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Ros-Nebot B, Rodiera-Olivé J, Verdera-Roig M, Tril-Queralt C, Pradas-Abadía A, Julián-González S, Falcó-Pegueroles A. Cognitive Training to Reduce Memory Disturbance Associated With Postoperative Cognitive Impairment After Elective Noncardiac Surgery: An Experimental Study. J Perianesth Nurs 2024:S1089-9472(23)01025-0. [PMID: 38573299 DOI: 10.1016/j.jopan.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 10/22/2023] [Accepted: 10/28/2023] [Indexed: 04/05/2024]
Abstract
PURPOSE Assess the efficiency of a cognitive training program using an artificial intelligence application to optimize cognitive reserve and reduce memory disturbance in patients aged 55 to 75 after Class II-III elective noncardiac surgery. DESIGN Experimental with random assignment. METHODS The study was conducted on 80 patients undergoing surgery at the Teknon Medical Center Hospital in Barcelona, from April 2018 to June 2021. Both groups were evaluated with cognitive tests before surgery and 7 and 30 days after surgery. The experimental group was subjected to cognitive training for 10 days before surgery to improve their cognitive reserve. FINDINGS Significant differences were found between the study groups 30 days after surgery in the three screening tests (Mini-Cog, T@M, and MFE). The intervention group presented with fewer cognitive and memory alterations. Age and pre-existing comorbidities were not correlated with an impact on memory impairment or cognitive function. CONCLUSIONS A cognitive training program based on artificial intelligence, prescribed and monitored by anesthesia nurses has a positive impact on increasing cognitive reserve and reducing memory disturbance in patients aged 55 to 75 undergoing Class II to III elective, noncardiac surgery. This intervention may serve as a prehabilitation strategy in patients with a risk of cognitive dysfunction evaluated by anesthesia nurses for the purpose of preserving their cognitive function and optimizing their recovery.
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Affiliation(s)
- Bibiana Ros-Nebot
- Department of Anesthesiology, Centro Médico Teknon, Barcelona, Spain.
| | | | | | | | | | | | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, Consolidated Research Group SGR 325 Bioethics, Law and Society (BIOELSi), University of Barcelona, Spain
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Sierra-Núñez D, Bosch-Alcaraz A, Falcó-Pegueroles A, Segura-Matute S, García-Godoy C, Otero-Arús C, Corral-Partearroyo C, Zuriguel-Pérez E. Multicenter study. Nursing professionals' perception of training needs in pain assessment in pediatric patients with cognitive dysfunction. Enferm Intensiva (Engl Ed) 2023:S2529-9840(23)00059-9. [PMID: 37968141 DOI: 10.1016/j.enfie.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION Pediatric patients with cognitive dysfunction are at greater risk of pain than typically developing children. Pain assessment in these patients is complex and could generate uncertainty in health professionals about what the key aspects are. AIM To determine the training needs perceived by nursing professionals regarding acute pain assessment in pediatric patients with cognitive dysfunction. METHODS A descriptive, cross-sectional, and multicenter study was performed using a survey addressed to nursing professionals who work in pediatrics during the months of August and September 2022. RESULTS 163 responses were obtained. Most of the professionals who responded were female (92.6%, n = 151), with a mean age of 38.98 ± 10.40 years. The most frequent work unit was the pediatric intensive care unit (PICU), in 36% (n = 58). Most of the participants reported not having previously received training on pain assessment in pediatric patients with cognitive disabilities (85.9%, n = 139). However, 70.4% (n = 114) considered it "very necessary" for the development of their work to receive specific training on this topic. Knowing how to assess acute pain in this population (85.3%, n = 139) and knowing the clinical and behavioral manifestations of pain in this type of patient (84.7%, n = 138) were the aspects that obtained higher scores. CONCLUSION This research notes more than 90% of participants consider "quite necessary" and "strong necessary" to be training in pediatric cognitive dysfunction patients pain assessment. Furthermore, work experience, academic education and to be pediatric specialist obtain statistical significance data.
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Affiliation(s)
- D Sierra-Núñez
- Unidad de Hospitalización de Cirugía Pediátrica, Hospital Universitario Vall Hebrón, Barcelona, Spain.
| | - A Bosch-Alcaraz
- Departamento de Enfermería de Salud Pública, Salud Mental y Maternoinfantil, Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, Spain
| | - A Falcó-Pegueroles
- Departamento de Enfermería Fundamental y Médico Quirúrgica, Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, Spain
| | - S Segura-Matute
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - C García-Godoy
- Uriach Consumer Healthcare, Sant Cugat del Vallès, Barcelona, Spain
| | - C Otero-Arús
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - C Corral-Partearroyo
- Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - E Zuriguel-Pérez
- Grupo de Investigación Multidisciplinar de Enfermería, Hospital Universitario Vall Hebrón, Barcelona, Spain
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Falcó-Pegueroles A, Viola E, Poveda-Moral S, Rodríguez-Martín D, Via-Clavero G, Barello S, Bosch-Alcaraz A, Bonetti L. Protective factors of ethical conflict during a pandemic-Quali-Ethics-COVID-19 research part 2: An international qualitative study. J Clin Nurs 2023; 32:6677-6689. [PMID: 37190669 DOI: 10.1111/jocn.16754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/10/2023] [Accepted: 04/28/2023] [Indexed: 05/17/2023]
Abstract
AIMS AND OBJECTIVES To determine which factors can be considered protective of ethical conflicts in intensive care unit healthcare professionals during a pandemic. BACKGROUND The COVID-19 pandemic gave rise to new ethical concerns in relation to the management of public health and the limitations on personal freedom. Continued exposure to ethical conflict can have a range of psychological consequences. DESIGN A qualitative design based on phenomenological approach. METHODS A total of 38 nurses and physicians who were regular staff members of Barcelona and Milan's public tertiary university hospitals and working in intensive care units during the first wave of the COVID-19 pandemic. Semi-structured online in-depth interviews were conducted. A thematic analysis was performed by two independent researchers following the seven steps of Colaizzi's methods. We adhere COREQ guidelines. RESULTS One theme 'Protective factors of ethical conflict in sanitary crisis' and four subthemes emerged from the data: (1) knowledge of the infectious disease, (2) good communication environment, (3) psychological support and (4) keeping the same work team together. CONCLUSIONS Four elements can be considered protective factors of ethical conflict for healthcare professionals during a sanitary crisis. While some of these factors have already been described, the joint identification of this set of four factors as a single element is, in itself, novel. This should help in ensuring the right mechanisms are in place to face future pandemics and should serve to improve institutional organisation and guarantee safe and high-quality patient care in times of healthcare crisis. RELEVANCE TO CLINICAL PRACTICE Future strategies for the prevention of ethical conflict during sanitary crises, pandemics or other catastrophes need to consider a set of four factors as a single element. These factors are the knowledge of the infectious disease, a good communication environment, psychological support and keeping the same work team together into joint consideration.
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Affiliation(s)
- Anna Falcó-Pegueroles
- Faculty of Nursing, University of Barcelona, Barcelona, Spain
- Consolidated Research Group 325 Bioethics, Law and Society (BIOELSi), University of Barcelona, Barcelona, Spain
| | - Elena Viola
- Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
- Nursing and Health Doctoral Program, University of Barcelona, Barcelona, Spain
| | - Silvia Poveda-Moral
- University School of Nursing and Occupational Therapy, Terrassa, Barcelona, Spain
| | | | - Gemma Via-Clavero
- Faculty of Nursing, University of Barcelona, Barcelona, Spain
- Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Loris Bonetti
- Nursing Research Competence Centre, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- University of Applied Sciences and Arts of Southerm Switzerland, Manno, Switzerland
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4
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Martínez-Momblan MA, Aguilar IB, Alonso-Fernández S, García MR, Zuriguel-Pérez E, Falcó-Pegueroles A, Aracil LB. Critical thinking among institutional academic advisors and sociodemographic, professional and academic variables: A multicenter correlation study. Nurse Educ Pract 2023; 71:103713. [PMID: 37478586 DOI: 10.1016/j.nepr.2023.103713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/19/2023] [Accepted: 07/04/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND In nursing education, essential skills include Critical Thinking (CT). There is scant evidence on how nurse educators could promote CT in students in a clinical context. OBJECTIVE To analyse the level of CT and correlated variables in healthcare nurses overseeing the clinicals of nursing undergraduates. METHODS The study population were all nurse educators for clinicals at hospitals with nursing undergraduates. To evaluate the CT skills of nurses the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 practice) was administered. Frequencies, percentages and measures of central tendency and scatter were obtained. A bivariate analysis was performed to analyze the correlation between the nurse educators' CT level and the sociodemographic, professional and academic levels. The nonparametric Mann-Whitney and Kruskal-Wallis tests were used to compare two independent groups. Statistical significance was defined as P < .05. RESULTS The total number of participants was 639. The highest mean CT level was seen in clinical nurses involved in undergraduate nursing instruction and with experience of up to 10 years (mean CT score = 372 (33.3), p = .007). Global CT levels were similar in women and men (mean CT score: 364 (31.9) in women and 358 (40.5) in men, p = .187), with statistically significant differences only observed in the intellectual and cognitive indicator (P = .022). CONCLUSIONS CT levels are high in teaching healthcare professionals in the clinical environment.
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Affiliation(s)
- Maria-Antonia Martínez-Momblan
- Fundamental Care and Medical-Surgical Nursing Department, School of Nursing, University of Barcelona, Pavelló de Govern, 3° pl., L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Biomedical Research Networking Centre of Rare Diseases (CIBER-ER), Unit 747 ISCIII, Madrid, Spain
| | - Inmaculada Bonilla Aguilar
- Nursing Research Group (GRIN). IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, 199, L'Hospitalet de Llobregat, 08908 Barcelona, Spain; Assistant Nurse, Hospital Universitari de Bellvitge, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Sergio Alonso-Fernández
- Fundamental Care and Medical-Surgical Nursing Department, School of Nursing, University of Barcelona, Pavelló de Govern, 3° pl., L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Nursing Research Group (GRIN). IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, 199, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Marta Romero García
- Fundamental Care and Medical-Surgical Nursing Department, School of Nursing, University of Barcelona, Pavelló de Govern, 3° pl., L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Nursing Research Group (GRIN). IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, 199, L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Esperanza Zuriguel-Pérez
- Multidisciplinary Nursing Research Group. Vall d'Hebron Research Institute (VHIR), Passeig Vall d'Hebron 119-129, Barcelona 08035, Spain; Vall d'Hebron University Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Department of Knowledge Management and Evaluation, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Anna Falcó-Pegueroles
- Fundamental Care and Medical-Surgical Nursing Department, School of Nursing, University of Barcelona, Pavelló de Govern, 3° pl., L'Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Llúcia Benito Aracil
- Fundamental Care and Medical-Surgical Nursing Department, School of Nursing, University of Barcelona, Pavelló de Govern, 3° pl., L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Nursing Research Group (GRIN). IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, 199, L'Hospitalet de Llobregat, 08908 Barcelona, Spain
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Ramos-Pozón S, Terribas-Sala N, Falcó-Pegueroles A, Román-Maestre B. Persons with mental disorders and assisted dying practices in Spain: An overview. Int J Law Psychiatry 2023; 87:101871. [PMID: 36871498 DOI: 10.1016/j.ijlp.2023.101871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
On 25 June 2021, the Law on Euthanasia in Spain came into force, providing for two modes of helping an individual end their life: euthanasia and/or medically assisted suicide. Among the requisites that a request for euthanasia has to fulfil are that the individual must be suffering a severe, chronic and debilitating condition or a severe and incurable disease, at the same time as that person shows the necessary competence to decide. The possibility exists that a patient suffering mental health problems submits such a request; however, the specific characteristics of a mental health disorder make such a request considerably more complex. In this article, based on a narrative review of the law itself and the related literature, the requisites established under the law are analysed from an ethical-legal perspective with the aim of defining when a request for euthanasia from a person with a mental health disorder may be deemed legitimate and in line with legal provisions. This should help clinicians make rational, reasoned decisions when dealing with a request of this type.
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Affiliation(s)
- Sergio Ramos-Pozón
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Pedreira-Robles G, Morín-Fraile V, Bach-Pascual A, Redondo-Pachón D, Pérez-Sáez MJ, Crespo M, Falcó-Pegueroles A, Garcimartín P. The role of Advanced Practice Nurses in creating the Kidney Transplant candidate care map (APN-preKT): a convergent-parallel mixed methods research protocol. BMC Nurs 2023; 22:44. [PMID: 36797711 PMCID: PMC9936119 DOI: 10.1186/s12912-023-01193-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Waiting time for kidney transplants (KT) is an important health determinant for patients with chronic kidney disease (CKD). During this time, ongoing evaluation and participation is necessary in order to guarantee the quality and suitability of the proposed treatment. There is no existing literature on the potential impact of inclusion of an Advanced Practice Nurse (APN) role in the hospital setting on care for CKD patients who are candidates for KT. The main objectives of this protocol are: to analyse outpatient nursing activity in the care of individuals with KT in Spain; to identify the needs of individuals who are KT candidates; and to measure the impact of the APN role through patient outcomes and experiences. These objectives are fulfilled through 5 specific related substudies. METHODS A convergent parallel mixed methods approach will be conducted between July 2021 and April 2024. Quantitative and qualitative data will be collected and analysed separately to ascertain whether the findings confirm or contradict one another. Each of the 5 substudies of the project require a specific design, sampling method, and data collection procedure in order to meet the overall objectives for the project. DISCUSSION The results of the project are expected to inform the design of future nursing roles and contribute to future improvements in the quality of care provided. The data that may be obtained from this protocol are limited to the specific context of the study facility and may be extrapolated but not compared to other settings due to the variability of care pathways for KT candidates internationally. TRIAL REGISTRATION This project was approved by the Clinical Research Ethics Committee (no.2020/9418/I). The study was supported by the "Strategic Plan for Health Research and Innovation" from the Generalitat de Catalunya, registration number SLT017/20/000001, with a contribution of 57,239 euros.
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Affiliation(s)
- Guillermo Pedreira-Robles
- grid.411142.30000 0004 1767 8811Nephrology Department, Hospital del Mar, Barcelona, Spain ,grid.418476.80000 0004 1767 8715ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra affiliated, Barcelona, Spain ,grid.411142.30000 0004 1767 8811SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.5841.80000 0004 1937 0247PhD Candidate, Nursing and Health PhD Programme, University of Barcelona, Barcelona, Spain
| | - Victoria Morín-Fraile
- Department of Public Health, Mental Health, and Maternal and Child Health Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| | - Anna Bach-Pascual
- grid.411142.30000 0004 1767 8811Nephrology Department, Hospital del Mar, Barcelona, Spain
| | - Dolores Redondo-Pachón
- grid.411142.30000 0004 1767 8811Nephrology Department, Hospital del Mar, Barcelona, Spain ,grid.20522.370000 0004 1767 9005Kidney Research Group (GREN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - María José Pérez-Sáez
- grid.411142.30000 0004 1767 8811Nephrology Department, Hospital del Mar, Barcelona, Spain ,grid.20522.370000 0004 1767 9005Kidney Research Group (GREN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Marta Crespo
- grid.411142.30000 0004 1767 8811Nephrology Department, Hospital del Mar, Barcelona, Spain ,grid.20522.370000 0004 1767 9005Kidney Research Group (GREN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Anna Falcó-Pegueroles
- grid.5841.80000 0004 1937 0247Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Paloma Garcimartín
- grid.411142.30000 0004 1767 8811Chief Nursing Officer, Hospital del Mar, Barcelona, Spain ,grid.20522.370000 0004 1767 9005Department of Biomedical Research in Heart Diseases, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
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Falcó-Pegueroles A, Bosch-Alcaraz A, Terzoni S, Fanari F, Viola E, Via-Clavero G, Hoyo SGD, Parini AM, Poveda-Moral S, Parozzi M, Guàrdia-Olmos J, Bonetti L. COVID-19 pandemic experiences, ethical conflict and decision-making process in critical care professionals (Quali-Ethics-COVID-19 research part 1): An international qualitative study. J Clin Nurs 2023. [PMID: 36740770 DOI: 10.1111/jocn.16633] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 02/07/2023]
Abstract
AIM AND OBJECTIVES The aim of this study was to explore the sources of ethical conflict and the decision-making processes of ICU nurses and physicians during the first and subsequent waves of the COVID-19 pandemic. BACKGROUND Depside several studies exploring ethical conflicts during COVID-19 pandemic, few studies have explored in depth the perceptions and experiences of critical care professionals regarding these conflicts, the decision-making process or which have analysed the complexity of actually implementing the recommendations of scientific societies and professional/healthcare institutions in interdisciplinary samples. DESIGN A descriptive phenomenological study. METHODS Thirty-eight in-depth interviews were conducted with critical care nurses and physicians from five hospitals in Spain and Italy between December 2020 and May 2021. A thematic content analysis of the interview transcripts was conducted by two researchers. Consolidated criteria for reporting qualitative research (COREQ) were employed to ensure the quality and transparency of this study. RESULTS Two main themes emerged as sources of ethical conflict: the approach to end of life in exceptional circumstances and the lack of humanisation and care resources. The former comprised two subthemes: end-of-life care and withholding and withdrawal of life-sustaining treatment; the latter comprised three subthemes: the impossibility of guaranteeing the same opportunities to all, fear of contagion as a barrier to taking decisions and the need to humanise care. CONCLUSIONS Professionals sought to take their decisions in line with professional ethics and bioethical principles, but, nevertheless, they experienced moral dilemmas and moral distress when not being able to care for, or to treat, their patients as they believed fit. RELEVANCE TO CLINICAL PRACTICE Further education and training are recommended on the provision of end-of-life and post-mortem care, effective communication techniques via video calls, disclosure of bad news and bioethical models for decision-making in highly demanding situations of uncertainty, such as those experienced during the COVID-19 pandemic.
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Affiliation(s)
- Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Consolidated Research Group 325 Bioethics, Law and Society (BIOELSi), University of Barcelona, Barcelona, Spain
| | - Alejandro Bosch-Alcaraz
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Stefano Terzoni
- Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Francesco Fanari
- Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco, Università degli Studi di Milano, Milan, Italy
| | - Elena Viola
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Gemma Via-Clavero
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Anna Maria Parini
- Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco, Milan, Italy.,Università degli Studi di Milano, Milan, Italy
| | | | - Mauro Parozzi
- Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy.,Università degli Studi di Milano, Milan, Italy
| | - Joan Guàrdia-Olmos
- Faculty of Psychology, University of Barcelona, Barcelona, Spain.,Consolidated Research Group 269 Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Loris Bonetti
- Ente Ospedaliero Cantonale, Bellinzona, Switzerland.,University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
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Manzano-Bort Y, Mir-Abellán R, Via-Clavero G, Llopis-Cañameras J, Escuté-Amat M, Falcó-Pegueroles A. Experience of mental health nurses regarding mechanical restraint in patients with psychomotor agitation: A qualitative study. J Clin Nurs 2022; 31:2142-2153. [PMID: 34459048 DOI: 10.1111/jocn.16027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
AIM To explore mental health nurses' experiences whilst managing a patient with psychomotor agitation, and the factors that influence the decision to use mechanical restraints. BACKGROUND Psychomotor agitation is considered a potentially violent psychiatric emergency. The management of disruptive behaviours includes mechanical restraints as the last resort although its use has consequences for patients, professionals and the therapeutic relationship. DESIGN A qualitative study design with a hermeneutical approach was developed. METHODS A total of 31 nurses were purposively sampled from six short- and medium-stay mental health inpatient units. Data were obtained from semi-structured interviews. A thematic content analysis following the seven steps of Colaizzi's method was performed. Three researchers independently conducted an inductive analysis within a perspective of a hermeneutic paradigm. The COREQ checklist was followed in carrying out this research. RESULTS Four themes emerged from the analysis: 1) Nurses' perceptions of restraint methods, 2) Factors influencing decision-making, 3) Consequences for professionals of the use of mechanical restraint and 4) Alternatives to mechanical restraint. CONCLUSIONS Aspects such as the importance of teamwork, the issue of cognitive dissonance, ethical conflict and barriers to effecting the withdrawal of these measures affect the mental health nurse's decision-making process. The understanding of these aspects is crucial to further reducing its incidence and negative consequences and achieving the elimination of mechanical restraints. RELEVANCE FOR CLINICAL PRACTICE Knowing how nurses feel during the patient's episode of psychomotor agitation and which factors influence the decision on whether to apply coercive methods can guide us on the quality of care offered.
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Affiliation(s)
- Yasmina Manzano-Bort
- Research Group on Patient Safety, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Ramón Mir-Abellán
- Patient Safety Department, Research Group on Patient Safety, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Gemma Via-Clavero
- Hospital Universitari de Bellvitge, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Nursing Research Group (GRIN-IDIBELL), Barcelona, Spain
| | - Jaime Llopis-Cañameras
- Department of Social and Cultural Anthropology, Autonomous University of Barcelona, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Montserrat Escuté-Amat
- Nursing Management Department, Research Group on Patient Safety, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - Anna Falcó-Pegueroles
- School of Nursing Faculty of Medicine and Healthf Sciences, Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona (Spain, Research Group on Patient Safety, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
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9
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Czyż-Szypenbejl K, Mędrzycka-Dąbrowska W, Falcó-Pegueroles A, Lange S. Conflict Sources and Management in the ICU Setting before and during COVID-19: A Scoping Review of the Literature. Int J Environ Res Public Health 2022; 19:ijerph19031875. [PMID: 35162897 PMCID: PMC8835561 DOI: 10.3390/ijerph19031875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/26/2022] [Accepted: 02/05/2022] [Indexed: 02/01/2023]
Abstract
Introduction. Conflicts are an inherent part of work within any organisation. They can arise between members of an interdisciplinary team (or between teams representing different departments), between patients and team members/family members, and patients’ families and team members. Various conflict situations among employees may occur, therefore it is very important to identify their causes and take preventive or targeted corrective measures. The aim of this study was to review the available literature concerning conflicts arising in ICUs—their types, methods of expression as well as their management and mitigation. In addition, we reviewed the available literature on the impact of the pandemic on the ICU environment caring for COVID-19 patients. Methods. The databases were searched. Single key words or their combinations using AND or OR operators were entered. Eventually, 15 articles were included in our review, which included two identical papers. Results. Conflicts occurred occasionally or rarely; researchers describing ethical conflicts demonstrated a moderate level of exposure to conflicts. The pandemic created many challenges and ethical dilemmas that are a source of ethical conflict. Conclusions. As conflict by nature remains inevitable, adequate procedures in conflict management should be developed and the leadership of managing personnel should be reinforced, because team members frequently expect guidance from their supervisors. The importance of training in interpersonal communication and crisis situation management in healthcare should therefore be emphasised.
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Affiliation(s)
- Katarzyna Czyż-Szypenbejl
- Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Wioletta Mędrzycka-Dąbrowska
- Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland;
- Correspondence:
| | - Anna Falcó-Pegueroles
- Department of Fundamental Care and Medical-Surgital Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain;
| | - Sandra Lange
- Department of Internal and Pediatric Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland;
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Bonetti L, Terzoni S, Ferrara P, Destrebecq A, Zuriguel-Pérez E, Falcó-Pegueroles A. Adaptation and validation of the Ethical Conflict Nursing Questionnaire-Critical Care Version to Italian language. Acta Biomed 2021; 92:e2021505. [PMID: 35037648 DOI: 10.23750/abm.v92is2.11761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 11/09/2021] [Indexed: 06/14/2023]
Abstract
Background and aim of the work Ethical conflict in Intensive Care Unit (ICU) can lead to poor quality health care and attention. Knowing the level of exposure to ethical conflict in health professionals allows to design strategies for improve the ethical environments and making decisions process. To study ethical conflict in health professionals it is necessary to have valid and reliable instruments that can be applied to different health and cultural contexts. No tool existed in Italian context still now. Therefore, the aim of this study was to adapt and validate the Ethical Conflict Nursing Questionnaire-Critical Care Version to the Italian sociocultural context. Methods This is a two-phase psychometric study, including one translation-back-translation phase, and an analysis phase for determining the content and construct validity, by means respectively Content Validity Index, Principal Component Analysis (PCA) and Confirmatory Factor Analysis(CFA), and reliability of the instrument, by means Cronbach's α calculation. Results The sample included 286 nurses from critical care units of four hospitals in (deleted for review) (Italy). Translation-back-translation phase was successful. A Content Validity Index of 95.39 was obtained. The overall Cronbach's α value was 0.866. When an item was eliminated, this value oscillated between 0.871 and 0.881. As the original tool, Principal Component Analysis (PCA) and Confirmatory Factor Analysis (CFA) confirmed a single factor capable of explaining more than 30% of the variance. Conclusions The ECNQ-CCV Italian version is a valid and reliable instrument for measuring the exposure of ICU nursing professionals to ethical conflict.
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Affiliation(s)
- Loris Bonetti
- ASST- FATEBENEFRATELLI- SACCO- Università degli studi di Milano.
| | - Stefano Terzoni
- San Paolo Bachelor School of Nursing, San Paolo teaching hospital - ASST Santi Paolo e Carlo, Milan, Italy..
| | - Paolo Ferrara
- San Paolo Bachelor School of Nursing, San Paolo teaching hospital - ASST Santi Paolo e Carlo, Milan, Italy..
| | - Anne Destrebecq
- University of Milan, Department of Biomedical Sciences for Health, Milan, Italy.
| | | | - Anna Falcó-Pegueroles
- Department of Fundamental Care and Medical-Surgital Nursing. School of Nursing. Faculty of Medicine and Health Sciences. Consolidated Research Group SGR 269 Quantitative Psychology. University of Barcelona (Spain)..
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Roca-Sarsanedas J, Galimany-Masclans J, Regidor-Braojos AM, Falcó-Pegueroles A. Topical treatment of tissue damage due to extravasation of iodinated contrast using thermal compresses. J Tissue Viability 2021; 31:135-141. [DOI: 10.1016/j.jtv.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 11/30/2021] [Accepted: 12/21/2021] [Indexed: 10/19/2022]
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Villa M, Balice-Bourgois C, Tolotti A, Falcó-Pegueroles A, Barello S, Luca EC, Clivio L, Biegger A, Valcarenghi D, Bonetti L. Ethical Conflict and Its Psychological Correlates among Hospital Nurses in the Pandemic: A Cross-Sectional Study within Swiss COVID-19 and Non-COVID-19 Wards. Int J Environ Res Public Health 2021; 18:ijerph182212012. [PMID: 34831768 PMCID: PMC8618535 DOI: 10.3390/ijerph182212012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 11/16/2022]
Abstract
Background: During the Covid-19 pandemic, nurses experienced increased pressure. Consequently, ethical concerns and psychological distress emerged. This study aimed to assess nurses’ ethical conflict, resilience and psychological impact, and compare these variables between nurses who worked in Covid-19 wards and nurses who did not. Methods: Design—Multicentre online survey. Setting—Multi-site public hospital; all nursing staff were invited to participate. The survey included validated tools and a novel instrument to assess ethical conflict. Spearman’s rho coefficient was used to assess correlations between ethical conflict and psychological distress, logistic regressions to evaluate relationships between nurses’ characteristics and outcome variables, and the Mann–Whitney/t-test to compare groups. Results: 548 questionnaires out of 2039 were returned (275 = Covid-19; 273 = non-Covid-19). We found a low–moderate level of ethical conflict (median = 111.5 [76–152]), which emerged mostly for seeing patients dying alone. A moderate and significant positive correlation emerged between ethical conflict and psychological distress rs (546) = 0.453, p < 0.001. Nurses working in Covid-19-ICUs (OR = 7.18; 95%CI = 3.96–13.01; p < 0.001) and Covid-19 wards (OR = 5.85; 95%CI = 3.56–9.6; p < 0.001) showed higher ethical conflict. Resilience was a protective factor for ethical conflict. Conclusions: Ethical conflict was significantly linked to psychological distress, while a higher level of resilience was found to be a protective factor. These results can be informative for nursing management in future similar crises.
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Affiliation(s)
- Michele Villa
- Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900 Lugano, Switzerland;
| | - Colette Balice-Bourgois
- Pediatric Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland;
| | - Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland;
- Correspondence:
| | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona (Spain), Campus Bellvitge, Pavelló de Govern, 3a planta, Despatx 331, Feixa Llarga, s/n L’Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Serena Barello
- EngageMinds HUB—Consumer, Food & Health Engagement Research Center, Department of Phychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy;
| | - Elena Corina Luca
- Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Via Tesserete, 46, 6903 Lugano, Switzerland;
| | - Luca Clivio
- ICT Data Science & Research Unit, Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland;
| | - Annette Biegger
- Nursing Department Direction, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzonal, Switzerland;
| | - Dario Valcarenghi
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Via Gallino, 12, 6500 Bellinzona, Switzerland;
- Nursing Research Competence Centre, Nursing Direction Department, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland;
| | - Loris Bonetti
- Nursing Research Competence Centre, Nursing Direction Department, Ente Ospedaliero Cantonale (EOC), Viale Officina, 3, 6500 Bellinzona, Switzerland;
- Department of Business Economics, University of Applied Sciences and Arts of Southern Switzerland, Health and Social Care, Via Violino, 11, 6928 Manno, Switzerland
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Poveda-Moral S, Falcó-Pegueroles A, Ballesteros-Silva MP, Bosch-Alcaraz A. Barriers to Advance Care Planning Implementation in Health care: An Umbrella Review with Implications for Evidence-Based Practice. Worldviews Evid Based Nurs 2021; 18:254-263. [PMID: 34506051 DOI: 10.1111/wvn.12530] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Advance care planning (ACP) refers to a process of discussions between professionals, patients, and their families, which allows the patient to define and communicate their care and treatment preferences. Understanding the barriers to advance care planning is the first step on the way to overcoming them and to improving person-centred care and attention. AIMS To identify the barriers perceived by professionals, patients, and family members when implementing ACP in a clinical context and to analyse the methodological quality of the evidence. METHODS An umbrella review guided by the Joanna Briggs Institute and a systematic review in accordance with PRISMA 2015 were utilized. Data were obtained from MEDLINE, Cochrane Library, The Joanna Briggs Institute, CINAHL, Scopus, and EMBASE in November 2018. RESULTS Fourteen systematic reviews were included. The main barriers reported by professionals were lack of knowledge and skills to carry out ACP, a certain fear of starting conversations about ACP, and a lack of time for discussions. Patients and family members considered that the main barriers were fear of discussing their relative's end of life, lack of ability to carry out ACP, and not knowing who was responsible for initiating conversations about ACP. LINKING EVIDENCE TO ACTION This review has examined the barriers presented by health professionals, patients, and family members, so that future lines of research can develop preventive or decisive measures that encourage the implementation of ACP in health care.
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Affiliation(s)
- Silvia Poveda-Moral
- Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa, School of Nursing, Faculty of Medicine and Health Sciences, Universitat Autònoma de Barcelona, University of Barcelona, Barcelona, Spain
| | - Anna Falcó-Pegueroles
- Department of Fundamental Care and Medical-Surgical Nursing, Faculty of Medicine and Health Sciences, School of Nursing, Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | | | - Alejandro Bosch-Alcaraz
- School of Nursing, Faculty of Medicine and Health Sciences, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
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Poveda-Moral S, de la Casa PJM, Sánchez-Valero P, Pomares-Quintana N, Vicente-García M, Falcó-Pegueroles A. Association between knowledge and attitudes towards advance directives in emergency services. BMC Med Ethics 2021; 22:75. [PMID: 34158034 PMCID: PMC8218476 DOI: 10.1186/s12910-021-00646-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/09/2021] [Indexed: 12/02/2022] Open
Abstract
Background Implementing the routine consultation of patient advance directives in hospital emergency departments and emergency medical services has become essential, given that advance directives constitute the frame of reference for care personalisation and respect for patients’ values and preferences related to healthcare. The aim of this study was to assess the levels and relationship of knowledge and attitudes of nursing and medical professionals towards advance directives in hospital emergency departments and emergency medical services, and to determine the correlated and predictor variables of favourable attitudes towards advance directives. Methods Observational, descriptive, and cross-sectional study. The study was conducted in the emergency department of a second-level hospital and in the emergency medical service. Data collection was performed from January 2019 to February 2020. The STROBE guidelines were followed for the preparation of the study. Results A total of 173 healthcare professionals responded to the questionnaire. Among them, 91.3% considered that they were not sufficiently informed about advance directives, and 74% acknowledged not having incorporated them into their usual practice. Multinomial analysis indicated a statistically significant relationship between the variable emergency medical service and having more favourable attitudes towards consulting the advance directives in their practical application (OR 2.49 [95% CI 1.06–5.88]; p = 0.037) and compliance in complex scenarios (OR 3.65 [95% CI 1.58 − 8.41]; p = 0.002). Working the afternoon and night shift was a predictor variable for obtaining a higher score with respect to attitudes in complex scenarios. Conclusion There is an association between the level of knowledge that nursing and medical professionals have about advance directives and the scores obtained on the attitude scales at the time of practical implementation and in complex scenarios. This shows that the more knowledge professionals have, the more likely they are to consult patients' advance directives and to respect their wishes and preferences for care and/or treatment.
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Affiliation(s)
- Silvia Poveda-Moral
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain. .,Escola Universitària D'Infermeria I Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona, Calle de La Riba, 90, 08221, Terrassa, Barcelona, Catalonia, Spain.
| | | | - Pere Sánchez-Valero
- Coordinador Territorial Servicio de Emergencias Médicas, Generalitat de Catalunya, Barcelona, Catalonia, Spain
| | | | | | - Anna Falcó-Pegueroles
- School of Nursing. Faculty of Medicine and Health Sciences. Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona, Barcelona, Spain
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Falcó-Pegueroles A, Zuriguel-Pérez E, Via-Clavero G, Bosch-Alcaraz A, Bonetti L. Ethical conflict during COVID-19 pandemic: the case of Spanish and Italian intensive care units. Int Nurs Rev 2021. [PMID: 33615479 DOI: 10.1111/inr.v68.210.1111/inr.12645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
AIM To identify factors underlying ethical conflict occurring during the current COVID-19 pandemic in the critical care setting. BACKGROUND During the first wave of the COVID-19 outbreak, Spanish and Italian intensive care units were overwhelmed by the demand for admissions. This fact revealed a crucial problem of shortage of health resources and rendered that decision-making was highly complex. SOURCES OF EVIDENCE Applying a nominal group technique this manuscript identifies a series of factors that may have played a role in the emergence of the ethical conflicts in critical care units during the COVID-19 pandemic, considering ethical principles and responsibilities included in the International Council of Nurses Code of Ethics. The five factors identified were the availability of resources; the protection of healthcare workers; the circumstances surrounding decision-making, end-of-life care, and communication. DISCUSSION The impact of COVID-19 on health care will be long-lasting and nurses are playing a central role in overcoming this crisis. Identifying these five factors and the conflicts that have arisen during the COVID-19 pandemic can help to guide future policies and research. CONCLUSIONS Understanding these five factors and recognizing the conflicts, they may create can help to focus our efforts on minimizing the impact of the ethical consequences of a crisis of this magnitude and on developing new plans and guidelines for future pandemics. IMPLICATIONS FOR NURSING PRACTICE AND POLICY Learning more about these factors can help nurses, other health professionals, and policymakers to focus their efforts on minimizing the impact of the ethical consequences of a crisis of this scale. This will enable changes in organizational policies, improvement in clinical competencies, and development of the scope of practice.
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Affiliation(s)
- Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences. Quantitative Psychology Research Group (SGR 269), University of Barcelona, Barcelona, Spain
| | | | - Gemma Via-Clavero
- Critical Care Unit, Hospital Universitari de Bellvitge, Nursing Research Group (GRIN-IDIBELL), Barcelona, Spain
- Pediatric Critical Care Unit, Sant Joan de Deu Hospital, Barcelona, Spain
| | - Alejandro Bosch-Alcaraz
- Pediatric Critical Care Unit, Sant Joan de Deu Hospital, Barcelona, Spain
- School of Nursing, Faculty of Medicine and Health Sciences, University de Barcelona, Barcelona, Spain
| | - Loris Bonetti
- Clinical Expert in Nursing Research, Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
- University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
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Bosch-Alcaraz A, Luna-Castaño P, Garcia-Soler P, Tamame-San Antonio M, Falcó-Pegueroles A, Alcolea-Monge S, Fernández Lorenzo R, Piqueras-Rodríguez P, Molina-Gallego I, Potes-Rojas C, Gesti-Senar S, Orozco-Gamez R, Tercero-Cano MC, Saz-Roy MÁ, Jordan I, Belda-Hofheinz S. [Level of discomfort in critically ill paediatric patients and its correlation with sociodemographic and clinical variables, analgosedation and withdrawal syndrome. COSAIP multicentre study (Phase 2)]. An Pediatr (Barc) 2020; 95:S1695-4033(20)30475-6. [PMID: 33317976 DOI: 10.1016/j.anpedi.2020.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/11/2020] [Accepted: 10/21/2020] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION There are clinical and sociodemographic factors that have an impact on the comfort of the critically ill paediatric patient. The main aim of this study was to determine the level of discomfort of paediatric patients admitted to different national hospitals, and to analyse its correlation with sociodemographic and clinical variables, analgosedation, and withdrawal syndrome. METHODS An observational, analytical, cross-sectional, and multicentre study was conducted in five Spanish hospitals. The level of analgosedation was assessed once per shift over a 24h period, using a BIS sensor, and pain with scales adapted to paediatric age population. The intensity of withdrawal syndrome was determined using the Withdrawal Assessment Tool (WAT-1) scale once per shift for 3 days. Discomfort level was simultaneous assessed using COMFORT Behaviour Scale-Spanish version (CBS-S). RESULTS A total of 261 critically ill paediatric patients with median age of 1.61 years (IQR=0.35-6.55) were included. An overall discomfort score of 10.79±3.7 was observed during morning compared to 10.31±3.3 observed during the night. When comparing analgosedation and non-analgosedation groups, statistically differences were found in both shifts (χ2: 45.48; P=.001). At the same time, an association was observed (P<.001) between low discomfort scores and development of withdrawal syndrome development assessed with WAT-1. CONCLUSIONS As there is a percentage of the studied population with discomfort, specific protocols need to be developed, guided by valuated and clinically tested tools, like the COMFORT Behaviour Scale-Spanish version.
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Affiliation(s)
- Alejandro Bosch-Alcaraz
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu de Barcelona, Barcelona, España; Departamento de Enfermería de Salud Pública, Salud Mental y Maternoinfantil. Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, España.
| | - Patricia Luna-Castaño
- Unidad de Apoyo a la Investigación Enfermera, Hospital Universitario La Paz, Madrid, España
| | - Patricia Garcia-Soler
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario Carlos Haya, Málaga, España
| | | | - Anna Falcó-Pegueroles
- Departamento de Enfermería Fundamental y Medicoquirúrgica, Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, España
| | - Sandra Alcolea-Monge
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu de Barcelona, Barcelona, España
| | - Rocío Fernández Lorenzo
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu de Barcelona, Barcelona, España
| | | | - Irene Molina-Gallego
- Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario La Paz, Madrid, España
| | - Cristina Potes-Rojas
- Unidad de Cuidados Intensivos Pediátrica, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España
| | - Silvia Gesti-Senar
- Unidad de Cuidados Intensivos Pediátrica, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España
| | - Rocío Orozco-Gamez
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España
| | | | - M Ángeles Saz-Roy
- Departamento de Enfermería de Salud Pública, Salud Mental y Maternoinfantil. Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, España
| | - Iolanda Jordan
- Unidad de Cuidados Intensivos Pediátrica, Hospital Sant Joan de Déu de Barcelona, Barcelona, España
| | - Sylvia Belda-Hofheinz
- Unidad de Cuidados Intensivos Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España
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Falcó-Pegueroles A, Zuriguel-Pérez E, Via-Clavero G, Bosch-Alcaraz A, Bonetti L. Ethical conflict during COVID-19 pandemic: the case of Spanish and Italian intensive care units. Int Nurs Rev 2020; 68:181-188. [PMID: 33615479 DOI: 10.1111/inr.12645] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 11/28/2022]
Abstract
AIM To identify factors underlying ethical conflict occurring during the current COVID-19 pandemic in the critical care setting. BACKGROUND During the first wave of the COVID-19 outbreak, Spanish and Italian intensive care units were overwhelmed by the demand for admissions. This fact revealed a crucial problem of shortage of health resources and rendered that decision-making was highly complex. SOURCES OF EVIDENCE Applying a nominal group technique this manuscript identifies a series of factors that may have played a role in the emergence of the ethical conflicts in critical care units during the COVID-19 pandemic, considering ethical principles and responsibilities included in the International Council of Nurses Code of Ethics. The five factors identified were the availability of resources; the protection of healthcare workers; the circumstances surrounding decision-making, end-of-life care, and communication. DISCUSSION The impact of COVID-19 on health care will be long-lasting and nurses are playing a central role in overcoming this crisis. Identifying these five factors and the conflicts that have arisen during the COVID-19 pandemic can help to guide future policies and research. CONCLUSIONS Understanding these five factors and recognizing the conflicts, they may create can help to focus our efforts on minimizing the impact of the ethical consequences of a crisis of this magnitude and on developing new plans and guidelines for future pandemics. IMPLICATIONS FOR NURSING PRACTICE AND POLICY Learning more about these factors can help nurses, other health professionals, and policymakers to focus their efforts on minimizing the impact of the ethical consequences of a crisis of this scale. This will enable changes in organizational policies, improvement in clinical competencies, and development of the scope of practice.
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Affiliation(s)
- Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences. Quantitative Psychology Research Group (SGR 269), University of Barcelona, Barcelona, Spain
| | | | - Gemma Via-Clavero
- Critical Care Unit, Hospital Universitari de Bellvitge, Nursing Research Group (GRIN-IDIBELL), Barcelona, Spain.,Pediatric Critical Care Unit, Sant Joan de Deu Hospital, Barcelona, Spain
| | - Alejandro Bosch-Alcaraz
- Pediatric Critical Care Unit, Sant Joan de Deu Hospital, Barcelona, Spain.,School of Nursing, Faculty of Medicine and Health Sciences, University de Barcelona, Barcelona, Spain
| | - Loris Bonetti
- Clinical Expert in Nursing Research, Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland.,University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
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Bosch-Alcaraz A, Jordan I, Guàrdia Olmos J, Falcó-Pegueroles A. Adaptación transcultural y características de la versión española de la escala COMFORT Behavior Scale en el paciente crítico pediátrico. Med Intensiva 2020; 44:542-550. [DOI: 10.1016/j.medin.2019.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/07/2019] [Accepted: 07/02/2019] [Indexed: 11/26/2022]
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Falcó-Pegueroles A, Rodríguez-Martín D, Ramos-Pozón S, Zuriguel-Pérez E. Critical thinking in nursing clinical practice, education and research: From attitudes to virtue. Nurs Philos 2020; 22:e12332. [PMID: 33029860 DOI: 10.1111/nup.12332] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/06/2020] [Accepted: 08/30/2020] [Indexed: 11/28/2022]
Abstract
Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science.
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Affiliation(s)
- Anna Falcó-Pegueroles
- Department of Fundamental Care and Medical Surgital Nursing, Faculty of Medicine and Health Sciences, School of Nursing, Consolidated Research Group Quantitative Psychology (2017-SGR-269), University of Barcelona, Barcelona, Spain
| | - Dolors Rodríguez-Martín
- Department of Fundamental Care and Medical Surgital Nursing, Faculty of Medicine and Health Sciences, School of Nursing, Consolidated Research Group on Gender, Identity and Diversity (2017-SGR-1091), University of Barcelona, Barcelona, Spain
| | - Sergio Ramos-Pozón
- Department of Fundamental Care and Medical Surgital Nursing, Faculty of Medicine and Health Sciences, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Esperanza Zuriguel-Pérez
- Multidisciplinary Nursing Research Group, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Hospital, Barcelona, Spain
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Poveda-Moral S, Rodríguez-Martín D, Codern-Bové N, José-María P, Sánchez-Valero P, Pomares-Quintana N, Vicente-García M, Falcó-Pegueroles A. Managing ethical aspects of advance directives in emergency care services. Nurs Ethics 2020; 28:91-105. [PMID: 32996375 DOI: 10.1177/0969733020952112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In Hospital Emergency Department and Emergency Medical Services professionals experience situations in which they face difficulties or barriers to know patient's advance directives and implement them. OBJECTIVES To analyse the barriers, facilitators, and ethical conflicts perceived by health professionals derived from the management of advance directives in emergency services. RESEARCH DESIGN, PARTICIPANTS, AND CONTEXT This is a qualitative phenomenological study conducted with purposive sampling including a population of nursing and medical professionals linked to Hospital Emergency Department and Emergency Medical Services. Three focus groups were formed, totalling 24 participants. We performed an inductive-type thematic discourse analysis. ETHICAL CONSIDERATIONS This study was approved by ethical committees of Ethical Commitee of Clínic Hospital (Barcelona) and Comittee of Emergency Medical Services (Barcelona). The participants received information about the purpose of the study. Patients' anonymity and willingness to participate in the study were guaranteed. FINDINGS There were four types of barriers that hindered the proper management of patients' advance directives in Hospital Emergency Department and Emergency Medical Services: personal and professional, family members, organisational and structural, and those derived from the health system. These barriers caused ethical conflicts and hindered professionals' decision-making. DISCUSSION These results are in line with those of previous studies and indicate that factors such as gender, professional category, and years of experience, in addition to professionals' beliefs and the opinions of colleagues and family members, can also influence the professionals' final decisions. CONCLUSION The different strategies described in this study can contribute to the development of health policies and action protocols to help reduce both the barriers that hinder the correct management and implementation of advance directives and the ethical conflicts generated.
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Affiliation(s)
- Silvia Poveda-Moral
- University of Barcelona, Spain; 212203Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (Universitat Autònoma de Barcelona), Spain; Barcelona College of Nursing, Spain
| | | | - Núria Codern-Bové
- 212203Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (Universitat Autònoma de Barcelona), Spain
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Barello S, Falcó-Pegueroles A, Rosa D, Tolotti A, Graffigna G, Bonetti L. The psychosocial impact of flu influenza pandemics on healthcare workers and lessons learnt for the COVID-19 emergency: a rapid review. Int J Public Health 2020; 65:1205-1216. [PMID: 32888048 PMCID: PMC7472941 DOI: 10.1007/s00038-020-01463-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES During a pandemic, healthcare workers (HCWs) are essential to the health system response. Based on our knowledge, little information is available regarding the psychosocial impact on HCWs or interventions for supporting them during pandemics. Therefore, the study aimed to assess available literature on perceived stress and psychological responses to influenza pandemics in HCWs and identify implications for healthcare practice and future research. METHODS This is a rapid review of the literature. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis. RESULTS Across all the studies-both qualitative and quantitative-HCWs working during the epidemic reported frequent concerns regarding their own health and the fear of infecting their families, friends and colleagues. Moreover, social isolation, uncertainty, fears of stigmatization and reluctance to work or considering absenteeism were frequently reported. Moreover, many studies highlighted a high prevalence of high levels of stress, anxiety and depression symptoms, which could have long-term psychological implications in HCWs. CONCLUSIONS This rapid review offers an overview of the major concerns regarding HCWs' psychosocial well-being and possible preventive strategies, which could be useful for the current COVID-19 outbreak and similar future pandemics. Studies suggested to invest on preventive psychological, social, family and physical support and to guaranteeing reasonable work conditions and others in order to protect HCWs from the long-lasting psychological effect of the COVID-19 pandemic.
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Affiliation(s)
- Serena Barello
- EngageMinds HUB – Consumer, Food and Health Engagement Research Center, L.go Gemelli 1, 20123 Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Anna Falcó-Pegueroles
- Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | | | - Angela Tolotti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland (IOSI), EOC, Via Ospedale, 1, 6500 Bellinzona, Switzerland
| | - Guendalina Graffigna
- EngageMinds HUB – Consumer, Food and Health Engagement Research Center, L.go Gemelli 1, 20123 Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Loris Bonetti
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland (IOSI), EOC, Via Ospedale, 1, 6500 Bellinzona, Switzerland
- Department of Business Economic Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
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Bosch-Alcaraz A, Jordan I, Benito-Aracil L, Saz-Roy MÁ, Falcó-Pegueroles A. Discomfort of the critically ill paediatric patient and correlated variables. Aust Crit Care 2020; 33:504-510. [PMID: 32605846 DOI: 10.1016/j.aucc.2020.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 02/07/2020] [Accepted: 02/17/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The care of critically ill children is usually invasive and aggressive, requiring numerous traumatic procedures that may cause fear, pain, and discomfort. OBJECTIVES The aim of this study was to analyse the level of discomfort of patients admitted to the paediatric intensive care unit of a specialist children's hospital and to determine the sociodemographic and clinical variables that influence the degree of discomfort experienced by critically ill paediatric patients. METHODS We performed a descriptive observational cross-sectional study that included a total of 311 children with a median age of 5.07 y (interquartile range = 0.9-11.7). A team of 10 paediatric critical care nurses assessed the degree of discomfort once for each shift (morning, afternoon, and night) on 2 successive days using the COMFORT Behavior Scale-Spanish version. RESULTS In total, 49.8% (n = 155) of the patients were free of discomfort (score ≤10 points) vs. 50.2% (n = 156) who experienced discomfort. There was a significant negative correlation between discomfort and the length of stay in days (Rho = 0.16; p = 0.02), that is, the longer the stay, the less discomfort the patient felt. The correlation between age and degree of discomfort was found to be both positive and significant (Rho = 0.230, p < 0.001); the greater the age, the greater the discomfort. In comparison of all children who received analgosedation (n = 205), with discomfort levels of 10.77 ± 2.94, with those who did not receive analgosedation (n = 106), with discomfort levels of 11.96 ± 2.80, we did find a statistically significant difference (χ2 = -4.05; p < 0.001). CONCLUSIONS Half of the patients admitted to the paediatric intensive care unit experienced discomfort. Age and analgosedation were the two most important variables involved with a high degree of discomfort. Clinical care practices must consider these factors and try to plan activities designed to relieve discomfort in all critically ill paediatric patients.
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Affiliation(s)
- Alejandro Bosch-Alcaraz
- Pediatric Nurse, Hospital Sant Joan de Déu, Barcelona, Spain; Department of Public Health, Mental Health, and Maternity/Childhood Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| | - Iolanda Jordan
- Pediatric Intensive Care Specialist, Hospital Sant Joan de Déu, Barcelona, Spain; Medicine Unit of Training and Research, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Llúcia Benito-Aracil
- Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Spain
| | - Mª Ángeles Saz-Roy
- Department of Public Health, Mental Health, and Maternity/Childhood Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Anna Falcó-Pegueroles
- Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, Spain; Consolidated Research Group SGR 269 Quantitative Psychology, University of Barcelona, Barcelona, Spain
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Lorca-Cabrera J, Grau C, Martí-Arques R, Raigal-Aran L, Falcó-Pegueroles A, Albacar-Riobóo N. Effectiveness of health web-based and mobile app-based interventions designed to improve informal caregiver's well-being and quality of life: A systematic review. Int J Med Inform 2019; 134:104003. [PMID: 31790857 DOI: 10.1016/j.ijmedinf.2019.104003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 09/30/2019] [Accepted: 10/04/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Internet-based interventions can help empower caregivers of people with chronic diseases and can develop solutions to decrease the physical and psychological consequences resulting from caregiving. OBJECTIVE Analysing the effectiveness of health web-based and/or mobile app-based interventions with regard to the level of well-being and quality of life of informal caregivers in charge of people with chronic diseases. MATERIALS AND METHODS Systematic review of the following databases: Pubmed, Apa PsycINFO, ProQuest Health & Medical Complete and Scopus. Quality standards established by PRISMA and Joanna Briggs Institute Systematic Review Approach have been followed. The two phases of the selection process were carried out independently and a cross-case comparative analysis by three reviewers. RESULTS A total of 17 studies met inclusion criteria. The analysis shows that almost all studies involved web-based interventions with the exception of one which concerned a mobile app-based intervention. Most of them prove their effectiveness in the overall well-being of the caregiver and more specifically in the mental dimension, highlighting a decrease in caregivers' anxiety and/or distress, depression symptoms and sense of competence. CONCLUSIONS The findings support that web-based interventions have an impact mainly on caregivers' well-being. Nevertheless, other dimensions that are necessary for caregiving, such as physical, mental and social dimension, have been scarcely explored. More studies on mobile app-based interventions are needed to know their effectiveness.
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Affiliation(s)
- Jael Lorca-Cabrera
- Nursing Department, Campus Terres de l'Ebre, Universitat Rovira i Virgili, Av/ Remolins, 13-15, 43500 Tortosa, Spain.
| | - Carme Grau
- Nursing Department, Campus Catalunya, Universitat Rovira i Virgili, Av/ Catalunya, 35, 43002 Tarragona, Spain.
| | - Rut Martí-Arques
- Nursing Department, Campus Terres de l'Ebre, Universitat Rovira i Virgili, Av/ Remolins, 13-15, 43500 Tortosa, Spain.
| | - Laia Raigal-Aran
- Nursing Department, Campus Catalunya, Universitat Rovira i Virgili, Av/ Catalunya, 35, 43002 Tarragona, Spain.
| | - Anna Falcó-Pegueroles
- Nursing Department, Escola Universitaria d'Infermeria, Universitat de Barcelona, Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona.
| | - Núria Albacar-Riobóo
- Nursing Department, Campus Terres de l'Ebre, Universitat Rovira i Virgili, Av/ Remolins, 13-15, 43500 Tortosa, Spain.
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Martínez C, Castellano Y, Fu M, Riccobene A, Feliu A, Tigova O, Ballbè M, Anton L, Fernández P, Cabrera-Jaime S, Puig-Llobet M, Moreno C, Falcó-Pegueroles A, Galimany J, Estrada JM, Guydish J, Fernández E. Patient perceptions of tobacco control after smoke-free hospital grounds legislation: Multi-center cross-sectional study. Int J Nurs Stud 2019; 102:103485. [PMID: 31862532 DOI: 10.1016/j.ijnurstu.2019.103485] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine patient perceptions of the role of health care providers in tobacco control and tobacco-related services they should provide after the introduction of national smoke-free hospital grounds legislation in Spain. DESIGN Multi-center cross-sectional study. SETTING Thirteen hospitals in Barcelona province in 2014-2015. PARTICIPANTS A total of 1,047 adult hospital patients, with a stay ≥ 24 h were randomly selected. METHOD We explored participants' perceptions of the role of health professionals and hospitals in tobacco control by asking about their agreement with several statements after the introduction of national legislation on smoke-free hospital grounds: (i) health professionals "should set an example and not smoke" and "should provide smoking cessation support"; (ii) hospitals "should provide smoking cessation treatments" and are "role model organizations in compliance with the smoke-free legislation", and (iii) "hospitalization is a perfect moment to quit smoking". Responses were described overall and according to participant and hospital characteristics: patient sex and age, type of hospital unit, number of beds, and smoking prevalence among hospital staff. RESULTS The majority of participants considered that health professionals should be role models in tobacco cessation (75.3%), should provide smoking cessation support to patients (83.0%), and that hospitalization is a good opportunity for initiating an attempt to quit (71.5%). Inpatients admitted to general hospitals where smoking cessation was not given as part of their portfolio, with a low level of implementation in tobacco control, and who stayed in surgical units had higher expectations of receiving smoking cessation interventions. CONCLUSIONS Inpatients strongly support the role of hospitals and health professionals in tobacco control and expect to receive smoking cessation interventions during their hospital stay. Systematically providing smoking cessation services in hospitals may have a relevant impact on health outcomes among smokers and on health care system expenditures.
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Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
| | - Yolanda Castellano
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Marcela Fu
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Anna Riccobene
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Olena Tigova
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Montse Ballbè
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona. C/ Villarroel 170, 08036 Barcelona, Spain
| | - Laura Anton
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Paz Fernández
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain; Nursing Research Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Sandra Cabrera-Jaime
- Nursing Research Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain
| | - Montse Puig-Llobet
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Carmen Moreno
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Anna Falcó-Pegueroles
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Jordi Galimany
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Joan María Estrada
- School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States
| | - Esteve Fernández
- Tobacco Control Unit, Institut Català d'Oncologia (ICO). Av. Granvia de L'Hospitalet 199-203, E-08908 L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL). Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat (Barcelona), Spain; School of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Feixa llarga s/n, 08907 L'Hospitalet del Llobregat (Barcelona), Spain
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Zuriguel-Pérez E, Falcó-Pegueroles A, Agustino-Rodríguez S, Gómez-Martín MDC, Roldán-Merino J, Lluch-Canut MT. Clinical nurses's critical thinking level according to sociodemographic and professional variables (Phase II): A correlational study. Nurse Educ Pract 2019; 41:102649. [PMID: 31698254 DOI: 10.1016/j.nepr.2019.102649] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 07/10/2019] [Accepted: 10/22/2019] [Indexed: 11/18/2022]
Abstract
Critical thinking ability is one of the basic competencies of clinical nurse and is widely accepted as being associated with the provision of quality care, however, the few evidence-based data related to the relationship between level of critical thinking ability and nurses' sociodemographic and professional characteristics. The aim of this study was to identify the level of critical thinking among nurses in clinical practice according to sociodemographic and professional variables. Descriptive cross-sectional and correlational study was carried out in a sample of 339 nurses from medical, surgical and critical care units at a tertiary care hospital. This study is related to a previous publication that presents psychometric analysis. Data were compiled using the Nursing Critical Thinking in Clinical Practice Questionnaire and ad hoc form for the recording of sociodemographic and professional characteristics. The statistical analysis of the data was performed using frequency, Mann-Whitney U Test, Kruskal-Wallis Test, and Pearson's correlation coefficients. Nurses reported moderate levels of critical thinking. Older nurses, with 11-15 years of experience in the actual unit, with continuous shift work, a permanent contract and master's degree indicated a higher level of critical thinking. Critical thinking skills are related to certain socio-demographic and professional variables, particularly age, years of experience, shift work, type of contract and educational level.
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Affiliation(s)
| | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Spain(1)(2).
| | | | | | - Juan Roldán-Merino
- Campus Docent Sant Joan de Déu Fundació Privada School of Nursing, Barcelona, Spain(2)
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Bosch-Alcaraz A, Jordan I, Rodríguez-Martín D, Falcó-Pegueroles A. Meaning and comfort factors in the paediatric intensive care unit from an adult perspective: a descriptive phenomenological study. Scand J Caring Sci 2019; 34:627-635. [PMID: 31614019 DOI: 10.1111/scs.12764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 08/28/2019] [Indexed: 11/29/2022]
Abstract
AIMS To explore the meaning of comfort and know the factors that contribute to it from the point of view of the young adults who received care in a paediatric intensive care unit, the family of the patient and the interdisciplinary team attending the patient. FINDINGS A total of 30 people were invited to participate in the focus groups; 24 did so. Thematic analysis yielded the following common categories: meaning of comfort, environmental factors in paediatric intensive care unit, family accompaniment during paediatric intensive care unit stay, management of information in the paediatric intensive care unit and, finally, the intimacy and privacy of the critically ill paediatric patient and their family. CONCLUSIONS Paediatric intensive care unit professionals need to consider not only the environmental input that may lead to discomfort but also aspects such as continuous family accompaniment, the sharing of complete information with the family and the promoting of privacy.
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Affiliation(s)
- Alejandro Bosch-Alcaraz
- Hospital Sant Joan de Déu, Barcelona, Spain.,School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Iolanda Jordan
- Hospital Sant Joan de Déu, Barcelona, Spain.,Medicine Unit of Training and Research, University of Barcelona, Barcelona, Spain
| | - Dolors Rodríguez-Martín
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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Lluch-Canut T, Sequeira C, Falcó-Pegueroles A, Pinho JA, Rodrigues-Ferreira A, Olmos JG, Roldan-Merino J. Ethical conflicts and their characteristics among critical care nurses. Nurs Ethics 2019; 27:537-553. [PMID: 31303110 DOI: 10.1177/0969733019857785] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Ethical conflict is a phenomenon that has been under study over the last three decades, especially the types moral dilemma and moral distress in the field of nursing care. However, ethical problems and their idiosyncrasies need to be further explored. AIM The objectives of this study were, first, to obtain a transcultural Portuguese-language adaptation and validation of the Ethical Conflict Nursing Questionnaire-Critical Care Version and, second, to analyse Portuguese critical care nurses' level of exposure to ethical conflict and its characteristics. METHODS A cross-cultural validation and descriptive, prospective and correlational study. The sample was made for 184 critical care nurses in 2016. ETHICAL CONSIDERATIONS The study was authorised by Bioethics Commission of the University of Barcelona, the Associaçâo de Apoio ao Serviço de Cuidados Intensivos do Centro Hospitalar do Porto and the Sociedade Portuguesa de Enfermagem de Saúde Mental. FINDINGS The Portuguese version of the Ethical Conflict Nursing Questionnaire-Critical Care Version was a valid and reliable instrument to measure exposure to conflict. Moral outrage was the most common type of conflict. The most problematic situations were the ineffectiveness of analgesic treatments, the administration of treatments considered futile and the mismanagement of resources.
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Pishgooie AH, Atashzadeh-Shoorideh F, Falcó-Pegueroles A, Lotfi Z. Correlation between nursing managers' leadership styles and nurses' job stress and anticipated turnover. J Nurs Manag 2018; 27:527-534. [PMID: 30136322 DOI: 10.1111/jonm.12707] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/28/2018] [Accepted: 08/16/2018] [Indexed: 11/28/2022]
Abstract
AIM To investigate the relationship between leadership style with nurse job stress and anticipated turnover. BACKGROUND An appropriate leadership style should promote the efficacy of nurses. Different leadership styles can affect nurse's job stress and the numbers of nurses leaving their workplace or their profession. METHODS In this cross-sectional correlational study, 1,617 nurses were selected from the governmental hospitals in Iran 2016-2017. Data were analyzed using descriptive and inferential statistics in SPSS20 . RESULTS Nursing Manager's leadership style was transactional leadership. Both transformational and transactional leadership style have a significant relationship with job stress and anticipate staff turnover. A positive relationship was found between a laissez-faire leadership style with job stress and anticipated turnover. CONCLUSION The transformational and transactional leadership styles can reduce nurse's job stress and intention to leave, so nurse leaders can use combination of transformational and transactional leadership for improving job satisfaction and quality of nursing services. IMPLICATIONS FOR NURSING MANAGEMENT Leaders should emphasize a clear expression of values, objectives, and mission of the organisation; and try to raise confidence in employees, respecting and caring for them, supporting their views and suggestions, and being optimistic about the future.
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Affiliation(s)
- Amir Hossain Pishgooie
- Department of Medical-Surgical Nursing, AJA University of Medical Sciences, Tehran, Iran
| | - Foroozan Atashzadeh-Shoorideh
- Department of Nursing Management, School of Nursing and midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anna Falcó-Pegueroles
- Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Zahra Lotfi
- Department of Nursing, Royal Free Hospital, London, UK
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Pishgooie AH, Barkhordari-Sharifabad M, Atashzadeh-Shoorideh F, Falcó-Pegueroles A. Ethical conflict among nurses working in the intensive care units. Nurs Ethics 2018; 26:2225-2238. [PMID: 30336767 DOI: 10.1177/0969733018796686] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Ethical conflict is a barrier to decision-making process and is a problem derived from ethical responsibilities that nurses assume with care. Intensive care unit nurses are potentially exposed to this phenomenon. A deep study of the phenomenon can help prevent and treat it. OBJECTIVES This study was aimed at determining the frequency, degree, level of exposure, and type of ethical conflict among nurses working in the intensive care units. RESEARCH DESIGN This was a descriptive cross-sectional research. PARTICIPANTS AND RESEARCH CONTEXT In total, 382 nurses working in the intensive care units in Iranian hospitals were selected using the random sampling method. Data were collected using the Ethical Conflict in Nursing Questionnaire-Critical Care Version (Persian version). ETHICAL CONSIDERATIONS This study was approved by the Medical Research Ethics Committee. Ethical considerations such as completing the informed consent form, ensuring confidentiality of information, and voluntary participation were observed. FINDINGS The results showed that the average level of exposure to ethical conflict was 164.39 ± 79.06. The most frequent conflict was related to "using resources despite believing in its futility," with the frequency of at least once a week or a month (68.6%, n = 262). The most conflictive situation was violation of privacy (76.9%, n = 294). However, the level of exposure to ethical conflict according to the theoretical model followed was the situation of "working with incompetent staff." The most frequently observed type of conflict was moral dilemma. CONCLUSION The moderate level of exposure to ethical conflict was consistent with the results of previous studies. However, the frequency, degree, and type of ethical conflict were different compared to the results of other studies. Recognizing ethical conflict among intensive care unit nurses can be useful as it allows to consolidate those measures that favor low levels of ethical conflict, design appropriate strategies to prevent ethical conflicts, and improve the nursing work environment.
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Zuriguel-Pérez E, Lluch-Canut MT, Agustino-Rodríguez S, Gómez-Martín MDC, Roldán-Merino J, Falcó-Pegueroles A. Critical thinking: A comparative analysis between nurse managers and registered nurses. J Nurs Manag 2018; 26:1083-1090. [PMID: 30198624 DOI: 10.1111/jonm.12640] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 11/26/2022]
Abstract
AIM To analyse the levels of critical thinking among nurse managers and registered nurses and to explore the association between these levels and socio-demographic and occupational factors. BACKGROUND Critical thinking is an essential skill in advanced clinical nursing. However, few studies to date have explored critical thinking levels in nurse managers or compared them with those recorded in registered nurses. METHODS A randomized sample of 44 nurse managers and 295 registered nurses from a tertiary hospital in Barcelona participated in this study. The Nursing Critical Thinking in Clinical Practice Questionnaire was used to measure the level of critical thinking. The data were analysed using multivariate analysis by logistic regression. RESULTS Levels of critical thinking were higher in nurse managers than in registered nurses. Age, work shift schedule and educational level were associated with a higher level of critical thinking in nurse managers and were predictor factors. CONCLUSIONS This study identified age, work shift schedule and educational level as factors that impact on the acquisition of critical thinking skills among nurse managers. IMPLICATIONS FOR NURSING MANAGEMENT This study provides substantive evidence of the levels of critical thinking among nurse managers. When introducing strategies to enhance these skills, the associated occupational factors should be taken into account.
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Affiliation(s)
- Esperanza Zuriguel-Pérez
- Department of Nursing Informatics and Knowledge Management, Hospital Vall d'Hebron, Barcelona, Spain.,Health Care Research, Vall d'Hebron Research Institute, Barcelona, Spain
| | - M Teresa Lluch-Canut
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Consolidated Research Group on Measurement Invariance and Analysis of Change (GEIMAC: 2014-1139), University of Barcelona, Barcelona, Spain
| | - Sandra Agustino-Rodríguez
- Department of Nursing Informatics and Knowledge Management, Hospital Vall d'Hebron, Barcelona, Spain
| | | | - Juan Roldán-Merino
- Consolidated Research Group on Measurement Invariance and Analysis of Change (GEIMAC: 2014-1139), University of Barcelona, Barcelona, Spain.,Sant Joan de Deu School of Nursing, University of Barcelona, Barcelona, Spain
| | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Consolidated Research Group on Advanced Techniques Applied Psychology (GTEAAP: 2014-326), University of Barcelona, Barcelona, Spain
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Martínez C, Fu M, Castellano Y, Riccobene A, Fernández P, Cabrera S, Gavilan E, Feliu A, Puig-Llobet M, Fuster P, Martínez-Sánchez JM, Montes J, Estrada JM, Moreno C, Falcó-Pegueroles A, Galimany J, Brando C, Suñer-Soler R, Capsada A, Fernández E. Smoking among hospitalized patients: A multi-hospital cross-sectional study of a widely neglected problem. Tob Induc Dis 2018; 16:34. [PMID: 31516433 PMCID: PMC6659490 DOI: 10.18332/tid/92927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/25/2018] [Accepted: 07/05/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION A comprehensive smoking ban was recently enacted for acute-care hospital campuses in Spain. The aim of this study was to assess the prevalence and patterns of smoking among inpatients before and during hospitalization. METHODS Multi-center cross-sectional study was conducted in 13 hospitals in the province of Barcelona, Spain from May 2014 to May 2015. Participants were adults who provided informed consent. The sample size was calculated to be representative of each hospital (prevalence 29.4%, precision ± 5%, error 5%). We approached 1228 subjects, 888 accepted to participate and 170 were replaced (were not available or declined to participate). Final sample comprised 1047 subjects. We used a computer-assisted personal interview system to collect data, including sociodemographic variables and use of tobacco before and during hospitalization. Smoking status was validated with exhaled carbon monoxide. We calculated overall tobacco prevalence and investigated associations with participant and center characteristics. We performed multiple polytomous and multilevel logistic regression analyses to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustments for potential confounders. RESULTS In all, 20.5% (95% CI: 18.1–23.0) of hospitalized patients were smokers. Smoking was most common among men (aOR=7.47; 95% CI: 4.88–11.43), young age groups (18–64 years), and individuals with primary or less than primary education (aOR=2.76; 95% CI: 1.44–5.28). Of the smokers, 97.2% were daily consumers of whom 44.9% had medium nicotine dependence. Of all smokers, three-quarters expressed a wish to quit, and one-quarter admitted to consuming tobacco during hospitalization. CONCLUSIONS Our findings indicate the need to offer smoking cessation interventions among hospitalized patients in all units and service areas, to avoid infringements and increase patient safety, hospital efficiency, and improve clinical outcomes. Hospitalization represents a promising window for initiating smoking interventions addressed to all patients admitted to smoke-free hospitals, specially after applying a smoke-free campus ban.
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Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain.,Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain.,Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Nursing Science, Gimbernat School, Barcelona, Spain.,Department of Nursing Science, University of Girona, Girona, Spain.,Fundació Althaia, Barcelona, Spain
| | - Anna Riccobene
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain
| | - Paz Fernández
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain
| | - Sandra Cabrera
- Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain
| | - Eva Gavilan
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Montse Puig-Llobet
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Pilar Fuster
- Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Javier Montes
- Department of Nursing Science, Gimbernat School, Barcelona, Spain
| | - Joan Maria Estrada
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Carmen Moreno
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Jordi Galimany
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Cecilia Brando
- Department of Nursing Science, Gimbernat School, Barcelona, Spain
| | - Rosa Suñer-Soler
- Department of Nursing Science, University of Girona, Girona, Spain
| | | | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
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Abstract
AIMS AND OBJECTIVES To investigate the meaning of comfort and to contextualise it within the framework of paediatric critical care. BACKGROUND The concept of comfort is closely linked to care in all health contexts. However, in specific settings such as the paediatric critical care unit, it takes on particular importance. DESIGN A literature review was conducted. METHODS A literature search was performed of articles in English and Spanish in international health science databases, from 1992-March 2017, applying the quality standards established by the PRISMA methodology and the Joanna Briggs Institute. RESULTS A total of 1,203 publications were identified in the databases. Finally, 59 articles which met the inclusion criteria were entered in this literature review. Almost all were descriptive studies written in English and published in Europe. The concept of comfort was defined as the immediate condition of being strengthened through having the three types of needs (relief, ease and transcendence) addressed in the four contexts of experience (physical, psychospiritual, social and environmental). Only two valid and reliable tools for assessing comfort were found: the Comfort Scale and the Comfort Behavior Scale. CONCLUSIONS Comfort is subjective and difficult to assess. It has four facets: physical, emotional, social and environmental. High levels of noise and light are the inputs that cause the most discomfort. Comfort is a holistic, universal concept and an important component of quality nursing care.
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Affiliation(s)
- Alejandro Bosch-Alcaraz
- Faculty of Medicine and Health Sciences, School of Nursing, University of Barcelona, Barcelona, Spain.,Hospital Sant Joan de Déu, Barcelona, Spain
| | - Anna Falcó-Pegueroles
- Faculty of Medicine and Health Sciences, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Iolanda Jordan
- Hospital Sant Joan de Déu, Barcelona, Spain.,School of Medicine, University of Barcelona, Barcelona, Spain
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Rodríguez-Martín D, Rodríguez-García C, Falcó-Pegueroles A. Ethnographic analysis of communication and the deaf community's rights in the clinical context. Contemp Nurse 2018; 54:126-138. [PMID: 29451100 DOI: 10.1080/10376178.2018.1441731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Communication is a key factor in the health system. In the case of Deaf Community healthcare interactions could be affected by communication and it can also have a negative impact on health and jeopardise some of their health rights. OBJECTIVES Aims (i) know the communication access difficulties of deaf people in healthcare context (ii) determine how these difficulties violate their rights. METHODS Ethnographical study. RESULTS Subjects were 25 deaf adults (7 men; 18 women). Two themes were identified (1) barriers to information access - right to information; (2) communication barriers - right to privacy and to decide. CONCLUSIONS Communication difficulties and access to information have an impact on the health of deaf people, and violate health rights. In addition, their language rights like a community are also violate. Impact statement: Research could have a positive impact on improvement to access, communication and safe in the Deaf Community, in a clinical context.
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Affiliation(s)
- Dolors Rodríguez-Martín
- a Faculty of Medicine and Health Sciences, School of Nursing , University of Barcelona , Barcelona , Spain.,b Consolidated Research Group 2014-1156 Anthropology of Kinship and Heritage (GRAPP) , University of Barcelona , Barcelona , Spain.,c Interuniversity Research Group on Gender, Diversity and Health (GIR-GEDIS) , University of Barcelona , Barcelona , Spain.,d Research Group on Gender, Identity and Diversity (GENI) , University of Barcelona , Barcelona , Spain
| | - Catalina Rodríguez-García
- a Faculty of Medicine and Health Sciences, School of Nursing , University of Barcelona , Barcelona , Spain.,e University Hospital of Bellvitge, Surgery Unit , Hospitalet de Llobregat , Spain
| | - Anna Falcó-Pegueroles
- a Faculty of Medicine and Health Sciences, School of Nursing , University of Barcelona , Barcelona , Spain.,f Consolidated Research Group 2014-326 Advanced Techniques Applied Psychology GTEAAP , University of Barcelona , Barcelona , Spain
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Falcó-Pegueroles A, Rodríguez-Martín D. Ten questions you should consider before submitting an article to a scientific journal. Enferm Intensiva (Engl Ed) 2018; 29:80-85. [PMID: 29329715 DOI: 10.1016/j.enfi.2017.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 12/05/2017] [Indexed: 11/25/2022]
Abstract
Investigating involves not only knowing the research methods and designs; it involves knowing the strategies for disseminating and publishing the results in scientific journals. An investigation is considered complete when it is published and is disclosed to the scientific community. The publication of a manuscript is not simple, since it involves examination by a rigorous editorial process evaluator to ensure the scientific quality of the proposal. The objective of this article is to communicate to potential authors the main errors or deficiencies that typically and routinely explain the decision by the referees of scientific journals not to accept a scientific article. Based on the experience of the authors as referees of national and international journals in the field of nursing and health sciences, we have identified a total of 10 types or groups, which cover formulation errors, inconsistencies between different parts of the text, lack of structuring, imprecise language, information gaps, and the detection of relevant inaccuracies. The identification and analysis of these issues enables their prevention, and is of great use to future researchers in the dissemination of the results of their work to the scientific community. In short, the best publishing strategy is one that ensures the scientific quality of the work and spares no effort in avoiding the errors or deficiencies that referees routinely detect in the articles they evaluate.
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Affiliation(s)
- A Falcó-Pegueroles
- Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España.
| | - D Rodríguez-Martín
- Escuela de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
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Bosch-Alcaraz A, Jordan-Garcia I, Alcolea-Monge S, Fernández-Lorenzo R, Carrasquer-Feixa E, Ferrer-Orona M, Falcó-Pegueroles A. Validity of contents of a paediatric critical comfort scale using mixed methodology. Enferm Intensiva (Engl Ed) 2017; 29:21-31. [PMID: 28760690 DOI: 10.1016/j.enfi.2017.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 03/07/2017] [Accepted: 04/06/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Critical illness in paediatric patients includes acute conditions in a healthy child as well as exacerbations of chronic disease, and therefore these situations must be clinically managed in Critical Care Units. The role of the paediatric nurse is to ensure the comfort of these critically ill patients. To that end, instruments are required that correctly assess critical comfort. OBJECTIVE To describe the process for validating the content of a paediatric critical comfort scale using mixed-method research. MATERIAL AND METHODS Initially, a cross-cultural adaptation of the Comfort Behavior Scale from English to Spanish using the translation and back-translation method was made. After that, its content was evaluated using mixed method research. This second step was divided into a quantitative stage in which an ad hoc questionnaire was used in order to assess each scale's item relevance and wording and a qualitative stage with two meetings with health professionals, patients and a family member following the Delphi Method recommendations. RESULTS All scale items obtained a content validity index >0.80, except physical movement in its relevance, which obtained 0.76. Global content scale validity was 0.87 (high). During the qualitative stage, items from each of the scale domains were reformulated or eliminated in order to make the scale more comprehensible and applicable. CONCLUSIONS The use of a mixed-method research methodology during the scale content validity phase allows the design of a richer and more assessment-sensitive instrument.
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Affiliation(s)
- A Bosch-Alcaraz
- Unidad de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Barcelona, España.
| | - I Jordan-Garcia
- Unidad de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Barcelona, España
| | - S Alcolea-Monge
- Unidad de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Barcelona, España
| | - R Fernández-Lorenzo
- Unidad de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Barcelona, España
| | - E Carrasquer-Feixa
- Unidad de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Barcelona, España
| | - M Ferrer-Orona
- Hospitalización Infantil, Hospital Sant Joan de Déu, Barcelona, España
| | - A Falcó-Pegueroles
- Departamento de Enfermería Fundamental y Médicoquirúrgica, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, Barcelona, España
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Zuriguel-Pérez E, Falcó-Pegueroles A, Roldán-Merino J, Agustino-Rodriguez S, Gómez-Martín MDC, Lluch-Canut MT. Development and Psychometric Properties of the Nursing Critical Thinking in Clinical Practice Questionnaire. Worldviews Evid Based Nurs 2017; 14:257-264. [PMID: 28281316 DOI: 10.1111/wvn.12220] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM A complex healthcare environment, with greater need for care based on the patient and evidence-based practice, are factors that have contributed to the increased need for critical thinking in professional competence. At the theoretical level, Alfaro-LeFevre () put forward a model of critical thinking made up of four components. And although these explain the construct, instruments for their empirical measurement are lacking. The purpose of the study was to develop and validate the psychometric properties of an instrument, the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice), designed to evaluate the critical thinking abilities of nurses in the clinical setting. METHODS A cross-sectional survey design was used. A pool of items was generated for evaluation by a panel of experts who considered their validity for the new instrument, which was finally made up of 109 items. Following this, validation was carried out using a sample of 339 nurses at a hospital in Barcelona, Spain. Reliability was determined by means of internal consistency and test-retest stability over time, although the validity of the construct was assessed by means of confirmatory factor analysis. RESULTS The content validity index of the N-CT-4 Practice was .85. Cronbach's alpha coefficient for the whole instrument was .96. The intraclass correlation coefficient was .77. Confirmatory factor analysis showed that the instrument was in line with the four-dimensional model proposed by Alfaro-LeFevre (). LINKING EVIDENCE TO ACTION The psychometric properties of theN-CT-4 Practice uphold its potential for use in measuring critical thinking and in future research related with the examination of critical thinking.
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Affiliation(s)
- Esperanza Zuriguel-Pérez
- Nurse, Department of Nursing Informatics and Knowledge Management, Hospital Vall d'Hebron, and Doctoral Student, School of Nursing, University of Barcelona, Barcelona, Spain
| | | | - Juan Roldán-Merino
- Professor, Sant Joan de Deu School of Nursing, University of Barcelona, Barcelona, Spain.,Associate Professor, Rovira i Virgili University, Tarragona, Spain, and Associate Professor, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Sandra Agustino-Rodriguez
- Nurse, Department of Nursing Informatics and Knowledge Management, Hospital Vall d'Hebron, Barcelona, Spain
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Roldán-Merino J, Lluch-Canut MT, Casas I, Sanromà-Ortíz M, Ferré-Grau C, Sequeira C, Falcó-Pegueroles A, Soares D, Puig-Llobet M. Reliability and validity of the Positive Mental Health Questionnaire in a sample of Spanish university students. J Psychiatr Ment Health Nurs 2017; 24:123-133. [PMID: 28150373 DOI: 10.1111/jpm.12358] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 12/01/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: In general, the current studies of positive mental health use questionnaires or parts thereof. However, while these questionnaires evaluate aspects of positive mental health, they fail to measure the construct itself. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: The widespread use and the lack of specific questionnaires for evaluating the positive mental health construct justify the need to measure the robustness of the Positive Mental Health Questionnaire. Also six factors are proposed to measure positive mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The availability of a good questionnaire to measure positive mental health in university students is useful not only to promote mental health but also to strengthen the curricula of future professionals. ABSTRACT Introduction Nursing has a relevant role in managing mental health. It is important to identify and thereafter to enhance positive aspects of mental health among university nursing students. Aim The aim of the present study was to analyse the psychometric properties of the Positive Mental Health Questionnaire (PMHQ) in terms of reliability and validity using confirmatory factor analysis in a sample of university students. Method A cross-sectional study was carried out in a sample of 1091 students at 4 nursing schools in Catalonia, Spain. The reliability of the PMHQ was measured by means of Cronbach's alpha coefficient, and the test-retest stability was measured with the intraclass correlation coefficient (ICC). Confirmatory factor analysis was used to determine the validity of the factorial structure. Results Cronbach's alpha coefficient was satisfactory (>0.70) for four of the six subscales or dimensions and ranged from 0.54 to 0.79. ICC analysis was satisfactory for the six subscales or dimensions. The hypothesis was confirmed in the analysis of the correlations between subclasses and the overall scale, with the strongest correlations being found between the majority of the subscales and the overall scale. Confirmatory factor analysis showed that the model proposed for the factors fit the data satisfactorily. Discussion This scale is a valid and reliable instrument for evaluating positive mental health in university students. Implications for Practice A good questionnaire to measure positive mental health in university students is useful not only to promote mental health but also to strengthen the curricula of future professionals.
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Affiliation(s)
- J Roldán-Merino
- Campus Docent, Sant Joan de Déu-Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain.,Faculty of Nursing, Rovira i Virgili University of Tarragona, Tarragona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain.,Research Group GEIMAC (Group Consolidat 2014-1139: Grupo de Estudios de Invarianza de los Instrumentos de Medida y Análisis del Cambio en los Ámbitos Social y de la Salud), Barcelona, Spain.,Research Group CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Sant Boi de Llobregat, Barcelona, Spain.,Research Group GIRISAME (International Researchers Group of Mental Health Nursing Care), Barcelona, Spain
| | - M T Lluch-Canut
- Research Group GEIMAC (Group Consolidat 2014-1139: Grupo de Estudios de Invarianza de los Instrumentos de Medida y Análisis del Cambio en los Ámbitos Social y de la Salud), Barcelona, Spain.,Research Group GIRISAME (International Researchers Group of Mental Health Nursing Care), Barcelona, Spain.,Mental Health Sciences Department, School of Nursing, University of Barcelona, Barcelona, Spain
| | - I Casas
- Universitat Autònoma de Barcelona, Barcelona, Spain.,Preventive Medicine Service, Hospital Germans Trias I Pujol, Badalona, Spain
| | - M Sanromà-Ortíz
- Facultat de Ciències de la Salut. Fundació Blanquerna, Universitat RamonLlull, Barcelona, Spain
| | - C Ferré-Grau
- Faculty of Nursing, Rovira i Virgili University of Tarragona, Tarragona, Spain.,Research Group GIRISAME (International Researchers Group of Mental Health Nursing Care), Barcelona, Spain.,Research Group Emergent Infermeria Avançada SGR1030, Tarragona, Spain
| | - C Sequeira
- Research Group GIRISAME (International Researchers Group of Mental Health Nursing Care), Barcelona, Spain.,Escola Superior de Enfermagem do Porto, Coordenador do Grupo de InvestigaçãoNursID: Innovation and development in Nursing -CINTESIS- Faculdade de Medicina da Universidade do Porto., Porto, Portugal
| | - A Falcó-Pegueroles
- Research Group GIRISAME (International Researchers Group of Mental Health Nursing Care), Barcelona, Spain.,Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing. University of Barcelona., Barcelona, Spain.,Research Group SRG Consolidat 2014-326 GTEAAP, Barcelona, Spain
| | - D Soares
- Faculty of Nursing, Rovira i Virgili University of Tarragona, Tarragona, Spain
| | - M Puig-Llobet
- Research Group GIRISAME (International Researchers Group of Mental Health Nursing Care), Barcelona, Spain.,Mental Health Sciences Department, School of Nursing, University of Barcelona, Barcelona, Spain.,Research Group Emergent Infermeria Avançada SGR1030, Tarragona, Spain
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Motaharifar F, Atashzadeh-Shoorideh F, Pishgooie AH, Falcó-Pegueroles A. Translation and psychometric properties of the "ethical conflict in nursing questionnaire: critical care version" in Iran. Electron Physician 2017; 9:3776-3785. [PMID: 28465806 PMCID: PMC5410905 DOI: 10.19082/3776] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 01/15/2017] [Indexed: 11/20/2022] Open
Abstract
Introduction Ethical conflict is one of ICU nurses’ main problems, which rise for several reasons that must be measured. Unfortunately, there is no native instrument for measuring ethical conflicts for ICU nurses in Iran. One of the more suitable and new tools for the measurement of ethical conflict is called the “Ethical Conflict in Nursing Questionnaire: Critical Care Version (ECCNQ-CCV).” This study was aimed to translate and investigate psychometric properties of the ECCNQ-CCV in Iranian nurses. Methods In this methodological study, after translation and cultural adaptation, face validity, content validity, and construct validity were assessed. Then, internal consistency and stability were measured for reliability. Two software programs (SPSS version 20 and AMOS) were used for data analysis. Result Face and content validities were acceptable. Confirmatory factor analysis was not fitted. Thus, exploratory factor analysis was done, which showed five factors. However, some of the scenarios in a factor were not compatible with each other, and choosing the fit name for factors was not possible. Thus, all the scenarios were put into one factor, which has been proposed by the developer in the original version. The alpha Cronbach was 0.92 for the total scale. Conclusions Findings show that the one factor Persian version of the ECNQ-CCV has acceptable psychometric properties. It can be used to evaluate ethical conflicts in Iranian ICU nurses.
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Affiliation(s)
- Fatemeh Motaharifar
- M.Sc. Management Nursing Student, Department of Nursing Management, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Foroozan Atashzadeh-Shoorideh
- Ph.D. in Nursing, Assistant Professor, Department of Nursing Management, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Hosein Pishgooie
- Assistant Professor, Ph.D., M.Sc., B.Sc., RN., Faculty of Nursing, AJA University of Medical Sciences, Tehran, Iran
| | - Anna Falcó-Pegueroles
- Ph.D. in Nursing, MHSc., RN, Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing., Faculty of Medicine and Health Sciences. University of Barcelona, Barcelona, Spain
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Mir-Abellán R, Falcó-Pegueroles A, de la Puente-Martorell ML. [Attitudes towards patient safety culture in a hospital setting and related variables]. Gac Sanit 2016; 31:145-149. [PMID: 27751646 DOI: 10.1016/j.gaceta.2016.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/21/2016] [Accepted: 07/21/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To describe attitudes towards patient safety culture among workers in a hospital setting and determine the influence of socio-demographic and professional variables. METHODS The Hospital Survey on Patient Safety Culture was distributed among a sample of professionals and nursing assistants. A dimension was considered a strength if positive responses exceeded 75% and an opportunity for improvement if more than 50% of responses were negative. RESULTS 59% (n=123) of respondents rated safety between 7 and 8. 53% (n=103) stated that they had not used the notification system to report any incidents in the previous twelve months. The strength identified was "teamwork in the unit/service" and the opportunity for improvement was "staffing". A more positive attitude was observed in outpatient services and among nursing professionals and part-time staff. CONCLUSIONS This study has allowed us to determine the rating of the hospital in patient safety culture. This is vital for developing improvement strategies.
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Affiliation(s)
- Ramon Mir-Abellán
- Programa de Doctorado de Enfermería y Salud de la Universidad de Barcelona, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España.
| | - Anna Falcó-Pegueroles
- Departamento de Enfermería Fundamental y Medicoquirúrgica, Escuela de Enfermería, Campus de Ciencias de la Salud de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
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Falcó-Pegueroles A, Lluch-Canut MT, Martínez-Estalella G, Zabalegui-Yarnoz A, Delgado-Hito P, Via-Clavero G, Guàrdia-Olmos J. Levels of exposure to ethical conflict in the ICU: Correlation between sociodemographic variables and the clinical environment. Intensive Crit Care Nurs 2016; 33:12-20. [PMID: 26796289 DOI: 10.1016/j.iccn.2015.10.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 10/22/2015] [Accepted: 10/23/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To analyse the level of exposure of nurses to ethical conflict and determine the relationship between this exposure, sociodemographic variables and perceptions of the clinical environment. DESIGN AND SETTING Prospective and descriptive correlational study conducted at 10 intensive care units in two tertiary hospitals affiliated to the University of Barcelona. Sociodemographic and professional data were recorded from a questionnaire and then the previously validated Ethical Conflict in Nursing Questionnaire-Critical Care Version was administered to obtain data regarding experiences of ethical conflict. RESULTS Two hundred and three nurses (68.6%) participated in the study, of whom only 11.8% had training in bioethics. Exposure to ethical conflict was moderate with a x¯=182.35 (SD=71.304; [0-389]). The realisation that analgesia is ineffective and the administration of treatment without having participated in the decision-making process were the most frequently reported ethical conflicts. Professionals who perceived their environment as supportive for dealing with ethical conflicts reported lower levels of these events (p=0.001). CONCLUSIONS Ethical conflict is an internal problem but it is strongly influenced by certain variables and environmental conditions. The involvement of nurses in the decision-making processes regarding the care of critically ill patients emerges as a factor that protects against ethical conflicts.
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Affiliation(s)
- Anna Falcó-Pegueroles
- School of Nursing, Consolidated Research Group 2014-326 Advanced Statistical Techniques Applied Psychology, University of Barcelona, Spain.
| | - M Teresa Lluch-Canut
- School of Nursing, Consolidated Research Group 2014-1139 GEIMAC, University of Barcelona, Spain
| | - Gemma Martínez-Estalella
- Hospital Universitari Bellvitge, University of Barcelona l'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Gemma Via-Clavero
- Hospital Universitari Bellvitge, University of Barcelona l'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Guàrdia-Olmos
- Faculty of Psychology, Consolidated Research Group 2014-326 Advanced Statistical Techniques Applied Psychology, Research Institute on Brain, Cognition and Behaviour (IR3C), University of Barcelona, Spain
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Falcó-Pegueroles A, Lluch-Canut T, Roldan-Merino J, Goberna-Tricas J, Guàrdia-Olmos J. Ethical conflict in critical care nursing: Correlation between exposure and types. Nurs Ethics 2014; 22:594-607. [PMID: 25335920 DOI: 10.1177/0969733014549883] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ethical conflicts in nursing have generally been studied in terms of temporal frequency and the degree of conflict. This study presents a new perspective for examining ethical conflict in terms of the degree of exposure to conflict and its typology. OBJECTIVES The aim was to examine the level of exposure to ethical conflict for professional nurses in critical care units and to analyze the relation between this level and the types of ethical conflict and moral states. RESEARCH DESIGN This was a descriptive correlational study. Central and dispersion, normality tests, and analysis of variance were carried out. PARTICIPANTS AND RESEARCH CONTEXT A total of 203 nurses were from two third-level teaching hospitals in Spain. Both centers are part of the University of Barcelona Health Network. Participants filled out the Ethical Conflict in Nursing Questionnaire-Critical Care Version. ETHICAL CONSIDERATIONS This investigation received the approval of the ethical committees for clinical investigation of the two participating hospitals. Participants were informed of the authorship and aims of the study. FINDINGS The index of exposure to ethical conflict was [Formula: see text]. The situations involving analgesic treatment and end-of-life care were shown to be frequent sources of conflict. The types of ethical conflict and moral states generally arranged themselves from lesser to greater levels of index of exposure to ethical conflict. DISCUSSION The moderate level of exposure to ethical conflict was consistent with other international studies. However, the situations related with family are infrequent, and this presents differences with previous research. The results suggest that there is a logical relationship between types of conflict and levels of exposure to ethical conflict. CONCLUSION The types of ethical conflict and moral states were related with the levels of exposure to ethical conflict. The new perspective was shown to be useful for analyzing the phenomenon of ethical conflict in the nurse.
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Falcó-Pegueroles A, Lluch-Canut T, Guàrdia-Olmos J. Development process and initial validation of the Ethical Conflict in Nursing Questionnaire-Critical Care Version. BMC Med Ethics 2013; 14:22. [PMID: 23725477 PMCID: PMC3711987 DOI: 10.1186/1472-6939-14-22] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 05/20/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables 'frequency' and 'degree of conflict'. In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable 'exposure to conflict', as well as considering six 'types of ethical conflict'. An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). METHODS The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach's alpha was used to evaluate the instrument's reliability. All analyses were performed using the statistical software PASW v19. RESULTS Cronbach's alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. CONCLUSIONS The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.
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Affiliation(s)
- Anna Falcó-Pegueroles
- Department of Fundamental Care and Medical-Surgical Nursing, Campus of Health Science of Bellvitge, Nursing School, University of Barcelona, Central Pavilion, 3r floor, L’08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Lluch-Canut
- Department of Public Health, Mental Health and Midwife Nursing, Health Science Campus of Bellvitge, Nursing School, University of Barcelona, Barcelona, Spain
| | - Joan Guàrdia-Olmos
- Methodology of Behavioural Sciences, Faculty of Psychology, Research Institute on Brain, Cognition and Behaviour (IR3C), University of Barcelona, Barcelona, Spain
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Falcó-Pegueroles A, Rodríguez-Garcia C, Estrada-Masllorens JM. [The nurse in the surgical area: prevention of complications and implemention of intervention in patient care]. Rev Enferm 2011; 34:32-39. [PMID: 25551912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The contribution made by the surgical nurse is essential to ensure the security of the patient who is subjected to surgery as well as accompany this specialized professional work to ensure that the patient is in the best physical and mental condition to deal with procedures of these characteristics. Nurse care in the surgical area is frequently described from a biomedical approach as it focuses on the type of surgery or the surgical technique, a perspective that might be inadequate and obsolete in identifying the areas of professional intervention and in clarifying the objectives of the nursing staff in the surgical area. In this paper nursing interventions such as emotional support, enhanced security and the prevention of infection are described as well as the identification of potential complications more prevalent in the different stages of surgical procedure, such as bleeding, hypoxia or hypothermia, among others, all these different points are developed, from a rationalistic nursing approach with emphasis on a humanistic vision of patient care. The specificity of the surgical area demands a prepared and competent professional nurse in the emotional support of the patient and his or her family, as well as the demons- tration of knowledge and skills in technical management and instruments associated with each type of surgery. It also requires competence in the diagnosis of potential com- plications and the development of activities designed to the prevention, early detection and treatment of potential health problems.
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Falcó-Pegueroles A. [The nursing profession regarding limitation of life support treatment in the intensive care units. Technical and practical features]. Enferm Intensiva 2010; 20:104-9. [PMID: 19775567 DOI: 10.1016/s1130-2399(09)72590-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The scientific and technical developments in medicine in the recent decades have greatly helped to increase life expectancy and quality of life of many patients. In hospitals, this technological scenario has clearly influenced patient care, for example, in the Intensive Medicine Departments, leading to new clinical perspectives and has made the growing complexity of giving treatment and making decisions more evident. In some cases, it is difficult to predict how beneficial intensive medical care can be when there is no reasonable prospect of improving the patient's health, prolonging their life in situations with poor prognosis or dramatically reducing their quality of life. The clinical diagnosis of irreversibility, through indicators of severity and principles of beneficence, autonomy and justice in the professional conduct are the elements that give rise to the consideration of withholding and withdrawing treatment in the critical patient. However, there are other factors that need to be taken into consideration and that are analyzed by professional ethics and bioethics. It is from this approach that any decision involving withholding and withdrawing treatment should be taken so that these decisions can be considered estimable form an ethical point of view. The nursing professional in intensive care units is expected to actively participate in decision making by contributing with their humanizing vision and care ethics. They should be aware of their contribution in the medical team behaving, representing and encouraging the requirements of bioethics.
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Affiliation(s)
- A Falcó-Pegueroles
- Departamento de Enfermería Fundamental y Médico-quirúrgica, Escuela de Enfermería, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España.
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