14 research outputs found
Effectiveness of Innovative Transitional Care Program in Improving Post Discharged Outcomes Among Caregivers of Traumatic Brain Injury Survivors: A Randomized Controlled Trial
Get PDFDoctor of Philosophy (Nursing Science (International Program)), 2023Caring for patients with traumatic brain injury (TBI) during the transition period from hospital to home can cause psychological disturbances to caregivers. Nursing interventions to support these caregivers delivered before discharge and continuing into the community might improve their mental health outcomes. The study aimed to assess the effectiveness of an innovative transitional care program in improving post-discharge outcomes among caregivers of TBI survivors. A randomized controlled trial study was conducted. Random Allocation Software allocated 74 study participants to the intervention or control group. Then, 37 participants were included in the intervention group, while 37 were included in the control group. Outcomes were measured at 3-time points: at hospital discharge (T0), two (T1) and four (T2) weeks post-discharge. The intervention instrument was an innovative transitional care program. Another two instruments, including Caregiver Stress Self-Assessment and Zarit Burden Interview, were used for data collection. The corrected item-total correlation of Caregiver Stress Self-Assessment ranges from .77 to .95, with the Cronbach’s alpha value of .91. In comparison, the range of the corrected item-total correlation of the Short-Zarit Burden Interview from .69 to .93, with Cronbach’s alpha value of 0.88. Data were analyzed using repeated-measure ANOVA.
The findings showed that stress within the intervention group decreased over time (p<.001, MD = 11.05). Both groups' stress was significantly different at T1 and T2 (p<.001). The caregiver burden showed similar results (T1 p<.001 and T2 p<.001). Only one patient in the control group was readmitted to the hospital, while no patients were readmitted in the intervention group. The innovative transitional care intervention reduced the stress and burden of caregivers of patients with moderate or severe TBI. Nurses must consider using mobile application to support caregivers from the hospital into the community.PSU Extension Centreการดูแลผู้ป่วยที่มีอาการบาดเจ็บที่สมอง (TBI) ในช่วงเปลี่ยนผ่านจากโรงพยาบาลสู่บ้านอาจทำให้เกิดการรบกวนทางจิตแก่ผู้ดูแลได้ การแทรกแซงทางการพยาบาลเพื่อสนับสนุนผู้ดูแลเหล่านี้ก่อนจำหน่ายและเดินทางต่อในชุมชนอาจช่วยปรับปรุงผลลัพธ์ด้านสุขภาพจิตของพวกเขา การศึกษานี้มีวัตถุประสงค์เพื่อประเมินประสิทธิผลของโปรแกรมการดูแลเฉพาะกาลที่เป็นนวัตกรรมใหม่ในการปรับปรุงผลลัพธ์หลังออกจากโรงพยาบาลในผู้ดูแลผู้รอดชีวิตจาก TBI มีการศึกษาทดลองแบบสุ่มมีกลุ่มควบคุม ซอฟต์แวร์การจัดสรรแบบสุ่มจัดสรรผู้เข้าร่วมการศึกษา 74 คนให้กับกลุ่มแทรกแซงหรือกลุ่มควบคุม จากนั้น มีผู้เข้าร่วม 37 คนรวมอยู่ในกลุ่มแทรกแซง ขณะที่ 37 คนรวมอยู่ในกลุ่มควบคุม วัดผลลัพธ์ที่จุดเวลา 3 ครั้ง: เมื่อออกจากโรงพยาบาล (T0) สอง (T1) และสี่ (T2) สัปดาห์หลังออกจากโรงพยาบาล เครื่องมือแทรกแซงเป็นโปรแกรมการดูแลเฉพาะกาลที่เป็นนวัตกรรมใหม่ เครื่องมืออีกสองชิ้น ได้แก่ การประเมินตนเองความเครียดของผู้ดูแล และการสัมภาษณ์ภาระของซาริต ถูกนำมาใช้ในการรวบรวมข้อมูล ความสัมพันธ์ระหว่างรายการ-รวมที่แก้ไขแล้วของการประเมินตนเองความเครียดของผู้ดูแลอยู่ในช่วงตั้งแต่ .77 ถึง .95 โดยมีค่าอัลฟ่าของครอนบาคอยู่ที่ .91 ในการเปรียบเทียบ ช่วงของความสัมพันธ์ระหว่างรายการ-ผลรวมที่ได้รับการแก้ไขของการสัมภาษณ์ภาระระยะสั้นจาก .69 ถึง .93 โดยมีค่าอัลฟ่าของ Cronbach เท่ากับ 0.88 วิเคราะห์ข้อมูลโดยใช้ ANOVA การวัดซ้ำ
ผลการวิจัยพบว่าความเครียดภายในกลุ่มแทรกแซงลดลงเมื่อเวลาผ่านไป (p<.001, MD = 11.05) ความเครียดของทั้งสองกลุ่มแตกต่างกันอย่างมีนัยสำคัญที่ T1 และ T2 (p<.001) ภาระผู้ดูแลให้ผลลัพธ์ใกล้เคียงกัน (T1 p<.001 และ T2 p<.001) ผู้ป่วยในกลุ่มควบคุมเพียงรายเดียวเท่านั้นที่ถูกส่งกลับโรงพยาบาล ในขณะที่ไม่มีผู้ป่วยกลับเข้ามาในกลุ่มแทรกแซง นวัตกรรมการดูแลเฉพาะกาลช่วยลดความเครียดและภาระของผู้ดูแลผู้ป่วยที่เป็นโรค TBI ระดับปานกลางหรือรุนแรง พยาบาลต้องพิจารณาใช้แอปพลิเคชันบนมือถือเพื่อสนับสนุนผู้ดูแลจากโรงพยาบาลสู่ชุมช
Feasibility Study Of M-Health Transition Care Program For Traumatic Brain Injury Caregivers
Get PDFBackground: Caring in discharge transition for patients with moderate to severe traumatic brain injury (TBI) has impacted caregivers. MHealth has become popular for communication between a patient/caregiver and a health profession integrated into numerous public well-being programs in low-middle income countries but is limited for TBI caregivers.
Purpose: This study aims to assess the feasibility of the mHealth supportive care transition program based on transitional care theory for improving discharge readiness and reducing caregivers\u27 transition stress and burden of caregiving and the patient\u27s readmission rate.
Methods: Seven family caregivers who met inclusion criteria were recruited. The mHealth supportive care transition program includes education and face-to-face information assisted by an android-based application, skill demonstration, assessment of the readiness of hospital discharge, and weekly monitoring and follow-up after the patient\u27s discharge is given. The outcomes were evaluated using a validated and standardized scale designed to measure transition stress and the burden of caregiving at the baseline, two weeks, and one-month post-discharge, including the patient\u27s readmission one month (within 28 days) after discharge. Feedback through the mHealth satisfaction questionnaire on the trial feasibility was also collected.
Results: The initial findings showed that all subjects experienced a decrease of stress transition and caregiver burden at two weeks and one-month post-discharge follow-up. High satisfaction scores on mHealth were also reported and no patient was readmitted within 28 days.
Conclusion: This feasibility study showed the mHealth supportive care transition program is feasible for implementation, but it is required to test the effectiveness in the next phase on RCT with a larger sample size
Experiences of discharge planning practices among Indonesian nurses: A qualitative study
No full textBackground: Discharge planning is vital to preventing hospital readmission, and nurses play a key role. The COVID-19 pandemic has posed challenges to hospital services that may persist or recur. Therefore, exploring nurses’ experiences with discharge planning practices before and during this pandemic is crucial.
Objective: This study aimed to describe the experiences of discharge planning practices among nurses at an Indonesian tertiary hospital before and during the COVID-19 pandemic.
Methods: A qualitative descriptive study design was used. Telephone interviews were conducted to collect data among ten nurses from March 2019 and continued between December 2020 and August 2021. Content analysis was done for data analysis.
Results: Two main themes emerged: 1) Challenges in discharge planning practices and 2) Perceived discharge planning as a professional responsibility. Implementing the inpatient ward fusion policy as part of the hospital’s pandemic response presented greater challenges to nurses in coordinating care and performing discharge planning. Fear of COVID-19 infection, social distancing measures, and using personal protective equipment also affected how nurses delivered discharge education during the pandemic. However, the nurses sensed a greater responsibility to ensure the maintenance of essential components of discharge planning procedures to guarantee the patient’s capability to perform self-care at home.
Conclusion: Nurses viewed discharge planning practices as their responsibility and continued them during the pandemic despite facing various challenges. In addition to recognizing the significance of nurses’ roles in discharge planning practices and overall patient care, it is crucial to anticipate and address the diverse working patterns and styles among healthcare professionals in unified wards, ensuring effective coordination
A Critical Advantage of Hypnobirthing to Ameliorate Antenatal Depression: A Systematic Review and Meta-Analysis
No full textBackground: Pregnant women are likely to experience depression due to various factors. Hypnobirthing is a non-invasive therapy that can be used to treat depression during pregnancy. This study aims to systematically review the effect of hypnobirthing on antenatal depression. Methods: This study employs a systematic review following PRISMA guidelines. Articles were retrieved from PubMed, ScienceDirect, the Cochrane Library, Google Scholar, and hand searches. Articles were included for review if they met the following inclusion criteria: (1) published in the last ten years (2014–2024); (2) the articles published in English; (3) article types are original research articles and reviews; (4) the full text can be retrieved; and (5) the findings of the selected articles should discuss the effect of hypnobirthing or hypnosis for birth. Articles were critically appraised using Joanna Briggs Institute tools. Results: The initial search yielded 7603 records; nine studies met the inclusion criteria for systematic review, and four studies for meta-analysis. The articles were analyzed, and findings were presented in narrative ways and categorized into three themes: the effect of therapy, the administration of the therapy, and the mechanism of the therapy. The therapy was performed by different methods, involving hypnosis, daily relaxation, progressive muscle relaxation, breathing exercises, the J-breathing technique, meditation, visualization, and ego strengthening. Additionally, participants were encouraged to do self-practice at home and were followed up by personal visits, phone calls, or text messages. Conclusions: The majority of the studies found that hypnobirthing ameliorated antenatal depression, despite the variation in initial administration and the duration of therapy. Further research is needed to standardize therapy protocols and explore long-term outcomes
A Mobile Health Transitional Care Intervention Delivered by Nurses Improves Postdischarge Outcomes of Caregivers of Patients with Traumatic Brain Injury: A Randomized Controlled Trial
Get PDFOBJECTIVE: Caring for patients with traumatic brain injury (TBI) during the transition from hospital to home can be psychologically challenging to caregivers. This study aimed to assess the effectiveness of a novel mobile health (m-health) transitional care intervention to reduce stress and burden of caregivers of patients with TBI and to reduce readmissions.
METHODS: A randomized controlled trial was conducted with 74 caregivers of adult patients with moderate or severe TBI admitted to a referral hospital in Indonesia. An m-health application for Android mobile phones was designed including education and information for caregivers. The application included an online chat feature with weekly monitoring. The m-health transitional care intervention also included face-to-face education before hospital discharge. Primary outcomes were caregivers\u27 stress and burden. Outcomes were measured at 3 time points: at hospital discharge, 2 weeks postdischarge, and 4 weeks postdischarge. Random Allocation Software was used for randomization of study participants.
RESULTS: Final analysis included data of 37 caregivers in the intervention group and 37 caregivers in the control group. Stress within the intervention group decreased over time (P \u3c 0.001, mean difference = 11.05). Between both groups, stress was significantly different at 2 weeks and 4 weeks postdischarge (P \u3c 0.001). Caregiver burden showed similar results (2 weeks postdischarge P \u3c 0.001 and 4 weeks postdischarge P \u3c 0.001). Only 1 patient in the control group was readmitted to the hospital.
CONCLUSIONS: The m-health transitional care intervention reduced stress and burden of caregivers of patients with moderate or severe TBI. Nurses should consider using m-health technologies to support caregivers in the transition from the hospital into the community
The Bandung neurosurgery patient outcomes project, Indonesia (Part II): Patient pathways and feasibility and acceptability of telephone follow-up
No full textMore with document work, less with patient care: An institutional ethnography of discharge planning practices for diabetic patients
No full textBackground: Diabetic patients required comprehensive discharge planning. However, this is a complex and challenging process. Nurses play significant roles and experience tensions in operating the everyday discharge planning practices.
Purpose: to explore how nurses’ everyday activities in providing DP for diabetic patients were regulated by the ruling relations operating in the hospital as an institutional context.
Methods: This institutional ethnography study applied phone-call interviews with 18 participants, participant observation, and document review to collect the data. Data analysis was concurrently conducted with the data collection processes following the institutional ethnography analytical approach. Trustworthiness was established.
Results: The everyday discharge planning practices for diabetic patients follow the flow of patient care. Nurses perceived these practices to be problematic as the initial assessment form did not guide the discharge education, which was informal and unstructured, and documentation was burdensome. The hospital accreditation, nurse ward manager, and the registered nurse were identified as the ruling relations that regulate those practices through the hospitals’ standards and forms, monitoring, and completeness principle.
Conclusion: The hospital’s forms, monitoring, and completeness principles are activated as the ruling relation that regulates the discharge planning practices for diabetic patients for satisfying good hospital service quality through standards and forms, monitoring, and completeness principles. This situation drives nurses to work more closely with the documents. Further study is crucial to identify a strategy to effectively bridge discharge planning practices and documentations works
Quality of life of primary brain tumor patients before and 3 months after discharge from a hospital in Bandung, Indonesia
Get PDFBackground: The quality of life of patients with primary brain tumor in Indonesia is poorly understood. Therefore, this study aimed to investigate the health‐related quality of life of patients admitted to the Neurosurgery Department of Dr. Hasan Sadikin Hospital, Bandung, Indonesia, up to 3 months after discharge. Methods: Baseline data were collected from patients aged ≥18 years who were admitted to the hospital between October 9, 2015, and February 17, 2016. In‐person interviews were then conducted 1–2 days pre‐discharge (n = 65) and follow-up telephone interviews were made 1, 2, and 3 months post-discharge (n = 58, 55, and 54, respectively) to collect socio-demographic data, clinical characteristics, and EQ‐5D‐5L data. Results: Prior to discharge, one‐third or less of the 65 patients interviewed reported “no problems” with mobility (32%), self‐care (32%), usual activities (18%), and pain/discomfort (43%), whereas 74% reported “no problems” with anxiety/depression. By contrast, at 3 months post-discharge, an increased proportion of patients reported “no problems” with mobility (61%), self‐care (67%), usual activities (56%), and pain/discomfort (76%), with little change in anxiety/depression (“no problems” 70%). Conclusions: While there was improvement, many patients were still reporting problems at 3 months post-discharge, highlighting the need for ongoing support and care to ensure the best possible outcomes
The Bandung neurosurgery patient outcomes project, Indonesia (Part I): Methods, participant characteristics, and pre-discharge outcomes
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