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Quarterly published in print and online "Inventi Impact: Advanced Nursing" publishes high quality unpublished as well as high impact pre-published research and reviews catering to the needs of researchers and professionals. The journal focuses on overall nursing care, especially that of under intensive or tertiary care settings. It welcomes articles from across the professional domain including the ones dealing with the cultural, geographic and demographic aspects of nursing.
Background: At the time of this study (2009) the role of the nurse practitioner was new to the province of British\r\nColumbia. The provincial government gave the responsibility for implementing the role to health authorities.\r\nManagers of health authorities, many of whom were unfamiliar with the role, were responsible for identifying the\r\nneed for the NP role, determining how the NP would function, and gaining team membersÃ¢â?¬â?¢ acceptance for the\r\nnew role.\r\nMethod: The purpose of the study was to explain the process of nurse practitioner role implementation as it was\r\noccurring and to identify factors that could enhance the implementation process. An explanatory, single case study\r\nwith embedded units of analysis was used. The technique of explanation building was used in data analysis. Three\r\nprimary health care settings in one health authority in British Columbia were purposively selected. Data sources\r\nincluded semi-structured interviews with participants (n=16) and key documents.\r\nResults: The results demonstrate the complexity of implementing a new role in settings unfamiliar with it. The\r\nfindings suggest that early in the implementation process and after the nurse practitioner was hired, team\r\nmembers needed to clarify intentions for the role and they looked to senior health authority managers for\r\nassistance. Acceptance of the nurse practitioner was facilitated by team membersÃ¢â?¬â?¢ prior knowledge of either the\r\nrole or the individual nurse practitioner. Community health care providers needed to be involved in the\r\nimplementation process and their acceptance developed as they gained knowledge and understanding of the role.\r\nConclusion: The findings suggest that the interconnectedness of the concepts of intention, involvement and\r\nacceptance influences the implementation process and how the nurse practitioner is able to function in the setting.\r\nWithout any one of the three concepts not only is implementation difficult, but it is also challenging for the nurse\r\npractitioner to fulfill role expectations. Implications for research, policy, practice and education are discussed....
Refugee families face a complex transition due to the nature of involuntary migration and the process of acculturation. There\r\nare several risk factors to the family adaptation process during the transition period, which are sociocontextually environmental\r\ndependant. Facilitating a healthy transition for refugee families, therefore, requires the role of nursing to incorporate sociopolitics\r\ninto the discipline. This paper introduces a sociopolitically oriented and community-driven assessment and intervention model\r\nwhich is based on a family systematic approach. Interventions that aid the families in their acculturation process as well as\r\nempowers them to a well-functioning daily life, as per the SARFI model, should be adopted. As such, the future of nursing may\r\nprovide additional primary health care services for refugee families; this is through a team-led Ã¢â?¬Å?family nurseÃ¢â?¬Â who provides quality\r\ncare for the family unit in collaboration with other health care professionals and societal authorities....
Diabetes mellitus, a systemic disease caused by imbalance between insulin supply and insulin demand is a common chronic disease requiring lifelong behavioural and life style change. The research was carried out to assess the correlation between hypoglycemia fear and self-care ability of patients with type II diabetes mellitus on insulin therapy. A descriptive co-relational research design was used to assess the hypoglycemia fear and self-care ability among 150 patients with type II diabetes mellitus on insulin therapy in selected hospitals at Mangalore. Purposive sampling technique was used to collect the sample for study. The data was collected by using rating scales. In the self-care inventory scale 41.33% of subjects scored between 36-40 and 59.33% of subjects scored between 71-80 in hypoglycemia fear survey. There was a significant association between the hypoglycemia fear with demographic characteristics of age (p = 0.769), type of treatment (p = 0.034), educational status (p = 0.037), type of family (p = 0.203), place of residence (p = 0.244), religion (p = 0.923), income of the family (p = 0.997), habit of alcohol intake (p = 0.335) and duration of diabetic mellitus (p = 0.029). The study also found that there was a positive and significant correlation between the hypoglycemia fear and self-care ability (r(148) = 0.032; p<0.05). The findings of the study concluded that when self-care ability increases, the hypoglycemia fear also increases....
The study defines a correlational observation to assess the knowledge and attitude about consuming fatty diet and blood cholesterol level among adults. Tools used for assessment are Socio demographic data of the adults, Structured questionnaire to assess the levels of knowledge among adults, Rating scale (five point Likert) to assess the levels of attitude among adults. Sample of the study comprised of 60 adults in Mahalakshmi Layout Bangalore. Observations revealed that 31 (51.66%) had moderate level of knowledge about consuming fatty diet and blood cholesterol whereas 21 (35%) of respondents had adequate level of knowledge and 8 (13.3%) of the respondents had inadequate level of knowledge about consuming fatty diet and blood cholesterol and Regarding attitude level majority of the respondents 45 (75%) have moderate level of attitude about consuming fatty diet and blood cholesterol whereas 11 (18.3%) of respondents have unfavorable attitude and 4 (6.66%) of the respondents have most favorable attitude towards consuming fatty diet and blood cholesterol. The tool used for the study is reliable and feasible....
Nursing presence, although it involves action at times, is a humanitarian quality\nof relating to a patient that is known to have powerful and positive implications for both\nnurse and patient. However, this phenomenon has not been well understood. Three\ntheories, drawn from the work of Paul Ricoeur and Hans-Georg Gadamer, served as the\nboundaries for both data collection and analysis. The theories were narrative identity, play\nand solicitude. This study follows a critical hermeneutic approach to field research and\ndata analysis. Literature regarding nursing presence is reviewed and discussed, and\nin-depth conversations with eleven participants are recorded. Examining the phenomenon\nof nursing presence through the hermeneutic lenses of narrative identity, play and solicitude\nhas elucidated the role of ethical orientation, creativity and connection with the human\nexperience through exploration of self and other. This more nuanced and complex\nunderstanding adds depth to the conversation and offers new possibilities to the effort to\nencourage and support presence in nursing practice....
Background: The deficits in the self-care of older people are often associated with a loss of autonomy and\nif care is not provided in the home environment by relatives or professional caregivers, then the self-care\ndeficits may result in the admission to a residential care facility (RCF). On the other hand, in industrialized\ncountries, the recruitment and long-term retention of professional caregivers are becoming increasingly\ndifficult. Technical aids such as sensor technology (SeTe) could solve this dilemma and improve the\nautonomy, the quality of life, and the safety of the residents.\nObjectives: To analyze the nursing problems targeted in the studies, where was the SeTe used, and why has\nit been chosen, the technical limitations of SeTe and whether the studies contain ethical considerations.\nDesign: This review followed the Cochrane Collaboration methods for systematic reviewing. The databases\nEBSCOhost (which includes CINAHL, MEDLINE, and PsycINFO), Web of Science, Cochrane Library, and\nGoogle Scholar were searched.\nMethods: This critical systematic review analyzes publications on SeTe if the nursing problems referred\nto by scientists have been in connection with residents of RCFs. Studies that focused on participants in\nhospitals and home environments or those using gaming consoles or medical applications were excluded.\nResults: Of the 49 studies included, 31% used only accelerometers, 20% used cameras, and 29% combined\nvarious types of SeTe devices. The use of various SeTe was beneficial, possibly because the more perspective\ndata are combined. 51% preferred non-wearable SeTe devices, Ã¢â?¦â? preferred the permanent surveillance by\nSeTe devices. The nursing problems which the research teams concentrated on were fall risk, immobility,\nagitation and sleep problems. Only Ã?Â¼ of the studies mention current or potential ethical considerations\nregarding the surveillance of residents by SeTe devices.\nConclusion: It is gratifying that the international interest in researching SeTe in RCFs has increased.\nEthical dilemmas were hardly discussed. The future use of SeTe in RCFs is certainly desirable and\nunavoidable, but consulting the residents, professional caregivers, and nursing scientists about their\nrequirements for useful and necessary technical surveillance first seems usefull.\nRelevance to Clinical Practice: Currently RCFs should continue to use the SeTe cautiously. Professional\ncaregivers in RCFs should be able to convey the growing self-image of nursing into similar SeTe research\nprojects....
Background: The rapid development in big data analytics and the data-rich environment of intensive care units\ntogether provide unprecedented opportunities for medical breakthroughs in the field of critical care. We developed\nand validated a machine learning-based model, the Pediatric Risk of Mortality Prediction Tool (PROMPT), for realtime\nprediction of all-cause mortality in pediatric intensive care units.\nMethods: Utilizing two separate retrospective observational cohorts, we conducted model development and\nvalidation using a machine learning algorithm with a convolutional neural network. The development cohort\ncomprised 1445 pediatric patients with 1977 medical encounters admitted to intensive care units from January\n2011 to December 2017 at Severance Hospital (Seoul, Korea). The validation cohort included 278 patients with 364\nmedical encounters admitted to the pediatric intensive care unit from January 2016 to November 2017 at Samsung\nMedical Center.\nResults: Using seven vital signs, along with patient age and body weight on intensive care unit admission, PROMPT\nachieved an area under the receiver operating characteristic curve in the range of 0.89-0.97 for mortality prediction\n6 to 60 h prior to death. Our results demonstrated that PROMPT provided high sensitivity with specificity and\noutperformed the conventional severity scoring system, the Pediatric Index of Mortality, in predictive ability. Model\nperformance was indistinguishable between the development and validation cohorts.\nConclusions: PROMPT is a deep model-based, data-driven early warning score tool that can predict mortality in\ncritically ill children and may be useful for the timely identification of deteriorating patients....
Background. Native Americans disproportionately experience adverse childhood experiences (ACEs) as well as health disparities,\r\nincluding high rates of posttraumatic stress, depression, and substance abuse.Many ACEs have been linked to methylation changes\r\nin genes that regulate the stress response, suggesting that these molecular changes may underlie the risk for psychiatric disorders\r\nrelated to ACEs. Methods.We reviewed published studies to provide evidence that ACE-related methylation changes contribute to\r\nhealth disparities in Native Americans. This frameworkmay be adapted to understand how ACEs may result in health disparities in\r\nother racial/ethnic groups. Findings. Here we provide evidence that links ACEs to methylation differences in genes that regulate the\r\nstress response. Psychiatric disorders are also associated withmethylation differences in endocrine, immune, and neurotransmitter\r\ngenes that serve to regulate the stress response and are linked to psychiatric symptoms and medical morbidity.We provide evidence\r\nlinking ACEs to these epigenetic modifications, suggesting that ACEs contribute to the vulnerability for developing psychiatric\r\ndisorders in Native Americans. Conclusion. Additional studies are needed to better understand how ACEs contribute to health and\r\nwell-being. These studies may inform future interventions to address these serious risks and promote the health and well-being of\r\nNative Americans....
Background: Shortcomings in elderly care have been reported in many parts of the world, including Sweden.\nHowever, national guidelines for elderly care have been introduced in Sweden, which contain core values and local\nguarantees of dignity. These highlight the need for dignity and well-being, and organising the older personÃ¢â?¬â?¢s daily\nlife so that they perceive it as meaningful. Therefore, the aim of the present study was to describe older personsÃ¢â?¬â?¢\nexperience and knowledge about obstacles, opportunities and solutions to developing a meaningful daily life for\nthose living in nursing homes.\nMethods: This study combined the Participatory Appreciative Action Reflection (PAAR) and hermeneutic\napproaches. Twenty-five older persons participated and persons with dementia or cognitive impairments were\nincluded. Repeated interviews were carried out as reflective conversations, leaving 50 interviews in total, wherein\nthe older persons provided their analyses and reflections on a meaningful daily life. Finally, an analysis of the data\nwas completed based on a life-world hermeneutic approach.\nResults: We identified five tentative interpretations that describe obstacles, opportunities and solutions for a\nmeaningful daily life. Themes 2 and 4 outline obstacles for a meaningful daily life, and Themes 1, 3 and 5 describe\nopportunities and solutions for a meaningful daily life: (1) Having space to be yourself; (2) No space to be yourself;\n(3) Belonging and security; (4) A feeling of insecurity; and (5) Longing for something to happen. In the main\ninterpretation, we found that the five tentative interpretations are related to TuanÃ¢â?¬â?¢s concepts of space and place,\nwhere place can be described as security and stableness, and space as freedom and openness.\nConclusions: The reciprocal relationship is a solution for a meaningful daily life and occurs in the interaction\nbetween staff and older persons in nursing homes. It is the balance of power, and constitutes a place of shelter\nand a space of freedom for a meaningful daily life. The older person must have balance between shelter and\nfreedom to have a meaningful daily life....
Objective: Critical care nurses work in a challenging intensive care (ICU)
environment that results in work-related psychological distress. Our objective
was to pilot an in-person or virtual mindfulness-based cognitive therapy
(MBCT) program enhanced resilience and a similarly designed attention control
group. Methods: We randomized ICU nurses with symptoms of burnout
syndrome and decreased resilience to an MBCT program or a similarly formatted
book club control. Our primary outcome was change in resilience as
measured by the Connor-Davidson Resilience Scale (CD-RISC). Results: Onehundred
one nurses completed study-related procedures. Overall, 70% had
baseline symptoms of anxiety and 26% had symptoms of depression. For the
in-person cohorts, there was no statistical difference between intervention
and control groups regarding the total number of sessions attended (3.85 days
± 1.4 versus 3.75 days ± 0.15; p = 0.64). Using the Client/Patient Satisfaction
Questionnaire-8 (CSQ-8), satisfaction scores were higher in the intervention
group for weeks two through four of the program: p = 0.03, 0.0003, 0.007 respectively.
There was no difference in the change in CD-RISC scores between
the two groups (mean difference: treatment = 5.0, control = 7.0; p = 0.30).
The online intervention cohort had greater improvements in the change of their median emotional exhaustion burnout scores when compared to the inperson
intervention cohorts (−5 [−8 to −1.5] vs. 2 [−5 to 8], p = 0.049).
Conclusions: We developed a feasible and acceptable in-person and online
MBCT-ICU intervention that did not increase resilience scores in ICU nurses
when compared to an attention control group. These results could help guide
the proper design of larger trials to determine the efficacy of other resilience
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