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Alshehri FA, Levett-Jones T, Pich J. Nursing students' knowledge of and attitudes towards pain management: An integrative review. NURSE EDUCATION TODAY 2024; 139:106207. [PMID: 38669861 DOI: 10.1016/j.nedt.2024.106207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES The objectives of this review were to appraise the available literature regarding nursing students' knowledge of and attitudes towards pain management; and secondly, to examine the instruments currently used to measure students' knowledge of and attitudes towards pain management. DESIGN This review was conducted using Whittemore and Knafl's five-stage framework for integrative reviews. DATA SOURCES A comprehensive search to retrieve relevant studies published in English between 1978 and 2022 was conducted using the databases: CINAHL, MEDLINE, Embase and Scopus databases. An updated search of the same databases was performed to identify studies published in 2023-2024. REVIEW METHODS The initial search located 558 articles. One more relevant article was identified from an updated search test. Total of 244 duplicated records were removed. The remaining 315 studies were eligible for screening. After screening and checking for eligibility, 29 included articles were critically appraised using the Joanna Briggs Institute critical appraisal tools. RESULTS Synthesis of the findings of the 29 included studies indicated that, internationally, nursing students have limited knowledge and often hold negative attitudes towards pain. Various instruments have been used to measure students' knowledge and attitudes towards pain. Most studies used true/false or multiple-choice questions and Likert-type scales. The validity and reliability of most of the tools were reported to be acceptable. The most commonly used instrument was the Knowledge and Attitudes Survey Regarding Pain. CONCLUSION The findings from this review suggest the need for refinement of pain education programs to improve nursing students' knowledge of and attitudes towards pain management. Future research should focus on understanding the personal and environmental factors that impact students' level of knowledge and attitudes so as to inform curriculum development and ultimately the quality of the care graduates provide.
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Affiliation(s)
- Fawaz Abdullah Alshehri
- University of Technology Sydney, Faculty of Health, 235 Jones St, Ultimo, NSW 2007, Australia; University of Tabuk, School of Nursing, Tabuk City, Saudi Arabia.
| | - Tracy Levett-Jones
- University of Technology Sydney, Faculty of Health, 235 Jones St, Ultimo, NSW 2007, Australia.
| | - Jacqui Pich
- University of Technology Sydney, Faculty of Health, 235 Jones St, Ultimo, NSW 2007, Australia.
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Köse Tosunöz İ, Yurtseven Ş, Deniz Doğan S. Perceptions of Nurses Regarding Opioid Administration: A cross-sectional study. Pain Manag Nurs 2024:S1524-9042(24)00022-5. [PMID: 38503631 DOI: 10.1016/j.pmn.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/18/2024] [Accepted: 02/19/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Opioids are important drugs used in pain management due to their strong analgesic effects. However, there is limited research on nurses' perceptions of administering opioids. PURPOSE This study aims to determine nurses' perceptions of administering opioids. DESIGN This study used a descriptive cross-sectional design. SETTINGS A university hospital located in the south of Turkey. METHODS A self-reporting survey was provided to a convenience sample of 190 nurses. The data were collected with the "Introductory Information Form," and the "Nurses' Perceptions on Opioid Medications Administration Questionnaire." Descriptive statistics were applied for data analysis. RESULTS The mean age of the nurses was 33.11 ± 7.82 and 86.3% were female. The majority of the nurses did not receive any training on opioid administration other than their undergraduate education. Among the nursing staff, 90.0% expressed the importance of having trust in the prescribing doctor for their comfort in administering opioids. Of the nurses, 30% were undecided about "Nurses associate opioids with drug abuse." and 78.9% disagreed with the statement "Nurses often associate giving opioids with helping patients to die." CONCLUSIONS The results of this study provided further insight into nurses' perceptions of administering opioids that potentially contribute to pain management. Nurses had information needs and some prejudices regarding opioid administration. Also, relying on the prescribing doctor was important, and problems with prescribing were an obstacle to pain control. CLINICAL IMPLICATIONS Determining the knowledge and needs of nurses regarding opioid administration and providing in-service training on this subject would positively affect their approach to opioids.
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Affiliation(s)
- İpek Köse Tosunöz
- Hatay Mustafa Kemal University, Faculty of Health Sciences, Nursing Department, Hatay, Turkey.
| | - Şeyma Yurtseven
- Çukurova University Balcalı Hospital Health Application and Research Center, Adana, Turkey
| | - Sevgi Deniz Doğan
- Isparta University of Applied Sciences, Uluborlu Selahattin Karasoy Vocational School, Health Services Department, Isparta, Turkey
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Issrani R, Alam MK. Theory of planned behavior as a conceptual framework for the willingness to self-isolate during the COVID-19 pandemic: A regional cross-sectional study. Work 2021; 70:11-20. [PMID: 34487003 DOI: 10.3233/wor-205322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Due to an unavailability of a vaccine, one of the efficient methods to prevent the spread of the novel coronavirus (COVID-19) is by applying self-isolation (SI). Hence there is an urgent need to investigate the factors leading to an individuals' willingness to choose to self-isolate. OBJECTIVES The current study utilized the Theory of Planned Behavior (TPB) as a conceptual model and aimed to investigate the extent to which subjective norms, personal attitudes and perceived control influences an individual's willingness to self-isolate during COVID-19 risk. METHOD A cross-sectional study was performed on 800 Saudi respondents aged≥18 years by using a validated self-administered questionnaire about factors related to willingness to self-isolate during COVID-19 pandemic risk based on the TPB. The effects of different variables on SI were analyzed by using ordinal logistic regression model. RESULTS A total of 756 (94.5%) were completed and analyzed. Subjective norms and perceived control over the behavior significantly (p < 0.05) influenced the intention of willingness to self-isolate, while attitude was found to be insignificant. The odds of letting others to know about self COVID status were 2.40 times higher than not telling the neighbors or colleagues. A statistically significant difference (p≤0.001) existed between males and females regarding the willingness to self-isolate. Similarly the odds of willingness to self-isolate with a presence of disabled person in family were 2.88 times higher than the absence of a disability in the family. Few recommendations for the policymakers that are needed to curb the spread of COVID-19 infection are also proposed. CONCLUSION The outcomes of study might be considered as an initial understanding of the factors that significantly influences an individual's willingness to SI when facing an unprecedented pandemic risk. Additionally, these factors provide a plan for policymakers to encourage citizens for self-isolation during pandemic infections.
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Affiliation(s)
- Rakhi Issrani
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
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Chung J, Buchanan B. A Self‐Report Survey: Australian Clinicians’ Attitudes Towards Progress Monitoring Measures. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Ben Buchanan
- School of Psychological Sciences, Monash University
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Chinnasamy A, Moodie M. Diabetes Related Knowledge, Attitudes and Practice - A Survey Among Oral Health Professionals in Victoria, Australia. Clin Cosmet Investig Dent 2020; 12:111-121. [PMID: 32308495 PMCID: PMC7138629 DOI: 10.2147/ccide.s240212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/29/2020] [Indexed: 01/29/2023] Open
Abstract
Purpose Until now, little is known as to how well the evidence supporting the link between periodontal disease and diabetes is incorporated in the dental practice, in Australia. This study aims to explore Oral health Professionals (OHP) knowledge, attitudes, and practice (KAP) towards diabetes screening in the dental setting. Methods The survey questionnaire consisted of sociodemographic, practice characteristics and Likert scaled questions categorised in different domains of KAP and one additional domain as barriers. A Mann–Whitney and Kruskal–Wallis test was performed to determine differences in the OHP response. To predict if practice behavior was influenced by knowledge and attitudes, a multiple linear regression was conducted. Results A total of 197 respondents were included in the analysis of the results. General dentists constituted 64.6% of the response. For chairside screening of diabetes, 58% felt it was essential and 70% felt it was appropriate. More public sector OHP (79%) felt it is important to conduct chairside screening for T2DM. Patient willingness was identified as the most important and insurance coverage as the least important (43%) consideration for T2DM screening. Conclusion Overall, knowledge, attitude and practice towards DM were positive, but a significant proportion of the OHP felt chairside screening may not be appropriate or important.
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Affiliation(s)
- Alagesan Chinnasamy
- Melbourne Dental School, The University of Melbourne, Melbourne, VIC, Australia
| | - Marjory Moodie
- Deakin Health Economics, Deakin University, Geelong, VIC, Australia
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El Tantawi M, AlJameel AH, Fita S, AlSahan B, Alsuwaiyan F, El Meligy O. Dentists' intentions to manage drug users: Role of theory of planned behaviour and continuing education. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2019; 23:364-372. [PMID: 31025512 DOI: 10.1111/eje.12438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To assess dentists' intention to manage drug users (DUs) and to evaluate the role of the theory of planned behavior (TPB) and continuing education (CE) in explaining this intention. MATERIALS AND METHODS A cross-sectional study was conducted in 2017, including dentists from three major Saudi cities. A questionnaire assessed personal and professional background and components of TPB: attitude, perceived social norms, perceived control and intention to manage DUs. Respondents expressed their agreement on a scale from 1 (disagree) to 7 (agree). Receiving CE to manage DUs was also assessed. Adjusted linear regression was used to assess the impact of the TPB constructs and receiving CE on dentists' intention. RESULTS Response rate = 72% (255/354), mean (SD) age = 35.2 (11.9). The mean (SD) for positive intention to manage DUs = 5.34 (1.37), negative attitude = 4.03 (1.10), positively perceived norms = 5.78 (1.06) and perception of no control = 4.45 (1.08). Only 9% received CE to manage DUs. Positive intention was associated with perception of positive norms (B = 0.73, 95% CI = 0.59, 0.87) and perception of no control (B = -0.47, 95% CI = -0.63, -0.32) but not with receiving CE (P = 0.58). CONCLUSION In major Saudi cities, dentists' intention to manage DUs was positive and was explained by TPB components: perception of norms and perception of control. Modified and targeted CE is needed to address this problem.
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Affiliation(s)
- Maha El Tantawi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Sarah Fita
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Basma AlSahan
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fatimah Alsuwaiyan
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Omar El Meligy
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Attitude and Intention Regarding Pain Management among Chinese Nursing Students: A Cross-Sectional Questionnaire Survey. Pain Manag Nurs 2017; 18:250-259. [DOI: 10.1016/j.pmn.2017.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 11/02/2016] [Accepted: 01/12/2017] [Indexed: 11/17/2022]
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Youngcharoen P, Vincent C, Park CG. Theory of Planned Behavior Constructs Associated with Nurses’ Pain Assessment and Pro Re Nata (PRN) Opioid Analgesic Administration: A Cross-sectional Study. Pain Manag Nurs 2017; 18:153-169. [DOI: 10.1016/j.pmn.2017.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/18/2016] [Accepted: 03/06/2017] [Indexed: 11/25/2022]
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Denness KJ, Carr ECJ, Seneviratne C, Rae JM. Factors influencing orthopedic nurses’ pain management: A focused ethnography. Can J Pain 2017; 1:226-236. [PMID: 35005357 PMCID: PMC8730550 DOI: 10.1080/24740527.2017.1403285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim: The aim of this study was to explore the factors influencing orthopedic surgery nurses’ decisions to administer pro re nata (PRN) opioid analgesia for postoperative pain. Background: Fast-track surgery programs reduce length of stay by identifying and addressing factors causing patients to remain in hospital, including pain (H. Kehlet, Lancet. 2013;381:9878(9878)). The management of acute pain is an important component of quality care for patients after total knee arthroplasty. Methods: The study used a qualitative design of focused ethnography. Ten nurses working on an orthopedic surgery unit at a large urban hospital in western Canada participated in semistructured interviews that used a patient vignette to examine factors that influenced participants’ pain management in the context of fast-track surgery. Interviews were transcribed and analyzed using thematic analysis and constant comparison. Findings: Nurses described a complex clinical environment where the interplay of several factors informed decisions to administer PRN opioid analgesia. The unit’s culture and physical space influenced nurses’ assessments of pain and their decisions whether to treat pain with PRN opioids. Each nurse’s self-concept affected pain management decisions because of perceived importance of pain control and perceived duty to provide analgesics. The subjectivity of pain added another layer of complexity as nurses responded to the patient’s expression of pain from within the milieu of the unit culture and their unique self-concept. Conclusion: Understanding the complexity of factors that influence nurses’ postoperative pain management provides clinical nurses and nursing leaders with directions for future education and research, guided by the goal of continued improvement in pain management in the challenging setting of fast-track surgeries.
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Affiliation(s)
- Kayla J. Denness
- Acute Pain Service, Alberta Health Services, South Health Campus, Calgary, Alberta, Canada
| | | | | | - Janice M. Rae
- Acute Pain Service, Alberta Health Services, South Health Campus, Calgary, Alberta, Canada
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Factors influencing the intentions of nurses and respiratory therapists to use automated external defibrillators during in-hospital cardiac arrest: a qualitative interview study. CAN J EMERG MED 2016; 20:68-79. [DOI: 10.1017/cem.2016.403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectivesNurses and respiratory therapists are seldom allowed to use automated external defibrillators (AED) during in-hospital cardiac arrest. This can result in significant time delays before defibrillation occurs and lower survival for cardiac arrest victims. We sought to identify barriers and facilitators to AED use by nurses and respiratory therapists.MethodsWe conducted semi-structured qualitative interviews with a purposeful sample of nurses and respiratory therapists. We developed the interview guide based on the constructs of the theory of planned behaviour, which elicits salient attitudes, social influences, and control beliefs potentially influencing the intent to use an AED. Interviews were recorded, transcribed verbatim, and analysed until achieving data saturation. Two independent reviewers performed inductive analyses to identify emerging categories and themes, and ranked them by frequency of the number of participants stating the topic.ResultsDemographics for the 24 interviewees include mean age 40.5, 79.2% female, 87.5% performed cardiopulmonary resuscitation (CPR), 29.2% defibrillated a patient. Identified attitudes pertained to the timeliness of defibrillation, patient survival, simplicity of AED use, accuracy of rhythm recognition, and harm to self or others. Social influences consisted of physician and hospital administration support of AED use. Control beliefs included training on AED use, policy allowing AED use, familiarity with AED, and task burden during resuscitation.ConclusionsMost nurses and respiratory therapists intended to use an AED if permitted to do so by a medical directive. Successful implementation would require educational initiatives focusing on safety and efficacy of AEDs, support from physicians and hospital administrators, and additional training on AED use.
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11
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Youngcharoen P, Vincent C, Park CG, Corte C, Eisenstein AR, Wilkie DJ. Nurses’ Pain Management for Hospitalized Elderly Patients With Postoperative Pain. West J Nurs Res 2016; 38:1409-1432. [DOI: 10.1177/0193945916652896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Using the theory of planned behavior, the study aim was to determine the relationships among nurses’ beliefs, attitudes, perceived norms, perceived behavioral control, intentions, and behavior regarding pain management for hospitalized elderly patients with postoperative pain. A cross-sectional design was used with a convenience sample of 140 nurses working in adult surgical units at three hospitals. Based on path analyses, nurses’ behavioral, normative, and control beliefs, respectively, had direct effects on their attitudes, perceived norms, and perceived behavioral control regarding pain management. Nurses’ attitudes and perceived norms had direct effects on their pain management intentions. However, nurses’ intentions had no direct effect on their behavior (measured by responses to questions about case study vignettes). This study highlights the need for education that enhances nurses’ perceptions of pain management benefits, the influence of normative referents, and their ability to assess pain and administer pro re nata (PRN) opioid analgesics.
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Affiliation(s)
| | | | | | | | | | - Diana J. Wilkie
- University of Illinois at Chicago, USA
- University of Florida, Gainesville, USA
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Vincent C, Riley BB, Wilkie DJ. Developing Items to Measure Theory of Planned Behavior Constructs for Opioid Administration for Children: Pilot Testing. Pain Manag Nurs 2015; 16:900-9. [PMID: 26527107 DOI: 10.1016/j.pmn.2015.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 07/05/2015] [Accepted: 07/13/2015] [Indexed: 11/25/2022]
Abstract
The Theory of Planned Behavior (TpB) is useful to direct nursing research aimed at behavior change. As proposed in the TpB, individuals' attitudes, perceived norms, and perceived behavior control predict their intentions to perform a behavior and subsequently predict their actual performance of the behavior. Our purpose was to apply Fishbein and Ajzen's guidelines to begin development of a valid and reliable instrument for pediatric nurses' attitudes, perceived norms, perceived behavior control, and intentions to administer PRN opioid analgesics when hospitalized children self-report moderate to severe pain. Following Fishbein and Ajzen's directions, we were able to define the behavior of interest and specify the research population, formulate items for direct measures, elicit salient beliefs shared by our target population and formulate items for indirect measures, and prepare and test our questionnaire. For the pilot testing of internal consistency of measurement items, Cronbach alphas were between 0.60 and 0.90 for all constructs. Test-retest reliability correlations ranged from 0.63 to 0.90. Following Fishbein and Ajzen's guidelines was a feasible and organized approach for instrument development. In these early stages, we demonstrated good reliability for most subscales, showing promise for the instrument and its use in pain management research. Better understanding of the TpB constructs will facilitate the development of interventions targeted toward nurses' attitudes, perceived norms, and/or perceived behavior control to ultimately improve their pain behaviors toward reducing pain for vulnerable children.
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Affiliation(s)
- Catherine Vincent
- Department of Women, Children, and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois.
| | - Barth B Riley
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, Illinois
| | - Diana J Wilkie
- Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, Illinois (currently at the College of Nursing, University of Florida, Gainesville, Florida)
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Hong S, Cagle JG, Van Dussen DJ, Carrion IV, Culler KL. Willingness to Use Pain Medication to Treat Pain. PAIN MEDICINE 2015. [DOI: 10.1111/pme.12854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Seokho Hong
- School of Social Work, University of Maryland-Baltimore; Baltimore Maryland USA
| | - John G. Cagle
- School of Social Work, University of Maryland-Baltimore; Baltimore Maryland USA
| | | | - Iraida V. Carrion
- School of Social Work, University of South Florida; Tampa Florida USA
| | - Krystal L. Culler
- Doctor of Behavioral Health Program; Arizona State University, College of Health Solutions; Phoenix AZ USA
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Yin HH, Tse MMY, Wong FKY. Systematic review of the predisposing, enabling, and reinforcing factors which influence nursing administration of opioids in the postoperative period. Jpn J Nurs Sci 2015; 12:259-75. [PMID: 25781037 DOI: 10.1111/jjns.12075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 12/17/2014] [Indexed: 11/28/2022]
Abstract
AIM To provide an overview of the administration of opioid analgesics by nurses when prescription is on an "as-needed" basis for postoperative pain, and to identify the important factors that determine the decisions of nurses, by using the framework of predisposing, reinforcing, and enabling causes in educational diagnosis and evaluation. METHODS Multiple databases were searched for the period from 2000-2012. Out of a total of 1755 citations and 148 abstracts retrieved, 39 studies met the criteria for inclusion. Studies were considered eligible for review if they focused on situations or factors influencing a nurse's performance in pain assessment and the administration of opioid analgesics in postoperative pain management. RESULTS The topics of the descriptive and qualitative studies presented four themes: (i) nurses' knowledge and attitudes about pain management; (ii) the situation of nurses' work practices in administrating range orders for opioid analgesics; (iii) factors that influenced nurses' work practices; and (iv) perceived barriers to effective pain management from the nurse's perspective. The experimental studies investigated the effects of different approaches in nurses' pain management practices in postoperative settings and their outcomes for patients. CONCLUSION A knowledge deficit was observed to be the reason in most cases for a nurse's failure to administrate adequate analgesics for postoperative pain relief. Pain-related education for nurses is the cornerstone to improve pain management. The integration of enabling and reinforcing factors will help nurses to develop the ability to make the decision to engage in a comprehensive intervention to improve pain management and patient outcomes.
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Affiliation(s)
- Hai-Hui Yin
- Department of Nursing Administration, Anhui Provincial Hospital, Hefei
| | - Mimi M Y Tse
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Frances K Y Wong
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
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Preferences, Experience, and Attitudes in the Management of Chronic Pain and Depression. Clin J Pain 2014; 30:766-74. [DOI: 10.1097/ajp.0000000000000035] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vatansever NA, Akansel N. Validation study of the strategic and clinical quality indicators in postoperative pain management questionnaire in Turkish surgery patients. Pain Manag Nurs 2014; 15:871-80. [PMID: 24981119 DOI: 10.1016/j.pmn.2014.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 01/21/2014] [Accepted: 01/23/2014] [Indexed: 10/25/2022]
Abstract
Determining patient satisfaction with postoperative pain management is an important intervention to improve strategies for effective pain control. The aim of this study was to validate an English version of the 14-item Strategic and Clinical Quality Indicators in Postoperative Pain Management questionnaire in Turkish language. The study included 113 patients who underwent elective surgeries at a university hospital in Bursa, Turkey. The data were collected after translation procedures and final adjustments were done on the original instrument. For the total scale, Cronbach's coefficient α was 0.81 and the main score obtained from the scale was 45.8 ± 10.8. Included were three subscales: nursing interventions, pain management, and environments. Of the patients, 40.7% reported more pain than expected in the postoperative period and their satisfaction with pain relief was 7.4 ± 2.5. This instrument is a reliable and valid instrument in Turkish language and can be used to evaluate the effectiveness of postoperative pain management.
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Affiliation(s)
| | - Neriman Akansel
- Department of Surgical Nursing, Uludag University School of Health, Bursa, Turkey.
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Yaakup H, Eng TC, Shah SA. Does Clinical Experience Help Oncology Nursing Staff to Deal with Patient Pain Better than Nurses from other Displines? Knowledge and Attitudes Survey Amongst Nurses in a Tertiary Care in Malaysia. Asian Pac J Cancer Prev 2014; 15:4885-91. [DOI: 10.7314/apjcp.2014.15.12.4885] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Légaré F, Borduas F, Freitas A, Jacques A, Godin G, Luconi F, Grimshaw J. Development of a simple 12-item theory-based instrument to assess the impact of continuing professional development on clinical behavioral intentions. PLoS One 2014; 9:e91013. [PMID: 24643173 PMCID: PMC3958345 DOI: 10.1371/journal.pone.0091013] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/05/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Decision-makers in organizations providing continuing professional development (CPD) have identified the need for routine assessment of its impact on practice. We sought to develop a theory-based instrument for evaluating the impact of CPD activities on health professionals' clinical behavioral intentions. METHODS AND FINDINGS Our multipronged study had four phases. 1) We systematically reviewed the literature for instruments that used socio-cognitive theories to assess healthcare professionals' clinically-oriented behavioral intentions and/or behaviors; we extracted items relating to the theoretical constructs of an integrated model of healthcare professionals' behaviors and removed duplicates. 2) A committee of researchers and CPD decision-makers selected a pool of items relevant to CPD. 3) An international group of experts (n = 70) reached consensus on the most relevant items using electronic Delphi surveys. 4) We created a preliminary instrument with the items found most relevant and assessed its factorial validity, internal consistency and reliability (weighted kappa) over a two-week period among 138 physicians attending a CPD activity. Out of 72 potentially relevant instruments, 47 were analyzed. Of the 1218 items extracted from these, 16% were discarded as improperly phrased and 70% discarded as duplicates. Mapping the remaining items onto the constructs of the integrated model of healthcare professionals' behaviors yielded a minimum of 18 and a maximum of 275 items per construct. The partnership committee retained 61 items covering all seven constructs. Two iterations of the Delphi process produced consensus on a provisional 40-item questionnaire. Exploratory factorial analysis following test-retest resulted in a 12-item questionnaire. Cronbach's coefficients for the constructs varied from 0.77 to 0.85. CONCLUSION A 12-item theory-based instrument for assessing the impact of CPD activities on health professionals' clinical behavioral intentions showed adequate validity and reliability. Further studies could assess its responsiveness to behavior change following CPD activities and its capacity to predict health professionals' clinical performance.
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Affiliation(s)
- France Légaré
- Public Health and Practice-Changing Research Group, CHUQ Research Centre (CRCHUQ), Quebec, Quebec, Canada
| | - Francine Borduas
- Office of the Vice-Dean of Education and Continuing Professional Development, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Adriana Freitas
- Public Health and Practice-Changing Research Group, CHUQ Research Centre (CRCHUQ), Quebec, Quebec, Canada
| | - André Jacques
- Practice Enhancement Division, Collège des médecins du Québec, Montreal, Quebec, Canada
| | - Gaston Godin
- Faculty of Nursing, Université Laval, Quebec, Quebec, Canada
| | - Francesca Luconi
- Continuing Health Professional Education Office, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jeremy Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Ferreira M, Verloo H, Mabire C, Vieira MMS, Marques-Vidal P. Psychometric evaluation of the French version of the questionnaire attitudes towards morphine use; a cross-sectional study in Valais, Switzerland. BMC Nurs 2014; 13:1. [PMID: 24406097 PMCID: PMC4029768 DOI: 10.1186/1472-6955-13-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 01/06/2014] [Indexed: 12/02/2022] Open
Abstract
Background In Switzerland, nurses are allowed to prescribe and administer morphine in emergency situations without a doctor. Still, nurses and other health professionals are often reluctant to prescribe and administer morphine for pain management in patients. No valid French-speaking instrument is available in Switzerland to assess the attitudes of nurses and other health professionals towards the prescription and administration of morphine. In this study, we evaluated the psychometric properties of the French version of the questionnaire “Attitudes towards morphine use”. Methods The instrument was derived from an Italian version. Forward and back translations of the questionnaire were performed. Item analysis and construct validity were assessed between April and December 2010 in a cross sectional study including five Swiss hospitals in a sample of 588 health professionals (533 nurses, mean age 38.3 ± 10.2 years). Thirty subjects participated in test-retest reliability. Results The time to complete the instrument ranged between 12 and 15 minutes and neither floor nor ceiling effect were found. The initial 24-item instrument showed an intraclass correlation (ICC) of 0.69 (95% CI: 0.64 to 0.73, P < 0.001), and a Cronbach’s α of 0.700. Factor analysis led to a six-component solution explaining 52.4% of the total variance. After excluding five items, the shortened version showed an ICC of 0.74 (95% CI, 0.70 to 0.77, P < 0.001) and a Cronbach’s α of 0.741. Factor analysis led to a five-component solution explaining 54.3% of the total variance. The five components were named “risk of addiction/dependence”; “operational reasons for not using morphine”; “risk of escalation”; “other (non-dependence) risks” and “external (non-operational) reasons”. In test-retest, the shortened instrument showed an ICC of 0.797 (95% CI, 0.630 to 0.911, P < 0.001) and a Cronbach’s α of 0.797. Conclusions The 19-item shortened instrument assessing attitudes towards the prescription and administration of morphine showed adequate content and construct validity.
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Affiliation(s)
- Maria Ferreira
- Hôpital de Sion, Avenue Grand-Champsec 80, Case Postale 736, Sion, 1951, Switzerland.
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Kiyang LN, Labrecque M, Doualla-Bell F, Turcotte S, Roch G, Farley C, Bas MC, Légaré F. Nurses' intention to support informed decision-making about breast cancer screening with mammography: a survey. Can J Nurs Res 2014; 45:136-52. [PMID: 24236376 DOI: 10.1177/084456211304500309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There is growing interest in informed decision-making about breast cancer screening with mammography and growing advocacy for the provision of balanced information about potential benefits and harms. The authors report on a survey evaluating nurses' intention to support women targeted by the Quebec Breast Cancer Screening Program in making informed decisions about breast cancer screening with mammography. Of the 840 questionnaires completed, 618 were included in the data analysis. The mean +/- standard deviation score for intention was 1.7 +/- 1.2 on a 6-point Likert scale ranging from -3 to +3, indicating strong intention to support the targeted women. Perceived behavioural control was the theory-based variable most strongly associated with intention, followed by attitude and social norm. These results can be used to develop interventions to train nurses in integrating informed decision-making about breast cancer screening with mammography into their practice and to design relevant decision support tools.
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Affiliation(s)
- Lawrence Ndoh Kiyang
- Centre Hospitalier Universitaire de Québec Research Centre, Hôpital Saint-François d'Assise, Quebec City, Quebec, Canada
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Kip KE, Rosenzweig L, Hernandez DF, Shuman A, Diamond DM, Girling SA, Sullivan KL, Wittenberg T, Witt AM, Lengacher CA, Anderson B, McMillan SC. Accelerated Resolution Therapy for treatment of pain secondary to symptoms of combat-related posttraumatic stress disorder. Eur J Psychotraumatol 2014; 5:24066. [PMID: 24959325 PMCID: PMC4014659 DOI: 10.3402/ejpt.v5.24066] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 04/12/2014] [Accepted: 04/12/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND As many as 70% of veterans with chronic pain treated within the US Veterans Administration (VA) system may have posttraumatic stress disorder (PTSD), and conversely, up to 80% of those with PTSD may have pain. We describe pain experienced by US service members and veterans with symptoms of PTSD, and report on the effect of Accelerated Resolution Therapy (ART), a new, brief exposure-based therapy, on acute pain reduction secondary to treatment of symptoms of PTSD. METHODS A randomized controlled trial of ART versus an attention control (AC) regimen was conducted among 45 US service members/veterans with symptoms of combat-related PTSD. Participants received a mean of 3.7 sessions of ART. RESULTS Mean age was 41.0 + 12.4 years and 20% were female. Most veterans (93%) reported pain. The majority (78%) used descriptive terms indicative of neuropathic pain, with 29% reporting symptoms of a concussion or feeling dazed. Mean pre-/post-change on the Pain Outcomes Questionnaire (POQ) was -16.9±16.6 in the ART group versus -0.7±14.2 in the AC group (p=0.0006). Among POQ subscales, treatment effects with ART were reported for pain intensity (effect size = 1.81, p=0.006), pain-related impairment in mobility (effect size = 0.69, p=0.01), and negative affect (effect size = 1.01, p=0.001). CONCLUSIONS Veterans with symptoms of combat-related PTSD have a high prevalence of significant pain, including neuropathic pain. Brief treatment of symptoms of combat-related PTSD among veterans by use of ART appears to acutely reduce concomitant pain.
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Affiliation(s)
- Kevin E Kip
- College of Nursing, University of South Florida, Tampa, FL, USA
| | | | | | - Amy Shuman
- Western New England University, Springfield, MA, USA
| | - David M Diamond
- Department of Psychology, University of South Florida, Tampa, FL, USA ; Department of Molecular Pharmacology and Physiology, Center for Preclinical/Clinical Research on PTSD, University of South Florida, Tampa, FL, USA
| | - Sue Ann Girling
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Kelly L Sullivan
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | | | | | | | - Brian Anderson
- Pasco County Veterans Service Office, Port Richey, FL, USA
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Nurses' self-efficacy and practices relating to weight management of adult patients: a path analysis. Int J Behav Nutr Phys Act 2013; 10:131. [PMID: 24304903 PMCID: PMC4235199 DOI: 10.1186/1479-5868-10-131] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 11/28/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health professionals play a key role in the prevention and treatment of excess weight and obesity, but many have expressed a lack of confidence in their ability to manage obese patients with their delivery of weight-management care remaining limited. The specific mechanism underlying inadequate practices in professional weight management remains unclear. The primary purpose of this study was to examine a self-efficacy theory-based model in understanding Registered Nurses' (RNs) professional performance relating to weight management. METHODS A self-report questionnaire was developed based upon the hypothesized model and administered to a convenience sample of 588 RNs. Data were collected regarding socio-demographic variables, psychosocial variables (attitudes towards obese people, professional role identity, teamwork beliefs, perceived skills, perceived barriers and self-efficacy) and professional weight management practices. Structural equation modeling was conducted to identify correlations between the above variables and to test the goodness of fit of the proposed model. RESULTS The survey response rate was 71.4% (n = 420). The respondents reported a moderate level of weight management practices. Self-efficacy directly and positively predicted the weight management practices of the RNs (β = 0.36, p < 0.01), and fully or partially mediated the relationships between perceived skills, perceived barriers, professional role identity and teamwork beliefs and weight management practices. The final model constructed in this study demonstrated a good fit to the data [χ2 (14) =13.90, p = 0.46; GFI = 0.99; AGFI = 0.98; NNFI = 1.00; CFI = 1.00; RMSEA = 0.00; AIC = 57.90], accounting for 38.4% and 43.2% of the variance in weight management practices and self-efficacy, respectively. CONCLUSIONS Self-efficacy theory appears to be useful in understanding the weight management practices of RNs. Interventions targeting the enhancement of self-efficacy may be effective in promoting RNs' professional performance in managing overweight and obese patients.
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Ben Natan M, Ataneli M, Admenko A, Har Noy R. Nurse assessment of residents' pain in a long-term care facility. Int Nurs Rev 2013; 60:251-7. [DOI: 10.1111/inr.12006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Ben Natan
- Pat Matthews Academic School of Nursing; Hillel Yaffe Medical Center; Hadera
| | - M. Ataneli
- Pat Matthews Academic School of Nursing; Hillel Yaffe Medical Center; Hadera
| | - A. Admenko
- Pat Matthews Academic School of Nursing; Hillel Yaffe Medical Center; Hadera
| | - R. Har Noy
- Shoham Geriatric Center; Pardes Hanna; Israel
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Greenberg BL, Glick M. Assessing systemic disease risk in a dental setting: a public health perspective. Dent Clin North Am 2012; 56:863-874. [PMID: 23017556 DOI: 10.1016/j.cden.2012.07.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Screening and monitoring for systemic disease risk in a dental setting are valuable components for more effective disease prevention and control and health care delivery. This strategy can identify patients at increased risk of disease yet unaware of their increased risk and who may benefit from proven prevention/intervention strategies. The involvement of oral health care professionals in strategies to identify individuals at risk for coronary heart disease and diabetes will extend preventive and screening efforts necessary to slow the development of these diseases, and provide a portal for individuals who do not see a physician on a regular basis to enter into the general health care system.
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Weber A, Dwyer T, Mummery K. Morphine administration by Paramedics: an application of the Theory of Planned Behaviour. Injury 2012; 43:1393-6. [PMID: 21215396 DOI: 10.1016/j.injury.2010.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 12/09/2010] [Accepted: 12/09/2010] [Indexed: 02/02/2023]
Abstract
Timely and appropriate pain management in the pre-hospital environment is paramount to effective patient care. Experts agree that there are many factors that hinder the delivery of adequate pain management to patients with pain. The purpose of this study was to use the Theory of Planned Behaviour (TPB) model to identify the factors influencing Ambulance Paramedics' intention to administer morphine to patients with pain. Participants of this study were Advanced Care and Intensive Care Paramedics who were deemed competent in morphine administration. Data were collected by means of a questionnaire that used the constructs of the TPB, including subjective norm, perceived behavioural control and attitude. Whilst participants reported strong intentions to administer morphine they also reported negative attitudes towards the behaviour. The constructs of the TPB explained 26% of the variance in intention to administer morphine with subjective norm being the strongest significant predictor. The findings related to specific attitudes and normative pressures provide an understanding into Paramedic's pain management behaviour.
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Affiliation(s)
- Anthony Weber
- School of Medical and Applied Sciences, Faculty of Sciences, Engineering and Health, CQUniversity Australia, Australia.
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Chabot G, Godin G, Gagnon MP. Determinants of the intention of elementary school nurses to adopt a redefined role in health promotion at school. Implement Sci 2010; 5:93. [PMID: 21110872 PMCID: PMC3003233 DOI: 10.1186/1748-5908-5-93] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Accepted: 11/26/2010] [Indexed: 11/26/2022] Open
Abstract
Background The quest for greater efficiency in the provision of primary healthcare services and the implementation of a "health-promoting school" approach encourage the optimal redefinition of the role of school nurses. School nurses are viewed as professionals who might be significant actors in the promotion of youth health. The aim of this study was to identify the determinants of the intention of elementary school nurses to adopt a new health-promotion role as a strategic option for the health-promoting school. Methods This study was based on an extended version of the theory of planned behaviour (TPB). A total of 251 respondents (response rate of 70%) from 42 school health programs across the Province of Québec completed a mail survey regarding their intention to adopt the proposed health-promotion role. Multiple hierarchical linear regression analyses were performed to assess the relationship between key independent variables and intention. A discriminant analysis of the beliefs was performed to identify the main targets of action. Results A total of 73% of respondents expressed a positive intention to accept to play the proposed role. The main predictors were perceived behavioural control (β = 0.36), moral norm (β = 0.27), attitude (β = 0.24), and subjective norm (β = 0.21) (ps < .0001), explaining 83% of the variance. The underlying beliefs distinguishing nurses who had a high intention from those who had a low intention referred to their feelings of being valued, their capacity to overcome the nursing shortage, the approval of the school nurses' community and parents of the students, their leadership skills, and their gaining of a better understanding of school needs. Conclusions Results suggest that leadership is a skill that should be addressed to increase the ability of school nurses to assume the proposed role. Findings also indicate that public health administrators need to ensure adequate nurse staffing in the schools in order to increase the proportion of nurses willing to play such a role and avoid burnout among these human resources.
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Affiliation(s)
- Guylaine Chabot
- Research Group on Behaviour and Health, Faculty of Nursing, Laval University, Québec, Canada.
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Rodríguez-Calvillo JA, Lana A, Cueto A, Markham WA, López ML. Psychosocial factors associated with the prescription of generic drugs. Health Policy 2010; 101:178-84. [PMID: 21094558 DOI: 10.1016/j.healthpol.2010.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 10/13/2010] [Accepted: 10/15/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate factors associated with "Generic drug prescription" (GDP) behaviour in Spain using the ASE (Attitude, Social Influence, Self-Efficacy) Model. METHODS General Practitioners were sent a validated and anonymous questionnaire measuring the ASE and Motivation variables for GDP and their generic drug prescription percentage. Most (n=486; 61.98%) responded to this cross-sectional survey. The mean scores and the 95% confidence intervals (95% CI) were calculated. A binary logistic regression was used to identify the variables that best predict GDP behaviour. RESULTS The main advantages and motivations for GDP were "saving money" and "protecting professional ethics". The greatest social influences were "doctors' personal preferences" and "authorities' pressure". GDP accounted for a scarce 15% of the total prescription. ASE and Motivation items were the best predictors: they explain 25% of being a 'high prescriber'. The highest prescribers were paediatricians (OR=5.07), workers in rural settings (OR=3.68) and professionals with high Motivation (OR=1.17) and Attitude (OR=1.11) scores. CONCLUSIONS GDP percentage is very low compared with other countries. Interventions to modify the Attitudes of Primary Care doctors towards generic drugs should be implemented. Better informed patients, longer doctor appointment times and more varied dosage forms of generic drugs would also facilitate improvements in GDP.
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Affiliation(s)
- Javier A Rodríguez-Calvillo
- Department of Medicine, Preventive Medicine and Public Health Area, University of Oviedo, C/Julián Clavería s/n, 33006 Oviedo, Asturias, Spain.
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Crawford FIJ, Armstrong D, Boardman C, Coulthard P. Reducing postoperative pain by changing the process. Br J Oral Maxillofac Surg 2010; 49:459-63. [PMID: 20728969 DOI: 10.1016/j.bjoms.2010.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Accepted: 07/23/2010] [Indexed: 11/26/2022]
Abstract
Untreated postoperative pain is an important ethical and financial issue that can lead to unnecessary suffering and prolonged stays in hospital. Despite the availability of effective analgesics and a growing body of published material that supports their use, postoperative pain remains a problem worldwide. To reduce acute postoperative pain, we introduced an intervention combining evidence-based analgesic protocols with the education of staff and patients on a surgical ward. The experiences of 68 patients before and 80 patients after the intervention were compared (worst pain scores, duration of pain, and satisfaction). Inadequately controlled pain was significantly reduced after the intervention, which suggests that the introduction of analgesic protocols supported by the education of staff and patients can be beneficial. Despite this, severe pain remained relatively common, indicating room for improvement. Duration of pain and patient satisfaction were not affected by the intervention, and patient satisfaction remained high throughout the study.
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Affiliation(s)
- F I J Crawford
- School of Dentistry, The University of Manchester, Manchester Academic Health Science Centre, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, M15 6FH, UK
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Verloo H, Mpinga EK, Ferreira M, Rapin CH, Chastonay P. Morphinofobia: the situation among the general population and health care professionals in North-Eastern Portugal. BMC Palliat Care 2010; 9:15. [PMID: 20569454 PMCID: PMC2900233 DOI: 10.1186/1472-684x-9-15] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Accepted: 06/22/2010] [Indexed: 11/10/2022] Open
Abstract
Background Morphinofobia among the general population (GP) and among health care professionals (HP) is not without danger for the patients: it may lead to the inappropriate management of debilitating pain. The aim of our study was to explore among GP and HP the representation and attitudes concerning the use of morphine in health care. Methods A cross-sectional study was done among 412 HP (physicians and nurses) of the 4 hospitals and 10 community health centers of Beira Interior (Portugal)and among 193 persons of the GP randomly selected in public places. Opinions were collected through a translated self-administered questionnaire. Results A significant difference of opinion exists among GP and HP about the use of morphine. The word morphine first suggests drug to GP (36,2%) and analgesia to HP (32,9%.). The reasons for not using morphine most frequently cited are: for GP morphine use means advanced disease (56%), risk of addiction (50%), legal requirements (49,7%); for HP it means legal risks (56,3%) and adverse side effects of morphine such as somnolence - sedation (30,5%) The socio-demographic situation was correlated with the opinions about the use of morphine. Conclusions False beliefs about the use of morphine exist among the studied groups. There seems to be a need for developing information campaigns on pain management and the use of morphine targeting. Better training and more information of HP might also be needed.
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Affiliation(s)
- Henk Verloo
- Geneva Altitude Clinic, Montana, Switzerland.
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Abstract
BACKGROUND of previous studies demonstrated the effectiveness of chairside medical screening by dentists to identify patients at increased risk of experiencing cardiovascular-associated events. In this study, the authors assessed dentists' attitudes, willingness and perceived barriers regarding chairside medical screening in the dental office. METHODS A national, random sample of U.S. general dentists was surveyed by mail by means of an anonymous questionnaire that involved a five-point Likert scale (1 = very important/very willing; 5 = very unimportant/very unwilling). Friedman nonparametric analysis of variance was used to compare response items within each question. RESULTS Of 1,945 respondents, most were male (82.3 percent), white (85.7 percent) and 40 to 60 years old (59.4 percent) and had practiced for more than 10 years (84.5 percent). The majority thought it was important for dentists to conduct screening for hypertension (85.8 percent), cardiovascular disease (76.8 percent), diabetes mellitus (76.6 percent), hepatitis (71.5 percent) and human immunodeficiency virus infection (68.8 percent). Respondents were willing to refer patients for consultation with physicians (96.4 percent), collect oral fluids for salivary diagnostics (87.7 percent), conduct medical screenings that yield immediate results (83.4 percent) and collect blood via finger stick (55.9 percent). Respondents were significantly more willing (P < .001) to collect saliva than height and weight measurements or blood via finger stick (mean ranks: 2.05, 2.96 and 3.05, respectively). Insurance was significantly less important (P < .001) than time, cost, liability or patients' willingness (mean ranks: 3.51, 2.96, 2.94, 2.83 and 2.77, respectively). CONCLUSIONS Dentists considered medical screening important and were willing to incorporate it into their practices. Additional education and practical implementation strategies are necessary to address perceived barriers. CLINICAL IMPLICATIONS The findings of this study regarding chairside medical screening may lead to changes in our approach to dental education and may help define the practice of dentistry in the future.
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Osborn CY, Kozak C, Wagner J. Theory in practice: helping providers address depression in diabetes care. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2010; 30:172-179. [PMID: 20872772 PMCID: PMC3093133 DOI: 10.1002/chp.20078] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION A continuing education (CE) program based on the theory of planned behavior was designed to understand and improve health care providers' practice patterns in screening, assessing, and treating and/or referring patients with diabetes for depression treatment. METHODS Participants completed assessments of attitudes, confidence, intentions, and behaviors regarding depression management at 3 time points: immediately prior to the CE program (baseline), immediately after the CE program (posttest) and 6 weeks after the CE program (follow-up). RESULTS Ninety-eight providers attended the CE program: 71 completed the baseline assessment, 66 completed the posttest assessment, and 37 completed the 6-week follow-up. Compared to baseline, at posttest providers reported significantly more favorable attitudes, fewer negative attitudes, greater confidence, and greater intention to address depression with their diabetes patients. At the 6-week follow-up, participants reported a marginally significant increase in educating patients about depression, but no other depression management practices changed. Intention to change and confidence predicted some depression practice patterns at follow-up. Fewer barriers were a consistent predictor of depression practice patterns at follow-up. DISCUSSION In the short term, provider attitudes, confidence, and intentions to address depression with their patients improved. Intentions, confidence, and especially barriers are important intervention targets.
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Affiliation(s)
- Chandra Y Osborn
- Division of General Internal Medicine and Public Health, Vanderbilt Eskind Diabetes Center, Vanderbilt University Medical Center, USA
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Wilding JR, Manias E, McCoy DGL. Pain assessment and management in patients after abdominal surgery from PACU to the postoperative unit. J Perianesth Nurs 2009; 24:233-40. [PMID: 19647660 DOI: 10.1016/j.jopan.2009.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 01/28/2009] [Accepted: 03/20/2009] [Indexed: 11/25/2022]
Abstract
The aim of this exploratory study was to determine the effectiveness of pain relief for surgical patients (N = 52) in transition from the PACU to the postoperative unit. The study also explored whether there was an association between a verbal numeric pain score (0 to 10) on discharge from the PACU and the duration of time until analgesia was administered in the postoperative unit. Information was obtained about pain management, time of discharge, and patient pain scores on discharge from the PACU, as well as pain scores and the time of first analgesic administered in the postoperative unit. Most patients were discharged from the PACU with a pain score in the mild range (0 to 4), indicating reasonable pain relief. An association existed between the pain score on discharge from the PACU and the duration of time to the first analgesic dose administered on the postoperative unit.
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Affiliation(s)
- Jane R Wilding
- Barwon Health, Centre for Education and Practice Development, Geelong, Victoria, Australia.
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Dewar A, Osborne M, Mullett J, Langdeau S, Plummer M. Psychiatric patients: how can we decide if you are in pain? Issues Ment Health Nurs 2009; 30:295-303. [PMID: 19437248 DOI: 10.1080/01612840902754297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
How do psychiatric nurses make decisions about pain management for hospitalized psychiatric patients? This is the question addressed by this research. Using an exploratory, naturalistic interview approach, 20 nurses and managers in varied settings described their decision making when providing pain relief. Analysis of these narratives indicates that decision making about pain, in this unique context, is influenced by a number of intrapersonal and interpersonal factors such as the patients' needs, history, and diagnosis; nurses' beliefs about pain tolerance and drug addiction; collegial pressure; and unit safety. For example, diagnosis and patient history impact pain relief negatively, while the responsibility to maintain a safe environment imposes pressure to administer medication. Although, in a psychiatric unit, the nurse-patient relationship is essential to the healing process, nurses often face a dilemma as to whether the pain medication will contribute to healing or exacerbate the patient's issues. In psychiatric wards, the means of recovery are far less clear, tangible, and immediate than in other clinical settings. Recommendations are made for better preparing and supporting nurses to work effectively in these practice settings where pain relief is confounded by addiction and psychiatric diagnoses.
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Affiliation(s)
- Anne Dewar
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
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Godin G, Bélanger-Gravel A, Eccles M, Grimshaw J. Healthcare professionals' intentions and behaviours: a systematic review of studies based on social cognitive theories. Implement Sci 2008; 3:36. [PMID: 18631386 PMCID: PMC2507717 DOI: 10.1186/1748-5908-3-36] [Citation(s) in RCA: 601] [Impact Index Per Article: 37.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Accepted: 07/16/2008] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND There is an important gap between the implications of clinical research evidence and the routine clinical practice of healthcare professionals. Because individual decisions are often central to adoption of a clinical-related behaviour, more information about the cognitive mechanisms underlying behaviours is needed to improve behaviour change interventions targeting healthcare professionals. The aim of this study was to systematically review the published scientific literature about factors influencing health professionals' behaviours based on social cognitive theories. These theories refer to theories where individual cognitions/thoughts are viewed as processes intervening between observable stimuli and responses in real world situations. METHODS We searched psycINFO, MEDLINE, EMBASE, CIHNAL, Index to theses, PROQUEST dissertations and theses and Current Contents for articles published in English only. We included studies that aimed to predict healthcare professionals' intentions and behaviours with a clear specification of relying on a social cognitive theory. Information on percent of explained variance (R(2)) was used to compute the overall frequency-weighted mean R(2) to evaluate the efficacy of prediction in several contexts and according to different methodological aspects. The cognitive factors most consistently associated with prediction of healthcare professionals' intention and behaviours were documented. RESULTS Seventy eight studies met the inclusion criteria. Among these studies, 72 provided information on the determinants of intention and 16 prospective studies provided information on the determinants of behaviour. The theory most often used as reference was the Theory of Reasoned Action (TRA) or its extension the Theory of Planned Behaviour (TPB). An overall frequency-weighted mean R(2) of 0.31 was observed for the prediction of behaviour; 0.59 for the prediction of intention. A number of moderators influenced the efficacy of prediction; frequency-weighted mean R(2) varied from 0.001 to 0.58 for behaviour and 0.19 to 0.81 for intention. CONCLUSION Our results suggest that the TPB appears to be an appropriate theory to predict behaviour whereas other theories better capture the dynamic underlying intention. In addition, given the variations in efficacy of prediction, special care should be given to methodological issues, especially to better define the context of behaviour performance.
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Affiliation(s)
- Gaston Godin
- Canada Research Chair on Behaviour and Health, Laval University, Québec, Canada
| | - Ariane Bélanger-Gravel
- Research Group on Behaviour and Health, Faculty of Nursing, Laval University, Québec, Canada
| | - Martin Eccles
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jeremy Grimshaw
- Clinical Epidemiology Program, Ottawa Health Research Institute, Ontario, Canada
- Department of Medicine, University of Ottawa, Ontario, Canada
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Manias E, Williams A. Communication between patients with chronic kidney disease and nurses about managing pain in the acute hospital setting. J Clin Nurs 2007; 16:358-67. [DOI: 10.1111/j.1365-2702.2007.02075.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Edwards H, Walsh A, Courtney M, Monaghan S, Wilson J, Young J. Promoting evidence-based childhood fever management through a peer education programme based on the theory of planned behaviour. J Clin Nurs 2007; 16:1966-79. [PMID: 17880485 DOI: 10.1111/j.1365-2702.2007.01767.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES This study examined effectiveness of a theoretically based education programme in reducing inappropriate antipyretic use in fever management. BACKGROUND Paediatric nurses' inconsistent, ritualistic antipyretic use in fever management is influenced by many factors including inconsistent beliefs and parental requests. Determinants of antipyretic administration, identified by the theory of planned behaviour, were belief-based attitudes and subjective norms. DESIGN A quasi-experiment explored group effects of a peer education programme, based on the theory of planned behaviour, on factors influencing paediatric nurses' antipyretic administration. Surveys and chart audits collected data from medical wards at experimental and control hospitals one month pre and one and four months postpeer education programme. METHODS All nurses employed in targeted wards were eligible to participate in surveys and all eligible charts were audited. The peer education programme consisted of four one-hour sessions targeting evidence-based knowledge, myths and misconceptions, normative, attitudinal and control influences over and rehearsal of evidence-based fever management. All nurses in experimental hospital targeted wards were eligible to attend. Peer education and support facilitated session information reaching those unable to attend sessions. RESULTS Two-way univariate anovas explored between subject, experimental and control group and within subject factors, pre, post and latency data. Significant interactions in normative influence (p = 0.01) and intentions (p = 0.01), a significant main group effect in control influence (p = 0.01) and a significant main effect between audit data across time points (p = 0.03) highlight peer education programme effectiveness in behaviour change. Normative, control and intention changes postpeer education programme were maintained in latency data; mean temperature was not. CONCLUSION The peer education programme, based on a behaviour change theory, initiated and maintained evidence-based intentions for antipyretics use in fever management. RELEVANCE TO CLINICAL PRACTICE The promotion of evidence-based change in organizational unit intentions and behaviour highlights the crucial role peer support and education can play in continuing educational programmes.
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Affiliation(s)
- Helen Edwards
- School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld, Australia.
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Zanolin ME, Visentin M, Trentin L, Saiani L, Brugnolli A, Grassi M. A questionnaire to evaluate the knowledge and attitudes of health care providers on pain. J Pain Symptom Manage 2007; 33:727-36. [PMID: 17531913 DOI: 10.1016/j.jpainsymman.2006.09.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2006] [Revised: 09/26/2006] [Accepted: 09/29/2006] [Indexed: 11/25/2022]
Abstract
The aims of this study were to survey the knowledge and attitudes of Italian health care professionals toward pain and develop a valid instrument to assess pain knowledge of physicians and nurses. A 21-item questionnaire on a Likert scale was given to 4,961 health professionals in 20 hospitals in Italy who volunteered to participate in the study. The results were analyzed psychometrically in three phases: the Principal Component Analysis phase identified two components, of which only the one that had 10 items about pain knowledge and attitudes (PAK) was studied; the Homogeneity Analysis revealed its acceptable internal reliability (Cronbach's alpha=0.72) and confirmed the Likert equidistance of the item options response; and the Confirmatory Factor Analysis proved that it had a very good construct validity. A standardized score was calculated on the PAK questionnaire using the final 10 selected items, considering 100% as the best level of knowledge of pain management and 0% as the worst. The standardized mean score on the whole sample was equal to 52.6% (95% Confidence Interval: 52.3%-53.0%). There was a statistically significant difference (P<0.001) in percentage score between physicians (56.5%) and nurses (51.3%). Knowledge was best among physicians in Anesthesiology and Emergency; this was followed by doctors in Medicine and then surgeons. The knowledge of nurses was almost constant. This scale fills a void by providing a validated instrument for testing the general knowledge about pain treatment of hospital staff. It is brief and can easily be administered to a considerable number of people.
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Affiliation(s)
- M Elisabetta Zanolin
- Unit of Epidemiology & Medical Statistics, Department of Public Health and Medicine, University of Verona, Verona, Italy.
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Influences of Attitudes on Family Physicians' Willingness to Prescribe Long-Acting Opioid Analgesics for Patients with Chronic Nonmalignant Pain. Clin Ther 2007; 29 Suppl:2589-602. [DOI: 10.1016/j.clinthera.2007.12.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2007] [Indexed: 11/22/2022]
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Abstract
AIM This paper reports a review which draws together findings from studies targeting parents' temperature-taking, antipyretic administration, attitudes, practices and information-seeking behaviours. BACKGROUND Parents' concerns about the harmful effects of fever have been reported for more than two decades. These concerns remain despite successful educational interventions. METHOD Medline, CINAHL, PsycINFO, PsycARTICLES and Web of Science databases were searched from 1980 to 2004 during November 2004. The search terms were fever, child, parent, education, knowledge, belief, concern, temperature, antipyretic and information, and combinations of these. FINDINGS In the 1980s, studies were mainly descriptive of small single site samples of parents with a febrile child seeking assistance from healthcare professionals. From 1990, sample sizes increased and multi-site studies were reported. Educational interventions were designed to increase knowledge and reduce unnecessary use of health services. One 2003 study targeted knowledge and attitudes. Parental knowledge about normal body temperature and the temperature that indicates fever is poor. Mild fever is misclassified by many as high, and they actively reduce mild fever with incorrect doses of antipyretics. Although some parents acknowledge the benefits of mild fever, concerns about brain damage, febrile convulsions and death from mild to moderate fever persist irrespective of parental education or socio-economic status. Many base their fever management practices on inaccurate temperature readings. Increased use of antipyretics to reduce fever and waking sleeping febrile children for antipyretics or sponging reflects heightened concern about harmful effects of fever. Educational interventions have reduced unnecessary use of healthcare services, improved knowledge about fever and when to implement management strategies, and reduced incorrect parental accuracy of antipyretic dosing. Information-seeking behaviours in fever management differ according to country of origin. CONCLUSION Despite successful educational interventions, little has changed in parents' fever management knowledge, attitudes and practices. There is a need for interventions based on behaviour change theories to target the precursors of behaviour, namely knowledge, attitudes, normative influences and parents' perceptions of control.
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Affiliation(s)
- Anne Walsh
- School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia.
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Everett B, Salamonson Y. Differences in Postoperative Opioid Consumption in Patients Prescribed Patient-Controlled Analgesia Versus Intramuscular Injection. Pain Manag Nurs 2005; 6:137-44. [PMID: 16337562 DOI: 10.1016/j.pmn.2005.09.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2005] [Revised: 08/31/2005] [Accepted: 09/01/2005] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to examine differences in opioid consumption in patients prescribed patient-controlled analgesia (PCA) versus intramuscular injection (IMI) in the early postoperative period after open abdominal surgery. A retrospective audit of 115 patients elicited demographic and clinical data. No significant differences were found between the demographic variables of the PCA and IMI groups. There was a significant difference in the mean opioid dose used during the first 3 postoperative days (p < .01). Mean opioid consumption was 136.89 mg for the PCA group and 50.79 mg for the IMI group. Although there was a reduction in the amount of opioid consumed over the first 3 postoperative days, the PCA group consistently consumed more opioid analgesia compared with the IMI group. Furthermore, there was a disproportionate reduction in opioid consumption between the two groups from Day 1 (r = .34; p < .01) to Day 3 (r = .14; p = .14). This study shows that the amount of analgesia consumed during the postoperative period by patients who had abdominal surgery varied markedly depending on the mode of analgesia (PCA or IMI). The difference in analgesic consumption was also found to increase throughout the 3-day postoperative period. This divergence in the amount of opioid consumption between patients who were prescribed PCA and patients who were prescribed IM analgesia heightens the need for vigilance in assessment and management of pain during the early postoperative period, particularly in patients prescribed IM analgesia on an "as-needed" basis.
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MESH Headings
- Adult
- Analgesia, Patient-Controlled/nursing
- Analgesia, Patient-Controlled/statistics & numerical data
- Analgesics, Opioid/administration & dosage
- Cholecystectomy/adverse effects
- Clinical Nursing Research
- Colorectal Surgery/adverse effects
- Drug Monitoring/nursing
- Drug Utilization/statistics & numerical data
- Female
- Hospitals, Public
- Humans
- Hysterectomy/adverse effects
- Injections, Intramuscular/nursing
- Injections, Intramuscular/statistics & numerical data
- Male
- Middle Aged
- New South Wales
- Nurse's Role
- Nursing Assessment
- Nursing Audit
- Pain Measurement/nursing
- Pain, Postoperative/diagnosis
- Pain, Postoperative/drug therapy
- Pain, Postoperative/etiology
- Pain, Postoperative/nursing
- Perioperative Nursing
- Postoperative Care/nursing
- Retrospective Studies
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Affiliation(s)
- Bronwyn Everett
- School of Nursing, Family and Community Health, College of Social and Health Sciences, University of Western Sydney, New South Wales, Australia
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Walsh AM, Edwards HE, Courtney MD, Wilson JE, Monaghan SJ. Fever management: paediatric nurses' knowledge, attitudes and influencing factors. J Adv Nurs 2005; 49:453-64. [PMID: 15713177 DOI: 10.1111/j.1365-2648.2004.03318.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS This paper describes Australian paediatric nurses' knowledge of and attitudes toward fever and its management and the predictors of their intentions to administer paracetamol to a febrile child. BACKGROUND Despite evidence-based support for the beneficial effects of fever over the past three decades, health professionals' negative attitudes toward fever and their reliance on antipyretics to reduce it have persisted and continue to be reported in the literature. METHODS A self-report questionnaire was used. An instrument was developed, piloted by test-retest and revised prior to data collection. Fifty-one paediatric nurses working in medical wards of a metropolitan paediatric hospital in Australia participated. RESULTS Nurses' mean knowledge score about the physiology of fever, general fever management and antipyretics was 62%, which was not as high as expected. Participants reported positive attitudes toward the benefits of fever, the necessity for its reduction in children with pre-existing cardiac or respiratory conditions and towards regular antipyretic administration masking the infective process. Negative attitudes included disbelief that temperature is often unrelated to illness severity. Conflicting attitudes toward febrile convulsions were highlighted by beliefs that antipyretic therapy prevents these and that antipyretics do not prevent initial febrile convulsions. Predictors of intentions to administer paracetamol were beliefs about the effectiveness of paracetamol and nurses' beliefs about the expectations of others in relation to paracetamol administration. Nurses reported strong intentions to administer paracetamol to the next febrile child they cared for. Limitations of the study include the use of a nurse manager for recruitment and collecting the data at only one site. CONCLUSIONS Fever management is an integral aspect of paediatric nursing. For its consistent rational management, nurses must have appropriate knowledge and positive attitudes. This highlights the need for continuing education in fever management.
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Affiliation(s)
- Anne M Walsh
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
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Ko N, Feng M, Chiu D, Wu M, Feng J, Pan S. Applying theory of planned behavior to predict nurses' intention and volunteering to care for SARS patients in southern Taiwan. Kaohsiung J Med Sci 2004; 20:389-98. [PMID: 15473650 PMCID: PMC7129400 DOI: 10.1016/s1607-551x(09)70175-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Severe acute respiratory syndrome (SARS) spread worldwide after an outbreak in Guangdong Province, China, in mid-November 2002. Health care workers were at highest risk of infection. The purpose of this study, which was based on Ajzen's theory of planned behavior (TPB), was to determine the extent to which personal attitudes, subjective norms, and perceived control influence nurses' intention and volunteering to care for SARS patients. After the SARS outbreak, a total of 750 staff nurses (response rate 90%) at one hospital completed a questionnaire assessing their intention to provide care to SARS patients. Overall, 42.7% of nurses had a positive intention to provide care to SARS patients, and 25.4% of nurses would volunteer to care for SARS patients. Four factors explaining 35% of the variance in nurses' intention to care for SARS patients were self-efficacy (beta = 0.39, p < 0.001), attitude (beta = 0.25, p < 0.001), years of working in the study hospital (beta = -0.15, p < 0.001), and receiving resources from the hospital (beta = 0.13, p < 0.001). Two factors explaining 15% of the variance in nurses' volunteering to care for SARS patients were intention (beta = 0.31, p < 0.001) and attitude (beta = 0.15, p < 0.001). The final model shows that the variables of the TPB contributed significantly to the explanation of a portion of variance in nurses' intention and volunteering to care for SARS patients. The results are helpful for human resources managers facing a new contagious disease.
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Affiliation(s)
- Nai‐Ying Ko
- School of Nursing, National Chang Kung University, Tainan
| | - Ming‐Chu Feng
- School of Nursing, National Chang Kung University, Tainan
- Department of Nursing, Kaohsiung Medical University, Chung‐Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Dan‐Ying Chiu
- School of Nursing, National Chang Kung University, Tainan
- Department of Nursing, Kaohsiung Medical University, Chung‐Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Mei‐Hsin Wu
- School of Nursing, National Chang Kung University, Tainan
- Department of Nursing, Kaohsiung Medical University, Chung‐Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Jui‐Ying Feng
- School of Nursing, National Chang Kung University, Tainan
- School of Nursing, University of Rochester, Rochester, New York, USA
| | - Shung‐Mei Pan
- School of Nursing, National Chang Kung University, Tainan
- Department of Nursing, Kaohsiung Medical University, Chung‐Ho Memorial Hospital, Kaohsiung, Taiwan
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