scholarly journals Explaining nursing attrition through the experiences of return-to-practice students: a mixed-methods study

2021 ◽  
Vol 30 (8) ◽  
pp. 490-496
Author(s):  
Joanne Garside ◽  
John Stephenson ◽  
Jean Hayles ◽  
Nichola Barlow ◽  
Graham Ormrod

Background: Nurse shortage is an international issue that has adverse effects on health and the quality of care of whole populations. Aims: The study aimed to explore attrition experienced by return-to-practice students attending higher education institutions in England. Methods: A mixed-methods design, involving questionnaires (n=114) and in-depth interviews (n=20), was used. Findings: Just over half (52%) of respondents left nursing after ≥10 years. Most of these (84%) stayed in alternative employment during their break from nursing. There were two distinct reasons for leaving nursing: the inability to maintain a positive work/life balance and a lack of opportunity for career advancement while retaining nursing registration. Respondents reflected positively on their nursing experience yet frequently reported significant personal or professional incidents prompting their decision to leave. Conclusion: The reasons nurses leave are complex. Professional bodies and managers need to work together to address concerns many nurses have during their careers that lead to them deciding to leave the profession.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ali Jasem Buabbas ◽  
Tareq Mohammad ◽  
Adel K. Ayed ◽  
Hawraa Mallah ◽  
Hamza Al-Shawaf ◽  
...  

Abstract Background Telepathology is the practice of reviewing and exchanging pathological images through telecommunication systems to obtain diagnoses remotely. Studying the factors that make such a system successful and favourable is important to ensure the merits of its implementation in clinical practice. Objective This study aims to evaluate the success of a telepathology system from the users’ perspectives, using specific evaluation criteria, namely: system quality, information quality, technical service quality, user satisfaction, and benefits. Methods A sequential explanatory mixed methods design was adopted in this study, which consists of two phases. Initially, a questionnaire was distributed via WhatsApp to all of the pathologists (total: 45) working at governmental hospitals in Kuwait. Followed by, semi-structured interviews with ten senior pathologists. Results Forty pathologists responded to the questionnaire, giving an 89% response rate. There were 42.5% of the respondents aged between 35–44 years old, and 52.5% were male. The quantitative results reveal that most of the respondents were satisfied with the quality of the telepathology system with a mean of 2.6025 (Standard Deviation (SD) = 0.47176), whereas they were dissatisfied with the quality of the information with a mean of 2.4100 (SD = 1.580) and the technical support services with a mean of 2.2750 (SD = 0.99535). In addition, there was disagreement on the benefits of telepathology in clinical practice among the pathologists with a mean of 2.4667 (SD = 0.77552). The qualitative results indicate that the lack of interest in and little experience with using the system were behind the general dissatisfaction of most of the respondents. All of the interviewees were satisfied with the performance of the telepathology system and considered it successful; however, the quality of the technical support services, including training workshops, was deemed deficient. Conclusion This study concluded that telepathology system in Kuwait is functioning well and has been successful in its implementation; however, pathologists are dissatisfied with it, mainly due to the deficient quality of the technical support services provided. In addition, the successful implementation of such advanced technologies requires careful steps to be taken on multiple levels: technical, organisational, and managerial. Recommendations were suggested.


2020 ◽  
Vol 4 (1) ◽  
pp. e000822
Author(s):  
Robert C Hughes ◽  
Patricia Kitsao-Wekulo ◽  
Sunil Bhopal ◽  
Elizabeth W Kimani-Murage ◽  
Zelee Hill ◽  
...  

IntroductionThe early years are critical. Early nurturing care can lay the foundation for human capital accumulation with lifelong benefits. Conversely, early adversity undermines brain development, learning and future earning.Slums are among the most challenging places to spend those early years and are difficult places to care for a child. Shifting family and work structures mean that paid, largely informal, childcare seems to be becoming the ‘new normal’ for many preschool children growing up in rapidly urbanising Africa. However, little is known about the quality of this childcare.AimsTo build a rigorous understanding what childcare strategies are used and why in a typical Nairobi slum, with a particular focus on provision and quality of paid childcare. Through this, to inform evaluation of quality and design and implementation of interventions with the potential to reach some of the most vulnerable children at the most critical time in the life course.Methods and analysisMixed methods will be employed. Qualitative research (in-depth interviews and focus group discussions) with parents/carers will explore need for and decision-making about childcare. A household survey (of 480 households) will estimate the use of different childcare strategies by parents/carers and associated parent/carer characteristics. Subsequently, childcare providers will be mapped and surveyed to document and assess quality of current paid childcare. Semistructured observations will augment self-reported quality with observable characteristics/practices. Finally, in-depth interviews and focus group discussions with childcare providers will explore their behaviours and motivations. Qualitative data will be analysed through thematic analysis and triangulation across methods. Quantitative and spatial data will be analysed through epidemiological methods (random effects regression modelling and spatial statistics).Ethics and disseminationEthical approval has been granted in the UK and Kenya. Findings will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content.


10.2196/13903 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e13903
Author(s):  
Nune Truzyan ◽  
Zaruhi Grigoryan ◽  
Lusine Musheghyan ◽  
Byron Crape ◽  
Varduhi Petrosyan

Background The quality of care for tuberculosis (TB) is deficient in high-burden countries and urgently needs improvement. However, comprehensively identifying the required improvements is challenging. Providing high-quality TB care is an important step toward improving patients’ quality of life and decreasing TB morbidity and mortality. Effective tools for assessing the quality of TB services using international standards and guidelines can identify existing gaps in services and inform improvements to ensure high-quality inpatient TB services. Objective This study aimed to develop evaluation instruments for defining the quality of provision of TB services. Methods To assess quality of services in the largest TB hospital in Armenia, we developed instruments based on the Joint Commission International Accreditation Standards for Hospitals, International Standards for TB Care, TB Laboratories Bio-Safety Standards, and the World Health Organization framework for conducting TB program reviews. A mixed methods approach was utilized, triangulating quantitative (checklists) and qualitative (in-depth interviews) results. A scoring system and strengths, weaknesses, opportunities, and treats analysis was applied to detail results for each of the 122 standards assessed. A scaling approach was used to present overall performances of inpatient services for eight patient-centered functions and five organization management functions. Results Overall, 40 in-depth interviews and 91 checklists (21 observations, 16 policy papers, 20 staff qualification documents, and 34 medical records) were developed, utilized, and analyzed to explore practices of health care professionals, assess inpatient treatment experience of patients and their family members, evaluate facility environmental conditions, and define the degree of compliance to standards. Conclusions The effective comprehensive evaluation instruments and methods developed in this study for quality of inpatient TB services support the implementation of similar effective assessments in other countries. It may also become a platform to develop similar approaches for assessing ambulatory TB services in resource-limited countries. International Registered Report Identifier (IRRID) DERR1-10.2196/13903


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e053099
Author(s):  
Elizabeth Rapa ◽  
Jeffrey R Hanna ◽  
Catriona R Mayland ◽  
Stephen Mason ◽  
Bettina Moltrecht ◽  
...  

ObjectiveThe objectives of this study were to investigate how families prepared children for the death of a significant adult, and how health and social care professionals provided psychosocial support to families about a relative’s death during the COVID-19 pandemic.Design/settingA mixed methods design; an observational survey with health and social care professionals and relatives bereaved during the COVID-19 pandemic in the UK, and in-depth interviews with bereaved relatives and professionals were conducted. Data were analysed thematically.ParticipantsA total of 623 participants completed the survey and interviews were conducted with 19 bereaved relatives and 16 professionals.ResultsMany children were not prepared for a death of an important adult during the pandemic. Obstacles to preparing children included families’ lack of understanding about their relative’s declining health; parental belief that not telling children was protecting them from becoming upset; and parents’ uncertainty about how best to prepare their children for the death. Only 10.2% (n=11) of relatives reported professionals asked them about their deceased relative’s relationships with children. This contrasts with 68.5% (n=72) of professionals who reported that the healthcare team asked about patient’s relationships with children. Professionals did not provide families with psychosocial support to facilitate preparation, and resources were less available or inappropriate for families during the pandemic. Three themes were identified: (1) obstacles to telling children a significant adult is going to die, (2) professionals’ role in helping families to prepare children for the death of a significant adult during the pandemic, and (3) how families prepare children for the death of a significant adult.ConclusionsProfessionals need to: provide clear and honest communication about a poor prognosis; start a conversation with families about the dying patient’s significant relationships with children; and reassure families that telling children someone close to them is dying is beneficial for their longer term psychological adjustment.


10.2196/15399 ◽  
2019 ◽  
Vol 8 (12) ◽  
pp. e15399
Author(s):  
Jan Porthun ◽  
Jonas Manschel

Background Currently, the importance of osteopathy within the health care system is controversial. The training structures and the acknowledgment of the occupational profile strongly differ in the German-speaking territory. Objective This study aims to examine the characteristics of the osteopathic profession as well as the possibilities and challenges for osteopaths in Germany, Austria, and Switzerland. Methods This study adopted a mixed methods design. The research topic will be examined based on qualitative and quantitative partial studies that will be conducted in parallel as well as sequentially. By applying different research methods and sample testing and by using standardized, validated measurement methods, we expect to be able to gain new insights into the work area of osteopathy. Results In November 2018, we started the research and data collection. Currently, we are conducting the first two partial studies. The planned duration of each of the partial study is 6-9 months. The project is scheduled to be completed in 2021. Conclusions This study will examine how osteopaths define themselves in comparison with professionals from other occupational profiles and how they describe the characteristics of their work. The identification of central issues is expected to help clarify the issues and define the profession. As such, the results might contribute to the conservation and improvement of the quality of osteopathic treatment. International Registered Report Identifier (IRRID) PRR1-10.2196/15399


2020 ◽  
Vol 83 (5) ◽  
pp. 316-325
Author(s):  
Qi Liu ◽  
Margaret Jones ◽  
Clare Hocking

Introduction Cognitive stimulation therapy is an evidence-based group intervention for promoting cognition and quality of life in people with dementia. This New Zealand study aimed to describe and measure the ‘switch-on’ effect, a recently reported benefit involving enhanced participation. Method A convergent parallel mixed methods design was implemented. Interviews guided by qualitative descriptive methodology were conducted with four community-dwelling men with mild dementia and their wives, before, during and after cognitive stimulation therapy. Concomitantly, participants with dementia were scored on the Volitional Questionnaire following a single-subject A–B design. Qualitative and quantitative data were analysed using NVivo-assisted thematic analysis and descriptive statistics respectively and conjointly. Findings ‘Switch-on’ was found to be multi-dimensional in nature, with increased engagement and expanded scope in Doing, Feeling, Relating, and Thinking and Reflecting. ‘Switch-on’ occurred with a noticeable onset within 3 weeks, which was sustained and consolidated towards completion of cognitive stimulation therapy in both group and home environments. Three men showed concurrent improvements on the achievement sub-scale of the Volitional Questionnaire. However, the measure did not effectively capture ‘switch-on’ due to its ceiling effect. Conclusion Findings about ‘switch-on’ suggest broader, under-researched benefits of cognitive stimulation therapy that merit further exploration from an occupational therapy perspective.


2019 ◽  
Vol 61 (1) ◽  
pp. 105-128
Author(s):  
Megan Moskos ◽  
Linda Isherwood

With projected future demand severely outstripping the current workforce size, it is crucial for the Australian aged care sector to develop strategies to encourage non-traditional workers (such as men) into the sector. Yet despite some recent progress, there is still surprisingly little empirical evidence about how to attract and retain men into gender atypical occupations such as aged care. This article offers an in-depth and innovative investigation into male aged care workers, their experience of the work and future employment plans. Using a mixed methods design, this article combines the findings from an analysis of the Australian National Aged Care Workforce Census and Survey with the findings arising from 51 in-depth interviews conducted with male aged care workers. The integration of these findings allows us to understand the determinants of men’s representation in the aged care sector so that workforce strategies and policies can be generated about how the sector can best attract and retain male workers to meet current and future skill shortages.


2021 ◽  
Vol 9 ◽  
Author(s):  
Ghadah A. Al-Sharif ◽  
Alia A. Almulla ◽  
Eman AlMerashi ◽  
Reem Alqutami ◽  
Mohammad Almoosa ◽  
...  

Background: The onset of the pandemic necessitated abrupt transition to telehealth consultations. Although there is a few tools that gauge the patients' perception about their experiences, none of them are contextualized to an emergency in the Middle East and North Africa region. Accordingly, this study aims at developing and validating a tool to address this gap, and deploying it to assess the patients' perception of telehealth services during COVID-19 in Dubai, United Arab Emirates (UAE).Methods: A convergent mixed methods design was adapted. A random selection of 100 patients from Dubai, UAE were invited to participate. Qualitative and quantitative datasets were collected using a tailor-made survey. The qualitative data, collected through open-ended questions, was analyzed using multi-staged thematic analysis. As for the quantitative data, it captured the patients' extent of satisfaction, and was assessed using SPSS (with a series of descriptive and inferential analyses). The qualitative and quantitative findings were then merged via joint display analysis.Results: Out of the 100 patients that were randomly selected, 94 patients participated in this study. The reliability score of Cronbach's Alpha for the instrument was 98.9%. The percentage of the total average of satisfaction was 80.67%. The Principal Component Analysis showed that 88.1% of the variance can be explained by the instrument (p < 0.001). The qualitative data analysis expanded upon the quantitative findings enabling a better understanding of the patients' perception. Three themes, revolving around the quality of the patient telehealth experiences, surfaced: “Factors that worked to the benefit of the patients,” “Factors that the patients were not in favor of,” and “Opportunities for improvements as perceived by the patients.”Discussion: This study introduced a novel patient satisfaction with telehealth consultation survey contextualized to the COVID-19 times in Dubai, UAE. The participants were quite satisfied with the quality of their experience, however they suggested areas for improvement. Regional healthcare decision-makers can leverage the identified advantages and opportunities for improvement of telehealth. This will enable making informed decisions regarding the continuity of telehealth irrespective of how matters unfold in relation to the pandemic. It will also better prepare the healthcare sector for potential resurgence(s) of COVID-19 and/or the occurrence of other similar emergencies.


2019 ◽  
Author(s):  
Nune Truzyan ◽  
Zaruhi Grigoryan ◽  
Lusine Musheghyan ◽  
Byron Crape ◽  
Varduhi Petrosyan

BACKGROUND The quality of care for tuberculosis (TB) is deficient in high-burden countries and urgently needs improvement. However, comprehensively identifying the required improvements is challenging. Providing high-quality TB care is an important step toward improving patients’ quality of life and decreasing TB morbidity and mortality. Effective tools for assessing the quality of TB services using international standards and guidelines can identify existing gaps in services and inform improvements to ensure high-quality inpatient TB services. OBJECTIVE This study aimed to develop evaluation instruments for defining the quality of provision of TB services. METHODS To assess quality of services in the largest TB hospital in Armenia, we developed instruments based on the Joint Commission International Accreditation Standards for Hospitals, International Standards for TB Care, TB Laboratories Bio-Safety Standards, and the World Health Organization framework for conducting TB program reviews. A mixed methods approach was utilized, triangulating quantitative (checklists) and qualitative (in-depth interviews) results. A scoring system and strengths, weaknesses, opportunities, and treats analysis was applied to detail results for each of the 122 standards assessed. A scaling approach was used to present overall performances of inpatient services for eight patient-centered functions and five organization management functions. RESULTS Overall, 40 in-depth interviews and 91 checklists (21 observations, 16 policy papers, 20 staff qualification documents, and 34 medical records) were developed, utilized, and analyzed to explore practices of health care professionals, assess inpatient treatment experience of patients and their family members, evaluate facility environmental conditions, and define the degree of compliance to standards. CONCLUSIONS The effective comprehensive evaluation instruments and methods developed in this study for quality of inpatient TB services support the implementation of similar effective assessments in other countries. It may also become a platform to develop similar approaches for assessing ambulatory TB services in resource-limited countries. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/13903


2020 ◽  
Vol 7 (1) ◽  
pp. 38-56
Author(s):  
Puspa Triani Adinda ◽  
Christ Billy Aryanto ◽  
Laurensia Harini Tunjungsari

Abstract –  This study aims to explore how self-compassion shapes the experience of hospital nurses in Emergency Department (ED) in Jakarta. Previous studies demonstrated that the lack of self-compassion can increase compassion fatigue, thereby reducing the quality of services and eventually affect patients’ well-being. Mixed-methods design was employed by collecting data from 77 nurses through convenient sampling. Two nurses with highest self-compassion scores and a nurse with lowest self-compassion score were interviewed for further analysis. The descriptive result indicated that self-compassion of ED nurses in Jakarta was considerably high and only one nurse had relatively low self-compassion. There was a significant difference in self-compassion based on working time and hospital types. Qualitative analysis indicated that under stressful circumstances, nurses with high self-compassion tended to engage with various religious activities, while the one with low self-compassion tended to be self-indulging.Abstrak — Penelitian ini bertujuan untuk mengeksplorasi self-compassion perawat rumah sakit bagian Instalasi Gawat Darurat (IGD) di Jakarta. Studi sebelumnya menunjukkan bahwa kurangnya self-compassion dapat meningkatkan rasa lelah secara mental, sehingga menurunkan kualitas pelayanan rumah sakit dan dapat berdampak pada kesejahteraan pasien. Desain mixed-methods digunakan dengan mengambil 77 sampel perawat dari berbagai tipe rumah sakit melalui teknik sampel convenient. Dua perawat dengan self-compassion tertinggi dan satu perawat dengan self-compassion terendah diwawancarai untuk analisa data kualitatif. Hasil deskriptif mengindikasikan bahwa self-compassion perawat IGD di Jakarta tergolong tinggi dan hanya satu perawat yang ditemukan memiliki self-compassion rendah. Terdapat perbedaan signifikan mengenai self-compassion perawat berdasarkan lama bekerja dan tipe rumah sakit. Hasil kualitatif mengindikasikan bahwa ketika stres, perawat dengan self-compassion tinggi cenderung melakukan aktivitas religius, sementara perawat dengan self-compassion rendah cenderung melakukan self-indulgence.


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