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Jerez-Roig J, Bezerra de Souza DL, Cambra-Badii I, March-Amengual JM, Comella A, Masó-Aguado M, Ramon-Aribau A, Luque-Suárez A, Feito Grande L, Terribas N, Vivanco L, Busquets-Alibés E. Change in demand for health-related undergraduate studies in Spain during 2015-2021: a temporal series study. PeerJ 2023; 11:e16353. [PMID: 37953777 PMCID: PMC10638917 DOI: 10.7717/peerj.16353] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/04/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction The expansion of higher education is a worldwide phenomenon. To our knowledge, there are no studies analyzing the trends in demands of enrollment in health-related studies in Spain. Therefore, the objective was to analyze the change in demand (the number of requests for enrollment divided by the number of offered places) for undergraduate health-related studies in Spain during the period 2015-2021 as well as compare the change by region in the pre (2015-2019) and pandemic (2020-2021) period. Methods This is an observational (ecological type) study with temporal series analyses using data from public (non-for-profit) higher education institutions from the Integrated University Information System. For the analysis by region, we calculated the demand of all twelve undergraduate health-related degrees and the percentages of change between both periods using the Wilcoxon test. The Joinpoint Regression program was used to analyze the trends in demand for each degree during the 7-year period. Results Significant (p < 0.001) increases in demand during the pandemic period were observed in all regions. During the pandemic, medicine, biomedicine, nursing, odontology and pharmacy presented a higher demand in comparison with data collected before the pandemic started. In contrast, this pattern was not confirmed in the following cases: physiotherapy, occupational therapy, podiatry, psychology, social work, human nutrition and dietetics. By regions, Navarra, Asturias, and La Rioja presented the most drastic changes. In regions with the biggest number of universities, such as Catalonia, Andalusia and Madrid, the change observed was smaller.
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Affiliation(s)
- Javier Jerez-Roig
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Dyego L. Bezerra de Souza
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Department of Collective Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Irene Cambra-Badii
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Jaume-Miquel March-Amengual
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Agustí Comella
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Montse Masó-Aguado
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Anna Ramon-Aribau
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Alejandro Luque-Suárez
- Department of Physiotherapy, University of Málaga, Málaga, Spain
- The Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | | | - Núria Terribas
- Grífols Foundation Chair of Bioethics, Universitat de Vic, Vic, Spain
| | - Luis Vivanco
- Platform of Bioethics and Medical Education, Center for Biomedical Research of La Rioja (CIBIR), Logroño, Spain
- National Center of Documentation on Bioethics, Rioja Health Foundation (FRS), Logroño, Spain
| | - Ester Busquets-Alibés
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
- Grífols Foundation Chair of Bioethics, Universitat de Vic, Vic, Spain
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Minaya-Freire A, Subirana-Casacuberta M, Pou-Pujol G, Ramon-Aribau A. Nursing Practice Variations in Pain Management in Older Adults With Dementia Admitted to an Acute Geriatrics Unit During the COVID-19 Pandemic. Res Gerontol Nurs 2023; 16:173-182. [PMID: 37040309 DOI: 10.3928/19404921-20230405-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
The current retrospective descriptive study evaluated nursing practice variations on pain management in older adults with dementia admitted to an acute geriatrics unit (AGU) before (2018) and during (2021) the coronavirus disease 2019 (COVID-19) pandemic. Data were gathered from electronic health records. Pain intensity was evaluated a median of 1.9 times per day of stay in the pre-COVID-19 sample, whereas in the COVID-19 sample, the median was 0.7 times per day of stay. Median number of analgesic administrations per day of stay and mean percentage of clinical care records that mentioned pain were higher in patients admitted during the pandemic. Variations in nursing care organization in the AGU due to the COVID-19 pandemic had an impact on the patterns of pain management nursing practice in older adults with dementia. [Research in Gerontological Nursing, 16(4), 173-182.].
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March-Amengual JM, Cambra-Badii I, Pineda Galán C, Busquets-Alibés E, Masó Aguado M, Ramon-Aribau A, Feito Grande L, Comella Cayuela A, Terribas I Sala N, Andrade-Gómez E, Martínez-Perez N, Jerez-Roig J. The impact of the COVID-19 pandemic on enrollment in undergraduate health-related studies in Spain. BMC Med Educ 2023; 23:386. [PMID: 37237295 DOI: 10.1186/s12909-023-04347-5] [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] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/10/2023] [Indexed: 05/28/2023]
Abstract
The aim of this study was to determine whether the pandemic has reinforced the choice of pursuing health-related bachelor's degrees, and to identify underlying factors that could contribute to that impact. This is a cross-sectional study using an online survey of 2,344 students of nursing, physiotherapy, medicine, psychology and podiatry who started health-related bachelor's degrees after the COVID-19 outbreak in Spanish higher education institutions. The pandemic influenced the choice of these studies by increasing the desire to help others (33.2%), by increasing citizenship values (28.4%), and by increasing the desire to contribute to improving the situation of the country (27.5%). Women had a significantly greater influence on the increase in social values related to the practice of the profession produced by the pandemic, whereas men and the bachelor's degree in podiatry were more influenced by salary prospects. An increased desire to help others was significantly higher among women and nursing and medical students. Podiatry and psychology were the degrees were most influenced by the pandemic, as more students decided to pursue them, something they had previously doubted, while in nursing, psychology, and medicine the pandemic reinforced their interest in pursuing the degree the most. Students personally affected by COVID-19 reported being more influenced in reconsidering their professional path and in reinforcing their desire to pursue the health-related studies.
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Affiliation(s)
- Jaume-Miquel March-Amengual
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Chair in Medical Education, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Irene Cambra-Badii
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.
- Chair in Medical Education, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.
- Grífols Foundation Chair of Bioethics, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.
| | | | - Ester Busquets-Alibés
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Grífols Foundation Chair of Bioethics, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Montse Masó Aguado
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Anna Ramon-Aribau
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | | | - Agustí Comella Cayuela
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Chair in Medical Education, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Nuria Terribas I Sala
- Grífols Foundation Chair of Bioethics, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | | | - Naiara Martínez-Perez
- Department of Nursing, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Javier Jerez-Roig
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
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Merchán-Baeza JA, Borralleras Andreu C, Minobes-Molina E, Grau Carrión S, Romero-Mas M, Ramon-Aribau A. Co-created Technological Solutions for Caregivers in Health Care: Systematic Review. J Med Internet Res 2023; 25:e41260. [PMID: 37126384 PMCID: PMC10186187 DOI: 10.2196/41260] [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: 07/20/2022] [Revised: 10/20/2022] [Accepted: 03/14/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Support interventions for caregivers can reduce their stress, possibly improving the quality of patients' care while reducing care costs. Technological solutions have been designed to cover their needs, but there are some challenges in making them truly functional for end users. Co-design approaches present important opportunities for engaging diverse populations to help ensure that technological solutions are inclusive and accessible. OBJECTIVE This study aimed to identify co-created technological solutions, as well as the process followed for their co-creation, in the field of health for caregivers. METHODS The literature review was conducted in the Medline, Web of Science, Scopus, Science Direct, Scielo, and IEEE Xplore databases. The inclusion criteria were studies written in English or Spanish and with a publication date until May 2021. The content had to specify that the caregivers actively participated in the co-creation process, which covered until the development phase of the technological solution (prototype). The level of evidence and the methodological quality were analyzed when possible, using the Scottish Intercollegiate Guidelines Network criteria and the Mixed Methods Appraisal Tool, version 2018, respectively. RESULTS In total, 410 papers were identified, and 11 met the eligibility criteria. The most predominant articles were mixed methods studies and qualitative studies. The technology used in the analyzed articles were mobile or web applications (9 studies) and specific devices such as sensors, cameras, or alarm systems (2 studies) to support the health and social aspects of caregivers and improve their education in care. The most common patient profile was older people (7 studies); 6 studies used co-creation in the requirements phase, 6 studies detailed the design phase. In 9 studies, the prototype was iteratively refined in the development phase, and the validation phase was performed in 5 of the reviewed studies. CONCLUSIONS This systematic review suggests that existing co-created technological solutions in the field of health for caregivers are mostly mobile or web applications to support caregivers' social health and well-being and improve their health knowledge when delivering care to patients, especially older people. As for the co-creation process, caregivers are particularly involved during development and in the design. The scarce literature found indicates that further research with higher methodological quality is needed.
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Affiliation(s)
- Jose Antonio Merchán-Baeza
- Methodology, Methods, Models and Outcomes of Health and Social Sciences, Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, Vic, Spain
| | - Cristina Borralleras Andreu
- Digital Care Research Group, Faculty of Science, Technology and Engineering, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, Vic, Spain
| | - Eduard Minobes-Molina
- Methodology, Methods, Models and Outcomes of Health and Social Sciences, Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, Vic, Spain
| | - Sergi Grau Carrión
- Digital Care Research Group, Faculty of Science, Technology and Engineering, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, Vic, Spain
| | - Montse Romero-Mas
- Methodology, Methods, Models and Outcomes of Health and Social Sciences, Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, Vic, Spain
| | - Anna Ramon-Aribau
- Methodology, Methods, Models and Outcomes of Health and Social Sciences, Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, Vic, Spain
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Galbany-Estragués P, Millán-Martínez P, Casas-Baroy JC, Subirana-Casacuberta M, Ramon-Aribau A. High hiring rate of nurses in Catalonia and the rest of Spain hides precarious employment from 2010 to 2019: a quantitative study. J Nurs Manag 2022; 30:1337-1344. [PMID: 35419907 PMCID: PMC9543516 DOI: 10.1111/jonm.13632] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 04/02/2022] [Accepted: 04/11/2022] [Indexed: 12/01/2022]
Abstract
Aim This study aims to describe the hiring of nurses in Catalonia and the rest of Spain over 10 years. Background Precarious employment (PE) has negative consequences for nurses' quality of life and work performance. Methods Quantitative study using a retrospective, longitudinal, descriptive design. We analysed publicly available employment data from Catalonia and the rest of Spain. Results Nurses are among the health professionals with the lowest proportion of open‐term (permanent) contracts, 25% during the first 4 years of employment. During the study period, each nurse hired had an average of 3.44 contracts per year. The proportion of nurses with a fixed‐term (non‐permanent) contract shrank from 25.3% in 2006 to 20.5% in 2012 and grew rapidly to 38.7% in 2018. We estimate that 14,800 nurses signed fixed‐term contracts in 2018 without ever having registered as unemployed in nursing. Conclusion High rates of fixed‐term hiring and the high number of contracts per nurse are evidence of a high level of PE for nurses in Catalonia. Implications for Nursing Management When policymakers and workforce planners design recruitment and retention programmes for nurses, they should consider improving working conditions by extending more open‐term contracts to combat PE and, indirectly, the shortage of nurses.
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Affiliation(s)
- Paola Galbany-Estragués
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain.,AFIN Research Group and Outreach Centre, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Pere Millán-Martínez
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain.,Servei Català de Trànsit Carrer Diputació, Barcelona, Spain
| | - Joan Carles Casas-Baroy
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Mireia Subirana-Casacuberta
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain.,Nursing Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Consorci Sanitari Parc Taulí, Sabadell, Spain
| | - Anna Ramon-Aribau
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
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Mondejar-Pont M, Gómez-Batiste X, Ramon-Aribau A. Translating research into health practice: a case study of integrated palliative care system in Catalonia, Spain. JICA 2022. [DOI: 10.1108/jica-06-2021-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeResearch findings provide the professional community with knowledge that enables to better understand healthcare interventions. Many authors point out that whilst these findings are valued, the findings are not always translated into healthcare practise. The purpose of the paper is to assess the applicability of the essential elements of an integrated palliative care system (IPCS) found in research into the practise of Osona Palliative Care System (OPCS).Design/methodology/approachThe study used a qualitative methodology with a case study design. In total, 24 health professionals were interviewed in Osona for the research, and the results were analysed using deductive content analysis.FindingsThe study concludes that research findings can better be translated into specific contexts by incorporating the needs and characteristics of the system. The process could be a strategy for bridging the research–practise gap.Originality/valueCombining the findings from the study and the findings found in the literature reviewed led to the creation of the IPCS-elements-blended model of research and practise. Such a kind of mixed model could be used in other studies seeking to overcome the research and practice gap.
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Mondejar-Pont M, Abbott-Anderson K, Ramon-Aribau A, Kumpula R, Neiman T, De Ruiter HP. International Palliative Care Systems: A comparative case study protocol examining palliative care in rural areas. (Preprint). JMIR Res Protoc 2021; 11:e36037. [PMID: 35776505 PMCID: PMC9288105 DOI: 10.2196/36037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/19/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background The aging population in the Global North is associated with an increased prevalence of multiple chronic diseases that would benefit from integrated palliative care. In this context, it is vital to consider the effectiveness of health care systems’ response to the needs of the older population residing in rural areas, including access to palliative care services. Understanding palliative care program availability and palliative care system characteristics is important in creating useful health interventions in rural areas. Objective This study aims to provide an international view on palliative care in rural areas. A study exploring palliative care services offered in Southern Minnesota will be carried out, building on a previous study conducted in Osona, Spain. Findings from both studies will be compared, providing insights into the strengths of each system and identifying areas for growth. Methods This study will be performed using qualitative case study methodology. Using a similar methodology to the one used in the Spanish study, palliative care services will be explored in a similarly sized rural area in Southern Minnesota. This will be accomplished by (1) reviewing available literature related to the Southern Minnesota palliative care system and (2) identifying key providers in this US palliative care system who will be invited to participate in semistructured interviews. The study participants will be asked about the gaps between ideal integrated palliative care system services and the existing complementary palliative care services, and the ethical issues and dilemmas that evolved during the COVID-19 pandemic. Results Following ethical approval for this protocol, data collection is anticipated to begin in spring or summer 2022 and is expected to take 6 months. Data collection will be followed by data analysis in fall 2022. Finally, the researchers plan to disseminate the findings in spring 2023. Conclusions Comparing 2 similarly sized but culturally different rural palliative care systems in Minnesota and Osona will provide insights into how integrated palliative care systems impact the older population and those with chronic illnesses. Study findings will contribute to enhanced patient care, organizational improvements, policy change, and an understanding of the impact of different health care system models. International Registered Report Identifier (IRRID) PRR1-10.2196/36037
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Affiliation(s)
| | | | - Anna Ramon-Aribau
- Faculty of Health Sciences and Wellness, University of Vic, Vic, Spain
| | - Renee Kumpula
- School of Nursing, Minnesota State University, Mankato, MN, United States
| | - Tammy Neiman
- School of Nursing, Minnesota State University, Mankato, MN, United States
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Minaya-Freire A, Subirana-Casacuberta M, Puigoriol-Juvanteny E, Ramon-Aribau A. Pain management nursing practice assessment in older adults with dementia. Nurs Open 2021; 8:3349-3357. [PMID: 33826237 PMCID: PMC8510716 DOI: 10.1002/nop2.880] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/29/2021] [Accepted: 03/21/2021] [Indexed: 01/13/2023] Open
Abstract
Aim To assess pain management nursing practice in older adults with dementia through electronic health records (EHR). Design Retrospective study. Methods Data were collected from EHR related to pain management in older adults with dementia treated at the Acute Geriatrics Unit (AGU) of a university hospital in early 2018. Results EHR related to the pain of 111 patients were reviewed. Pain intensity was assessed at admission in 88% of patients and a median of 1.9 times per day of stay. A disproportionate number of the assessments (39%) occurred during the late shift. A median of 1 drug per day was administered. Pain was recorded in 28% of patients’ care plans, and non‐pharmacological interventions were recorded in 12%. In conclusion, exist variability in pain management nursing practice in older adults with dementia. Admission diagnosis correlated with the analgesic administration schedule, the number of drugs administered and the number of pain nursing annotations.
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Affiliation(s)
- Alícia Minaya-Freire
- University Hospital Of Vic-Vic Hospital Consortium (HUV-CHV). C. Francesc Plà "El Vigatà", Vic, Barcelona, Spain.,Research Group on Methodology, Methods, Models and Health and social Outcomes (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC). C. Sagrada Família, Vic, Barcelona, Spain
| | - Mireia Subirana-Casacuberta
- Research Group on Methodology, Methods, Models and Health and social Outcomes (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC). C. Sagrada Família, Vic, Barcelona, Spain.,Nursing Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Emma Puigoriol-Juvanteny
- University Hospital Of Vic-Vic Hospital Consortium (HUV-CHV). C. Francesc Plà "El Vigatà", Vic, Barcelona, Spain.,Tissue Repair and Regeneration Laboratory (TR2Lab), Faculty of Sciences and Technology, University of Vic - Central University of Catalonia, Faculty of Medicine, University of Vic - Central University of Catalonia. C. Sagrada Família, Vic, Barcelona, Spain
| | - Anna Ramon-Aribau
- Research Group on Methodology, Methods, Models and Health and social Outcomes (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC). C. Sagrada Família, Vic, Barcelona, Spain
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Romero-Mas M, Ramon-Aribau A, de Souza DLB, Cox AM, Gómez-Zúñiga B. Improving the Quality of Life of Family Caregivers of People with Alzheimer's Disease through Virtual Communities of Practice: A Quasiexperimental Study. Int J Alzheimers Dis 2021; 2021:8817491. [PMID: 33884204 PMCID: PMC8041528 DOI: 10.1155/2021/8817491] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/11/2021] [Accepted: 03/01/2021] [Indexed: 11/19/2022] Open
Abstract
Caring for a person with dementia burdens family caregivers, and there is a close negative relationship between this burden and their quality of life (QoL). Research suggests that caregivers' main needs are information and training about the disease and support from others experiencing the same situation, and Internet interventions hold considerable promise for meeting these needs. Virtual communities of practice (VCoPs) are Internet frameworks to share knowledge where members collaborate and achieve a sense of trust in the community. This paper seeks to evaluate the impact of participating in a VCoP (developed through an App) on the QoL of caregivers to people with Alzheimer's. Results show QoL before and after the intervention changed significantly. The impact of VCoP on caregivers' overall QoL is moderated by age and relation with the person with Alzheimer's, specifically those over 65, and spouses. VCoPs allow interaction and knowledge sharing among caregivers which provide them mainly with information and support from peers helping them to meet their needs. Furthermore, caregivers' QoL did not decrease when their relative deteriorated functionally, which could be due to the participation in VCoP. Although we found significant pre- and post differences in caregivers' health literacy, we must report the ambiguous result that this variable only impacts on QoL's physical domain. Participants also reported that they had a positive experience because the App was perceived to be a useful tool, because they could manage their own participation and they met peers and felt less lonely. Results suggest that participation in a VCoP impacts positively on caregivers' QoL.
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Affiliation(s)
- Montse Romero-Mas
- Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Spain
| | - Anna Ramon-Aribau
- Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Spain
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Gorchs-Font N, Ramon-Aribau A, Yildirim M, Kroll T, Larkin PJ, Subirana-Casacuberta M. Nursing students' first experience of death: Identifying mechanisms for practice learning. A realist review. Nurse Educ Today 2021; 96:104637. [PMID: 33181484 DOI: 10.1016/j.nedt.2020.104637] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/30/2019] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Many studies regarding nursing student's first experience of facing the death of a patient have focused on classroom methods or exploring attitudes towards death and related fears or anxieties. This review is the first to identify the mechanisms that facilitate practice learning as a result of students' first time experience of handling a patient's death. DESIGN A realist review as a form of a systematic review of the literature. DATA SOURCES The literature search focused on the earliest death experience of baccalaureate nursing students and end-of-life care, using databases MEDLINE, CINAHL, SCOPUS, ERIC, PSYCINFO. REVIEW METHODS Three research questions were addressed following a five-step process of (1) defining the scope of review and developing a theoretical framework, (2) conducting a theory-driven purposive search for evidence, (3) appraising evidence and extracting data, (4) synthesizing data and drawing conclusions, and (5) disseminating findings; with iterative expert consultation and discussion to answer the five questions of any realist review: 'what works, for whom, in what circumstances, how and why'. RESULTS Thirteen publications were included. Practice learning involves both changes and context improvements to be assessed and discussed by managers, leaders, nurse educators-facilitators and students. The environment and nursing role models are an inherent part of practice learning. Further work is needed to theorize the twelve key outcomes laid out in this review. These proposals require further consensus and the inclusion of inputs from both students and nurses. CONCLUSION The student nurse receives contradictory messages during the first experience of facing the death of a patient under their care. Considering the importance of this experience, specific indicators should be developed to track and guarantee and the optimal achievement of required competencies.
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Affiliation(s)
- Núria Gorchs-Font
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M(3)O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500 Vic, Spain
| | - Anna Ramon-Aribau
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M(3)O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500 Vic, Spain.
| | - Meltem Yildirim
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M(3)O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500 Vic, Spain
| | - Thilo Kroll
- University College of Dublin, School of Nursing, Midwifery and Health Systems, Dublin, Ireland
| | - Philip J Larkin
- Lausanne University Hospital and University of Lausanne, Switzerland
| | - Mireia Subirana-Casacuberta
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M(3)O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500 Vic, Spain; Nursing Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
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Romero-Mas M, Gómez-Zúñiga B, Cox AM, Ramon-Aribau A. Designing virtual communities of practice for informal caregivers of Alzheimer's patients: An integrative review. Health Informatics J 2020; 26:2976-2991. [PMID: 32951497 DOI: 10.1177/1460458220950883] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The main aim of this study is to review the literature to show how ideas around virtual communities of practice (VCoP) offer a model for supporting informal caregivers of Alzheimer's patients (caregivers) to learn how to deal with caregiving demands. Caregivers are individuals who have a significant personal relationship with and provide a broad range of unpaid assistance to an older person or an adult with a chronic or disabling condition outside of a professional or formal framework. This review will examine the current evidence on the needs of caregivers, identify dimensions to be considered in VCoP design and suggest further directions of research. The investigation is an integrative review that builds a bridge between different areas of work. The outcome is eleven dimensions for the design of successful VCoPs for caregivers: Network Structure, Technology, Moderator, Scale, Alignment, Community Design, Sense of Trust, Knowledge Sharing, Sustainability, Ethics and Evaluation. In addition, we propose a Tree Metaphor to present our research results. Well-designed interventions based on VCoP principles have the potential of addressing caregivers' needs.
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Minaya-Freire A, Ramon-Aribau A, Pou-Pujol G, Fajula-Bonet M, Subirana-Casacuberta M. Facilitators, Barriers, and Solutions in Pain Management for Older Adults with Dementia. Pain Manag Nurs 2020; 21:495-501. [PMID: 32482567 DOI: 10.1016/j.pmn.2020.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/10/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Although qualitative studies have been conducted to identify barriers and facilitators that influence the pain management of older adults with dementia, as far as we know, only a very recent study (Andrews et al., 2019) has used participatory action research (PAR) as a methodology for studying pain management. It allows nurses to examine and improve their practice based on their realities and within their context. AIM To reflect on nursing practice and identify facilitators and barriers in the management of pain in older adults with dementia and to propose actions for improvement. DESIGN We used qualitative participatory action research. PARTICIPANTS/SETTINGS Ten nurses from the geriatric acute care unit of a university hospital in Spain were recruited through convenience sampling. METHODS Data were generated through a written questionnaire and three focus groups. RESULTS One of the main facilitators the participants identified was professional experience. The main barriers they identified were lack of knowledge and skills and lack of time. The participants proposed two main improvements: (1) a training program consisting of three courses (pain evaluation and management, dementia and pain, and pharmacology) and (2) the creation of a specific register for nurses to record patients' pain. CONCLUSIONS Involving nurses directly in research on their practices can result in precise proposals for improvements based on their needs and oriented toward improving the quality of care. Moreover, our results confirm previous findings in other countries.
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Affiliation(s)
- Alícia Minaya-Freire
- University Hospital of Vic, Vic Hospital Consortium (HUV-CHV), Barcelona, Spain; Research Group on Methodology, Methods, Models and Health and Social Outcomes (M(3)O), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
| | - Anna Ramon-Aribau
- Research Group on Methodology, Methods, Models and Health and Social Outcomes (M(3)O), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain.
| | - Gemma Pou-Pujol
- University Hospital of Vic, Vic Hospital Consortium (HUV-CHV), Barcelona, Spain
| | | | - Mireia Subirana-Casacuberta
- University Hospital of Vic, Vic Hospital Consortium (HUV-CHV), Barcelona, Spain; Research Group on Methodology, Methods, Models and Health and Social Outcomes (M(3)O), Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
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Abstract
Purpose
The purpose of this paper is to propose a unified definition of integrated palliative care (IPC), and to identify the elements that facilitate or hinder implementation of an integrated palliative care system (IPCS).
Design/methodology/approach
A scoping review of the conceptualization and essential elements of IPC was undertaken, based on a search of the PubMed, Scopus and ISI Web of Science databases. The search identified 79 unduplicated articles; 43 articles were selected for content analysis.
Findings
IPC is coordinated and collaborative across different health organizations, levels of care and types of providers. Eight key elements facilitate implementation of an IPCS: coordination, early patient identification, patient-centered services, care continuity, provider education and training, a standard implementation model and screening tool, shared information technology system, and supportive policies and funding. These elements were plotted as a “Circle of Integrated Palliative Care System Elements.”
Practical implications
This paper offers researchers an inclusive definition of IPC and describes the essential elements of its successful implementation.
Originality/value
This study provides evidence from researchers on five continents, offering insights from multiple countries and cultures on the topic of IPC. The findings of this thematic analysis could assist international researchers aiming to develop a standard evaluative model or assess the level of integration in a health care system’s delivery of palliative care.
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