Nursing Strategies Research Articles

Ostomy Complications, Risk Factors, and Applied Nursing Care: A Retrospective, Descriptive Study

This study aimed to describe the frequency of colostomy and ileostomy complications and types of nursing interventions as well as to examine patient and ostomy variables associated with early and late complications. The records of 572 patients who received ostomy care from a wound ostomy care (WOC) nurse between 2013 and 2017 were abstracted. Patient demographic and ostomy variables, early period (< 30 days after surgery) and late period (> 30 days after surgery) complications, as well as documented nursing interventions were retrieved. Percentages and rates, chi-square statistics, and logistic regression were used to analyze the data. The mean patient age was 59.1 years (standard deviation [SD], 13.86), and the majority of patients were male (302 patients; 52.8%), married (454; 79.4%), and had a temporary (438; 76.6%) end colostomy (253; 44.2%). One (1) or more complications developed in 323 patients (56.5%) in the early period and in 207 patients (36.2%) in the late period. The most common complications in the early period were peristomal irritant contact dermatitis (PICD) (181; 31.6%) and mucocutaneous separation (135; 23.6%). PICD was also the most common complication in the late period (149; 26%). The risk of PICD was significantly higher in patients with a body mass index > 24.9 kg/m2 (odds ratio [OR] = 1.547), who had an ileostomy (OR = 1.654), or a temporary ostomy (OR = 1.728). Variables associated with an increased risk of mucocutaneous separation included obstacles to ostomy care (OR = 2.222), having an end ostomy (OR = 2.171), and ostomy height < 10 mm (OR = 1.964). Complications were treated by the WOC nurse in 67.5% of patients, and the most common intervention was application of skin barrier powder and wipe layers. The rate of ostomy complications, especially PICD and mucocutaneous separation, in this study was high. Results confirm that patient and ostomy characteristics might significantly affect the risk of complications. The findings support the importance of outpatient follow-up by a WOC nurse. Explorative or randomized controlled studies are needed to identify optimal nursing strategies to decrease complication rates.

The relationship between self-esteem of nurses and their choice of strategies to cope with workload burden

Aim: To identify coping strategies nurses working in clinical practice use to manage workload, and, subsequently, to determine whether the choice of coping strategies is related to self-esteem. Design: Quantitative cross-sectional study. Methods: The sample consisted of 509 nurses. Two coping strategies questionnaires &#8211; Brief COPE and Rosenberg Self-Esteem Scale &#8211; RSES were used to collect data. The data were evaluated by descriptive statistical methods and analysed via ANOVA. Results: Nurses prefer to adopt a range of adaptive coping strategies rather than maladaptive coping strategies. The most frequently chosen adaptive coping strategies used by nurses in clinical practice are acceptance, planning, and active coping. We found that selection of coping strategies is closely related to self-esteem. We registered a significant difference in preferences for adaptive and maladaptive coping strategies as follows: nurses with high self-esteem scores (RSES) preferred adaptive coping strategies: active coping (p = 0.017), positive reframing (p = 0.001), planning (p = 0.020), and acceptance (p = 0.045). We identified selection of maladaptive coping strategies in nurses with average and low self-esteem scale results, i.e.: denial (p = 0.000), disengaged behaviour (p = 0.001), and self-blaming (p = 0.000). Conclusion: The results of the study suggest that it is important to support nurses&#8217; self-esteem since this influences choice of adaptive coping strategies. These are an effective means of coping with the burden on nurses, which directly affects the quality of nursing care provided to patients in clinical practice.

Meta-Synthesis Of Community Health Nursing Strategy

Background : Currently, Indonesia is facing growth and development problems that can lead to health vulnerability and risk of health problems in society. The role of community health nursing is the key to reducing health disparities that occur in society. Strengthening community health nurse strategies must be able to adapt to various settings so that the goals of community nursing care can be achieved optimally.&#x0D; Purpose : The purpose of this meta-synthesis is to comprehensively understand and explore scientific evidence related to community health nursing strategies.&#x0D; Design/ methodology/ approach : Article review was conducted through several electronic databases including Science Direct, Ebsco Host, ProQuest, PubMed, and Google Scholar through the Indonesian National Library account. The keywords used are strategy, community health nursing OR public health nursing, and qualitative. Inclusion criteria include peer-reviewed articles, published in (2000-2020), and qualitative studies. The exclusion criteria are articles that are not in English, not in full text, and do not have a good article writing structure.&#x0D; Findings : This literature search found 7 articles analyzed. The findings of this study indicate that if self nurse ablity, quality nursing care, building partnership, health promotion strategy, and facing challenges have been identified through qualitative studies, they can be used as a strategy in the implementation of community health nursing.&#x0D; Research Limitations : This study only discusses in quantity about community health nursing strategies. This requires further research on the quality of community nursing care to evaluate the strategies that have been implemented.&#x0D; Originality/ Value : The meta-synthesis review provides an interpretation of qualitative data to capture the essence of the phenomenon of interest regarding community health nursing strategies

Thymomas in rabbits

This article will look at thymoma recognition and treatment in rabbits. Medical versus surgical treatment options will be explored along with nursing strategies for dyspnoeic rabbit patients. Thymomas are slow growing neoplasms in the cranial mediastinum that can pose life-threatening complications to rabbit patients. Although the incidence of this condition is thought to be low, clinicians and nurses should be aware of the symptoms and morbidity associated with this condition in order to provide rabbits with the correct treatment options.

Acute stress disorder, coping self-efficacy and subsequent psychological distress among nurses amid COVID-19.

PurposeHealth care professionals, particularly nurses, are considered a vulnerable group to experience acute stress disorder (ASD) and subsequent psychological distress amid COVID‐19 pandemic. This study aims to establish the prevalence of acute stress disorder and predictors of psychological distress among Jordanian nurses.MethodsA quantitative, cross‐sectional, descriptive and comparative design was used. Data were collected using a Web‐based survey. A total of 448 Jordanian nurses (73% females) completed and returned the study questionnaire.ResultsThe majority of nurses (64%) are experiencing ASD due to the COVID‐19 pandemic and thus are at risk for PTSD predisposition. More than one‐third of nurses (41%) are also suffering significant psychological distress. Among our sample, age, ASD and coping self‐efficacy significantly predicted psychological distress. More specifically, younger nurses are more prone to experience psychological distress than older ones. While higher scores on ASD showed more resultant psychological distress, coping self‐efficacy was a protective factor.ConclusionGiven that individuals who suffer from ASD are predisposed to PTSD, follow‐up with nurses to screen for PTSD and referral to appropriate psychological services is pivotal. Coping self‐efficacy is found to ameliorate the effect of psychological distress on nurses' traumatic experience. Such findings warrant intensive efforts from health care institutions to provide psychosocial support services for nurses and ongoing efforts to screen them for traumatic and psychological distress symptoms.Implications for Nursing ManagementNursing leaders and managers are in the forefront of responding to the unique needs of their workforces during the COVID‐19 crisis. They need to implement stress‐reduction strategies for nurses through providing consecutive rest days, rotating allocations of complex patients, arranging support services and being accessible to staff. They also need to ensure nurses' personal safety through securing and providing personal safety measures and undertake briefings to ensure their staff's physical and mental well‐being, as well as providing referrals to appropriate psychological services.

Stress management training program for stress reduction and coping improvement in public health nurses: A randomized controlled trial.

This study aimed to evaluate the effect of the stress management interventional program in reducing occupational stress and improving coping strategies among public health nurses. A double-blind, cluster-randomized approach was used as a randomization method for this study to evaluate the stress management interventional program. A cluster-randomized controlled trial was carried out in eight comprehensive healthcare centres in Amman city, Jordan; four centres were randomly assigned to each experimental and control group. One hundred and seventy nurses were selected randomly from March 2019 - August 2019 and data were collected by using the Nursing Stress Scale & brief COPE over three data collection times. Both descriptive and inferential statistics (repeated measure ANOVA, Independent t test, and chi-squared) were used to answer the research questions of this study. The results showed that both the levels of occupational stress and coping strategies were significantly different between the two study groups over the three data collection points (p<0.05). Based on the findings of this study, the stress management program is an effective non-invasive method that can be used to reduce stress levels and improve coping strategies for public health nurses. The implementation of stress management interventions in health care is likely to help nurses manage occupational stress in practice. Nurses suffer from a high level of occupational stress. In particular, approximately74% of nurses experience severe occupational stress, which can lead to many mental and physical disorders. However, nurses were less able to utilize the correct stress preventive strategies due to gaps in knowledge, skills, and awareness. This study contributed to the provision of empirical evidence of the effectiveness of the stress management program in reducing occupational stress and improving coping strategies among public health nurses. A stress management intervention program is a valuable non-invasive method that can be used by healthcare organizations to reduce stress levels and improve coping strategies for nurses in practice. NCT03833986.

Promoção da saúde e prevenção do câncer do colo uterino: estratégias utilizadas pelos enfermeiros

Objetivo: analisar os cuidados realizados para a promoção da saúde na prevenção do câncer do colo do útero pelos enfermeiros na Atenção Primária à Saúde conforme protocolo Ministerial. Metodologia: trata-se de uma pesquisa de campo de abordagem qualitativa, descritiva e exploratória. O estudo foi realizado com dez enfermeiras vinculadas às equipes de Estratégia Saúde da Família de um município da região central do Estado do Rio Grande do Sul. A seleção, ocorreu de forma aleatória através de sorteio. A coleta de dados foi realizada a partir de entrevista semiestruturada. Os resultados obtidos na coleta de dados foram analisados de acordo com análise de conteúdo de Minayo. Resultados: resultaram três categorias. A promoção da saúde como estratégia de cuidado de enfermagem; O cuidado de enfermagem a partir do protocolo do Ministério da Saúde; O acesso aos serviços como estratégia de cuidado de enfermagem. Percebe-se que entre as enfermeiras, o cuidado desvela-se um processo de trabalho bastante heterogêneo, sendo que a promoção e a prevenção do câncer do colo do útero ocorrem de forma desigual e fragmentada. Considerações finais: para o cuidado efetivo das mulheres, é necessário que a educação permanente em saúde seja balizada em mudanças, permeada com sentidos e significados para que o cuidado seja pautado por meio de evidências científicas e alicerçado nos protocolos oficias instituídos.

Use of an audit with feedback implementation strategy to promote medication error reporting by nurses.

To outline the development and effect of an audit with feedback implementation strategy that intended to increase the rate of voluntary medication error reporting by nurses. Medication errors are a serious global health issue. Audit with feedback is a widely used implementation strategy that has potential to modify nurses' reporting behaviour and improve medication error reporting rates. Quasi-experimental implementation study (fulfilling the TIDieR checklist) with two pairs of matched wards at a private hospital in Australia was conducted from March 2015-September 2016. One ward from each pair was randomised to either the intervention or control group. Nurses within intervention wards received audit with feedback on a quarterly basis over a 12-month implementation period. Control wards underwent quarterly audits only (without feedback). Feedback consisted of a one-page infographic poster, with content based on medication error data obtained from audits and the hospitals' risk management system (RiskMan). The primary outcome-rate of medication errors reported per month-was determined in both groups at pre-implementation, implementation and postimplementation phases. Differences between groups were compared using generalised linear mixed models with Poisson distribution and log link. A nonsignificant intervention effect was found for rate of medication errors reported per month. Interestingly, when combining data from both groups, a significant increasing time trend was observed for medication errors reported per month across pre-implementation and implementation phases (80% increase). The audit with feedback strategy developed in the present study did not effectively influence the voluntary reporting of medication errors by nurses. Despite the lack of intervention effects, the use of a published checklist to optimise the reporting quality of this study will contribute to the field by furthering the understanding of how to enhance audit with feedback implementation strategies for nurses.

Nursing strategies for the facial skin injuries caused by wearing medical-grade protective equipment

For effective resistance to virus attack and infection and reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. The paper summarizes the occurrence causes, common locations, and prevention ways about the device related pressure ulcers on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the prevention and nursing strategies for device related pressure ulcers and other related skin injuries during application of medical-grade protective equipment. The paper aims to provide reference for the prevention and nursing of device related pressure ulcers and related skin diseases for clinical medical staff, especially to the respectable personnel in front line of fighting against coronavirus disease 2019.

What's in this Special Issue

What's in this Special Issue

The Stress and Coping Strategies in Nurses of a Tertiary Hospital, Punjab

Introduction: Stress is a non-specific reaction over organic entities initiated. Adapting for stress (coping) may be portrayed concerning illustration that fruitful management from claiming issues and particular distressing circumstances. The aim of this study is to assess the level of stress and coping strategies in nurses working at DHQ teaching hospital Dera ghazi khan Punjab Pakistan. Method: In this study, quantitative cross-sectional study design is used. A self-administered questionnaire was designed to assess the job-related stress level and coping strategies among nurses. The data was analyzed by SPSS version-18. Results: Out of 100 nurses, only (02) 2% nurses show severe level of stress, (76) 76% show moderate level of stress and remaining (22) 22% were mildly stressed. The level of stress attains maximum value r = +1, the coping strategy is r = 0.218 in one-tailed in term of two-tail its value become .030 having negative correlation one variable increase other decreased and vice versa. Conclusions: This study concluded that as the coping level of nurse’s increase the stress level goes down and when nurses fail to cope the stress level become increased. The night shift enhances the work load and cause stress and qualified nurses cope with stress more effectively than diploma holders.

Interview With Cathleen Wheatley, DNP, RN, CENP

There are interviews with colleagues that are intriguing. Then there are interviews that raise the level of nursing’s collective consciousness. Cathleen Wheatley, DNP, RN, CENP, does both. As president of Wake Forest Baptist Medical Center and system chief nurse executive of Wake Forest Baptist Health System, her impact and influence not only benefit those in her care, but those nursing professionals aspiring to effect lasting change. She humbly shares her thoughts and ideas about the changing health care milieu, never realizing how relevant they truly are.

AN ANALYSIS OF COPING STRATEGY FOR NURSE CARE IN FACING PSYCHIATRIC PATIENTS IN INTENSIVE SERVICE UNITS (UPI) AT PSYCHIATRIC HOSPITAL OF DR. SOEROJO MAGELANG

This study aims to get understanding on how the anxiety coping strategies of psychiatric nurses in handling patients who still feel anxious in the Intensive Service Unit (UPI). The method used in this study is a qualitative research by taking data based on the condition of natural objects. The study is conducted on psychiatric nurses in the Intensive Service Unit at Prof. Dr. Soerojo psychiatric Hospital in Magelang. The respondents of this study are taken from stratified purposive sampling that the writers take 2 female psychiatric nurses from female UPI and 3 male psychiatric nurses from Male UPI. Data are collected by observation and interview. The results show that the coping strategies that emerged from each subject differr one another, not all aspects of the coping strategy were used by the respondents. This means that by varying the coping strategies emerging from each respondent can be used as a reference as a study learned by individuals with the same conditions experienced by the respondents.

\u201cWe try our best to offer them the little that we can\u201d coping strategies of Ghanaian community psychiatric nurses: a qualitative descriptive study

IntroductionCommunity psychiatric nurses work in extremely stressful environments with intense patient relationships as they try to prevent self-harm and manage aggressive behaviors. In order to improve their ability to manage the stressful work environments, community psychiatric nurses need to incorporate formal coping strategies into their daily work routines. With evidence-based coping strategies, community psychiatric nurses can effectively manage the stressful situations in their work environment to increase their work longevity. The purpose of this study was to explore the individual coping strategies currently used by community psychiatric nurses in practice in order to develop an intervention strategy for future implementation.MethodsThis was an exploratory qualitative study using an interpretative approach. A purposive sampling method was used to identify participants from the community psychiatric nurses in a region of Ghana. Participants were recruited and interviewed, guided by semi-structured questions, until saturation was reached. The interviews were audio-taped, transcribed verbatim, and analyzed thematically.ResultsA total of 13 participants, 10 women and 3 men ages 26 to 60 years, were interviewed for this study. From the inductive analysis, four coping themes emerged from the data including: 1) self-disguise, 2) reliance on religious faith, 3) self-motivation, and 4) reduction in the number of home visits. The participants described their work environment as stressful, almost to the point of overwhelming. In this regard, they identified the individual coping strategies as critical daily practices for self care to manage their high stress levels.ConclusionIndividual coping strategies are often used by community psychiatric nurses in daily practice. The participants identified personal coping strategies as critical interventions to manage stress and to decrease their risk for burnout. However, community psychiatric nurses must develop.personal-mastery in various coping strategies to care for themselves, as well as motivate them despite the challenging working environment. The individual coping strategies adopted by community psychiatric nurses was not only helped them deliver care, but also protected their clients so people would not label them as ‘mental patients.’ Collectively, the four strategies reported in this study need to be developed into a cohesive and comprehensive intervention.

Current status quo of ICU low-grade nurse training and management

Abstract Intensive care unit (ICU) needs professional nursing staff with high professionalism to ensure the quality of nursing work and ensure patient's safety. However, low-age nurses play an important role in the ICU care team. In this study the authors reviewed the relevant literature, summarized the basic characteristics and training methods of ICU low-grade nurses, and analyzed the insecure factors and management strategies of ICU low-grade nurses.

Exploring experiences and coping strategies of nurses working in intensive care unit: A qualitative study

Background: The nursing profession is in its developing stages in the country yet when it comes to the work itself, the environment can be very competitive. Though nurses, in general, go through a tough time, it is the intensive care unit (ICU) nurses who have to be on their toes all the time. Those working in the pediatric department, deal with young patients requiring constant supervision and care compared to other ICUs.&#x0D; The aim of the current project was to explore the experiences and coping strategies of nurses working in pediatric ICUs in a public sector hospital of Lahore, Pakistan.&#x0D; Methodology: Semi structured in-depth interviews were conducted with 5 nurses who were working in pediatric ICU (PICU) in a public sector hospital. All the nurses were female.&#x0D; Results: The data was managed and analyzed using NVivo 12 version. The four superordinate themes, e.g. vocational problems, psychological problems, biosocial problems and coping had 11 master themes and 70 sub themes. &#x0D; Conclusion: Nurses in PICU face a lot of problems in their everyday work life, yet they have found their own ways to cope with their stress. Regardless the shortage of staff and constant complaints against them, nurses of PICU find solace in religious coping and socialization (as much as they can get). These results will help authorities to look into the problems and provide suitable solutions.&#x0D; Citation: Zulfiqar L, Rafiq M. Exploring experiences and coping strategies of nurses working in intensive care unit: A qualitative study. Anaesth Pain Intensive Care 2020;24(1):__&#x0D; DOI: https://doi.org/10.35975/apic.v2i1.&#x0D; Received – 03 February 2020;&#x0D; Reviewed – 7 March 2020;&#x0D; Revised – 11 March 2020;&#x0D; Accepted – 12 March 2020;

Factors Affecting Health-related Quality of Life for Subjects with Breast Cancer

Background/Objectives: The purpose of this study was to compare the health-related quality of life between subjects in good health and subjects with breast cancer.Method/Statistical Analysis: A secondary analysis was performed with data from 255 adults using raw data from the Korean National Examination Survey (KNHANES) conducted from 2010 to 2017.Findings: Subjects with breast cancer displayed a poor level of health awareness and high activity confinement. The EQ-5D index scores between subjects in good health and subjects with breast cancer did not show any significant differences. However, factors affecting health related quality of life for subjects with breast cancer and subjects in good health were different. Household income, perceived health status and activity confinement were the strongest factors affecting the health related quality of life among subjects with breast cancer while residential area, level of education, household composition, perceived health status, activity confinement and BMI were significant for subjects in good health.Improvements/Applications: The results of the study will be instrumental in giving insights on health-related quality of life for patients with breast cancer and establishing nursing strategies to promote their HR-QoL.

Assistência de enfermagem no manejo da dor em crianças com anemia falciforme: uma revisão integrativa

Objetivo: analisar as estratégias de cuidado de Enfermagem empregadas no manejo da dor em crianças com anemia falciforme. Método: revisão integrativa da literatura sobre o tema nas bases virtuais de dados Scielo, Lilacs, PubMed, MEDLINE e BDENF nos meses de janeiro e fevereiro de 2020. Resultados: foram selecionados 17 artigos e identificadas duas categorias analíticas: conhecimento dos profissionais e educação das crianças e familiares sobre o processo patológico da dor e tratamento farmacológico e não farmacológico para o manejo da dor. Conclusão: como estratégias no enfrentamento da dor em crianças há o tratamento farmacológico e não farmacológico adequado, além do conhecimento da Enfermagem que previne complicações, bem como a educação das crianças e familiares sobre a doença, que favorece a melhora e adaptação aos sintomas.

Estratégias utilizadas por enfermeiras para minimizar a ocorrência de delirium em pacientes críticos

Objetivo: descrever as estratégias utilizadas por enfermeiras para minimizar a ocorrência de delirium em pacientes internados em unidade de terapia intensiva (UTI). Método: estudo exploratório-descritivo, de abordagem qualitativa, desenvolvido em um hospital de ensino, público, de grande porte da cidade de Salvador. Foi realizado nos meses de setembro e outubro de 2018, participaram do estudo 16 enfermeiras. Os dados foram coletados mediante entrevista semiestruturada e analisados por meio da “Técnica de Análise de Conteúdo Temática”. Resultados: da análise dos dados emergiram duas categorias temáticas, denominadas: “Desconhecimento sobre monitorização do delirium em UTI” e “Estratégias das enfermeiras para minimizar a ocorrência de delirium em UTI”. Conclusão: apesar do pouco conhecimento das enfermeiras sobre o delirium existe uma coerência quantos aos métodos de intervenções para preveni-lo. A implementação de protocolos e atividades educativas são imprescindíveis para empoderar o enfermeiro quanto às intervenções realizadas.

Thinking and Discussion on Nursing Mode of New Infectious Diseases

With the spread of new coronavirus in the world, all countries are facing a serious public health security crisis. How to effectively deal with new infectious diseases has become a hot topic of research and discussion. Based on this, this paper first studies the self-protection of nursing staff under the new infectious disease epidemic situation, then analyses the nursing strategies of the new infectious disease epidemic situation, and finally gives the management strategies and suggestions for the new infectious disease epidemic situation nursing.