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Providing Personal Care to Patients: The Role of Nursing Students' Emotional Labor
Get PDFProviding personal care may be a source of emotional difficulties and negative feelings for students interacting with patients during their first clinical placement. This study was done to describe the role of emotional strategies for first year nursing students providing personal care to patients and the relationship of these strategies to students' emotional exhaustion, self-efficacy, and turnover intention. A self-reported questionnaire was administrated to a convenience sample of 226 first-year undergraduate nursing students attending their first clinical placement in one Italian University hospital. Results suggested a positive link between students' cognitive re-evaluation of their experiences and their self-perceived self-efficacy. Attentional deployment was the strongest antecedent of emotional exhaustion. Emotional dissonance was the primary contributor to students' turnover intention. Emotional exhaustion mediated the relationship between emotional dissonance and turnover intention. This research suggested that there are emotional coping strategies useful for protecting student nurses from emotional exhaustion and turnover intention and that these strategies are positively related to students' self-perceived self-efficacy in providing personal care
Ethical perspectives in communication in cancer care: An interpretative phenomenological study
No full textBackground: In cancer care, many clinical contexts still lack a good-quality patient–health professional communication about diagnosis and prognosis. Information transmission enables patients to make informed choices about their own healthcare. Nevertheless, disclosure is still an ethically challenging clinical problem in cancer care. High-quality care can be achieved by understanding the perspectives of others. The perspective of patients, their caregivers, physicians and nurses have seldom been simultaneously studied. Objective: To investigate the phenomenon of diagnosis and prognosis-related communication as experienced by patients, their caregivers, and both their attending nurses and physicians, to enlighten meanings attached to communication by the four parties. Methods: A qualitative study using interpretative phenomenological analysis was performed. Participants and research context: Purposive sampling of six patients, six caregivers, seven nurses and five physicians was performed in two oncological hospitals in Italy. Ethical considerations: Local Ethics Committee approved the study. It was guided by the ethical principles of voluntary enrolment, anonymity, privacy and confidentiality. Results: Three main themes were identified: (a) the infinite range of possibilities in knowing and willing to know, (b) communication with the patient as a conflicting situation and (c) the bind of implicit and explicit meaning of communication. Conclusion: The interplay of meanings attached by patients, their caregivers, and their attending oncologist and nurse to communication about diagnosis and prognosis revealed complexities and ambiguities not yet settled. Physicians still need to solve the ethical tensions in their caring relationship with patients to really allow them ‘to choose with dignity and being aware of it’. Nurses need to develop awareness about their role in diagnosis and prognosis-related communication. This cognizance is essential not just to assure consistency of communication within the multi-disciplinary team but mostly because it allows and enables the moral agent to take its own responsibilities and be accountable for them
Relationship between tutor support, caring self-efficacy and intention to leave of nursing students: the roles of self-compassion as mediator and moderator
Get PDFObjectives: Analyze the mediating e moderating roles of self-compassion in the relationship between tutor support and both students' caring efficacy and intention to leave. Methods: A cross-sectional study using an online questionnaire was conducted. Results: Self-compassion mediates the relationship between tutor support and students' caring efficacy. Tutor support play a role on all the facets of self-compassion, but only two dimensions of this variable (mindfulness vs. over-identification) are significantly associated with both the dimensions of caring self-efficacy, with inverse effects. Self-compassion moderates the relationship between tutor support and intention to leave. Conclusions: Tutor support can improve students' caring efficacy by helping them to be mindful of their experiences in a nonjudgmental way. Supportive tutor can mitigate intention to leave by increasing self-compassion ability. Implications for International Audience Nursing education programs should implement workshops and briefings to develop students' self-compassion ability. This can foster perceived caring efficacy in students and reduce intention to leave
Does Screening for Bipolar Disorders Identify a “Dysregulation of Mood, Energy, and Social Rhythms Syndrome” (DYMERS)? A Heuristic Working Hypothesis
Get PDFThe aim of this paper is to verify if people with a positive score on the Mood Disorder Questionnaire (MDQ) without comorbidity of mood disorders showed a worse level of Health-related Quality of life (HRQol) compared to a control-matched sample of MDQ negatives, identifying a specific syndrome. This is a case-control study based on a database from a community survey. Cases: MDQ-positive without mood disorders; Controls: MDQ negatives matched by sex, age, and psychiatric diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria. Tools: MDQ, the Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS) semi-structured interview for psychiatric diagnosis, and the Health Survey Short Form (SF-12) for measuring HRQol. People scoring positive on the MDQ without a diagnosis of mood disorders showed significantly lower scores on the SF-12 compared to people of the same age and of the same sex with an equal diagnosis of psychiatric disorders not related to mood disorders (35.21 ± 6.30 vs. 41.48 ± 3.39, p < 0.0001). In the debate whether a positive score on the MDQ selects an area of “malaise” due to the presence of disorders differing from Bipolar Disorders, or if a positive score on the MDQ may be considered a “subthreshold” form of bipolar disorder in people who may later develop bipolar disorder, a third hypothesis can be advanced, i.e., that a positive score on the MDQ identifies a specific “Dysregulation of Mood, Energy, and Social Rhythms Syndrome” (DYMERS), characterized by a considerable amount of suffering and not attributable to other disorders, and which might represent a trigger for the previously mentioned disorders with which a positive score on the MDQ is associated, probably including, in severe conditions, bipolar disorder
Screening, Genetic Variants, and Bipolar Disorders: Can Useful Hypotheses Arise from the Sum of Partial Failures?
Get PDFBipolar disorder (BD) is a relevant public health issue, therefore accurate screening tools could be useful. The objective of this study is to verify the accuracy of the Mood Disorder Questionnaire (MDQ) and genetic risk as screeners, and their comparison in terms of reliability. Older adults (N = 61, ≥60 years) received a clinical psychiatric evaluation, the MDQ, and were evaluated according to the presence of the genetic variant RS1006737 of CACNA1C. MDQ+ versus the diagnosis of BD as a gold standard shows a sensitivity of 0.286 (Cl 95% 0.14–0.39); a specificity of 0.925 (Cl 95% 0.85–0.08); a predictive positive value (PPV) of 0.667 (Cl 95% 0.33–0.91); and a predictive negative value (PNV) of 0.702 (Cl 95% 0.65–0.75). The positivity for the variant RS1006737 of the CACNA1C against the diagnosis of BD as a gold standard shows a sensitivity of 0.750 (Cl 95% 0.55–0.90); a specificity of 0.375 (Cl 95% 0.28–0.45); a PPV of 0.375 (Cl 95% 0.28–0.45); and a PNV of 0.750 (Cl 95% 0.55–0.90). The reliability between the MDQ+ and positivity for the variant RS1006737 of the CACNA1C was very low (K = −0.048, Cl 95% −0.20–0.09). The study found that both the genetic and the paper and pencil test were quite accurate, but were not reliable in case finding. In fact, despite some validity, albeit specular (in the case of a positive genetic test, the probability of having the disorder is very high, whereas in the case of a negative score on the paper and pencil test, the probability of not having the disorder is very high), the unreliability of the two tests (i.e., they certainly do not measure the same underlying dimension) opens the door to the need for an interpretation and the possibility of a synergistic use for screening. From a heuristic perspective, which obviously requires all of the necessary verifications, this study seems to suggest the hypothesis that a condition of hyperactivation common to disorders and stress conditions, and identified by a positive score on the MDQ (which is common to BD, post-traumatic stress disorder (PTSD), and anxiety disorders and whose genetic basis has not yet been clarified) can trigger BD in people with a predisposition to hyperactivity (i.e., in people with the condition identified by the analyzed genetic variant)
Nurses’ behavior regarding pain treatment in an emergency department: A single-center observational study
Get PDFPurpose: The aim of this prospective study was to assess the behavior of emergency department (ED) nurses with regard to pain and their role in pain management in a real-life clinical setting. Methods: A total of 509 consecutive patients were enrolled during a 6-week period. A case-report form was used to collect data on nurses’ approaches to pain, time to analgesia provision, and patient-perceived quality of analgesia. Results: Triage nurses actively inquired about pain in almost every case, but they did not estimate pain intensity in a third of patients. In the majority of cases, triage nurses did not report pain-related findings to the physician, who was the only professional that could prescribe analgesia to patients. The assignment of the color-coding of triage by nurses appears to be related to the perceived severity of the clinical case and a more comprehensive evaluation of pain. More than half of patients were at least fairly satisfied with analgesia. Conclusion: Pain is increasingly screened during triage, but its comprehensive assessment and management still lack systematic application. We believe that further education and implementation of analgesia protocols may empower nurses to manage ED patients’ pain more effectively and in a more timely manner
Reliability and Validity of the Health-Promoting Lifestyle Profile II Spanish Version in University Students
Get PDFAim: The purpose of this study was to assess the reliability and validity of the Spanish version of the Health Promoting Lifestyle Profile II (HPLP-II) scale in Colombian university students. Methods: This was a methodological study to verify reliability and construct validity. A total of 763 undergraduate university students in Cali, Colombia, agreed to participate in the study by filling out a form that included information on sociodemographic characteristics and the HPLP-II scale Spanish version. Data were collected between February and June 2021. To determine construct validity, a confirmatory factor analysis was performed, and internal consistency was determined through Cronbach's alpha. Results: The confirmatory factor analysis of the proposed theoretical model showed that the goodness-of-fit indices of the scale demonstrated an acceptable level of validity nearing an excellent level of fit (chi(2) = 7168.98; gl = 1268; p < 0.001; root mean square error of approximation = 0.08; normed fit index, adjusted goodness-of-fit index = 0.95). Cronbach's alpha coefficient of the scale was 0.94, and the subscales ranged from 0.68 to 0.89. Conclusions: The HPLP-II Spanish version is a valid and reliable instrument to assess the health-promoting lifestyle profile of university students
Knowledge and Attitudes Toward Organ Donation and Transplantation Among Nursing Students: A Multicentre Cross-Sectional Study
Get PDFBackground/Objectives: Organ transplantation is a vital treatment for individuals with advanced chronic-degenerative diseases. However, the global shortage of donated organs remains a significant challenge. Improving knowledge and attitudes could positively impact this issue. This study assessed the knowledge and attitudes of nursing students regarding organ donation and transplantation. Methods: A cross-sectional study was conducted using a previously validated questionnaire administered to 235 second- and third-year undergraduate nursing students from two Italian universities. Results: The response rate was 67.3%. Only 40.4% of students felt adequately informed about transplants and brain death, while 12.8% would not authorise organ transplantation for a family member. Willingness to authorise organ procurement from family members in a brain-dead state was positively associated with being atheist or agnostic (χ2 = 7.235; p = 0.022), being in the third year of study (χ2 = 4.282; p = 0.039) and having positive self-assessed knowledge (χ2 = 8.061; p = 0.005). Conclusions: Nursing students exhibited suboptimal knowledge and positive attitudes toward organ and tissue donation. However, there is a need for health policymakers to implement strategies to raise awareness of the importance of organ donation through school and community programmes and public education campaigns
The Quality of Life of People with Solid Cancer is Less Worse than Other Diseases with better Prognosis, Except in the Presence of Depression
Get PDFBackground: Suffering from Solid Cancer (SC) may adversely impact the Health-related Quality of Life (H-QoL). The aims of this study are to measure the H-QoL in a sample of people suffering from SC and to clarify the role of the co-occurrence of depressive episodes. Results were compared with a healthy control group and with groups of other disorders. Methods: In 151 patients with SC (mean±sd age 63.1±11.5; female 54.3%), H-QoL was assessed by SF-12, depressive episodes were identified by PHQ-9. The attributable burden of SC in impairing H-QoL was calculated as the difference between SF-12 score of a community sex and age 1⁄4 matched healthy control group and that of the study sample. The attributable burden of SC was compared with other chronic diseases using specific diagnostic groups drawn from case-control studies that used the same database for selecting control samples. Results: H-QoL in people with SC was significantly worse than in the healthy control group (p<0.0001). The attributable burden in worsening the H-QoL due to SC was similar to those of severe chronic diseases, but lower than Multiple Sclerosis (p<0.0001) or Fibromyalgia (p<0.00001). Having a depressive episode was a strong determinant of decreasing H-QoL, regardless of the severity of cancer. Conclusion: The findings confirm a strong impact of SC but showed that H-QoL in SC was higher than in chronic diseases with better “quoad vitam” outcome. Since depression was a strong determinant, its prevention, early detection and therapy are the main objectives that must be reached in cancer patients
The Impact on Anxiety Symptoms of an Immersive Virtual Reality Remediation Program in Bipolar Disorders: A Randomized Clinical Trial
Get PDFBackground: The objective of this work is to investigate the effectiveness of a cognitive remediation intervention on anxiety symptoms in people with bipolar disorder and the therapeutic effect on people whose anxiety symptoms were above the threshold for a screener and whose comorbidity could be identified as an anxiety disorder. Methods: The experimental intervention included 24 sessions (around 45 min each), two for each week over three months. The entire program was inspired by user-centered rehabilitation principles in a recovery-oriented perspective and an approach to bipolar disorder in an evolutionary and non-discriminating vision. The primary outcomes measure the score of the Zung Self-Rating Anxiety Scale (SAS), hypothesizing a higher decrease in the experimental group than in the control group. The survey has been conducted per the CONSORT guidelines for feasibility studies. Results: We evaluate a decrease in the overall SAS score from T0 to T1 to be higher in the experimental group compared to the control group, indicating an improvement in anxiety symptoms (p < 0.0001). Conclusions: The study suggests that virtual reality could have a role in treating anxiety symptoms and disorders in young adults with bipolar disorders or anxiety symptoms in people with hyperactivity and novelty-seeking behaviorsunder stress and high risk for bipolar disorder
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