. Participants were from multiple countries. Research statements were generated in the areas of: education, training, and curriculum; psychosocial; strategy, relationship, and networking; and clinical practice. Psychosocial aspects of disaster nursing ranked the highest, with five statements appearing in the top ten research areas, followed by statements relating to: education, training, and curriculum; clinical practice; and finally, strategy, relationship, and networking. Future disaster nursing research should focus on the area of psychosocial aspects of disaster nursing, in particular, both the psychosocial needs of a disaster-affected community and the psychosocial wellbeing of nurses who assist in disaster health activities.

Patient evaluation of community nurse-led follow-up clinics for colon cancer.

587 Background: Health services face an ever increasing demand for quality patient focussed healthcare with limited financial resources. Our group has designed and implemented, using non-specialist community nurses, a nurse led follow up service for patients with potentially cured colon and prostate cancers in 4 community hospitals in North East Scotland. Nurses use a structured questionnaire, take tumour specific blood tests & order some imaging. Results communicated to patients via letter from oncologist. Methods: A user-group & professionals were consulted and a customised questionnaire designed. Topic sections were-basic demographic data; mode of transport; perceptions of parking; travel; continuity of care; timing of appointments; satisfaction with service attributes; any concerns; suggestions for improvement and an overall rating score. Details of the evaluation were considered by the ethics committee as 'service evaluation'. Results: The questionnaire was successfully piloted in 5 patients. The main study targetted 100 patients, & data-collection ran from August 2010 until July 2011, the 4th year of the service. 103 questionnaires returned, all useable, from 216 sent out across 4 community clinic sites. The 48% return rate was consistent across all sites. The findings were grouped together rather than presented by clinic, due to lack of response variation by site. Verbatim comments were recorded. Returns from colon cancer patients were 75% of the total (47% M, 28% F) & 25% prostate patients. Median age 71, range 41 - 90 years. Travel was by car 87%, foot 8% & public transport 5%. Topics covered included, own health 96%, appt times 79%, tests & results 75%, patient support 37%, carer support 12% & 'other' 16%. Ranking of statements suggests 90% satisfaction with administration & 94% quality of clinic, and 85% prefer local proximity of clinic. Only 36% accompanied to clinic, less than when at central clinic. Only 8% expressed concerns, usually about scan results. Conclusions: an overwhelmingly positive patient evaluation provides evidence that non-specialist community nurses can deliver a follow up service in the community for potentially cured colon (& prostate) cancer patients.

Focus section on program debugging

Focus section on program debugging

Coping with caring: Profiles of caregiving by informal carers living with a loved one who has dementia

Background and aim: While the number of people suffering from dementia in the Netherlands will double in the next 25 years, there are no plans to expand the capacity of residential care facilities for these patients. This will almost inevitably lead to an increase in the burden placed on informal carers. We investigated how caregivers living with a loved one who has dementia experience their caregiving situation. Methods: For this study, 53 caregivers ranked a structured set of opinion statements covering a representative range of aspects of caregiving. By-person factor analysis was used to uncover patterns in the rankings of statements. Results: Five distinct profiles of caregiving were identified that provide information on the various care situations that can occur, the needs and dilemmas that these caregivers face, and the subjective burden and perseverance time of the carers. Conclusions: The findings contribute to the development of interventions for the support of informal caregivers.

Patient Views on Determinants of Compliance with Tuberculosis Treatment in the Eastern Cape, South Africa

: Tuberculosis (TB) constitutes one-quarter of all avoidable deaths in developing countries. In the Eastern Cape, South Africa, TB is a public health problem of epidemic proportion. Poor compliance and frequent interruption to treatment are associated with increased transmission rates, morbidity, and costs to TB control programs. This study explored determinants of (non-)compliance from the patients' perspective. : Semi-structured interviews were conducted with patients (33 treatment compliers and 34 treatment non-compliers) and 14 community health workers from local community clinics and the hospital in the township of Grahamstown, Eastern Cape, South Africa. Q-methodology was used. Patients rank ordered 32 opinion statements describing determinants of treatment compliance from the TB adherence model. By-person factor analysis was used to explore patterns in the rankings of statements by compliers and non-compliers. These patterns were interpreted and described as patient views on determinants of compliance with treatment. Patients and community health workers selected the top five determinants of compliance and non-compliance. : Compliers believed that completing treatment would cure them of TB. Economic prospects were crucial for compliance. Compliers felt that the support of the government disability grant helped with compliance. Non-compliers believed that stigmatization had the greatest impact on non-compliance, together with the burden of disease, the arrangements involved with receiving treatment, restrictions accompanying treatment, and the association of TB with HIV/AIDS infection. : Stigmatization makes TB a 'social disease'. Individual motivation and self-efficacy appear to have a considerable effect on compliance, but, for non-compliers, the general lack of job prospects and being able to provide for themselves or their family also makes TB very much an 'economic disease'.

Preferences for health care and self-management among Dutch adolescents with chronic conditions: A Q-methodological investigation

Background Adolescents with chronic conditions have to learn to self-manage their health in preparation for transitioning to adult care. Nurses often struggle with how to approach youth with chronic conditions successfully. Little is known about the preferences and attitudes of these young people themselves. Objective To uncover preferences for self-management and hospital care of adolescents with various chronic conditions. Design and method A Q-methodological study was conducted. Semi-structured interviews were held with adolescents who rank-ordered 37 opinion statements on preferences for care delivery and self-management. They were asked to motivate their ranking. By-person factor analysis was conducted to uncover patterns in the rankings of statements. The factors were described as preference profiles. Participants and setting A purposive sample of 66 adolescents (12–19 years) treated in a university children's hospital in the Netherlands was invited to participate. Thirty-one adolescents, 16 boys and 15 girls with various chronic conditions eventually participated (response 47%). Eight participants (26%) had a recently acquired chronic condition, while the rest (74%) had been diagnosed at birth or in the first 5 years of life. Results Four distinct preference profiles for health care delivery and self-management were identified: ‘Conscious & Compliant’; ‘Backseat Patient’; ‘Self-confident & Autonomous’; and ‘Worried & Insecure’. Profiles differ in the level of independence, involvement with self-management, adherence to therapeutic regimen, and appreciation of the parents’ and health care providers’ role. The desire to participate in treatment-related decisions is important to all preference profiles. The profiles are recognizable to adolescents and nurses alike. As Q-methodology allows no inferences with respect to the relative distribution of these profiles in a given population, only tentative hypotheses were formulated about associations between profiles and patient characteristics. Conclusion This study increases our understanding of different subjectivities of adolescents living with a chronic condition related to their treatment and health. There is no “one size fits all” approach to adolescent health care, but rather a limited number of distinct preference profiles. This study demonstrates the value of a non-disease-specific approach in that adolescents with various chronic conditions were found to have much in common. The profiles seem a promising tool for nurses to actively seek adolescents’ opinion and participation in health care and will be further explored.

Patterns of Parenting in Korean Mothers of Children With ADHD

The purpose of this study was to investigate patterns of parenting in Korean mothers of children with attention-deficit/hyperactivity disorder (ADHD) and identify major threads that structured various patterns of parenting. Q-methodology, a technique for extracting subjective attitudes, was used for data collection and analysis. Participants were asked to sort statements on issues associated with parenting. Factor analysis was applied to identify patterns in the ranking of statements. Participants were 45 Korean mothers of children with ADHD. As a result, three patterns of parenting emerged: Praise-Fairness, Strict-Control, and Sensitive Response-Balanced. These patterns differed on two axes: external and internal control and positive and negative reinforcement. This study provides an opportunity to enhance our understanding of the parenting patterns of mothers of children with ADHD in Korea. The findings can function as a cornerstone for developing future models of parenting children with ADHD and parent-child interactions.

Q-Methodology to Identify Young Adult Renal Transplant Recipients at Risk for Nonadherence

Young adult renal transplant recipients may display patterns of behavior that affect graft survival. The present study aimed to identify young adults at risk for nonadherent behavior by investigating their attitudes about posttransplant health lifestyle. A Q-methodological study was conducted. Participants were asked to rank-order statements on issues potentially associated with (non)adherence. Factor analysis was applied to uncover patterns in the ranking of statements. The resulting factors represent attitudes and are described using a composite ranking of the statements. As a first test of discriminated validity, a different group of 34 young renal transplant patients was asked how well the factor descriptions fitted them. Twenty-six young renal transplant recipients (18-25 years) participated in the study. They were remarkably willing to discuss sensitive issues when confronted with statements on cards. Four distinct attitude profiles concerning posttransplant health lifestyle were found among these young adults: (a) concerned and controlled, (b) appearance orientated, (c) opinionated and independent, and (d) easy going and pliable. In a follow-up analysis, self-categorization proved to discriminate well between the four attitude profiles in 67% of the respondents. Using Q-methodology, four attitude profiles about posttransplant health lifestyle were uncovered. Self-categorization on these attitudes seems feasible and may be a useful screening aid to identify young adults at risk for nonadherence.

Future career pathways in nursing and midwifery. A Delphi survey of nurses and midwives in South West England

There is growing interest, both nationally and internationally and within healthcare research, regarding future career pathways for nurses and midwives and what these pathways should represent. This paper presents the results of a research project that investigated these issues. A Delphi approach was taken to determine consensus, and consisted of three rounds: round 1 — statementgeneration, rounds 2 and 3 — rating and ranking of statements. The study aimed to discover the extent to which participants agreed about what the key features of a future career pathway should represent. Forty-three nurses and midwives representing a wide range of nurses and midwives participated. Consensus was achieved and 14 key features were identified. The paper concludes by suggesting that these statements will aid and inform stakeholders and decision-makers as to the future direction that career pathways in nursing and midwifery could take.

Comparative Study of Adult Education Practitioners and Professors on Future Knowledge and Skills Needed By Adult Educators

The purpose of the study was to compare practitioners' opinions concerning knowledge and skills needed by future adult educators with those of professors. The sample population of practitioners was 78 NUCEA members who were deans or directors of continuing education.Practitioners, through two rounds of questionnaires, priority ranked thirty knowledge and thirty seven skill statements identified and priority ranked by professors of adult education in an earlier Delphi Study. Kendall Tau Coefficients computed for both knowledge and skill statement rankings between the two samples indicated that professors and practitioners tended to agree more on skill statement relative ranking than on knowledge statement relative ranking. It was concluded, from examination of means and rank order, that differences, as well as convergence, of opinion exist between the two study populations regarding the sampled knowledge and skill areas needed by future adult educators.

Comparative Study of Adult Education Practitioners and Professors On Future Knowledge and Skills Needed By Adult Educators

The purpose of the study was to compare practitioners' opinions concerning knowledge and skills needed by future adult educators with those of professors. The sample population of practitioners was 78 NUCEA members who were deans or directors of continuing education. Practitioners, through two rounds of questionnaires, priority ranked thirty knowledge and thirty- seven skill statements identified and priority ranked by professors of adult education in an earlier Delphi Study. Kendall Tau Coefficients computed for both knowledge and skill statement rankings between the two samples indicated that professors and practitioners tended to agree more on skill statement relative ranking than on knowledge statement relative ranking. It was concluded, from examination of means and rank order, that differences, as well as convergence, of opinion exist between the two study populations regarding the sampled knowledge and skill areas needed by future adult educators.