Converting threats from COVID-19 in long term care into opportunities for improvement

The effects of the COVID-19 pandemic on long term care (LTC) have been published in the literature and experienced by residents, their support persons and nursing staff. The morbidity and mortality, as well as the threats of isolation and psychosocial distress continue. Both LTC residents and staff experience physiological and psychological impacts. Nurses can use the current threats produced by the pandemic to advocate for alternate models of care and reduced isolation for residents. The pandemic is an opportunity for nursing advocacy in LTC for shared governance and empowerment, involvement in policy development, and oversight in policy implementation. Nurses are presented with the opportunities for advocacy related to resources and reshaping the paradigm of residential care for older adults.

Perceptions, beliefs and societal factors impacting on exclusive breastfeeding of primiparous mothers: An exploratory study

This study aims to explore the perceptions of Omani primiparous mothers towards exclusive breastfeeding. A qualitative exploratory study was conducted at Royal Hospital between March and November 2020. Purposive sampling was applied to recruit newly delivered mothers and face to face interview was done for data collection. Interview protocol along with prompts was used to guide researchers during the interview. Specific questions were administered to assess mothers’ knowledge of exclusive breastfeeding, sources of information, influencing factors toward exclusive breastfeeding and intention to exclusively breastfeeding. Thematic analysis revealed six themes, namely: the effects of lack of knowledge on the mother perception towards exclusive BF, family members influencing the decision-making process regarding BF, impact of social life on BF practices, the effect of mother’s beliefs on exclusive BF, factor that affect BF practice in early days, mother’s concern regarding emotional support for successful exclusive BF. This study revealed a lack of basic knowledge on exclusive breastfeeding among mothers. Moreover, grandmothers and husbands were found to be the most influential family members on the decision regarding exclusive breastfeeding. Mothers had major concerns regarding milk adequacy in the first few days after delivery and emotional support plays a major role in encouraging exclusive breastfeeding.

Effect of implementing epilepsy educational guidelines on nurses’ performance and patients’ outcomes

Objective: Epilepsy is considered one of the most common neurological diseases affecting 65 people worldwide. People with epilepsy are more likely to get injured and die prematurely than the general population. Nurses must acquire professional knowledge related to epilepsy and should strengthen patients to play a more active role in their care to improve their understanding of their diseases. The study aimed to evaluate implementing epilepsy educational guidelines on nurses’ performance and patients’ outcomes.Methods: A quasi-experimental research design was conducted at the Neurology department in Mansoura University Hospital. This study sample is a convenient sample of 28 nurses and a purposive sample of 60 adult patients with epilepsy who attend the neurological department in Mansoura University Hospital.Results: The results indicate a significant improvement in nurses’ knowledge and practice regarding epilepsy. Also, it helped to improve patients’ knowledge and thus promoted epilepsy self-management behaviors in the study group.Conclusions: The designed nursing guidelines have achieved their objectives by improving nurses’ knowledge and practice regarding epileptic patient care, in addition to improving patients’ knowledge and epilepsy self-management scale for the study group compared with the control group.

Nursing and medical students’ perceptions of interprofessional education and social interactions: A qualitative study

Objective: Interprofessional education (IPE) is becoming increasingly popular and highly recommended for inclusion in curricula for healthcare professionals. Implementing IPE may improve students’ knowledge, skills, and attitudes toward collaborative teamwork, thereby improving health services and health outcomes for patients. This work aimed to explore nursing and medical students’ perceptions of IPE and social interactions.Methods: A qualitative study was conducted using a purposive sample of eight nursing and medical students. Data were collected via two semi-structured focus-group sessions and were analyzed using inductive thematic analysis.Results: Five main themes and seven subthemes emerged. The main themes were (1) IPE meaning, (2) IPE barriers, (3) IPE facilitators, (4) social interactions, and (5) bridging gaps in students’ perspectives. We found that students from both schools had a clear understanding of the definition and importance of IPE. Students reported that lack of interaction is an issue that they have never attempted to address. Students highlighted that IPE enhances IP collaboration and teamwork.Conclusions: Teaching students about IP communication and professional roles and involving students in joint sessions prepare them for a promising future of high-quality patient care.

Meaning of the family and family communication — Experiences of Hikikomoris

The originally Japanese phenomenon of hikikomori, or being socially withdrawn, has been identified in several countries across the world. This qualitative study describes meanings ascribed by self-defined hikikomoris to family and family communication. The study aims at producing knowledge that can be used by professionals in education, health care and social services to support and counsel the socially withdrawn individuals. The data were collected in May 2020 from an anonymous forum for self-defined hikikomoris or socially withdrawn people in Finland. Inductive content analysis was used to analyze the data. The socially withdrawn people had both positive and negative experiences associated with their families. Some of the hikikomoris appreciated the support and encouragement from their families, while others associated their failures in life with poor family dynamics, abusive experiences and lack of communication in the family. Counseling and support are required to improve interaction, dialogue and other aspects of family dynamics.

Empowerment perception and health-related quality of life among schizophrenic patients

Objective: The study aims to explore the perception of empowerment, HRQoL and their relationship in schizophrenia patients in rehabilitation ward.Methods: Cross-sectional correlational design and convenience sampling were used to recruit 102 subjects from rehabilitation wards of a psychiatric hospital in southern Taiwan. Three instruments were used: the Brief Psychiatric Rating Scale, the Empowerment Scale (subscales: self-esteem and self-efficacy, power-powerlessness, righteous anger, and community autonomy), and the Taiwanese version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) with four domains (physical health, psychological, social relationship, and environment).Results: (1) Overall empowerment perception and overall HRQoL were at a moderate and above level in patients with schizophrenia in rehabilitation ward. (2) Older patients having a lower empowerment perception with power-powerlessness than youngers; the more severe the psychiatric symptoms, the lower the righteous anger. (3) Male patients scored higher than female patients on overall HRQoL and “environment” domain. The duration of mental illness also influenced at “environment” domain, 6-10 years group scored higher than ≤ 5 years group. (4) Actively participate in rehabilitation activities correlated positively; psychiatric symptoms correlated negatively with overall HRQoL and with each individual domain. (5) Empowerment perception correlated positively with overall HRQoL and with each individual domain.Conclusions: Mental health workers should assist chronic schizophrenic patients in coping with their psychiatric symptoms, allow patients to express negative emotions, and provide opportunities for patients to make their own decisions and exercise their own rights.

Quality of life in patients with mild acute brain injury and their carers’ needs in Greece

Background: Investigating quality of life (QoL) is of crucial importance for the scientific community as it could function not only as an indicator of prognosis and post-traumatic clinical and psychological changes in patients who have suffered from acute brain injury (ABI), but also as an indicator of the effectiveness of their treatment and social rehabilitation. In addition, it can highlight changes in the carer’s health, social life and well-being. This study examined the QoL of patients following ABI and the needs of their carers.Material and methodology: This study was conducted in patients suffering from ABI, who were admitted to the General Hospital of Attica “KAT” and to the National Rehabilitation Center and on their carers. Data collection including demographics and Quality of Life After Brain Injury Questionnaire (QOLIBRI) and the Family Needs Questionnaire (FNQ) was performed during patients’ rehabilitation, while six months after release, a follow-up survey was conducted using the same questionnaires. Statistical analysis of data was performed using SPSS.Results: We analysed 50 patients with mild ABI (GCS ≥ of 13/15) during rehabilitation and six months after release and found that their QoL improves and is positively related to improvement of health status (i.e. in terms of thinking ability, QoL improves from r = 2.33, p < .01 to r = 3.37, p < .001). We also found that “Age” has the greatest impact on the patient’s progress for recovery and the general QoL after ABI (r = -0.423, p < .01). In addition, it was found that carers of patients with ABI are confronted with the burden of care, while they record both fulfilled and unmet needs regarding their individual needs (i.e. only for 30% of the sample the need for help in preparing them for the worst is met).Conclusions: Our study confirms previous findings that underline that ABI has a major impact on QoL of both patients and their carers providing them with long-term daily care. Although it has been found that over time there is an improvement in the QoL of patients with ABI, the absence of an official support network for carers from public health system, hospitals and rehabilitation centers may adversely affect the QoL of patients and their carers. Therefore, more structured, long-term family-wide monitoring and support is needed, focusing on identifying those at risk of social isolation and incomplete social networking.

Prevalence of unintended pregnancy and associated factors among pregnant women attending antenatal clinics

Objective: Unintended pregnancy is an important worldwide public health problem and one of the important factors contributing to high level of maternal and child morbidity and mortality. The study was aimed to assess the prevalence and associated factors of unintended pregnancy among pregnant women attending antenatal clinics.Methods: The study followed a descriptive cross-sectional design on 1,254 pregnant women who were chosen by convenient sample technique. The study was done at governmental hospitals in EL-Mansoura City, Egypt including: The antenatal clinics of Obstetric and Gynecological specialty Center at EL-Mansoura University Hospitals, Old General Hospital and Mansoura International Hospital. Two tools were utilized for data collection (The Urdu version of pregnancy intention scale (LMUP) and structured Interviewing Questionnaire.Results: The prevalence of unintended pregnancy among studied women was (29.1%), of which 229 (18.3%) were mistimed and 136 (10.8%) were unwanted. Age, higher family size, lower family income, gravidity, parity, increased number of children and birth spacing were significantly associated with unintended pregnancy.Conclusions: The study concluded that the prevalence of unintended pregnancy was high in El-Mansoura city. It is recommended to develop educational programs and campaigns especially for rural areas to improve awareness regarding family planning and other co-factors associated with unintended pregnancy.

Effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes

Background: Gestational Diabetes Mellitus (GDM) is one of the most common medical health problems that may happen during pregnancy and may lead to a range of short and long-term maternal, fetal as well as neonatal complications. However, effective management and education on GDM self-care measures improve pregnancy outcomes for both women and their neonates.Aim: The study was carried out to evaluate the effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes.Methods: A quasi-experimental research design was used at Antenatal Clinic of Obstetric and Gynecological Specialty Center at Mansoura University Hospitals, Mansoura city. A purposive sample of 126 pregnant women diagnosed with GDM, assigned to the intervention group (n = 63) who utilized the Gestational Diabetes Mellitus Guideline (GDMG) of care in addition to routine antenatal care and control group (n = 63) who followed routine antenatal care only. Tools: Three tools were used to collect data from participants as A structured interview schedule, maternal assessment record and fetal & neonatal assessment record.Results: The current study findings indicated that, there was a highly statistical significant reduction of body mass index and the mean random blood glucose levels at 34 & 37 weeks’ of pregnancy after intervention in the GDMG group than control groups (p < .001). Also, there was a statistical significant reduction in the occurrence of maternal complications as gestational hypertension, preeclampsia, preterm labor and polyhydramnios in the GDMG group .Similarly, the neonates of the GDMG group had better Apgar scores after birth & lower incidence for developing neonatal complications as prematurity, respiratory distress syndrome and NICU admission.Conclusions and Recommendations: This study showed that, pregnant women with GDM who utilized the GDMG had better maternal & neonatal outcomes than those who did not utilize it. It is recommended to provide a manual GDMG to all pregnant women with GDM for better lifestyle changes & maintaining self-management regimen as well as better pregnancy outcomes.

Situational awareness in the identification of abuse – Out-of-hospital emergency care providers’ experiences

This qualitative study describes out-of-hospital emergency care providers’ experiences and views of situational awareness (SA) in the identification of abuse, including observations that led them to suspect abuse. Nine prehospital emergency care providers and three community paramedics were interviewed based on preselected themes. The data was analyzed using inductive content analysis. According to the results, emergency care providers’ self-defined situational awareness consisted of cognitive competence (logical reasoning and detection of cause-effect relationships); emotional competence (empathy and emotional intelligence); social competence (interaction skills and assessment of family dynamics), and experiential knowledge. Indicators of abuse involved the overall situation; the client’s physical condition; the client’s mental condition; the context and circumstances, and the logic in client reports. Although situational awareness develops with work experience, it is advisable for educators to include a wide range of cognitive, emotional and social skills in the initial and continuing education of emergency care professionals. These skills can be practiced using multi-professional simulation-based education.