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Aims and Objectives: The purpose of this empirical study was to explore the current status and associated factors of lymphedema self‐management behaviours among Chinese breast cancer survivors. Background: Breast cancer‐related lymphedema is a lifetime concern for survivors and is currently incurable. Lifetime lymphedema self‐management takes a significant role in preventing development and progression of lymphedema. Understanding influencing factors of lymphedema self‐management behaviours can help to develop targeted intervention programs. Design: A multicentre cross‐sectional study. Methods: From December 2021 to April 2022, a convenience sample of 586 participants were recruited at four tertiary hospitals in four cities in China. Self‐reported questionnaires were used to measure socio‐demographic characteristics, disease‐and treatment‐related characteristics, lymphedema self‐management behaviours, lymphedema knowledge, illness perception, self‐efficacy, self‐regulation and social support. Descriptive analysis, bivariate analysis and hierarchical multiple regression were conducted. This study was registered at Chinese Clinical Trial Registry (ChiCTR2200057084), and was reported followed the STROBE checklist. Results: Breast cancer survivors reported moderate level of lymphedema self‐management behaviours. Promotion of lymph reflux management was ranked the least performed self‐management behaviours, while the affected limb protection management ranked the most. 36.2% of self‐management behaviours was explained by exercise regularly, level of attention on lymphedema prevention, unclear about the tumour stage (vs. stage I), knowledge, self‐efficacy, emotional illness representation and social support. Conclusions: Lymphedema self‐management behaviours of breast cancer survivors was insufficient. Performance of lymphedema self‐management varied with different socio‐demographic characteristics, along with different levels of knowledge, self‐efficacy, perception and social support. All these identified predictors should be reckoned in assessment and intervention of lymphedema self‐management behaviours. Relevance To Clinical Practice: This study addressed that breast cancer survivors' lymphedema self‐management behaviours should be promoted. Focusing on identified predictors, further lymphedema surveillance, knowledge education or social facilitation programs are recommended to enhance their self‐management performance and adherence. [ABSTRACT FROM AUTHOR]

Background: Spasticity is a frequent symptom of multiple sclerosis (MS), which may negatively influence daily living activities (ADL). Objectives: To (1) explore the feasibility to conduct a structured interview by specialist nurses about limitations in ADL; (2) determine the percentage of people with MS (PwMS) with limitations in ADL related to spasticity; (3) to assess the knowledge about spasticity and describe its clinical features. Design: Observational, cross‐sectional, multicentre study in 16 MS units of Catalonia (Spain). Participants were recruited from the outpatient facility and day‐care hospital between July 2018 and June 2019 and met the following criteria: (1) age 18 or older, (2) diagnosis of MS according to McDonald criteria 2010 and (3) no clinical relapse in previous 30 days. Methods: Specialist nurses conducted a structured interview divided in two parts: the assessment of (1) limitations in the ADL and (2) the presence of spasticity and associated symptoms. The usefulness of this intervention was requested. This study met the STROBE reporting guidelines checklist for observational studies. Results: Three hundred sixty eight pwMS (244 women) with a mean age of 46 years and a median Expanded Disability Status Scale score of 2.5 (range, 0–8.5) were included. 262 (71%) pwMS had limitations in the ADL, and spasticity was reported as the most limiting symptom in 59 (23%). As a result of the interview, spasticity was observed in 199 (76%) participants; 47 (24%) of them were unaware that they had spasticity and 102 (51%) would not have reported it spontaneously. The level of the interview satisfaction was high (90%). Conclusions: Spasticity is a complex and limiting symptom in MS. The structured interview conducted by specialist nurses is feasible and has good acceptance. Patient contribution Specialist nurses can be proactive in MS clinical assessment, which may help to detect symptoms with negative impact on quality of life. [ABSTRACT FROM AUTHOR]

Aims and objectives: To determine the effect of the knowledge and health beliefs of individuals about colorectal cancer on their screening behaviour. Background: Colorectal cancer ranks third among the most common cancers both worldwide and in Turkey. Colorectal cancer plays an important role in cancer mortality but can be prevented by promoting healthy behaviour and participation in early screening programmes. Design: This descriptive study was completed with 114 women and 121 men. Methods: The study data were collected using the 'Data collection form' and 'Health Belief Model Scale for Protection from Colorectal Cancer'. Potential risk factors were investigated using logistic regression analyses. The AGREE checklist was completed. Results: The colorectal cancer screening tests were known by 23.0% of the subjects and 17% had undergone one of these tests. The score medians obtained from the confidence‐benefit subscale of Health Belief Model Scale for Protection from Colorectal Cancer were found to be significantly higher in those who had undergone colorectal cancer screening. Logistic regression analysis revealed that having knowledge of the relevant tests was associated with undergoing colorectal cancer screening. Conclusions: Having knowledge on colorectal cancer screening tests increases the relevant confidence‐benefit perception regarding the tests and the behaviour of participating in screening programmes. Regular training on colorectal cancer and early diagnosis should therefore be provided by healthcare professionals to both women and men aged 50–70 years to increase the rate of undergoing early screening tests. Relevance to clinical practice: Increasing the rate of early screening is among the responsibilities of health workers working in primary health centres. Therefore, problems that prevent individuals from participating in these programmes need to be identified. In this way, health workers will develop suggestions and initiatives that change the individual's health beliefs and increase motivation. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the level of perception of the quality of discharge teaching and its associations with the readiness for hospital discharge among surgical patients in acute care hospitals. Background: Discharge teaching is a primary strategy to facilitate patients' readiness for hospital discharge. The extent to which the surgical ward was perceived as providing patient‐focused education when discharged has never been explored. Its impact on a patient's readiness is also unknown in the Indonesian context. Design: A correlational descriptive study was used to collect data from four hospitals in Indonesia. Methods: Ninety‐six surgical patients who were in the discharge process enrolled in this study. The demographic form, the quality of discharge teaching scale (QDTS) and the readiness for hospital discharge scale (RHDS) were utilised for data collection. Data were collected from January–February 2018. Descriptive statistics and Spearman rank‐order correlation were applied for data analysis. Results: The discharge teaching quality was perceived as being at a low level. The readiness for hospital discharge was reported to be at a moderate level. Overall, the discharge teaching quality was not statistically associated with the patients' readiness. However, positive correlations were found in QDTS and RHDS subscales such as content received and delivery, knowledge, coping ability and expected support. Patient's readiness for hospital discharge was also greater for those who had a caregiver, a short hospital stay, a health insurance and occupation. Conclusions: Surgical patients perceived a low quality of discharge teaching, which may decrease their readiness for hospital discharge. Relevance to clinical practice: This study provides baseline information reflecting the patient learning needs in discharge preparation to guide surgical nurses for improving the discharge teaching quality and enhancing the patients' readiness for hospital discharge. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe patients' and nurses' knowledge and beliefs regarding pain management. Moreover, to explore the effect of information and education on patients' and nurses' knowledge and beliefs regarding pain management. Background In the treatment of postoperative pain, patients' and nurses' inadequate knowledge and erroneous beliefs may hamper the appropriate use of analgesics. Design A randomised controlled trial and a cross-sectional study. Methods In 2013, half of 760 preoperative patients were allocated to the intervention group and received written information about the complications of postoperative pain. The knowledge and beliefs of 1184 nurses were studied in 2014 in a cross-sectional study. All data were collected with the same questionnaires. Results In the intervention group, patients' knowledge level was significant higher than in the control group, while no differences were found in beliefs. Nurses had higher knowledge and more positive beliefs towards pain management compared with both patient groups. Nurses with additional pain education scored better than nurses without additional pain education. Nurses were also asked what percentage of pain scores matched their impression of the patient's pain, and the mean was found to be 63%. Conclusions Written information was effective for increasing patients' knowledge. However, it was not effective for changing beliefs about analgesics and patients and nurses had erroneous beliefs about analgesics. Relevance to clinical practice It is necessary to continue to inform patients and nurses about the need for analgesics after surgery. Such education could also emphasise that a discrepancy between a patient's reported pain score and the nurse's own assessment of the patient's pain should prompt a discussion with the patient about his/her pain. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe what nursing and rehabilitation staff know and do with regard to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery. Background Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent urinary incontinence, there are indications that these guidelines are not applied in hospital care. Design A qualitative study with descriptive design was conducted in two orthopaedic units. Methods Forty-six interviews and 36 observations of care were conducted from January-October 2014 and analysed with qualitative content analysis. Results Enrolled nurses performed most of the care related to bladder function, with focus on urinary catheterisation and preventing urinary tract infection and urinary retention. Registered nurses' role in urinary matters mainly comprised documentation, while the rehabilitation staff focused on making it possible for the patient to be independent in toileting. The nursing staff considered urinary incontinence a common condition for older people and that it was convenient for the patients to have an indwelling catheter or incontinence pad/pant, although they acknowledged some of the risks associated with these procedures. Conclusions Urinary incontinence is not a priority in orthopaedic care, and urinary incontinence guidelines are not applied. Further, attitudes and actions are mainly characterised by a lack of urinary incontinence knowledge and the nursing and rehabilitation staff do not take a team approach to preventing and managing urinary incontinence. Relevance to clinical practice An increased focus on knowledge on urinary incontinence and evidence-based guidelines is needed. To secure evidence-based practice, the team of nursing and rehabilitation staff and managers must be aligned and work actively together, also including the patient in the team. [ABSTRACT FROM AUTHOR]

Aims and Objectives To evaluate the efficacy of action learning for improving cancer related pain management in the acute healthcare settings. Background Despite the prevalent use of action learning in private, public, clinical and non-clinical settings, no studies were found in the literature that either examined cancer pain management or used action learning as an approach to improve patient care in acute healthcare settings. Methods An intervention pre - posttest design was adopted using an action learning programme ( ALPs) as the intervention. Healthcare professionals' knowledge, attitudes and practice were assessed and evaluated before and after the implementation of the six-month ALPs. A pre and post audit and survey were conducted for data collection. The data were collected from the entire population of 170 healthcare professionals in one healthcare organisation. Results The management of cancer related pain improved significantly following the intervention. Significant improvement were also seen in healthcare professionals' knowledge, attitudes with improved cancer related pain management as a consequence of this. Conclusion Despite many organisational challenges to practice development and collaborative working in healthcare settings there is evidence that action learning can achieve positive outcomes for improving CRP and supporting collaborative working. Relevance to clinical practice Action learning needs to be considered as a strategy for achieving high quality standards. [ABSTRACT FROM AUTHOR]

Aims and objectives To survey intensive care unit healthcare professionals' awareness and practice related to delirium. Background Despite the current evidence revealing the risks linked to delirium and advances in practice guidelines promoting delirium assessment, healthcare professionals show little sensitivity towards delirium and evident training needs. Design The study had a cross-sectional survey design. Methods A sample of 168 intensive care unit healthcare professionals including nurses and physicians completed a semistructured questionnaire to survey their awareness, screening and management of delirium in intensive care units. The survey took place at 11 intensive care units from academic (university) and nonacademic (nonuniversity) governmental hospitals in Mansoura, Egypt. Results The mean score of delirium awareness was 64·4 ± 14·0 among intensive care unit healthcare professionals. Awareness of delirium was significantly lower when definition of delirium was not provided, among diploma nurses compared to bachelor degree nurses and physicians, among those who did not attend any workshop/lecture or read an article related to delirium and lastly, those who work in an intensive care unit when <50% of patients develop delirium. The survey found that only 26·8% of the healthcare professionals screen for delirium on a routine basis, and 14·3% reported attending workshops or lectures or reading an article related to delirium in the last year. In screening delirium, healthcare professionals did not use any tools, nor did they follow adopted protocols or guidelines to manage delirium. To manage delirium, 52·4% of the participants reported using sedatives, 36·9% used no drugs, and 10·7% reported using antipsychotics (primarily haloperidol). Conclusion Intensive care unit healthcare professionals do not have adequate training or routine screening of delirium. There is an evident absence of using standardised tools or adapting protocols to monitor and manage delirium. Relevance to clinical practice This study has the potentials to shed some lights on the variables that might explain the problem of underdiagnosing delirium by healthcare professionals at intensive care units in Mansoura. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this study is to describe the participation of family members in the care of Finnish adult surgical patients and the connection of the participation with the quality of patient care as perceived by surgical patients. Background The family members of adult surgical patients are important. Earlier studies vary concerning the nature of participation, its meaning and the connection of participation with patient-centred quality of care. In this study, we aim to produce new knowledge about adult surgical patients whose family members have participated in their care. Design This was a cross-sectional descriptive survey study. Methods The data were collected among adult surgical patients ( N = 481) before being discharged home from hospital with two instruments: the Good Nursing Care scale and the Received Knowledge of Hospital Patients. Results Based on the results, most adult surgical patients report that family members participate in their care. Participation was connected with received knowledge and preconditions of care, which are components of the quality of patient care. Conclusions In future, testing of different solutions for improving the participation of surgical patients' family members in patient care should be implemented. Furthermore, the preconditions of family members' participation in care and the concept of participation should be analysed to emphasise the active role of family members. Relevance to clinical practice The results emphasised the importance of family members for the patients in surgical care. Family members' participation is connected with the quality of patient care. [ABSTRACT FROM AUTHOR]

Aims and objectives This study aimed to assess the reasons and the frequency of the use of over-the-counter ( OTC) nonsteroidal anti-inflammatory drugs ( NSAIDs) or analgesics by liver transplant recipients ( LTR). Patient awareness of possible drug-related side-effects was also assessed. Background NSAIDs and analgesics available without prescription belong to the most commonly used class of drugs. However, use of these drugs might be complicated by toxic adverse effects ( AEs). Patients at risk for AEs include the transplant recipients. Design/methods This was a descriptive study. An anonymous survey was carried out in 73 randomly selected LTR, who represented 10% of all LTR at our centre. Results There were 64% of the patients who confirmed taking NSAIDs or analgesics; 16% of these patients took these drugs at least several times a week and 10% took them daily. For 39% of patients, the only way to manage their pain were OTC NSAIDs or analgesics. As many as 36% of patients were unaware of the risks associated with the use of these drugs. Ninety per cent of LTR consider physicians the most trusted source of drugs information. Conclusions Our study shows that two-thirds of LTR take OTC NSAIDs or analgesics and one-third are unaware of the AEs associated with these drugs. Therefore, both transplant nurses and doctors should educate their patients about the use and possible AE of these drugs. Relevance to clinical practice Considering the high NSAIDs consumption rates, the side effects of these drugs should always be suspected. Especially in patients taking these drugs and referring to medical advisors with specific symptoms, such as: abdominal pain, anaemia, elevated serum creatinine concentration or liver enzymes activity. Awareness of the scale of the problem enables health professionals to cooperate in educating patients. Such practices may reduce uncontrolled abuse of these drugs and related health care costs. [ABSTRACT FROM AUTHOR]

Aims and objectives. Medication adherence in people with cirrhosis is largely unknown. This study aims to determine adherence patterns and factors associated with adherence in patients with cirrhosis. Background. Prescribed medications are a pivotal component in the clinical management of cirrhosis with potential to retard disease progression and reduce complication risks. Medication adherence is necessary to optimise health outcomes. Understanding why medications are missed may help to develop strategies and inform nursing practice. Design. Prospective cohort study. Methods. Participants (n = 29) diagnosed with cirrhosis attending a tertiary hospital consented to complete a self-reported survey. Demographic information, adherence to medications, patient knowledge and quality of life data were collected, collated, checked and analysed using SPSS version 21. Results. Less than half of the 28 patients who completed the adherence questionnaire (n = 13, 46%) reported that they had never missed medication. Being forgetful, being away from home and falling asleep contributed to nonadherence. Having less abdominal symptoms, less fatigue and increased emotional well-being were significantly associated with patients never missing medications. Conclusions. To our knowledge this is the first published study to describe adherent behaviour and the reasons medications are missed in this population. The percentage of nonadherent participants is of concern considering the potential morbidity risk that is associated with missed medications and rebound symptoms of cirrhosis. Strategies to improve and sustain adherence levels are required including enhanced adherence counselling offered to patients who are deteriorating or experience periodic exacerbation of symptoms. Relevance to clinical practice. Study findings have the potential to change clinical practice especially the way nurses target motivational adherence counselling, key treatment messages, education and adherence monitoring. The results presented here provide a basis for developing adherence strategies and nursing management plans to improve adherence and health outcomes in people with cirrhosis. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this study was to describe people's perceptions of needs to feel confident in self-care for minor illnesses as well as their perceptions about supporting and obstructing factors in the practice of self-care. Background Minor illness constitutes a large part of primary care, and patients' attendance to doctors' appointments for minor illness has been seen to increase future attendance for the same condition. Almost half of the consultations with telenurses result in the provision of self-care advice. Design A cross-sectional survey. Method Primary data were collected using a questionnaire, and the study participants ( n = 315) were randomly selected from the national Swedish address register. Results Having knowledge and receiving health care advice and reliable information were perceived to be needs in order for participants to feel confident in self-care. Having family or friends to consult with was perceived to be a positive factor influencing confidence in self-care, especially for persons under the age of 35. Health care services were perceived to support self-care practice by offering easy access to care, giving information about self-care, and offering increased follow-up after consultations. Lack of knowledge, along with difficulties being away from work, were obstructing factors in the practice of self-care. Conclusions Young age was the factor influencing people's perceptions of needs and supporting factors the most. Young age and low knowledge scores about minor illnesses were the two factors that had the most influence on perceived obstructing factors. Relevance to clinical practice Nurses play a major role in the promotion of self-care and in the dissemination of self-care advice. If health care services fail to meet the needs of care-seekers with minor illnesses, patients might turn to out-of-hours clinics and emergency departments for help. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the reliability and the factor structure of the Readiness for Hospital Discharge Scale - French version. Background The patient's perspective is essential when assessing risk for adverse events at hospital discharge. Developed in the USA, the Readiness for Hospital Discharge Scale is the only instrument that measures an individual's self-perception of readiness before leaving the hospital. A French version of the Readiness for Hospital Discharge Scale was developed and validated. Design Cross-sectional study. Methods A convenience sample of 265 older inpatients from four medical units was selected. The translation and cultural adaptation of the scale involved experts in gerontology and the French language and included back translation. The items were semantically evaluated and pretested in 10 older inpatients. The scale's psychometric properties were internally validated by using confirmatory and exploratory factor analyses. Reliability was assessed by examining the internal consistency of its items. Results Goodness-of-fit indices of the confirmatory factor analyses were not adequate, but reliability was acceptable (Cronbach's α = 0·80). Exploratory factor analysis of the French version provided results close to those described for the English version, with three similar subscales ( physical and emotional readiness, coping with medical treatment and personal care), whereas the initially described Expected Support subscale was not identified in the French version. Conclusion The Readiness for Hospital Discharge Scale - French version appears to be partially consistent with its original English version, but requires additional adaptation to fully take into account the Swiss context and culture to achieve its original aim. Relevance to clinical practice Assessing patient readiness for hospital discharge before leaving hospital could help nurses to improve the discharge planning process and achieve better patient preparedness and care coordination. [ABSTRACT FROM AUTHOR]

The article presents a research on the knowledge of nurses and physicians in unsuitable drug that is not prescribe to patients with dysphagia or feeding tubes. It discusses data collection and knowledge to the case of patient with dysphagia or feeding tubes where data analysis are presented to assess self-estimated knowledge with the use of drug given to patients.

Aims and objectives This study seeks (1) to investigate the impact of the implementation of the 'Diagnostic Guideline for Anxiety and challenging behaviours in clients with intellectual disability' on nurses/social workers' knowledge and self-efficacy; and (2) to evaluate the role of nurses/social workers in the diagnostic process when applying the guideline. Background Nurses/social workers have extensive contact with clients with intellectual disabilities. Despite this key position, the contribution of nurses/social workers to the diagnosis of mental health problems and challenging behaviours is rather limited. The authors developed the multidimensional 'Diagnostic Guideline for Anxiety and challenging behaviours'. In this article, the implementation of this guideline is evaluated concerning knowledge and self-efficacy of nurses/social workers, as well the role of nurses/social workers in the diagnostic process. Design This study employed a comparative multiple case study design. Methods Qualitative and quantitative research methods. Results Working with the 'Diagnostic Guideline for Anxiety and challenging behaviours' led to a statistically significant increase in knowledge and self-efficacy among the nurses/social workers in the experimental condition, compared with nurses/social workers in the control condition. Nurses/social workers and psychologists appreciated the more active contribution of the nurses/social workers in the diagnostic process. Conclusions Working with the guideline increased the knowledge and self-efficacy of nurses/social workers, and led to more active participation of nurses/social workers in the diagnostic process. Relevance to clinical practice After following a training programme, nurses/social workers can effectively contribute to the diagnostic process in clients with anxiety and related challenging behaviours. [ABSTRACT FROM AUTHOR]

Aims and objectives To compare the influence of a systematic nursing intervention on primary caregivers' knowledge and skills about nasogastric tube feeding and the number of nasogastric tube-related complications with that of routine nursing instructions Background To ensure the quality of care and reduce the incidence of complications, it is crucial that primary caregivers receive comprehensive health education about nasogastric tube feeding before hospital discharge. Design A quasi-experimental research with pretest/post-test evaluations. Methods The control group included 127 inpatients whose caregivers received routine education about nasogastric tube feeding, while the experimental group included 106 inpatients whose caregivers received systematic nursing intervention including comprehensive educational pamphlets and video education. The evaluation questionnaire included demographic variables, a nasogastric tube care knowledge scale, and a nasogastric tube skills assessment scale. The post-test was administered after the caregiver performed nasogastric tube feeding for the first time, and complications were noted at follow-up within three months of discharge. Results In terms of post-test knowledge and skills, the experimental group scored significantly higher than the control group, despite no difference in the pretests. In addition, the incidence rates for constipation, diarrhoea and abdominal distention were lower in the experimental group. Conclusions Systematic nursing intervention, including comprehensive educational pamphlets and video education, significantly improved the knowledge and skills of primary caregivers for nasogastric tube feeding. The increased ability of caregivers may have contributed to less incidence of complication. Relevance to clinical practice The results of this study underlined the importance of developing nasogastric tube-related nursing interventions and educational strategies for clinical nurses, home care nurses and caregivers. The research tool used here may serve as a reference for assessing the technical operations of healthcare professionals and the knowledge and skills of caregivers. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine parents' knowledge about and attitudes towards pain management, use of pain relief strategies and satisfaction with their children's postoperative pain management, as well as the relationships among these variables. Background Children's postoperative pain is inadequately managed worldwide. Despite increasing emphasis on parental involvement in children's postoperative pain management, few studies have examined parents' management of their child's postoperative pain in Singapore. Design A descriptive correlational study. Methods A convenience sample of 60 parents having 6- to 14-year-old children undergoing inpatient elective surgery in a public hospital in Singapore was recruited. Data were collected one day after each child's surgery using the Pain Management Knowledge and Attitudes questionnaire and the Parents' Use of Pain Relief Strategies questionnaire. Descriptive statistics, Mann-Whitney U tests, Kruskal-Wallis tests and Spearman's rank correlation coefficient were used for data analyses. Results Parents displayed moderate levels of knowledge, attitudes and use of pain relief methods in relation to their children's postoperative pain and pain management. They were generally satisfied with the management of their child's postoperative pain. There was significant difference in Parents' Use of Pain Relief Strategies scores between parents with and without previous experience of caring for their hospitalised child. Statistically significant positive correlations were found between parents' knowledge and attitude, knowledge and satisfaction, attitude and satisfaction, knowledge and pain relief strategies, as well as attitude and pain relief strategies. Conclusion This study indicates the need to provide parents with more information regarding their children's postoperative pain management. Future studies are needed to develop educational interventions for parents to improve their knowledge and attitudes, which will eventually improve their use of pain relief strategies for their children. Relevance to clinical practice Health professionals need to provide more information to equip parents with knowledge and skills regarding paediatric postoperative pain management. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the perceptions of a group of culturally and linguistically diverse participants with the comorbidities of diabetes, chronic kidney disease and cardiovascular disease to determine factors that influence their medication self-efficacy through the use of motivational interviewing. Background These comorbidities are a global public health problem and their self-management is more difficult for culturally and linguistically diverse populations living in English-speaking communities. Few interventions have been tested in culturally and linguistically diverse people to improve their medication self-efficacy. Design A series of motivational interviewing telephone calls were conducted in the intervention arm of a randomised controlled trial using interpreter services. Methods Patients with these comorbidities aged ≥18 years of age whose preference it was to speak Greek, Italian or Vietnamese were recruited from nephrology outpatient clinics of two Australian metropolitan hospitals in 2009. Results The average age of the 26 participants was 73·5 years. The fortnightly calls averaged 9·5 minutes. Thematic analysis revealed three core themes which were attitudes towards medication, having to take medication and impediments to chronic illness medication self-efficacy. A lack of knowledge about medications impeded confidence necessary for optimal disease self-management. Participants had limited access to resources to help them understand their medications. Conclusion This work has highlighted communication gaps and barriers affecting medication self-efficacy in this group. Culturally sensitive interventions are required to ensure people of culturally and linguistically diverse backgrounds have the appropriate skills to self-manage their complex medical conditions. Relevance to clinical practice Helping people to take their medications as prescribed is a key role for nurses to serve and protect the well-being of our increasingly multicultural communities. The use of interpreters in motivational interviewing requires careful planning and adequate resources for optimal outcomes. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the impact of a provider focused quality improvement educational intervention on appropriate prescribing for community associated methicillin-resistant Staphylococcus aureus infection. Background Patient, provider and health system factors contribute to appropriate antibiotic prescription. Achieving appropriate prescribing is critical in decreasing the burden of antibiotic resistance. Knowledge of appropriate prescribing for community associated methicillin-resistant Staphylococcus aureus infection is the first step in shifting prescriber behaviour to evidence-based recommendations. Design Quality Improvement Project. Method Following a review of best practice guidelines and application of the Stetler Research Utilization model, a brief educational intervention was delivered using voice over PowerPoint. Items in the educational intervention included indications for screening, particularly focusing on the role of watch and wait after culturing for simple abscesses. The intervention was delivered in a for-profit, nonacademic, urgent care setting, and assessed prescribing providers' knowledge and practice. Results Out of 48 medical doctor, physician assistant and nurse practitioner providers, 18 (37·5%) participated; 12 of the 18 (67%) participants showed an increase in knowledge. Forty three per cent of prescribers' charts demonstrated improved practice through use of the guidelines. Out of 18 prescribers, 44% sent a total of 21 cultures for abscesses. There was no difference in practice behaviours between professional groups. Conclusions In spite of the increase in knowledge scores, this improvement in knowledge did not translate in dramatic change in practice, although trends in a positive direction were noted. Relevance to clinical practice This quality improvement project underscores the complexity of changing prescriber behaviour and the need for ongoing interventions. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the association between confidence level in venepuncture and knowledge in determining causes of blood sample haemolysis among clinical staff and phlebotomists. Background Various collection methods are used to perform venepuncture, also called phlebotomy, the act of drawing blood from a patient using a needle. The collection method used has an impact on preanalytical blood sample haemolysis. Haemolysis is the breakdown of red blood cells, which makes the sample unsuitable. Despite available evidence on the common causes, extensive literature search showed a lack of published evidence on the association of haemolysis with staff confidence and knowledge. Design A quantitative primary research design using survey method. Methods A purposive sample of 290 clinical staff and phlebotomists conducting venepuncture in one North England hospital participated in this quantitative survey. A three-section web-based questionnaire comprising demographic profile, confidence and competence levels, and knowledge sections was used to collect data in 2012. The chi-squared test for independence was used to compare the distribution of responses for categorical data. anova was used to determine mean difference in the knowledge scores of staff with different confidence levels. Results Almost 25% clinical staff and phlebotomists participated in the survey. There was an increase in confidence at the last venepuncture among staff of all categories. While doctors' scores were higher compared with healthcare assistants', p ≤ 0·001, nurses' were of wide range and lowest. There was no statistically significant difference (at the 5% level) in the total knowledge scores and confidence level at the last venepuncture F(2,4·690) = 1·67, p = 0·31 among staff of all categories. Conclusion Evidence-based measures are required to boost staff knowledge base of preanalytical blood sample haemolysis for standardised and quality service. Monitoring and evaluation of the training, conducting and monitoring haemolysis rate are equally crucial. Relevance to clinical practice Although the hospital is succeeding in providing regular training in venepuncture, this is only one aspect of quality. The process and outcome also need interventions. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine nursing students' and registered nurses' teamwork skills whilst managing simulated deteriorating patients. Background Studies continue to show the lack of timely recognition of patient deterioration. Management of deteriorating patients can be influenced by education and experience. Design Mixed methods study conducted in two universities and a rural hospital in Victoria, and one university in Queensland, Australia. Methods Three simulation scenarios (chest pain, hypovolaemic shock and respiratory distress) were completed in teams of three by 97 nursing students and 44 registered nurses, equating to a total of 32 student and 15 registered nurse teams. Data were obtained from (1) Objective Structured Clinical Examination rating to assess performance; (2) Team Emergency Assessment Measure scores to assess teamwork; (3) simulation video footage; (4) reflective interview during participants' review of video footage. Qualitative thematic analysis of video and interview data was undertaken. Results Objective structured clinical examination performance was similar across registered nurses and students (mean 54% and 49%); however, Team Emergency Assessment Measure scores differed significantly between the two groups (57% vs 38%, t = 6·841, p < 0·01). In both groups, there was a correlation between technical (Objective Structured Clinical Examination) and nontechnical (Team Emergency Assessment Measure) scores for the respiratory distress scenario (student teams: r = 0·530, p = 0·004, registered nurse teams r = 0·903, p < 0·01) and hypovolaemia scenario (student teams: r = 0·534, p = 0·02, registered nurse teams: r = 0·535, p = 0·049). Themes generated from the analysis of the combined quantitative and qualitative data were as follows: (1) leadership and followership behaviours; (2) help-seeking behaviours; (3) reliance on previous experience; (4) fixation on a single detail; and (5) team support. Conclusions There is scope to improve leadership, team work and task management skills for registered nurses and nursing students. Simulation appears to be beneficial in enabling less experienced staff to assess their teamwork skills. Relevance to clinical practice There is a need to encourage less experienced staff to become leaders and for all staff to develop improved teamwork skills for medical emergencies. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the differences in the knowledge and compliance with secondary prevention of stroke between transient ischaemic attack patients with and without subsequent stroke. Background No previous study has demonstrated whether there are differences in the knowledge and compliance with secondary prevention of stroke between transient ischaemic attack patients with and without subsequent stroke. If there are differences, the health education regarding the stroke knowledge should be conducted separately and differently for the two groups. Methods and design We consecutively recruited 355 transient ischaemic attack patients with/without subsequent stroke from our hospital from 1 December 2008-31 December 2011. There were 304 patients receiving health education both upon hospital discharge and 90 days after discharge. Through telephone interviews, six months after discharge, only 180 patients completed the survey to determine in detail their general knowledge and compliance with secondary prevention of stroke. Results The transient ischaemic attack patients with subsequent stroke exhibited a higher identification rate of speech disorder, weakness and decreased sensation or inability to feel things, compared with those without subsequent stroke (76·1 vs. 66·3%, p < 0·05; 91·5 vs. 73·5%, p < 0·05; 62·2 vs. 46·9%, p < 0·05). The compliance rates to antiplatelet agents and statins therapy were higher in transient ischaemic attack patients with subsequent stroke compared with those without subsequent stroke (80·5 vs. 65·3%, p < 0·05; 53·7 vs. 35·7%, p < 0·05). Conclusions The transient ischaemic attack patients with subsequent stroke exhibit a higher identification rate of most of the warning signs of stroke and a better compliance with antiplatelet agents and statins therapy of stroke compared with those without subsequent stroke. Thus, we suggest that transient ischaemic attack patients should receive additional health education to increase their awareness of the harms of stroke. Relevance to clinical practice Clinicians should be aware of conducting different health education to patients with transient ischaemic attack and stroke. Also, it is important to give health education to individualised patients based on their actual risk of stroke. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop an online system for the detection of osteoporosis risk and to test its accuracy. Background Osteoporosis is a silent killer; usually, there are no symptoms, such as pain, until bone erosion and fracture occur. The risks of osteoporosis have been underestimated and neglected; as a result, osteoporosis can be as dangerous as heart diseases and cancers that lead to a healthcare crisis. Design Cross-sectional study. Methods The study participants were individuals presenting for routine health examinations at a medical centre in Taiwan from 2006-2007. Women over 30 years of age who underwent dual-energy X-ray absorptiometry scanning for measurement of bone mineral density were eligible for this study. The system for osteoporosis detection and health risk, which was developed in this study, was analysed. Results The findings indicated a high sensitivity of 75%, specificity of 75%, positive predictive value of 75% and negative predictive value of 75%. In addition, the online osteoporosis detective system had a higher predictive power (24·2% vs. 11%) and a similar cut-off point (33% vs. 27%) compared with the tool designed by the International Osteoporosis Foundation. Conclusion The online system for detection of osteoporosis risk had excellent reliability and validity. It performed well in predicting osteoporosis and the cut-off point used for identifying the risk among women at risk of developing osteoporosis. Therefore, it is suitable for the Asian women and can help women achieve the goals of early detection and health promotion. Relevance to clinical practice Early detection is the only way to prevent osteoporosis. Professional nurses should apply effective technology to promote health care in community-dwelling people. [ABSTRACT FROM AUTHOR]

Aims and objectives To report on a study of what primary care nurses and physicians know about medications and healthcare products to prevent and treat pressure ulcers. Background The prevention and treatment of pressure ulcers has generally become the responsibility of the nursing staff; this has resulted in studies of nurses' knowledge of this task, although few studies include physicians in their analysis. Design Cross-sectional survey conducted in North Girona (Province) Primary Care Services from February to April 2010. Methods The study questionnaire had three sections: sociodemographic data, questions about division of responsibility for the care of patients with pressure ulcers or at risk of developing them, and 36 statements based on the recommendations in clinical practice guidelines provided by well-recognised national and international institutions. Results Eighty-one nurses (64·8%) and 46 physicians (36·8%) responded to this study. Nurses had greater responsibility for the care of pressure ulcers, made greater use of medical prescriptions to obtain supplies if not available in the primary care centre, were more familiar with the site's clinical practice guidelines on the topic and showed better adherence to their recommendations. Nurses also had better knowledge than the participating physicians of the use of medications and healthcare products to heal or to prevent pressure ulcers. Conclusions Nurses had sufficient knowledge and more appropriate skills than the participating physicians for the prescription of medications and healthcare products for the prevention and treatment of pressure ulcers. Relevance to clinical practice The data demonstrated that nurses have sufficient knowledge and skill to provide wound care and could safely write these prescriptions, although Spanish law permitting nurse prescription is not fully implemented. [ABSTRACT FROM AUTHOR]

Aims and objectives To prospectively evaluate the effects of a nurse-led educational intervention on the management of hyperphosphataemia as well as knowledge of phosphate among patients with end-stage renal disease. Background Haemodialysis and phosphate binder therapy are the major methods used to reduce the phosphate level in dialysis patients. However, patient education related to hyperphosphataemia, diet and phosphate binders may be another important factor associated with the success of the control of the hyperphosphataemia. Design This prospective randomised controlled trial was conducted during the period from June 2009-March 2011 at the HD units of two hospitals in Tianjin, China. Methods A total of 80 participants were randomly assigned to experimental group ( n = 40) and control group ( n = 40). Participants in the experimental group received the nurse-led intensive educational programme, including individualised education and educational session about diet and medicine regimes, etc., while participants in the control group received the routine guidance. Results There were statistically significant differences between the study groups in decline in serum phosphorus and calcium-phosphorus product levels and improvement in patients' general knowledge three months postintervention, and these differences sustained until the end of the study. Increased serum calcium level was observed both in the experimental group and in the control group, but there was no significant difference between groups. No statistical significance was found regarding serum albumin level between the groups. No significant difference in the serum parathyroid hormone level was found between the groups by month 6. Conclusions Nurse-led intensive educational programme plays an important role in the control of hyperphosphataemia among patients with end-stage renal disease. Relevance to clinical practice Chronic kidney failure patients with hyperphosphataemia are more likely to benefit from nurse-led intensive educational programmes. [ABSTRACT FROM AUTHOR]

Aims and objectives. The purpose of the study was to evaluate the effects of a structured educational programme on the patient-controlled analgesia device in terms of postoperative pain, dose of analgesics used, adverse reactions, patient knowledge and attitudes of patient-controlled analgesia and patient satisfaction with postoperative pain management among gynaecological patients in South Korea. Background. Patient-controlled intravenous analgesia has become the most common method to manage postoperative pain. Although the patient-controlled analgesia device can be very effective in managing pain, patients using external pump delivery have several problems because of their lack of knowledge of patient-controlled analgesia. To minimise these problems, nursing interventions that may decrease the number of problems should be developed and adopted into clinical practice. Design. A non-equivalent control group, non-synchronised design. Methods. The participants were 79 patients who had gynaecological surgery under general anaesthesia. Of the 79 patients, 39 were assigned to the experimental group and 40 to the control group. A day before surgery, 40 minutes of structured education on the patient-controlled analgesia device was provided individually to the patients in the experimental group using both a CD-ROM and brochure. Results. Pain level and adverse reactions were significantly lower in the experimental group than in the control group. Furthermore, the analgesic dose administered and the level of patient satisfaction with postoperative pain management increased significantly in the experimental group compared with the control group. Conclusion. A structured educational programme on the patient-controlled analgesia can be an effective nursing intervention for pain management in gynaecological patients. Relevance to clinical practice. Nurses caring for the patients who are using the patient-controlled analgesia should provide a structured educational programme to increase knowledge of pain management with patient-controlled analgesia, patient satisfaction with pain management, as well as more effective management of the pain and adverse reaction caused by patient-controlled analgesia. [ABSTRACT FROM AUTHOR]

Background. Little research has been conducted to investigate students' attitudes, knowledge and beliefs regarding lesbian, gay, bisexual and transgender parents seeking health care for their children. Design. Descriptive, comparative study. Validated scales were used to assess students' attitudes, knowledge and beliefs and gay affirmative practice. Three open ended questions assessed beliefs regarding lesbian, gay, bisexual and transgender parents accessing health care for their children. Method. Nursing and medical students completed questionnaires about attitudes to homosexuality. Associations between variables were assessed using chi-square tests of independence, and differences between nursing and medical student groups were assessed using the Mann-Whitney U-test or the Kruskal-Wallis one-way analysis of variance test. Responses to the open ended questions were evaluated, coded and described. Results. Knowledge and attitudes about homosexuality were significantly associated with students' race, political voting behaviour, religious beliefs and having a friend who is openly lesbian, gay, bisexual and transgender. Conclusions. It is important to develop strategies to address the existence of prejudicial attitudes among student health professionals and prevent discriminatory practices towards lesbian, gay, bisexual and transgender parents when seeking health care for their children. Relevance to clinical practice. Educators can develop programs that provide students with knowledge and skills to ensure lesbian, gay, bisexual and transgender families receive effective health care when they access services for their children. [ABSTRACT FROM AUTHOR]

Aim. The aim of the study was to assess health professionals' knowledge, attitudes and beliefs regarding lesbian, gay, bisexual and transgender parents accessing health care for their children. Background. Lesbian, gay, bisexual and transgender parents can be reluctant to reveal their sexual orientation to health professionals, and consequently, they may not receive adequate or timely provision of health care. Currently, there is little research in this area. Design. Descriptive, comparative study of 86 health professionals using a cross-sectional survey design with a set of validated, anonymous questionnaires. Method. Associations between variables were assessed using chi-squared tests of independence, and differences between groups were assessed using the Mann-Whitney U-test or the Kruskal-Wallis one-way analysis of variance test. Content analysis was used to examine responses to open-ended questions. Results. Knowledge and attitude scores were significantly associated with race, religious beliefs, frequency of attendance at religious services and having a friend who is openly lesbian, gay, bisexual and transgender. Conclusions. Information gained from this study will assist clinicians and hospital management to develop policies and practices that ensure lesbian, gay, bisexual and transgender families receive equitable, high-quality and holistic health care. Relevance to clinical practice. Properly implemented family-centred care is an ideal model to provide care for lesbian, gay, bisexual and transgender families. However, the benefits of family-centred care can only be realised fully if health professionals delivering that care are sensitive to the context, functions and constructs of all the families they encounter. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aims of this study were to determine (1) the prevalence of complementary and alternative medicine use among patients with cancer, (2) the method of use of the particular therapy, (3) the reasons for using complementary and alternative medicine therapies, (4) the benefits experienced by the use of complementary and alternative medicine, (5) the source of information about complementary and alternative medicine therapies and, (6) the satisfaction and cost of complementary and alternative medicine. Background. Complementary and alternative medicine consists of diverse medical and healthcare systems, practices and products that are not considered at present to be a part of conventional medicine. The majority of patients who use complementary and alternative medicine use more than one method. Complementary and alternative medicine use is more common in cases of advanced disease or poor prognosis. Design. This is a descriptive study of complementary and alternative medicine. Methods. This study was conducted in the Chemotherapy Unit at Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey, between 18 March 2008-30 June 2008. Two hundred fifty-three patients with cancer, among 281 patients who applied to the chemotherapy clinic between these dates, agreed to take part in the study with whom contact could be made were included. A questionnaire including descriptive characteristics in collecting data, characteristics about diseases and their treatments, complementary and alternative medicine information and implementation situations and a control list about complementary and alternative medicine implementations were given. The collected data were evaluated by computer using descriptive statistics, the chi-square test and Student's t-test. Results. In this study, 94·1% of the patients were content with medical treatment, 58·9% of them used complementary and alternative medicine treatments, 41·1% did not use any complementary and alternative medicine treatments. The satisfaction level of the patients with complementary and alternative medicine methods was slightly above mediocre (2·33 SD 0·64, on a scale of 1-3). The average cost per capita spent by the patients using complementary and alternative medicine for all the different methods was US$288·26. Conclusions. It was determined that although patients did not have enough knowledge about complementary and alternative medicine methods, the prevalence of complementary and alternative medicine and satisfaction levels are high that complementary and alternative medicine users spend substantial sums of money for these methods. Relevance to clinical practice. To sustain medical treatment and prognosis of cancer, it is important for nurses to consult with their patients regarding the use and potential risks of some complementary and alternative medicine. [ABSTRACT FROM AUTHOR]