A qualitative study of nurses’experiences of self-care counseling in migrant patients with heart failure

Objectives:This study aims to enhance researchers’and nurses’understanding of how to best support migrant patients with heart failure in self-care management.Previous research on self-care in heart failure patients has highlighted its importance,particularly among migrant populations.Nurses play an important role in informing and engaging patients with chronic conditions like heart failure to support their active participation in self-care.However,nurses’experiences of providing self-care counseling to migrant populations with heart failure have not been studied.Methods:A qualitative study was conducted.Nurses working with migrant patients with HF(n?13)from different types of facility in Western Sweden were interviewed between October and December 2020.Data were collected using semi-structured interviews and analyzed using inductive thematic analysis.Results:The main theme that emerged from the interviews was the difficulty for nurses“to find balance”in self-care counseling.The nurses during self-care counseling had:“to accept challenges,”“to use creative strategies,”faced“problems related to health literacy,”and“to work according to their(the nurses’)obligations.”It was evident that nurses faced several challenges in counseling migrants in self-care,including language and cultural barriers,time resource constraints,low levels of health literacy,and experienced disharmony between the law and their professional norms.They perceived building caring relationships with their patients to be crucial to fostering health-promoting self-care processes.Conclusions:To increase self-care adherence,nurses must become more sensitive to cultural differences and adapt self-care counseling to patients’health literacy.The findings of this research support and challenge nurses in providing the best counsel to migrant patients with heart failure living in Sweden’s multi-ethnic society.Policymakers in the health care organization should act to facilitate mutual cultural understanding between all involved partners for patient-safe self-care counseling.

The Relationship of Occupational Health Nurses’ Experiences with Associated Departments in Relation to Project Development of Mental Health Care for Primary Preventive Treatment

Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the Japanese occupational health setting. Method: A total of 235 OHNs who are members of the Japan Academy of Occupational Health Nursing were sent an anonymous self-administered questionnaire survey. The questionnaire included items on the following: the OHN’s background, whether the OHN had experience in project development, the communication between the associated departments, the Japanese version of the Work Engagement Scale (UWES-J), occupational assessments, workplace assessments, and the Transtheoretical Model (TTM) for health promotion in companies and the OHN’s working environment. We performed logistic regression analysis to examine the relationship between experience and these harmonious relationships with other associated departments. Result: Responses from 61 OHNs (valid response rate: 25.9%) were analyzed. The mean number of years of service as an OHN was 18.9, and 82% of respondents had experience in project development. The logistic analysis further revealed that OHNs who had experience in project development of mental health care usually had a harmonious relationship with other associated departments. Conclusion: To promote mental health care for workers, OHNs have the capability to create individual and workplace assessments, enhance their work engagement, and make further improvements to their working environment. .

Parents' experience of caring for children with type 1 diabetes in China's Mainland: A qualitative study

BACKGROUND Parents of children with type 1 diabetes mellitus(T1DM)are under heavy caregiving stress,and parental caregivers'experience can affect the health outcomes of children with T1DM.AIM To describe the true inner feelings of parents caring for children with T1DM.METHODS Descriptive research methods were used to classify and summarize parents'experience when adapting to the role of caregivers for children with T1DM.The data was sorted and analyzed using content analysis.Themes of parents'experience caring for children with T1DM were refined,and their feelings were deeply investigated.RESULTS A total of 4 themes and 12 subthemes were identified:(1)Desire for information(disease-related information,home care information,and channels of information acquisition);(2)Skill guidance needs(insulin injection techniques,skills required for symptom management,and skills for parent-child communication);(3)Seeking emotional support(family support,peer support from other parents of children with T1DM,and professional support);and(4)Lack of social support(needs for financial support and needs for social security).Exploring the true experience of parents caring for children with T1DM is of great significance for helping them adapt to their role as caregivers.Nurses should provide professional guidance in terms of information,skills,emotion,and social support to parental caregivers.

Elderly African Americans Insights on the COVID-19 Pandemic: An Exploratory Study of Risk Perception and Personal, Social, and Cultural Factors

This exploratory study examined elderly African Americans attitudes on the COVID-19 pandemic by identifying their perceptions of risk based personal, social, and cultural factors. It seeks to understand their insights toward public health pandemic response initiatives and other efforts to mitigate COVID-19 outbreak response measures impacting elderly African Americans, including policies, interventions, and public information/communication. The effectiveness of pandemic response measures and community caregiving support for the elderly African Americans was examined as well. Respondents in this study were a convenient sample of 60 residents predominantly in a Midwestern metropolitan area. Respondents were eligible for study participation if 1) there were 60 years and over and, 2) African American or people of African descent. A mixed research method design comprising focus groups and online survey was used to collect the data for the study. The respondents characterized the impact of the coronavirus as a personal, family, and community loss (e.g., less socially engaged and burdensome). An overwhelming majority (98.3%) expressed no worries about getting health care if they or their family members needed it. A sizable number of respondents expressed the need for all to be tested to help prevent the spread of the virus.

Promoting Clinician Well-Being and Patient Safety Using Human Factors Science: Reducing Unnecessary Occupational Stress

Our healthcare delivery system has accumulated complexity of payment, regulation systems, expectations and requirements. Often these are not designed to align with clinical thinking process flow of patient care. As a result, clinicians are utilizing enormous mental (cognitive) resource to comply with these complexities, over and above the baseline mental effort required to give good care to the patient. Recent studies suggest a significant number of physicians, advanced practice providers and nurses no longer want to stay in healthcare due to difficult work expectations and conditions that have become unreasonable. Technology has benefitted healthcare delivery, but also is a conduit of many expectations that have been grafted upon clinician workloads, exceeding the resources provided to accomplish them. Cognitive load is a measure of mental effort and is divided into Intrinsic, Germane and Extraneous Cognitive Load. Extraneous Cognitive Load (ECL) is what is not necessary and can be removed by better design. High cognitive load is associated with increased risk of both medical error and clinician burnout. Chronic high level occupational stress occurs from dealing with this job/resource imbalance and is showing serious personal health impact upon clinicians and the quality of the work they can provide for patients. Since organizational systems have become more complex, leadership methods, clinician wellbeing and patient safety efforts need to adjust to adapt and succeed. Safety efforts have tended to predominantly follow methods of a few decades ago with predominant focus upon how things go wrong (Safety I) but are now being encouraged to include more of the study of how things go right (Safety II). Human Factors/Ergonomics (HFE) science has been used in many industries to preserve worker wellbeing and improve system performance. Patient safety is a product of good system performance. HFE science helps inform mechanisms behind Safety I and II approach. HFE concepts augment existing burnout and safety interventions by providing a conceptual roadmap to follow that can inform how to improve the multiple human/technology, human/system, and human/work environment interfaces that comprise healthcare delivery. Healthcare leaders, by their influence over culture, resource allocation, and implementation of requirements and workflows are uniquely poised to be effective mitigators of the conditions leading to clinician burnout and latent medical error. Basic knowledge of HFE science is a strategic advantage to leaders and individuals tasked with achieving quality of care, controlling costs, and improving the experiences of receiving and providing care.

PATIENT EXPERIENCE WITH HOSPITAL CARE-COMPARISON OF A SAMPLE OF GREEN HOS PITALS AND NON-GREEN HOSPITALS

Although the sustainability movement in the healthcare sector was initiated in response to ecological concerns,green hospitals are expected to outperform traditional hospitals on a variety of levels.The impacts of environmental quality on patients and caregivers are demonstrated in numerous studies.However,there is still a lack of evidence on the benefits of green hospitals with respect to different dimensions of patients’experiences.In this study,data from the public Hospital Consumer Assessment of Health Plans Survey is used to compare the performance of green hospitals with the average performance of traditional hospitals.This study included 19 green hospitals and found that patients hospitalized in green facilities reported overall higher ratings than those in traditional hospitals when compared to the average performance of traditional hospitals of similar sizes and locations.Additionally,patients in green hospitals were more likely to recommend the hospital to their friends and family.However,relationships between specific green building features and patient experiences were not identified in this study.