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Vicens-Blanes F, Molina-Mula J, Miró-Bonet R. Discursive analysis of nursing care toward childhood fever and its contextual differences: An ethnomethodological study. Nurs Health Sci 2024; 26:e13110. [PMID: 38452800 DOI: 10.1111/nhs.13110] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/23/2024] [Indexed: 03/09/2024]
Abstract
Fever is the most common clinical sign during infancy. Nurses deal with fever in children most directly and it is an integral aspect of their role as pediatric nurses. The objective of this study is to analyze the perceptions, knowledge and attitudes toward childhood fever of nurses in three health contexts: pediatric hospitalization, pediatric emergency and primary care. To respond this objective, a qualitative study with ethnomethodological approach has been carried out. In-depth interviews were conducted and theoretical clinical cases were presented to nurses working in pediatrics in the three settings studied. After the analysis of the discourses, the codes were classified into three categories: static and number-centric knowledge, dependent nursing attitude, and unconscious model nurses. On the one hand, when we analyze and compare the perceptions, attitudes and knowledge of the nurses between the different contexts, we find differences that consist mainly of what the context requires of them. On the other hand, in general and regardless of the context, the nurses interviewed place themselves in a traditional framework when faced with the phenomenon of fever in children.
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Affiliation(s)
| | - Jesús Molina-Mula
- Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain
| | - Rosa Miró-Bonet
- Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain
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Vicens-Blanes F, Miró-Bonet R, Molina-Mula J. Analysis of the perceptions, knowledge and attitudes of parents towards fever in children: A systematic review with a qualitative meta-synthesis. J Clin Nurs 2023; 32:969-995. [PMID: 35224809 DOI: 10.1111/jocn.16271] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/03/2022] [Accepted: 02/14/2022] [Indexed: 02/05/2023]
Abstract
Fever is the most common symptom in childhood. Despite its prevalence and decades of education and research, the treatment of fever and febrile illnesses continues to cause concern and anxiety in parents. The objective of this systematic review with meta-synthesis is to analyse parents' perceptions, knowledge and attitudes towards the febrile child and how they influence the construction of the concept of fever. The PRISMA international standards and PRISMA checklist, as well as the Cochrane recommendations, were followed. Articles with qualitative methodology have been selected that analyse what fever means to parents, what their concerns about this sign are, where they get their information and what their expectations are of healthcare professionals during treating their feverish child. Finally, 17 articles that met the inclusion criteria were added in the qualitative meta-synthesis. The concept of fever has been represented as a non-harmful sign in and of itself, an aspect that emerges in fathers and mothers' discourse. Meanwhile, the perceived need to lower the temperature still appears to be the main aim of their approach, with attitudes implying an emergency to reach normothermia, focusing on temperature as the primary indicator of severity.
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Affiliation(s)
| | - Rosa Miró-Bonet
- Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain
| | - Jesús Molina-Mula
- Department of Nursing and Physiotherapy, Balearic Islands University, Palma, Spain
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Vicens-Blanes F, Miró-Bonet R, Molina-Mula J. Analysis of Nurses' and Physicians' Attitudes, Knowledge, and Perceptions toward Fever in Children: A Systematic Review with Meta-Analysis. Int J Environ Res Public Health 2021; 18:ijerph182312444. [PMID: 34886174 PMCID: PMC8656872 DOI: 10.3390/ijerph182312444] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 11/10/2021] [Accepted: 11/23/2021] [Indexed: 02/05/2023]
Abstract
CONTEXT Fever is a common symptom in children that nurses and pediatricians treat. Although it is a common sign in clinical practice, fever instills irrational fears in parents that health professionals share. OBJECTIVE To investigate whether doctors' and nurses' knowledge, perceptions, and attitudes toward fever influence how this sign is managed. Furthermore, it intends to evaluate whether educational programs increase knowledge and change attitudes and/or perceptions of nurses about children's fever. DATA SOURCES A systematic review with meta-analysis was conducted with PRISMA international standards and the Cochrane recommendations. STUDY SELECTION Articles examining health professionals' (doctors and/or nurses) knowledge, perceptions, and/or attitudes toward fever in children and the use of antipyretics were selected for the study. DATA EXTRACTION The qualitative analysis was carried out by classifying the articles according to the applied educational programs for nurses related to fever care for children that evaluated different outcomes to determine their efficacies. RESULTS For the qualitative synthesis, 41 articles were included, and 5 of these were taken in meta-analysis, which measured the effectiveness of educational programs for fever management in nurses. LIMITATIONS All of the included studies generally had a high risk of bias. CONCLUSION According to the evidence reviewed, nurses' and physicians' perceptions and attitudes regarding fever management in children indicate an overtreatment of this sign. We can give a recommendation grade of D on the use of educational programs to modify attitudes, perceptions, and knowledge about fever in children and improve clinical practice in nurses.
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Rodriguez-Calero MA, Fullana-Matas A, Miró-Bonet R. Classification of Pressure Injury Stages and Skin Damage Photographs by RNs and Nursing Students in Spain: An Observational Comparison Study. J Wound Ostomy Continence Nurs 2021; 48:403-409. [PMID: 34495930 DOI: 10.1097/won.0000000000000803] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE The purpose of this study was to evaluate and classify pressure injuries (PIs) and other skin lesions according to the judgment of hospital-based RNs and nursing students who recently trained in wound care using photographs and comparing findings to those of wound care experts. DESIGN Cross-sectional observational survey. SUBJECT AND SETTING RNs working at Manacor Hospital, Mallorca, Spain, and third-year nursing students from the University of the Balearic Islands. Data were collected in June 2017. METHODS The survey instrument was accompanied by a set of 24 photographs in 7 categories of skin lesions, such as PIs or moisture-associated skin damage, which the respondents were asked to classify. Descriptive analysis of the classifications was carried out, and levels of agreement using the chi-square test were compared with evaluations/classifications of a panel of experts. RESULTS In total, 314 surveys (199 RNs and 115 students) were included in the analyses. Findings showed a wide variability among participants with levels of agreement, with expert opinion ranging from 91.4% to 15.61%. The levels of agreement were substantially lower for unstageable PIs (47.92%), those caused by moisture (53.50%), and mixed etiology (38.37%) than for stages 1-4 PIs. Of note, 62.12% of RNs had not received PI training or continuing education during the previous 2 years. This lack of education was statistically significantly associated with the accuracy of the classification made by the RNs for some of the photographs evaluated such as moisture-associated skin damage. CONCLUSIONS We found discrepancies in the classification of PIs and other wounds/lesions among experts, RNs, and students. The regular provision of up-to-date information in training and continuing education programs is imperative to maintain nurses' abilities to identify and classify PIs and other skin-related damage.
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Affiliation(s)
- Miguel Angel Rodriguez-Calero
- Miguel Angel Rodriguez-Calero, MSc, RN, Health System of the Balearic Islands, Palma, Spain; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain; and CurES Research Group, Balearic Islands Healthcare Research Institute (IdISIBa), Palma, Spain
- Antonia Fullana-Matas, RN, Fundación Hospital Manacor, Mallorca, Spain
- Rosa Miró-Bonet, PhD, MSc, RN, Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - Antonia Fullana-Matas
- Miguel Angel Rodriguez-Calero, MSc, RN, Health System of the Balearic Islands, Palma, Spain; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain; and CurES Research Group, Balearic Islands Healthcare Research Institute (IdISIBa), Palma, Spain
- Antonia Fullana-Matas, RN, Fundación Hospital Manacor, Mallorca, Spain
- Rosa Miró-Bonet, PhD, MSc, RN, Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - Rosa Miró-Bonet
- Miguel Angel Rodriguez-Calero, MSc, RN, Health System of the Balearic Islands, Palma, Spain; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain; and CurES Research Group, Balearic Islands Healthcare Research Institute (IdISIBa), Palma, Spain
- Antonia Fullana-Matas, RN, Fundación Hospital Manacor, Mallorca, Spain
- Rosa Miró-Bonet, PhD, MSc, RN, Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
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Miró-Bonet M, Bover-Bover A, Moreno-Mulet C, Miró-Bonet R, Zaforteza-Lallemand C. Genealogy as a critical toolbox: deconstructing the professional identity of nurses. J Adv Nurs 2013; 70:768-76. [DOI: 10.1111/jan.12236] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Margalida Miró-Bonet
- Critical Health Research Group; Faculty of Nursing and Physiotherapy; University of the Balearic Islands; Spain
| | - Andreu Bover-Bover
- Critical Health Research Group; Faculty of Nursing and Physiotherapy; University of the Balearic Islands; Spain
| | - Cristina Moreno-Mulet
- Critical Health Research Group; Faculty of Nursing and Physiotherapy; University of the Balearic Islands; Spain
| | - Rosa Miró-Bonet
- Critical Health Research Group; Faculty of Nursing and Physiotherapy; University of the Balearic Islands; Spain
| | - Concha Zaforteza-Lallemand
- Critical Health Research Group; Faculty of Nursing and Physiotherapy; University of the Balearic Islands; Spain
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Perelló-Campaner C, Molina-Mula J, Miró-Bonet R. [Ethical conflicts over verbal statements regarding last wishes]. Enferm Clin 2011; 21:47-51. [PMID: 21349754 DOI: 10.1016/j.enfcli.2010.07.009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 07/12/2010] [Accepted: 07/27/2010] [Indexed: 02/08/2023]
Abstract
Within our socio-professional framework, there are few occasions in which there is sincere communication between health care teams and patients and their families that allows questions to be raised about decisions made during the process of an illness i.e., whether an intervention, or its omission in certain cases, would be accepted. Decisions regarding representation or living wills are merely an extension of the inclusion of the patients' moral autonomy in clinical decision making. Nevertheless, the best way to make patients' rights effective is not by focussing on these documents, but rather by achieving the development of integral processes that promote patient participation and decision making. On the basis of a discussion in which a number of ethical conflicts that concern patients' last wishes are intertwined, we present the following clinical case that allows reflection on the most effective kind of intervention, the nature of its duration and intensity and the way health care professionals must be faithful to patients' and families' desires and expressions in these cases.
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Affiliation(s)
- Catalina Perelló-Campaner
- Departamento de Enfermería y Fisioterapia, Universitat de les Illes Balears, Palma de Mallorca, Baleares, España.
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Miró-Bonet M, Gallego-Caminero G, Alorda-Terrassa C, Miró-Bonet R. Ansiedad durante el proceso de destete. Estudio de un caso. Enfermería Clínica 2006. [DOI: 10.1016/s1130-8621(06)71189-5] [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] [Indexed: 10/21/2022]
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