scholarly journals Companions in the Abyss: A Feasibility and Acceptability Study of an Online Therapy Group for Healthcare Providers Working During the COVID-19 Pandemic

2022 ◽  
Vol 12 ◽  
Author(s):  
Lorraine Smith-MacDonald ◽  
Jaimie Lusk ◽  
Dayna Lee-Baggley ◽  
Katherine Bright ◽  
Alexa Laidlaw ◽  
...  
Keyword(s):  
Registered Nurses ◽  
Therapy Group ◽  
Healthcare Providers ◽  
Structured Interview ◽  
Outcome Data ◽  
Psychotherapeutic Intervention ◽  
Respiratory Therapists ◽  
The Third ◽  
Practical Nurses ◽  
Parametric Testing

Introduction:In the context of the global pandemic of the SARS-CoV-2 coronavirus (COVID-19), healthcare providers (HCPs) have experienced difficult moral and ethical dilemmas. Research is highlighting the importance of moral injury (MI)–a trauma syndrome related to transgressing personal morals and values–in understanding the psychological harm and occupational impairment experienced by HCPs. To date, MI treatments have largely been developed for military personnel and veterans and rely on in-person one-on-one psychotherapy.Purpose:This project aims to explore the feasibility and acceptability of an evidence-informed online Acceptance and Commitment Therapy-based group therapy for MI in HCPs called “Accepting Moral Pain and Suffering for Healthcare Providers” (AMPS-HCP).Method:This feasibility and acceptability study included three separate phases with the first two phases focused on the development of the psychotherapeutic intervention and the third phase focused on the evaluation of the psychotherapeutic intervention. Eight participants (including registered nurses, practical nurses and respiratory therapists) completed seven 90-min sessions in an online group format. The focus of these sessions included ACT and MI psychoeducation and experientials. Qualitative semi-structured interview data was thematically analyzed while demographic and quantitative self-reported outcome data underwent descriptive analysis and non-parametric testing.Results:Results show that the intervention was highly feasible and acceptable to healthcare providers who worked on the frontline during COVID-19. Feasibility (referrals, eligibility, retention, participation engagement) was strong (8 out of 10 participants; 80% vs. desired >70% eligibility) and overall, 80% of participants completed 71% of the intervention. Data further supported the applicability and acceptability of the intervention. Preliminary data suggests that AMPS-HCP may supports HCPs to address MI.Discussion:This study is the first to report on the development and evaluation of an online MI group intervention for registered nurses, registered practical nurses, and respiratory therapists working during COVID-19. Results showed the use of both the online and group components of the intervention were acceptable and feasible during the third wave of COVID-19.

scholarly journals A75 IMPLEMENTING A CIRRHOSIS ORDER SET: A QUALITATIVE ANALYSIS OF PROVIDER-IDENTIFIED BARRIERS AND FACILITATORS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 41-42
Author(s):  
E Johnson ◽  
M Carbonneau ◽  
D Campbell-Scherer ◽  
P Tandon ◽  
A Hyde
Keyword(s):  
Focus Groups ◽  
Gastrointestinal Disease ◽  
Pragmatic Trial ◽  
Healthcare Providers ◽  
Structured Interview ◽  
Barriers And Facilitators ◽  
Care Utilization ◽  
Implementation Barriers ◽  
Mortality And Morbidity ◽  
Order Set

Abstract Background Cirrhosis is the leading cause of mortality and morbidity in individuals with gastrointestinal disease. Multiple care gaps exist for hospitalized patients with cirrhosis, resulting in high rates of re-hospitalization (e.g. 44% at 90 days in Alberta). The Cirrhosis Care Alberta (CCAB) is a 4-year multi-component pragmatic trial with an aim to reduce acute-care utilization by implementing an electronic order set and supporting education across eight hospital sites in Alberta. Aims As part of the pre-implementation evaluation, this qualitative study analyzed data from provider focus groups to identify barriers and facilitators to implementation. Methods We conducted focus groups at eight hospital sites with a total of 54 healthcare providers (3–12 per site). A semi-structured interview guide based upon constructs of the Consolidated Framework for Implementation Research (CFIR) and Normalization Process Theory (NPT) frameworks was used to guide the focus groups. Focus groups were recorded and transcribed verbatim. Data was analyzed thematically and inductively. Results Five major themes emerged across all eight sites: (i) understanding past implementation experiences, (ii) resource challenges, (iii) competing priorities among healthcare providers, (iv) system challenges, and (v) urban versus rural differences. Site-specific barriers included perceived lack of patient flow, time restraints, and concerns about the quality and quantity of past implementation interventions. Facilitators included passionate project champions, and an ample feedback process. Conclusions Focus groups were useful for identifying pre-implementation barriers and facilitators of an electronic orders set. Findings from this study are being refined to address the influence of COVID-19, and the data will be used to inform the intervention roll-out at each of the sites. Funding Agencies Alberta Innovates

Comparisons of Narrative Psychotherapy to Conventional CBT for the Psychotherapy of Psychosis and Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. s779-s779
Author(s):  
L. Mehl-Madrona ◽  
B. Mainguy
Keyword(s):  
Bipolar Disorder ◽  
Narrative Therapy ◽  
Rating Scales ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Therapy Group ◽  
Well Being ◽  
Outcome Data ◽  
Symptom Scale ◽  
Young Mania

IntroductionThere is ongoing debate about about both the value of psychotherapy in psychotic disorders and the best type of psychotherapy to use if necessary.MethodsWe conducted narrative psychotherapy with 18 adults, all diagnosed as having bipolar disorder with psychotic features and/or schizo-affective disorder. Outcome data consisted of the Positive and Negative Symptom Scale, the Clinical Global Impressions Scale, the Young Mania Rating Scale, the Hamilton Anxiety and Depression Scales, the My Medical Outcome Profile, Version 2(MYMOP2), and the Outcome Rating Scales of Duncan and Miller. We compare the outcomes of our patients to those of a matched comparison group receiving conventional psycho-education and cognitive behavioural therapy. Patients were seen for a minimum of 16 weeks over an average of 22 weeks. Average age was 31.5 years with a standard deviation of 8.1 years.ResultsThe narrative therapy group showed statistically significant reductions in all outcome measures compared to the conventional treatment group. They continued treatment significantly longer and had fewer re-hospitalizations. They were less distressed by voices.ConclusionsA narrative psychotherapy approach using dialogical theory and therapy ideas is a reasonable approach for the psychotherapy of psychosis. Review of psychotherapy notes showed that narrative approaches allowed the therapist to align with the patient as collaborator in considering the story presented and was therefore less productive of defensiveness and self-criticism than conventional approaches. The therapy included techniques for negotiating changes in illness narratives, identity narratives, and treatment narratives that were more conducive of well-being and recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Determinants of preconception care among pregnant women in an urban and a rural health facility in Kenya: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. K. Okemo ◽  
D. Kamya ◽  
A. M. Mwaniki ◽  
M. Temmerman
Keyword(s):  
Child Health ◽  
Pregnant Women ◽  
Preconception Care ◽  
Healthcare Providers ◽  
Preventive Health Care ◽  
Structured Interview ◽  
University Hospital ◽  
Rural Setting ◽  
Rural Settings ◽  
And Child Health

Abstract Background Preconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could contribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in rural areas. Little is known regarding PCC use in Kenya that could help in addressing this shortfall. This study aimed to qualitatively assess the determinants of PCC in urban and rural settings in Kenya. Methods A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The study was conducted from May to October 2017. Selected pregnant women seeking antenatal care (ANC) were recruited by quota sampling, at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). The interviews were thereafter transcribed verbatim and analyzed thematically. Findings A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred with 13 interviews (7 at AKUH and 6 at MLFH). Transcription, coding and thematic analysis of the IDIs yielded 12 themes. Eleven of these themes were identified as determinants of PCC. The twelfth theme contained suggested strategies of increasing PCC awareness and utilization, such as using the media, setting up PCC clinics and integrating PCC into other clinics. The dominant themes were awareness about PCC and attitudes towards PCC and pregnancy. The broad determinants of PCC were similar in urban and rural settings – with a few notable exceptions. For example, in the rural setting, women’s level of education and a pervasive history of poor interactions with healthcare providers were major determinants of PCC. Conclusion From this study we conclude that women’s lack of awareness about PCC, in conjunction with attitudes towards PCC and pregnancy impact strongly on its utilization. This lack of awareness could be addressed through health education programs for both the public and for healthcare providers, as well as integrating PCC in the curricula of the later.

scholarly journals Career Motivation in Newly Licensed Registered Nurses: What Makes Them Remain

2014 ◽  
Author(s):  
Zarata Banks ◽  
Jessica Bailey
Keyword(s):  
Registered Nurses ◽  
Role Models ◽  
Structured Interview ◽  
Healthcare Management ◽  
Career Motivation ◽  
Face To Face ◽  
Interview Guide ◽  
Determining Factors ◽  
Emerging Themes ◽  
Newly Licensed Registered Nurses

Despite vast research on newly licensed registered nurses (RNs), we don't know why some newly licensed registered nurses remain in their current jobs and others leave the nursing profession early in their career. Job satisfaction, the most significant factor emerging from the literature, plays a significant role in nurses' decisions to remain in their current jobs. This study examined the lived experiences of newly licensed registered nurses early in their careers. The researcher interviewed 14 newly licensed registered nurses to ask why they chose nursing as a profession and to determine factors that would influence their choice to stay in nursing as a career. Data were collected from newly licensed registered nurses through in-depth, face-to-face interviews, using a semi-structured interview guide developed by the researcher. Data analysis identified the emerging themes of altruism, self-fulfillment, challenging career, and the influence of role models as determining factors for nurses staying in the field. Findings suggest that those in positions of healthcare management should consider how they can create a workplace environment that provides newly licensed registered nurses the opportunity to fulfill these employment expectations.

scholarly journals Determinants of Preconception care among Pregnant Women In an Urban and a Rural Health Facility In Kenya: A Qualitative Study

2021 ◽  
Author(s):  
Joan Khavugwi Okemo ◽  
Dorothy Kamya ◽  
Abraham Mukaindo Mwaniki ◽  
Marleen Temmerman
Keyword(s):  
Child Health ◽  
Pregnant Women ◽  
Preconception Care ◽  
Healthcare Providers ◽  
Preventive Health Care ◽  
Structured Interview ◽  
University Hospital ◽  
Rural Setting ◽  
Rural Settings ◽  
And Child Health

Abstract BACKGROUNDPreconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could contribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in the rural areas. Little is known regarding PCC use in Kenya that could help in bridging this gap. This study aimed to assess the determinants of PCC in urban and rural settings in Kenya.METHODSSelected pregnant women seeking antenatal care (ANC) were recruited by purposive sampling at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed thematically.RESULTS A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred after 13 interviews (7 at AKUH and 6 at MLFH).Transcription, coding and thematic analysis of the IDIs yielded 12 main themes. Eleven of the main themes were identified as determinants of PCC while the twelfth theme contained suggested strategies of increasing PCC awareness and utilization, such as using the media, setting up PCC clinics and integrating PCC into other clinics. The dominant themes were awareness about PCC and attitudes towards PCC and pregnancy.The broad determinants of PCC were similar in urban and rural settings – with a few notable exceptions. For example, in the rural setting, women’s level of education and a pervasive history of poor interactions with healthcare providers were major determinants of PCC.CONCLUSIONFrom this study we conclude that women’s lack of awareness about PCC, in conjunction with attitudes towards PCC and pregnancy impact strongly on its utilization. This lack of awareness could be addressed through health education programs for both the public and for healthcare providers, as well as integrating PCC in the curricula of nurses and doctors.

Multifaceted competence requirements in care homes: Ethical and interactional competence emphasized

2017 ◽  
Vol 38 (1) ◽  
pp. 48-58 ◽  
Author(s):  
Outi Kiljunen ◽  
Tarja Välimäki ◽  
Pirjo Partanen ◽  
Päivi Kankkunen
Keyword(s):  
Older People ◽  
Registered Nurses ◽  
Delphi Study ◽  
Care Home ◽  
Care Homes ◽  
Interactional Competence ◽  
Licensed Practical Nurses ◽  
Modified Delphi ◽  
Practical Nurses ◽  
Care For Older People

Nurses need versatile competence to care for older people in care home settings. A modified Delphi study was conducted to identify competencies registered nurses and licensed practical nurses need to care for older people in care homes. A total of 38 panelists consisting of experienced professionals in clinical and managerial roles were recruited to identify types of competencies these nurses require. In total, 80 competencies for licensed practical nurses and 81 competencies for registered nurses were identified as necessary. This study has shown that licensed practical nurses are required to have similar competencies to registered nurses in care homes. Nurse managers, nurse educators, and policy makers should pay more attention, to nurses’ work requirements, especially for licensed practical nurses, and support nurses to meet the needs of older people living in care homes.

scholarly journals A Survey of Suctioning Practices among Physical Therapists, Respiratory Therapists and Nurses

1999 ◽  
Vol 6 (6) ◽  
pp. 513-520 ◽  
Author(s):  
Dina Brooks ◽  
Sherra Solway ◽  
Ian Graham ◽  
Laurie Downes ◽  
Margaret Carter
Keyword(s):  
Registered Nurses ◽  
Physical Therapists ◽  
Mail Survey ◽  
Perfect Agreement ◽  
Main Indication ◽  
Respiratory Therapists ◽  
Professional Characteristics ◽  
Random Samples ◽  
Practice Variability ◽  
Harmful Effects

OBJECTIVE: To assess the current tracheal and oropharyngeal suctioning practice variability within and among the professions of physical therapy, respiratory therapy and nursing.DESIGN: A mail survey of physical therapists, respiratory therapists and registered nurses who perform suctioning. The survey instrument consisted of questions about professional characteristics, clinical suctioning practice and sociodemographics.SETTING: The survey was restricted to professionals practising within the province of Ontario.PARTICIPANTS: Random samples (n=448) were drawn from membership of the regulatory boards of all three professions.MAIN RESULTS: Fifty-eight per cent of respondents returned completed questionnaires. There was large variation in reports of gloving procedure (eg, double clean: 26% for physical therapists, 5% for respiratory therapists, 55% for registered nurses, P<0.0001) and technique of catheter use (sterile, inline or clean, P<0.01). There was also discrepancy in the techniques used to minimize harmful effects, ie, prelubrication with gel (83% for physical therapists, 54% for respiratory therapists, 17% for registered nurses, P<0.0001), use of hyperinflation (12% of physical therapists, 25% of respiratory therapists, 39% of registered nurses never hyperinflate) and use of instillation (7% of physical therapists, 0% of respiratory therapists, 19% of registered nurses never instill). However, there was agreement about the routine application of hyperoxygenation (74% or more) and there was almost perfect agreement (99% or more) within and across the three professions that secretion removal was the main indication for suctioning.CONCLUSIONS: The results of this study indicate a wide variation in suctioning techniques among physical therapists, respiratory therapists and registered nurses. Comparisons among professions revealed inconsistencies in some areas, such as the use of in-line catheters, gloving procedures, prelubrication and hyperinflation.

Assessment of Staffing Needs for Registered Nurses and Licensed Practical Nurses at Primary Care Units in Brazil Using the Workload Indicators of Staffing Need (WISN) Method

2021 ◽  
Author(s):  
Daiana Bonfim ◽  
Ana Carolina Cintra Nunes Mafra ◽  
Danielle da Costa Palacio ◽  
Talita Rewa
Keyword(s):  
Primary Care ◽  
Registered Nurses ◽  
Supply And Demand ◽  
Licensed Practical Nurses ◽  
Primary Health ◽  
Practical Nurses ◽  
High Workload ◽  
Planning Methods ◽  
Staffing Needs ◽  
The City

Abstract Background The balance between supply and demand for primary health care (PHC) services is one of the main challenges to the health system in Brazil. In this context, the application of planning methods could benefit the decision-making process for human resources organizations. Hence, the objective of this study was to assess the staffing needs for registered nurses (RNs) and licensed practical nurses (LPNs) at PHC services using the WISN method. Methods The Workload Indicators of Staffing Need (WISN) methodology was applied at 13 Primary Care Units (PCU) located in the city of São Paulo, Brazil. It included 87 RNs and 174 LPNs, and used data from 2017 to 2019. Results The WISN results found that RNs were under high workload pressure at 10 PCUs (77%) in 2017 and 2018, with a decrease to 8 PCUs (61%) in 2019. For LPNs, high workload pressure increased from 2 PCUs (15%) in 2017 to 13 PCUs (100%) in 2018, with a decrease to 11 (85%) in 2019. Conclusion The assessment of staffing needs for RNs and LPNs at the PCUs included in the study identified a consistent deficit in the number of professionals, and high workload pressure in most services throughout the study period.

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