Development of a Readiness for Hospital Discharge assessment tool in Thai patients with stroke

Background: The transition from hospital to home among patients with stroke is quite challenging. If the patients are not ready for hospital discharge, their condition may worsen, which also causes a high rate of readmission. Although instruments to measure readiness for hospital discharge exist, none of them fit with the Thailand context. Objective: This study aimed to develop a Readiness for Hospital Discharge assessment tool in Thai patients with stroke. Methods: The study was conducted from February to September 2020, which consisted of several steps: 1) conducting an extensive literature review, 2) content validity with five experts, 3) pilot testing with 30 samples, and 4) field testing with 348 participants. Content validity index (CVI) was used to measure the content validity, Cronbach’s alpha and inter-item correlation to evaluate reliability, and multiple logistic regression analysis to measure the construct validity. Results: The findings showed good validity and reliability, with I-CVI of 0.85, Cronbach’s alpha of 0.94, and corrected item-total correlation ranging from 0.43 to 0.86. The construct validity was demonstrated through the results of regression analysis showing that the nine variables include level of consciousness (OR = 0.544; CI 95% = 0.311 - 0.951), verbal response (OR = 0.445; 95% CI 0.272- 0.729), motor power right leg (OR = 0.165; 95% CI 0.56- 0.485), visual field (OR = 0.188; 95% CI 0.60-0.587), dysphagia (OR = 0.618; 95% CI 0.410-0.932), mobility (OR = 0.376; 95% CI 0.190 - 0.741), self-feeding (OR = 0.098; 95% CI 0.036 -0.265), bathing (OR = 0.099; 95% CI 0.026-0.378), and bladder control (OR = 0.589; 95% CI 0.355-0.977) that significantly influenced the hospital readmission within 30 days in patients with stroke. Conclusion: The Readiness for Hospital Discharge assessment tool is valid and reliable. Healthcare providers, especially nurses, can use this tool to assess discharge conditions for patients with stroke with greater accuracy in predicting hospital readmission.

Nurse workforce scheduling: A qualitative study of Indonesian nurse managers’ experiences during the COVID-19 pandemic

Background: The increase in COVID-19 cases in Indonesia has resulted in changes in the hospital workflow, including the staffing process and scheduling, especially in the isolation units. Nurse managers are working hard in the scheduling system to ensure high-quality care is provided with the best human resources. Objective: This study aimed to explore the experiences of nurse managers in managing staff nurses’ work schedules during the COVID-19 pandemic. Methods: A qualitative descriptive design was used in this study. Eleven nurse managers from three COVID-19 referral hospitals were selected using purposive sampling. Data were collected using online semi-structured interviews. Thematic analysis was used for data analysis, and data were presented using a thematic tree. Consolidated criteria for reporting qualitative research (COREQ) checklist was used as a reporting guideline of the study. Results: Four themes were developed: (i) Nurse shortage, (ii) Strategically looking for ways to fulfill the workforce, (iii) Change of shift schedule, and (iv) Expecting guidance from superiors and compliance from staff. Conclusion: The lack of nurse staff is a problem during a pandemic. Thus, managing personnel effectively, mobilizing and rotating, and recruiting volunteers are strategies to fulfill the workforce during the pandemic. Using a sedentary shift pattern and sufficient holidays could prevent nurses from falling ill and increase compliance with scheduling. In addition, a staffing calculation formula is needed, and top nursing managers are suggested to provide guidance or direction to the head nurses to reduce confusion in managing the work schedule during the pandemic.

Aesthetics in nursing practice as experienced by nurses in Indonesia: A phenomenological study

Background: While aesthetics in nursing practice brings out the beauty in nursing, studies regarding how aesthetics are implemented in practice are lacking. Objective: To describe the meanings of aesthetics in nursing practice experienced by nurses in Indonesia. Methods: This qualitative study employed a hermeneutic phenomenological approach based on Gadamerian philosophy. Thirteen nurses were asked to reflect on their experiences of providing aesthetics in their practice through drawing, followed by individual face-to-face interviews. Data were collected in a public hospital in West Sumatra, Indonesia. The interview transcripts and the pictures were analysed following van Manen’s approach. Results: Five thematic categories were revealed: 1) Engaging in caring for persons; 2) Full of compassion; 3) Sympathetic place of care; 4) A joyful time of care; and 5) Distracting the inconvenience in care. Conclusion: Aesthetics in nursing practice is understood and experienced by Indonesian nurses in various ways, not only limited to the visual beauty, cleanness or tidiness of nursing intervention, but are expressed in other ways within caring, including providing care with compassion, applying the art of communication, relieving the pain, and applying innovation in care. These findings can be used to inform nurses in practising aesthetic nursing for enhancing the quality of care. Funding: Faculty of Nursing Research Grant, Prince of Songkla University, Thailand.

The influence of workplace stress and coping on depressive symptoms among registered nurses in Bangladesh

Background: Nurses report high levels of workplace stress, which has been linked to an increased risk for experiencing depressive symptoms.Nurses’ workplace stress is also linked to increased absenteeism and decreased job satisfaction. Objectives: The objectives of this study were to examine: (1) the incidence of depressive symptoms among hospital-based registered nurses in Bangladesh; (2) common sources of workplace stress and their relationships to individual characteristics and depressive symptom scores; and (3) the potential mediating roles of coping strategies in the relationship between workplace stress and depressive symptoms. Methods: A cross-sectional study design involved three hundred and fifty-two registered nurses. Data were collected using a demographic questionnaire and three standardized tools measuring sources of nurses’ workplace stress, coping strategies, and depressive symptoms. Results: More than half of the participants scored ≥ 16 on the CES-D, which was associated with a major depression episode. Total NSS scores had a small but significant influence on scores on the depression scale. Coping strategies had no mediated effect on the relationship between workplace stress and scores on the depression scale. Low-reliability coefficients for subscales of two of the standardized tools highlight the challenge for researchers in developing countries to address contextual differences that may influence the meanings attached to individual items. Conclusion: Findings suggest that the mental health of registered nurses in Bangladesh requires immediate attention in part by attending to workplace stressors. Further research should focus on a deeper understanding of Bangladeshi registered nurses’ work experiences and the unique contribution that workplace stressors have on their physical and mental health.

Suicide prevention: A qualitative study with Thai secondary school students

Background: Suicide is the second leading cause of death among adolescents around the globe. Therefore, understanding its causes and prevention is needed. Objective: This study aimed to explore Thai secondary school students’ perceptions related to causes and preventions of suicide and the learning needs of suicide prevention. Methods: A descriptive qualitative approach was employed in this study. Purposive sampling was used to select 32 adolescents for focus group discussions, and in-depth interviews were conducted with ten adolescents from September 2019 to March 2020. Data were analyzed using content analysis. Results: Causes of suicide included seven sub-categories: parents’ expectations of children’s academic achievement, bullying, family problems, teenage love, lack of stress management skill, imitation behavior on social media, and substance use behavior. Suicide prevention consisted of five sub-categories: peer support, parental support, school support, health professionals and significant support, and knowing the value and believing in self. In addition, students’ learning needs had two sub-categories: developing online learning platforms regarding suicide prevention and mental health promotion and prevention projects. Conclusion: The findings of this study could guide nurses and other health professionals to develop a suicide prevention program for secondary school students. The study results could also be used as essential evidence for driving health care policy in promoting and preventing suicide in adolescents with the involvement of key stakeholders. Funding: Funding was provided by the Child and Youth Development Center, Faculty of Education, Chulalongkorn University, and Thai Health Promotion, Thailand

Exploring the issues, practices, and prospects of family planning among married couples in Southern Philippines

Background: Nurses are involved in all aspects of health, including reproductive health. They play a fundamental role in family planning and are often designated as point persons in family planning-related concerns. In order to provide effective counseling on family planning, the nurse must understand issues, practices, and prospects of family planning among married couples in their community. Objective: This exploratory multiple case study investigates family planning issues, practices, and prospects among couples in a municipality located in Southern Philippines. Methods: Ten married couples of varying characteristics were interviewed to elicit their perspectives on family planning practices. The data were analyzed using coding transcriptions and thematic analysis. Results: Five sub-themes emerged under the theme of Family Planning Issues: family planning as a burden; fear of side effects; peer-driven contraceptive choice; family planning as a social stigma; family planning as a sin. Two sub-themes emerged under the theme of Family Planning Practices: knowledge of family planning commodities; availability and acceptance of the contraceptive method. Finally, two sub-themes also emerged under the theme of Family Planning Prospects: family planning as a financially beneficial practice; prospects on family planning depend on husband’s acceptance. Conclusion: These sub-themes were also distinguished by their similarities and differences based on the four parameters identified, including age, sex, financial status, and educational attainment, which aided in the development of recommendations that could be implemented in the local community. The results of this study especially have a bearing on nurses and their role in the family planning process. Nurses play a fundamental role in guiding community members and families toward health and wellness. Thus, it is crucial for nurses to understand family planning issues underpinning their community so they can better exercise their role.

Aging-related Resiliency Theory Development

As a dynamic developmental process, the older population further displays the capacity to resist change over time, improve resilience, and keep a basis for the continuity working and progress over positive management of detrimental consequences of life risks and difficulties. This study aims at developing a theory that endeavors to explore the process of developing aging-related resiliency in people’s later in life that can lead to a successful aging experience. In the development of a theory, this study utilized a deductive reasoning approach specifically, using the axiomatic approach. Aging-related Resiliency Theory was efficaciously developed by three propositions generated from four axioms that were derived after reviewing several sets of literature and studies. This developed theory implies that various deleterious events in life activate older persons to respond, adapt, and recover effectively. Acceptance emerges as they acknowledge the natural effects of aging while taking adaptive strategies and supportive resources to be resilient to one’s environment. In this sense, it impacts their optimistic outlook towards successful aging. Based on the extraction of axioms, such propositions denoted those older adults call to respond with their total capacity to accept, adapt, recover, and continuously resist deleterious life experiences while using enriched coping strategies and resources towards an optimistic outlook in achieving successful aging. Therefore, emphasizing to improve their capacity to respond to natural decline to essential processes could benefit them at promoting a healthier life span.

Greater accountability in nursing handover

Nursing handover exemplifies both the nurse’s professional ethics and the profession’s integrity. The article by Yetti et al. acknowledges the critical role of structure and process in handover implementation. At the same time, they emphasised the fundamental necessity to establish and update handover guidelines. I assert that effective patient handover practices do not simply happen; instead, nurses require pertinent educational support. It is also pivotal to develop greater professional accountability throughout the handover process. The responsibility for ensuring consistent handover quality should be shared between nurse managers and those who do the actual handover practices.

Nursing diagnoses in hospitalized patients with COVID-19 in Indonesia

Background: The COVID-19 pandemic has become a global public health issue, and the roles of nurses are very much needed in providing nursing services in the current situation. The enforcement of appropriate nursing diagnoses for patients with COVID-19 is also fundamental in determining proper nursing care to help the patients achieve maximum health. Objective: This study aimed to describe and analyze nursing diagnoses in patients with COVID-19 treated in the isolation rooms and ICUs. Methods: This study used a secondary data analysis from hospital medical record data of patients with COVID-19 from early December 2020 to the end of February 2021. Data were selected using a cluster random sampling technique and analyzed using descriptive statistics. Results: The results showed that the signs and symptoms of the patients with COVID-19 that often appeared were fever, cough, shortness of breath, and decreased consciousness. The common nursing diagnoses in the hospitalized patients with COVID-19 were hyperthermia, ineffective airway clearance, gas exchange disorder, self-care deficit, spontaneous ventilation disorder, spontaneous circulation disorder, knowledge deficit, and shock risk. Conclusion: This study offers an insight into nursing practices in the hospital setting, which can be used as a basis for nurses to perform complete nursing assessments and nursing diagnoses during the pandemic.

Determinants of latent tuberculosis infection among nurses at public health centers in Indonesia

Background: The incidence of latent tuberculosis among healthcare workers, especially nurses, at public health centers in Indonesia has been increased. Therefore, factors related to the tuberculosis incidence need to be further investigated. Objective: This study aimed to identify the determinants of latent tuberculosis infection among nurses at public health centers in Indonesia. Methods: This non-experimental, cross-sectional study included 98 nurses. Data on the determinants of latent tuberculosis infection were collected using validated questionnaires, and the infection status was confirmed by Interferon Gamma Release Assay or IGRA test. Logistic regression was used for statistical analysis, with a significance level of p < 0.05. Results: Health facilities for tuberculosis transmission prevention were available in all public health centers (100%). Protocols for preventingtuberculosis transmission including occupational health and safety training (OR = 13.24, 95% CI [2.29–58.55]; p = 0.001), handwashing after contact with patients or specimens (OR = 20.55, 95% CI [4.23–99.93]; p = 0.000), and wearing of medical masks (OR = 9.56, 95% CI [1.99–45.69];p = 0.005) were found to be significant determinants of latent tuberculosis infection among nurses. Conclusion: The availability of protective equipment and implementation of health protocols among nurses at public health centers are the main determinants of latent tuberculosis infection. Hence, they should be maintained by all nurses to prevent the spread of tuberculosis. Funding: This study was funded by the Ministry of Research, Technology, and Higher Education (DRPM), Republic of Indonesia (Basic Research Grant, No 257-11/UN7.P4.3/PP/2019 in 2019).