Self-Care for Nurse Leaders in Acute Care Environment Reduces Perceived Stress: A Mixed-Methods Pilot Study Merits Further Investigation

Acute care practice settings are stressful. Nurse leaders face stressful demands of numerous competing priorities. Some nurse leaders experience unmanageable stress, but success requires self-care. This article presents a repeated measures intervention design study using mixed methods to investigate a self-care simple meditation practice for nurse leaders. Themes and subthemes emerged in association with the three data collection points: at baseline (pretest), after 6 weeks, and after 12 weeks (posttest) from introduction of the self-care simple meditation practice. An analysis of variance yielded a statistically significant drop in perceived stress at 6 weeks and again at 12 weeks. Conducting future research is merited.

Download Full-text

Development and Initial Validation of the Self-Care Practices Scale

Social Work ◽

10.1093/sw/swz045 ◽

2019 ◽

Vol 65 (1) ◽

pp. 21-28

Author(s):

Jacquelyn J Lee ◽

Shari E Miller ◽

Brian E Bride

Keyword(s):

Social Work ◽

Construct Validity ◽

Social Workers ◽

Self Care ◽

Well Being ◽

Social Work Practice ◽

The Self ◽

Future Research ◽

Care Practice ◽

Care Practices

Abstract Self-care is regarded as essential for effective social work practice, offsetting occupational stress and promoting well-being and resiliency among practitioners. However, the literature reveals a notable absence of psychometrically sound instruments to measure self-care. The purpose of the present study was to describe the development, refinement, and construct validity of the Self-Care Practices Scale (SCPS). The piloted version of the SCPS is a 38-item instrument designed to measure frequency of engagement in personal and professional self-care practices. Data were collected through mailed surveys from a random sample of master’s-level clinical social workers and members of the National Association of Social Workers (N = 492). Analysis supports the construct validity of an 18-item SCPS with two subscales that demonstrate strong internal validity. The SCPS is useful for social work educators, practitioners, and administrators to ascertain frequency of self-care practice and build a stronger culture of self-care. The role of SCPS in future research is discussed.

Download Full-text

3361 Feasibility, Acceptability, and Appropriateness of an Insertable Vaginal Cup to Manage Urinary Incontinence Among Women with Obstetric Fistula in Ghana: A Mixed Methods Study

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.105 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 44-45

Author(s):

Nessa E Ryan

Keyword(s):

Urinary Incontinence ◽

Mixed Methods ◽

Repeated Measures ◽

Obstetric Fistula ◽

Mixed Methods Study ◽

Relative Advantage ◽

Self Management ◽

Future Research ◽

Leakage Reduction ◽

The Mean

OBJECTIVES/SPECIFIC AIMS: 1. To assess feasibility (efficacy, safety, acceptability) of the menstrual cup for managing urinary incontinence among women with obstetric fistula 2. To examine pre-implementation facilitators and barriers (including appropriateness) among additional stakeholders METHODS/STUDY POPULATION: Sequential explanatory mixed methods study whereby repeated measures clinical trial results are explained by subsequent interviews with additional women with OF on coping and stigma and other stakeholders on perceptions of fistula self-management. RESULTS/ANTICIPATED RESULTS: Of the 32 patients screened, 11 were eligible (100% consent rate). At baseline, mean (±SD) leakage in ml was 63.2 (±49.2) (95% CI: 30.2-96.3) over two hours, while the mean leakage over two hours of use of the cup was 16.8 (±16.5) (95% CI: 5.7-27.9). The mean difference of 46.4 (±52.1) ml with use of the cup (95% CI: 11.4-81.4) was statistically significant (p = 0.02). With the cup, women experienced an average 61.0% (±37.4) (95% CI: 35.9-86.2) leakage reduction, a difference 10/11 users (91.0%) perceived in reduced leakage. One participant, reporting four previous surgical attempts, experienced a 78.7% leakage reduction. Acceptability was high–women could easily insert (8/11), remove (8/11), and comfortably wear (11/11) the cup and most (10/11) would recommend it. No adverse effects attributable to the intervention were observed on exam, although some women perceived difficulties with insertion and removal. Data collection tools were appropriate with slight modification advised. Interviews highlighted that women were already using various active coping and resistance strategies but lacked access to tools to support coping. Additional stakeholders reported the innovation was a simple, low-cost device that is an appropriate fit with ongoing fistula programming. Pre-implementation facilitators include the clear relative advantage to existing self-management strategies, the potential to build upon existing partnerships to implement, and a tension for change to address surgical gaps. Barriers included additional stakeholder’s perceptions of low user acceptability and appropriateness in some cases and the need for additional study data to inform decision making for practice and policy. DISCUSSION/SIGNIFICANCE OF IMPACT: The innovation is efficacious, acceptable, adds to current coping strategies, and fits within existing fistula programs. Stakeholders’ pre-implementation perceptions highlight the importance of partnerships and the need for an evidence base related to effectiveness, acceptability, and cost. Challenges to address include access to resources within these contexts (water, soap, and safe space to empty cup) and development of a culturally appropriate counseling message. Future research warranted.

Download Full-text

Impact of COVID-19 on patient health and self-care practices: a mixed-methods survey with German patients

BMJ Open ◽

10.1136/bmjopen-2021-051167 ◽

2021 ◽

Vol 11 (9) ◽

pp. e051167

Author(s):

Amelia Fiske ◽

Antonius Schneider ◽

Stuart McLennan ◽

Siranush Karapetyan ◽

Alena Buyx

Keyword(s):

Mixed Methods ◽

Rural Areas ◽

Self Care ◽

Care Practice ◽

Cross Sectional ◽

Patient Health ◽

Care Practices ◽

Urban And Rural Areas ◽

The Impact ◽

First Time

ObjectiveThis study aimed to examine German patients’: (1) self-estimation of the impact of the pandemic on their health and healthcare; and (2) use of digital self-care practices during the pandemic.DesignCross-sectional mixed-methods survey.Setting and participantsGeneral practice patients from four physicians’ offices located in urban and rural areas of Bavaria, Germany, between 21 July 2020 and 17 October 2020. A total of 254 patients participated (55% response rate); 57% (262 of 459) identified as female and participants had an average age of 39.3 years. Patients were eligible to participate if they were 18 years or older and spoke German, and had access to the internet.Results(1) Healthcare for patients was affected by the pandemic, and the mental health of a small group of respondents was particularly affected. The risk of depression and anxiety disorder was significantly increased in patients with quarantine experience. (2) Self-care practices have increased; more than one-third (39%) of participants indicated that they started a new or additional self-care practice during the pandemic, and about a quarter (23%) of patients who were not previously engaged in self-care practices started new self-care activities for the first time; however, such practices were not necessarily digital.ConclusionsFurther investigation is required to understand the relationship between digital self-care and public health events such as the COVID-19 pandemic, and to develop strategies to alleviate the burden of the quarantine experience for patients.

Download Full-text

Self-Confidence and Perceptions of Athletic Training Students Following Simulated Experiences: A Mixed-Methods Pilot Study

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2021.1973 ◽

2021 ◽

Author(s):

Hannah Stedge ◽

Valerie Herzog

Keyword(s):

Mixed Methods ◽

Athletic Training ◽

Clinical Education ◽

Repeated Measures ◽

Real Life ◽

Future Research ◽

High Fidelity ◽

Athletic Training Students ◽

Repeated Measures Design ◽

Self Confidence

Purpose: Athletic training clinical education provides students with a variety of real-life patient encounters under the supervision of a credentialed athletic trainer. However, clinical education experiences may not allow for all students to practice more invasive or less common skills such as rectal thermometry. The purpose of this study was two-fold: 1) determine the effect of a series of low to high-fidelity simulated rectal thermometry experiences on athletic training students’ self-confidence scores; and 2) through a phenomenological qualitative approach, explore athletic training students’ perceptions following the simulated rectal thermometry experiences. Method: This study used a quasi-experimental, mixed methods, one-group repeated measures design. Participants were nine first year professional Master of Athletic Training students who completed four simulated experiences on the skill of rectal thermometry. The outcome measures were The Athletic Trainer’s Self-Confidence Scale (ATSCS) and qualitative semi-structured open-ended interviews. Results: Friedman’s ANOVA revealed a statistically significant improvement from the participant’s baseline ATSCS scores to the last post-test scores. We identified three major themes following qualitative interviews: 1) Perception changes before and after participation; 2) Benefits of a series of four simulations; 3) Explanations for the improvements in confidence and competence. Conclusions: A series of simulated learning activities using high-fidelity and standardized patient interactions can help improve athletic training students’ self-confidence. Though future research is needed, athletic training education programs should consider implementing simulated experiences to equip athletic training students to transition to practice.

Download Full-text

Mindful Self-Care Practice of Nurses in Acute Care: A Multisite Cross-Sectional Survey

Western Journal of Nursing Research ◽

10.1177/01939459211004591 ◽

2021 ◽

pp. 019394592110045

Author(s):

Hussan Zeb ◽

Ijaz Arif ◽

Ahtisham Younas

Keyword(s):

Acute Care ◽

Self Care ◽

Male Nurses ◽

Care Practice ◽

Organizational Strategies ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Convenience Sample ◽

Care Practices ◽

Female Nurses

Consistent mindful self-care practices mitigate professional burnout and improve resilience to enable nurses provide safe and effective patient care. This study determined the levels and the influencing factors of mindful self-care of nurses in acute care settings. Data were collected from a convenience sample of 258 nurses from seven acute care hospitals using the 36-item Mindful Self-Care Scale. Data were analyzed using descriptive and correlation analyses. Nurses’ mindful self-care scores were low, and female nurses had higher levels of mindful self-care than male nurses. Statistically significant negative correlations were found between nurses’ mindful self-care levels and their age and clinical experience. Nurses’ engagement in mindful self-care is low which may negatively affect their interactions with and care of patients and their families. Therefore, a need exists to develop and evaluate more clinical-based personal and organizational strategies to enhance the mindful self-care practices of nurses.

Download Full-text

Power of Modified Brown-Forsythe and Mixed-Model Approaches in Split-Plot Designs

Methodology ◽

10.1027/1614-2241/a000124 ◽

2017 ◽

Vol 13 (1) ◽

pp. 9-22 ◽

Cited By ~ 1

Author(s):

Pablo Livacic-Rojas ◽

Guillermo Vallejo ◽

Paula Fernández ◽

Ellián Tuero-Herrero

Keyword(s):

Repeated Measures ◽

Statistical Power ◽

Mixed Model ◽

Covariance Structure ◽

Simulation Method ◽

Future Research ◽

Repeated Measures Design ◽

Fixed And Random Effects ◽

Split Plot ◽

High Level

Abstract. Low precision of the inferences of data analyzed with univariate or multivariate models of the Analysis of Variance (ANOVA) in repeated-measures design is associated to the absence of normality distribution of data, nonspherical covariance structures and free variation of the variance and covariance, the lack of knowledge of the error structure underlying the data, and the wrong choice of covariance structure from different selectors. In this study, levels of statistical power presented the Modified Brown Forsythe (MBF) and two procedures with the Mixed-Model Approaches (the Akaike’s Criterion, the Correctly Identified Model [CIM]) are compared. The data were analyzed using Monte Carlo simulation method with the statistical package SAS 9.2, a split-plot design, and considering six manipulated variables. The results show that the procedures exhibit high statistical power levels for within and interactional effects, and moderate and low levels for the between-groups effects under the different conditions analyzed. For the latter, only the Modified Brown Forsythe shows high level of power mainly for groups with 30 cases and Unstructured (UN) and Autoregressive Heterogeneity (ARH) matrices. For this reason, we recommend using this procedure since it exhibits higher levels of power for all effects and does not require a matrix type that underlies the structure of the data. Future research needs to be done in order to compare the power with corrected selectors using single-level and multilevel designs for fixed and random effects.

Download Full-text

Complementary Medicine and Self-Care Strategies in Women with (Recurrent) Urinary Tract and Vaginal Infections: A Cross-Sectional Study on Use and Perceived Effectiveness in The Netherlands

Antibiotics ◽

10.3390/antibiotics10030250 ◽

2021 ◽

Vol 10 (3) ◽

pp. 250

Author(s):

Louise Witteman ◽

Herman A. van Wietmarschen ◽

Esther T. van der Werf

Keyword(s):

Urinary Tract ◽

The Netherlands ◽

Complementary Medicine ◽

Self Care ◽

Future Research ◽

Perceived Effectiveness ◽

Vaginal Infections ◽

Cross Sectional ◽

Treatment Implementation ◽

Specific Symptoms

Due to the excessive use of antibiotic and antimycotic treatments, the risk of resistant microbes and fungi is rapidly emerging. Previous studies have demonstrated that many women with (recurrent) urinary tract infection (UTI) and/or vaginal infections (VIs) welcome alternative management approaches to reduce the use of antibiotics and antifungals and avoid short- and long-term adverse effects. This study aims to determine which complementary medicine (CM) and self-care strategies are being used by women suffering from (recurrent) UTI and VI in The Netherlands and how they perceive their effectiveness in order to define directions for future research on safety, cost-effectiveness, and implementation of best practices. A cross-sectional online survey was performed among women, ≥18 years old, with a history of UTIs; 162 respondents were included in the data analysis, with most participants aged between 50 and 64 years (36.4%). The women reported having consulted a CM practitioner for UTI-specific symptoms (23.5%) and VI-specific symptoms (13.6%). Consultations of homeopaths, acupuncturists, and herbal physicians are most often reported. Overall, 81.7% of the women suffering from UTI used complementary or self-care strategies besides regular treatment, and 68.7% reported using CM/self-care strategies to treat vaginal symptoms. UTI- related use of cranberries (51.9%), vitamin C (43.8%), and D-mannose (32.7%) were most reported. Perceived effectiveness was mostly reported for homeopathic remedies and D-mannose. The results showed a substantial burden of UTI and VI on daily and sexual activities. Besides the frequency of use, the indication of perceived effectiveness seems to be an important parameter for further and rigorously designed research to encourage nonantibiotic/antifungal treatment implementation into daily clinical practice.

Download Full-text

Self‐care agency and self‐care practice in youth workers reduces burnout risk and improves compassion satisfaction

Drug and Alcohol Review ◽

10.1111/dar.13209 ◽

2020 ◽

Author(s):

Karen T. Hallam ◽

Danielle Leigh ◽

Cassandra Davis ◽

Nathan Castle ◽

Jenny Sharples ◽

...

Keyword(s):

Self Care ◽

Compassion Satisfaction ◽

Care Practice ◽

Youth Workers ◽

Burnout Risk ◽

Care Agency

Download Full-text

A Taxonomy for Psycho-Oncological Intervention Techniques in an Acute Care Hospital in Germany

Oncology Research and Treatment ◽

10.1159/000517532 ◽

2021 ◽

pp. 1-7

Author(s):

Martina Madl ◽

Marietta Lieb ◽

Katharina Schieber ◽

Tobias Hepp ◽

Yesim Erim

Keyword(s):

Acute Care ◽

Interrater Reliability ◽

Acute Care Hospital ◽

Future Research ◽

Systematic Research ◽

Care Hospital ◽

Certification System ◽

Stepwise Procedure ◽

Further Development

Background: Due to the establishment of a nationwide certification system for cancer centers in Germany, the availability of psycho-oncological services for cancer patients has increased substantially. However, little is known about the specific intervention techniques that are applied during sessions in an acute care hospital, since a standardized taxonomy is lacking. With this study, we aimed at the investigation of psycho-oncological intervention techniques and the development of a comprehensive and structured taxonomy thereof. Methods: In a stepwise procedure, a team of psycho-oncologists generated a data pool of interventions and definitions that were tested in clinical practice during a pilot phase. After an adaptation of intervention techniques, interrater reliability (IRR) was attained by rating 10 previously recorded psycho-oncological sessions. A classification of interventions into superordinate categories was performed, supported by cluster analysis. Results: Between April and June 2017, 980 psycho-oncological sessions took place. The experts agreed on a total number of 22 intervention techniques. An IRR of 89% for 2 independent psycho-oncological raters was reached. The 22 techniques were classified into 5 superordinate categories. Discussion/Conclusion: We developed a comprehensive and structured taxonomy of psycho-oncological intervention techniques in an acute care hospital that provides a standardized basis for systematic research and applied care. We expect our work to be continuously subjected to further development: future research should evaluate and expand our taxonomy to other contexts and care settings.

Download Full-text

Cohort profile of Acutelines: a large data/biobank of acute and emergency medicine

BMJ Open ◽

10.1136/bmjopen-2020-047349 ◽

2021 ◽

Vol 11 (7) ◽

pp. e047349

Author(s):

Ewoud ter Avest ◽

Barbara C van Munster ◽

Raymond J van Wijk ◽

Sanne Tent ◽

Sanne Ter Horst ◽

...

Keyword(s):

Acute Care ◽

De Novo ◽

Medical Center ◽

Large Data ◽

Future Research ◽

Imaging Data ◽

Novel Studies ◽

Long Term Follow Up ◽

Registration Number

PurposeResearch in acute care faces many challenges, including enrolment challenges, legal limitations in data sharing, limited funding and lack of singular ownership of the domain of acute care. To overcome these challenges, the Center of Acute Care of the University Medical Center Groningen in the Netherlands, has established a de novo data, image and biobank named ‘Acutelines’.ParticipantsClinical data, imaging data and biomaterials (ie, blood, urine, faeces, hair) are collected from patients presenting to the emergency department (ED) with a broad range of acute disease presentations. A deferred consent procedure (by proxy) is in place to allow collecting data and biomaterials prior to obtaining written consent. The digital infrastructure used ensures automated capturing of all bed-side monitoring data (ie, vital parameters, electrophysiological waveforms) and securely importing data from other sources, such as the electronic health records of the hospital, ambulance and general practitioner, municipal registration and pharmacy. Data are collected from all included participants during the first 72 hours of their hospitalisation, while follow-up data are collected at 3 months, 1 year, 2 years and 5 years after their ED visit.Findings to dateEnrolment of the first participant occurred on 1 September 2020. During the first month, 653 participants were screened for eligibility, of which 180 were approached as potential participants. In total, 151 (84%) provided consent for participation of which 89 participants fulfilled criteria for collection of biomaterials.Future plansThe main aim of Acutelines is to facilitate research in acute medicine by providing the framework for novel studies and issuing data, images and biomaterials for future research. The protocol will be extended by connecting with central registries to obtain long-term follow-up data, for which we already request permission from the participant.Trial registration numberNCT04615065.

Download Full-text