Search

Patients with end stage renal failure require dialysis and strict adherence to treatment plans to sustain life. However, non-adherence is a common and serious problem among patients with chronic kidney disease. There is a scarcity of studies in examining the effects of disease management programmes on patients with chronic kidney disease.This paper examines whether the study group receiving the disease management programme have better improvement than the control group, comparing outcomes at baseline (O1), at 7 weeks at the completion of the programme (O2) and at 13 weeks (O3).This is a randomized controlled trial. The outcome measures were non-adherence in diet, fluid, dialysis and medication, quality of life, satisfaction, symptom control, complication control and health service utilisation.There was no significant difference between the control and study group for the baseline measures, except for sleep. Significant differences (p0.05) were found between the control and study group at O2 in the outcome measures of diet degree non-adherence, sleep, symptom, staff encouragement, overall health and satisfaction. Sustained effects at O3 were noted in the outcome measures of continuous ambulatory peritoneal dialysis (CAPD) non-adherence degree, sleep, symptom, and effect of kidney disease.Many studies exploring chronic disease management have neglected the group with end stage renal failure and this study fills this gap. This study has employed an innovative model of skill mix using specialist and general nurses and demonstrated patient improvement in diet non-adherence, CAPD non-adherence, aspects of quality of life and satisfaction with care. Redesigning chronic disease management programmes helps to optimize the use of different levels of skills and resources to bring about positive outcomes.

Background The significance of effective interpersonal communication in healthcare is well established, as is the importance of overcoming language barriers. This has a particular bearing for minority language speakers, where denying language choice can compromise the quality of healthcare provision. Nevertheless, there is limited empirical research exploring language awareness in healthcare and the factors that influence language choice for minority language speakers. Objectives This paper reports on the nurses, midwives and health visitors (NMHV) data set of the first phase of a large-scale national study, commissioned by the Welsh Assembly Government, to examine the nature and extent of Welsh language awareness amongst healthcare professionals in Wales, UK. Design The study involved a questionnaire survey of healthcare professionals working in the public, private and voluntary sectors of healthcare. Participants A stratified random sample of 3358 healthcare professionals was surveyed, of which 1842 (55%) were nurses, midwives and health visitors. The researcher-designed self-administered questionnaire was distributed by post to participants between July and September 2003. A total of 1042 (57%) NMHV returned their questionnaires for analysis. Results A strong positive correlation is identified between the NMHV use of the Welsh language in practice and their Welsh language proficiency ( p . 01 ); language attitudes ( p . 01 ); and language region ( p . 01 ). Mean language attitude scores are more positive than expected, particularly amongst those with limited Welsh language proficiency and those working in regions with the lowest proportions of Welsh speakers. Conclusions In view of the universal drive for culturally and linguistically appropriate healthcare practice, the findings have important implications for bilingual and multilingual healthcare settings worldwide. The evidence emerging from this survey confirms that cross-cultural communication is enhanced by NMHV language attitudes as well as their proficiency levels. Language awareness training is therefore recommended as a way of enhancing care delivery for minority language speakers.

Infection is an acknowledged hospital problem. Micro-organisms are disseminated mainly via hands but there is evidence that hand decontamination, the most important means of prevention, is performed too seldom, and not always after activities likely to result in heavy contamination. Nurses themselves are exposed to risks of infection, chiefly through contact with blood and body fluids, yet it has also been reported that gloves are not always worn during contact with patients' secretions and that the handling and disposal of sharp instruments may be performed unsafely. The study reported in this paper documents nursing behaviour in relation to hand decontamination, the use of gloves and sharps, taking into consideration a number of variables which could influence practice: availability of the expertise afforded by an infection-control nurse, clinical setting, nursing workload, knowledge and the resources available to control infection. Hands were decontaminated after 28.78% of patient contacts. Hands were decontaminated after 49.85% of activities likely to result in heavy contamination. Performance was related to nursing workload and the availability of hand decontaminating agents, especially when the nurses became busy. Use of gloves when they were available also proved good, with little evidence of wasteful use. The handling and disposal of sharps were commendable for most subjects but a few grossly unsafe incidents were nevertheless witnessed, apparently not associated with any of the variables examined.

Background The effect of emotional intelligence and its dimensions on job satisfaction and organisational commitment of nurses has been investigated in this study. Objectives This paper examines the relations among emotional intelligence, job satisfaction and organisational commitment of nurses and the mediating effect of job satisfaction between emotional intelligence and organisational commitment. Design A questionnaire survey was carried out to explore the relations between emotional intelligence, job satisfaction and organisational commitment. Setting Teaching hospital in Ankara, Turkey. Participants Questionnaires were distributed by Nursing Services Administration to 550 nurses working at different departments of the hospital and 267 questionnaires were analyzed. Methods A 45-item questionnaire which consists of emotional intelligence, job satisfaction and organisational commitment parts was carried out to investigate the relations among these variables. Some basic socio-demographic questions were included. Results Emotional intelligence was significantly and positively related to job satisfaction \( r = 0.236 , p ≤ 0.01 \) and organisational commitment \( r = 0.229 , p ≤ 0.01 \) . The positive relation between job satisfaction and organisational commitment was also significant \( r = 0.667 , p ≤ 0.01 \) . Job satisfaction was found to be related with "regulation of emotion (ROE)" \( r = 0.228 , p ≤ 0.01 \) and "use of emotion (UOE)" \( r = 0.155 , p ≤ 0.01 \) but not with other dimensions of emotional intelligence. "Others's emotional appraisal" did not have any relations with job satisfaction or organisational commitment and "self-emotional appraisal (SEA)" was found to be a suppressor. Conclusion It was found that job satisfaction is a mediator between emotional intelligence and organisational commitment. The other finding of the study was that "SEA" and "UOE" have direct effects on organisational commitment whereas job satisfaction is a mediator between "regulation of emotion" and organisational commitment.

Background Patients with chronic heart failure have a reduced quality of life due in part to their limited range of physical activity and independence. Objectives The paper examines whether a physical activity ‘lifestyle’ intervention, based on motivational interviewing, will improve quality of life at five months from baseline, compared with conventional treatment. Methods Sixty older patients with chronic heart failure were randomly assigned to either a ‘standard care’, ‘motivational interviewing’ or ‘both’ treatment groups for five months in 2002. The primary outcome measures were the Medical Outcomes Short Form-36 Health Survey, the disease-specific Minnesota Living with Heart Failure questionnaire and the Motivation Readiness for Physical Activity scale. Results There were non-significant differences between the groups at baseline for age, coronary risk factors, severity of chronic heart failure, ejection fraction, specific laboratory tests, length of hospitalisation, medication and social support. Following treatment there was a significant increase (p

The study reported in this paper describes the estimation of a causal model of job satisfaction. This study's sample consists of 353 nurses from two general hospitals in the cities of Seoul and Taegu, Korea. Data were collected from self-administered questionnaires and analyzed with LISREL. The results showed that four structural variables (workload, supervisory support, routinization, and pay), two psychological variables (positive and negative affectivity), and one environmental variable (job opportunity) had a significant net effect on hospital nurses' job satisfaction. The explained variance for job satisfaction is 53.0%. The implications of these findings were discussed and suggestions for future research were advanced.