The Transformational Experience of Junior Nurses Resulting from Providing Care to COVID-19 Patients: From Facing Hurdles to Achieving Psychological Growth

The rapid spread of coronavirus disease 2019 (COVID-19) has put significant pressure on junior nursing staff. The objective of this study was to examine the in-depth experiences of junior nurses in providing care for COVID-19 patients within an acute care setting. This study employed a phenomenological method to understand the situation from a first-person perspective. Purposive sampling was used. Interviews were performed with 40 junior nurses (<4 years of clinical experience) who provided direct care to COVID-19 patients in isolation wards in acute care settings in Hong Kong. The interviews were conducted from 1 January 2021 to 24 May 2021 via virtual conferencing software (Zoom) to maintain social distancing, and the responses were analysed using Colaizzi’s seven-step method. Junior nurses’ psychological experiences of providing direct care to COVID-19 patients were categorised into four main themes. First, there were hurdles in the early stages, in which participants experienced negative emotions, such as fear, anxiety, helplessness, and fatigue. Somatic symptoms, such as headaches and sleep disturbance, were reported. Second, the adoption of self-care coping strategies enabled nurses to confront the hurdles, signifying the start of self-transformation. Third, junior nurses maintained positivity under pressure by appreciating their sources of support (including their families and other important relationships in their lives). Professionalism was also found to reinforce positivity. Fourth, self-transformation resulted in psychological growth, which prepared junior nurses to be resilient and confident in their clinical practice to take up future challenges in the ongoing battle against the pandemic. The hurdles experienced by junior nurses at the early stage of their work in isolation wards provided the foundation upon which self-transformation took place. Being able to employ self-care coping strategies and further sustain positivity characterised the self-transformation process. Eventually, junior nurses became resilient and more capable of understanding both the negativity and positivity of their experiences. The self-transformation process also enabled junior nurses to recognise and appreciate the wider support system from various parties in society.

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“Self-care index” (SPI) and “Post-acute care discharge score” (PACD) to predict transfer of adult medical inpatients to a post-acute care facility: study protocol for a multicentre validation study (Preprint)

10.2196/preprints.21447 ◽

2020 ◽

Author(s):

Antoinette Conca ◽

Daniel Koch ◽

Katharina Regez ◽

Alexander Kutz ◽

Ciril Baechli ◽

...

Keyword(s):

Acute Care ◽

Study Protocol ◽

Negative Impact ◽

External Validation ◽

Self Care ◽

Care Facility ◽

The Self ◽

Acute Care Facility ◽

Care Index ◽

Post Acute Care

BACKGROUND Delays in patient discharge can not only lead to deterioration especially among geriatric patients, but also incorporates unnecessary resources at the hospital level. Many of these delays and their negative impact may be preventable by early focused screening to identify patients at risk for transfer to a post-acute care facility. Early interprofessional discharge planning is crucial in order to fit the appropriate individual discharge destination. As prediction of discharge to a post-acute care facility using post-acute care discharge score, the self-care index and a combination of both has been shown in a single centre pilot study, an external validation is still missing. OBJECTIVE This paper outlines the study protocol and methodology currently being used to replicate the previous pilot findings whether the post-acute care discharge score, the self-care index or the combination of both can reliably identify patients requiring transfer to post-acute care facilities. METHODS This study will use prospective data involving all phases of the quasi-experimental study “In-HospiTOOL” conducted at seven Swiss hospitals in urban and rural areas. During a 18-month period consecutive adult medical patients admitted to the hospitals through the emergency department will be included. This data will enable a prospective external validation of the prediction instruments. RESULTS We expect to gain more insight into the predictive capability of the above mentioned prediction instruments. This approach will allow us to get important information about the generalizability of the three different models. CONCLUSIONS This study will provide evidence on prognostic properties, comparative performance, reliability of scorings, and suitability of the instruments for screening purpose in order to be able to recommend application in clinical practice.

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Co-Designing and Evaluating a Self-Care Curriculum of an App for Chinese Immigrant Caregivers

Innovation in Aging ◽

10.1093/geroni/igaa057.1639 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 507-508

Author(s):

Ying Wang ◽

Mandong Liu ◽

Iris Chi

Keyword(s):

Mental Health ◽

United States ◽

Physical Health ◽

Self Care ◽

The United States ◽

The Self ◽

Community Resources ◽

Chinese Immigrant ◽

Knowledge And Skills ◽

Support Resources

Abstract Chinese immigrant caregivers face unique self-care difficulties in the United States due to language barriers, cultural isolation, and occupational stress. This study aimed to conduct a formative evaluation on a caregiver self-care curriculum of an app designed for Chinese immigrants in the United States. Using a co-design approach in 2019, 22 Chinese immigrant caregivers in Los Angeles county were recruited through purposive sampling method. The directed content analysis was adopted to analyze the qualitative data using NVivo 12.1.0 software. We organized the findings under two main contents: self-care and caregiving. Three categories were identified under the self-care content: physical health, emotional and mental health, and support resources. Sixteen subcategories under physical health (e.g., dietary supplements), five subcategories under emotional and mental health (e.g., depression) and eight subcategories under support resources (e.g., support and networking group, senior center) are suggested. Two categories were identified under the caregiving content: caregiving knowledge and skills, and community resources. Fourteen subcategories under caregiving knowledge and skills (e.g., care assessment) and six subcategories under community resources (e.g., medical emergency call) were mentioned. With this useful information, we could further refine the self-care curriculum to be more linguistically, culturally and occupationally sensitive for Chinese immigrant caregivers. Empowerment approach for enhancing the ability to caregiving and self-care should be emphasized in content design for immigrant caregivers. The co-design approach is crucial for planning of the program and intervention curriculum to improve understanding of the users’ needs and better cater them.

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A survey of coping strategies among clinical nurses in China during the early stage of coronavirus disease 2019 pandemic: A cross‐sectional study

Nursing Open ◽

10.1002/nop2.908 ◽

2021 ◽

Author(s):

Jiao Tang ◽

You Zhang ◽

Fangfang Xiong ◽

Fuying Li ◽

Zehong Zheng ◽

...

Keyword(s):

Coping Strategies ◽

Early Stage ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Clinical Nurses

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Teaching Mindfulness for the Self-Care and Well-Being of Counselors-in-Training

Journal of Creativity in Mental Health ◽

10.1080/15401383.2019.1642171 ◽

2019 ◽

Vol 15 (2) ◽

pp. 140-153 ◽

Cited By ~ 2

Author(s):

Lacretia Dye ◽

Monica Galloway Burke ◽

Cheryl Wolf

Keyword(s):

Self Care ◽

Well Being ◽

The Self ◽

Counselors In Training

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Scale of Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis: A Psychometric Study in Brazil

Clinical Nursing Research ◽

10.1177/1054773821989800 ◽

2021 ◽

pp. 105477382198980

Author(s):

Marta Nunes Lira ◽

Clemente Neves Sousa ◽

Maria Carolina Medeiros Wanderley ◽

Natália Ramos Costa Pessoa ◽

Kelly Cristiane Rocha Lemos ◽

...

Keyword(s):

Factor Analysis ◽

Psychometric Properties ◽

Arteriovenous Fistula ◽

Content Validity ◽

Self Care ◽

The Self ◽

Expert Committee ◽

Cronbach’S Alpha ◽

Cronbach's Alpha ◽

Confirmatory Factor

The purpose of this study was to evaluate the psychometric properties of the Brazilian Scale for the Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis. Cross-sectional validation study, followed the recommendation provided by Sousa and Rojjanasrirat. Content validity, explanatory and confirmatory factor analyses used to check validity and Cronbach’s alpha was the reliability measure. Three hundred hemodialysis patients with arteriovenous fistula were included in the study. The expert committee assessed the content validity. Exploratory factor analysis confirmed the same two-factor structure found for the original scale, explaining 60.10% of the variance. Such solution was checked by confirmatory factor analysis with Cronbach’s alpha equal to 0.920, 0.810, and 0.884 for the overall scale, the self-care in management of signs and symptoms and the self-care in prevention of complications subscales respectively. The scale has good psychometric properties to assess self-care behaviors and can be used with Brazilian patients on hemodialysis with arteriovenous fistula.

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Effect of Self - Care Program on the Self- Esteem of Multiple Sclerosis Patients

European Psychiatry ◽

10.1016/s0924-9338(09)71173-3 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

H. Madani ◽

H. Navipoor ◽

P. Roozbayani

Keyword(s):

Multiple Sclerosis ◽

Self Care ◽

Care Program ◽

Self Esteem ◽

The Self ◽

Self Report ◽

The Mean ◽

Muscular Spasm ◽

Multiple Sclerosis Patients ◽

Paired T Test

Aims:According to decreased self- esteem in multiple sclerosis (MS) patients, it is necessary to utilize appropriate methods in order to improve self- esteem in MS patients. So this study was conducted on patients with MS supported by the Iranian MS society for determining the effect of self - care program on their self- esteem.Method:In this semi - experimental study 34 patients with MS who were not in the acute phase of disease were selected. The data were collected via personal questionnaires, problem list, Cooper and smith standard questionnaire for self- esteem and self report check lists. Self - care program(self - care for muscular spasm, fatigue, constipation and amnesia and …) was educated, then it was performed for one month period and the data were analyzed using paired t- test, wilcoxon, croscal - wallis and manwithney tests.Results:Application of self - care program improve the self- esteem and reduced some symptoms such as muscular spasm, fatigue, constipation and amnesia in MS patients. The mean valve of self- esteem increased from 54 before performing the program to 68 after the program ( p < 0.05).Conclusion:Using self-care program can be an effective method for improving self- esteem of MS patients.

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

Journal of Holistic Nursing ◽

10.1177/0898010116685655 ◽

2017 ◽

Vol 36 (1) ◽

pp. 79-90 ◽

Cited By ~ 4

Author(s):

Susan Mac Leod Dyess ◽

Angela S. Prestia ◽

Doren-Elyse Marquit ◽

David Newman

Keyword(s):

Mixed Methods ◽

Acute Care ◽

Perceived Stress ◽

Repeated Measures ◽

Self Care ◽

Nurse Leaders ◽

Future Research ◽

Care Practice ◽

Meditation Practice ◽

Significant Drop

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.

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Healthcare pathways and resource use: mapping consequences of ambulance assessment for direct care with alternative healthcare providers

BMC Emergency Medicine ◽

10.1186/s12873-020-00380-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sofi Varg ◽

Veronica Vicente ◽

Maaret Castren ◽

Peter Lindgren ◽

Clas Rehnberg

Keyword(s):

Emergency Department ◽

Acute Care ◽

Resource Use ◽

Healthcare Providers ◽

Healthcare Utilisation ◽

Direct Care ◽

Care Centre ◽

Decision System ◽

Geriatric Ward ◽

Patient Pathways

Abstract Background A decision system in the ambulance allowing alternative pathways to alternate healthcare providers has been developed for older patients in Stockholm, Sweden. However, subsequent healthcare resource use resulting from these pathways has not yet been addressed. The aim of this study was therefore to describe patient pathways, healthcare utilisation and costs following ambulance transportation to alternative healthcare providers. Methods The design of this study was descriptive and observational. Data from a previous RCT, where a decision system in the ambulance enabled alternative healthcare pathways to alternate healthcare providers were linked to register data. The receiving providers were: primary acute care centre or secondary geriatric ward, both located at the same community hospital, or the conventional pathway to the emergency department at an acute hospital. Resource use over 10 days, subsequent to assessment with the decision system, was mapped in terms of healthcare pathways, utilisation and costs for the 98 included cases. Results Almost 90% were transported to the acute care centre or geriatric ward. The vast majority arriving to the geriatric ward stayed there until the end of follow-up or until discharged, whereas patients conveyed to the acute care centre to a large extent were admitted to hospital. The median patient had 6 hospital days, 2 outpatient visits and costed roughly 4000 euros over the 10-day period. Arrival destination geriatric ward indicated the longest hospital stay and the emergency department the shortest. However, the cost for the 10-day period was lower for cases arriving to the geriatric ward than for those arriving to the emergency department. Conclusions The findings support the appropriateness of admittance directly to secondary geriatric care for older adults. However, patients conveyed to the acute care centre ought to be studied in more detail with regards to appropriate level of care.

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