Shortage of nurses is a major concern across healthcare systems. One contributing factor that has received little attention is the shortage of adequately prepared nurse faculty. The nurse shortage will be exacerbated ...Shortage of nurses is a major concern across healthcare systems. One contributing factor that has received little attention is the shortage of adequately prepared nurse faculty. The nurse shortage will be exacerbated if the supply of adequately prepared nurse faculty is insufficient. Little is known about the factors that influence nurse faculty to remain employed. Focus groups were conducted in 2011 with nurse faculty from both colleges and universities in Ontario, Canada. Six focus groups including 37 participants were held with different groups of nurse faculty in geographically diverse areas of the province. Focus group transcripts were reviewed by five members of the research team using thematic analysis strategies to identify factors related to nurse faculty intention to remain employed. Nurse faculty members’ intention to remain employed was influenced by factors that fell into four thematic categories: personal characteristics, work environment and organizational support, job content, and external characteristics. Each thematic category includes several factors reported to influence nurse faculty intention to remain employed. The “Determinants of Nurse Faculty Intention to Remain Employed” Model is hypothesized. Strategies to address modifiable factors and support non-modifiable factors are suggested to promote retention of nurse faculty. Additional research is needed to test the hypothesized model of nurse faculty intention to remain employed.展开更多
Background: The importance of adapting evidence-based health interventions to enhance their congruence with the beliefs of ethno-cultural communities is well recognized. Although a systematic cultural adaptation proce...Background: The importance of adapting evidence-based health interventions to enhance their congruence with the beliefs of ethno-cultural communities is well recognized. Although a systematic cultural adaptation process is available, it lacks specific instructions on how to adapt interventions so that they are aligned with cultural beliefs. In this paper, we present an integrated strategy that operationalizes the adaptation process by describing specific practical instructions on how to align interventions with cultural beliefs. Methods: The strategy integrates concept and intervention mapping, and uses mixed methods for gathering data from community representatives. The data pertain to a community’s cultural beliefs and values related to a health problem, acceptability of evidence-based interventions targeting the problem, and aspects of the interventions that should be modified to enhance their fit with cultural beliefs. A step-by-step protocol is described to guide application of the integrated strategy for cultural adaptation. Conclusions: The strength of the integrated strategy relies on the use of concept and intervention mapping approaches for specifying a step-by-step protocol to actively engage community representatives in the cultural adaptation of interventions. Future research should evaluate the utility of this strategy.展开更多
Until recently, older adults with a cognitive impairment (CI) who experienced a hip fracture were filtered from being admitted into active rehabilitation units. The increased complexity of care required for older adul...Until recently, older adults with a cognitive impairment (CI) who experienced a hip fracture were filtered from being admitted into active rehabilitation units. The increased complexity of care required for older adults with a CI may negatively influence the attitudes and job satisfaction of healthcare practitioners working with this population. The current study is a part of a larger intervention study allowing patients with CI following a hip fracture access to rehabilitation care and implementing a patient-centred model to facilitate caring for this new population. This new model required a substantial change in the skillset and knowledge of healthcare practitioners. The focus of this study was to explore the impact on the healthcare practitioners of adopting this new model for providing care to older adults with a CI following a hip fracture. The attitudes, dementia knowledge, job satisfaction, and work stress of healthcare practitioners were the focus of evaluation. Key study findings showed that stress due to relationships with coworkers, workloads and scheduling, and the physical design and conditions at work were moderated post-intervention. Staff responses also improved for job satisfaction, biomedical knowledge of dementia, and degree of hopefulness about dementia. Although we cannot state conclusively that the our model was solely responsible for all the staff improvements observed post-intervention, our findings provide further support to the argument that patients with CI should be allowed access to rehabilitation care. Rehabilitation units need to provide education that utilizes a person-centred approach accepting of patients with CI, and focuses on areas that can bolster staff’s positive, dementia-sensitive attitudes. Ultimately, the aim is to create a culture that provides the highest standard of care for all patients, reduces work-related stress, increases job satisfaction, and leads to the highest quality of life for patients during and after rehabilitation.展开更多
The purpose of this study was to test and refine a model of part-time nurse faculty intent to remain employed in the academic organization. Cross-sectional survey methods were used. A total of 282 part-time nurse facu...The purpose of this study was to test and refine a model of part-time nurse faculty intent to remain employed in the academic organization. Cross-sectional survey methods were used. A total of 282 part-time nurse faculty working in colleges or universities in Ontario, Canada were invited to participate. Survey instruments and items measured demographic, workplace, nurse responses to the workplace, and external variables. Correlation, multiple regression, and mediation analyses were conducted using data from 119 participants (47.6% response rate). Of the 19 variables hypothesized to affect intent to remain employed in the academic organization, seven influenced intent to remain. The resulting model indicated that the older the part-time nurse faculty member, the lower the level of intent to remain and the more years worked in the organization, the higher the level of intent to remain. The more opportunities perceived to exist outside of the employing organization, the higher the level of intent to remain. Additionally, the more satisfied part-time nurse faculty were with their job overall, the higher their level of intent to remain. In the workplace, the more support from the leader, the more formal or informal recognition received, and the more fair work procedures were perceived to be, the higher levels of part-time nurse faculty intent to remain employed in the academic organization, mediated by job satisfaction. Although age, organizational tenure, and external career opportunities are non-modifiable variables, deans and directors can encourage part-time nurse faculty to remain employed in their academic job by focusing on enhancing overall job satisfaction. Effective strategies may include formal or informal acknowledgement of good performance, consistent verbal and behavioural support, and implementation of procedural practices, such as performance evaluations and pay raises in a fair manner.展开更多
Objectives:To examine the effects of the Roy Adaptation Model-based interventions on adaptation in persons with heart failure.Methods:A quasi-experimental study was conducted in Hangzhou,China,from March 2018 to Novem...Objectives:To examine the effects of the Roy Adaptation Model-based interventions on adaptation in persons with heart failure.Methods:A quasi-experimental study was conducted in Hangzhou,China,from March 2018 to November 2019.A convenience sample of 112 participants with heart failure from a multi-campus hospital was enrolled.Participants were allocated into an intervention group(n=55)and a control group(n=57)according to their hospitalized campus.A culturally-tailored care plan intervention based on the Roy Adaptation Model was performed in the intervention group.The control group received bedside patient education and a regular booklet for HF home care before discharge.Heart ultrasound,Minnesota Living with Heart Failure Questionnaire(MLHFQ),a knowledge survey,Self-care Heart failure Index(SCHFI),and Coping and Adaptation Processing Scale-Short Form(CAPS-SF)were used to measure patients’levels of adaptation of physical function,self-concept,role function,and interdependence at baseline and six months after discharge.Results:Ninety-one participants with complete data,43 in the intervention group and 48 in the control group,were included in the analysis for the primary endpoints and showed adaptive improvement trends.Most patients in the intervention group completed 60%or more of the given interventions.At the sixth month after discharge,compared with the control group,the intervention group had improved adaptive behaviors showing higher scores of the MLHFQ(70.90±22.45 vs.54.78±18.04),heart failurerelated knowledge(13.79±2.45 vs.10.73±4.28),SCHFI maintenance(57.67±13.22 vs.50.35±10.88),and CAPS-SF(40.23±4.36 vs.38.27±2.60)at the six-month follow-up(P<0.05).There were no significant differences between the two groups in the scores of left ventricular ejection fraction,scores of SCHFI management and SCHFI confidence subscales(P>0.05).Conclusions:The findings reported evidence of positive adaptation in patients with heart failure,indicating that the Roy Adaptation Model is an effective guide for developing an implemented framework for the nursing practice of the patients.The culturally-tailored care plan intervention is helpful to improve adaptation of patients with heart failure.展开更多
We appreciate the question raised in a discussion with a reader and the editor about an instrument for outcome measure of the quality of life among people with chronic heart failure[1].We recognized that we should hav...We appreciate the question raised in a discussion with a reader and the editor about an instrument for outcome measure of the quality of life among people with chronic heart failure[1].We recognized that we should have described more details about how to convert the score of the Minnesota Living with Heart Failure Questionnaire(MLHFQ).Lack of scoring details might lead to some confusion to understand the results of this study.We thank the International Journal of Nursing Sciences for the opportunity to provide further information to clarify the process of data analysis and research findings.展开更多
Context: Higher income countries have an average physician density of 300 physicians per 100,000 people. In stark contrast, lower income countries have an average physician density of 17 physicians per 100,000 people....Context: Higher income countries have an average physician density of 300 physicians per 100,000 people. In stark contrast, lower income countries have an average physician density of 17 physicians per 100,000 people. A major cause of this discrepancy is the migration of healthcare professionals from lower income to higher income countries, a phenomenon colloquially known as the “brain drain”. Objective: To explore factors that led International Medical Graduate (IMG) physicians to leave their home countries and migrate to Canada. Methods: An anonymous questionnaire with a mix of open- and close-ended questions was sent to 500 randomly selected IMG physicians practicing in Ontario, Canada. Results were analyzed using a mixed-method design utilizing both descriptive statistics and a thematic analysis approach. Results: 39 physicians met inclusion criteria and completed the survey. The majority were 50 years or older, and over 60% were male. The most common reason for emigration from their home country was the socioeconomic and/or political situation, and the most common reason for selecting Canada was family issues. Suggestions for how brain drain could be stemmed fell into three broad categories: 1) more accurate information about lack of opportunities in Canada, 2) more continuing medical education opportunities in home countries, and 3) address issues such as safety and quality of life in home countries. Conclusions: This survey provides insights into the reasons for emigration and immigration for international medical graduates. The results of this survey can assist stakeholders in working toward appropriate and acceptable solutions to the brain drain.展开更多
Objectives:To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in health-care.Methods:We applied Walker and Avant method to clarify the concept of so...Objectives:To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in health-care.Methods:We applied Walker and Avant method to clarify the concept of social movement in the context of knowledge uptake and sustainability.Peer-reviewed and grey literature databases were systematically searched for relevant reports that described how social movement action led to evidence-based practice changes in health and community settings.Titles,abstracts and full texts were reviewed independently and in duplicate,resulting in 38 included articles.Results:Social movement action for knowledge uptake and sustainability can be defined as individuals,groups,or organizations that,as voluntary and intrinsically motivated change agents,mobilize around a common cause to improve outcomes through knowledge uptake and sustainability.The 10 defining attributes,three antecedents and three consequences that we identified are dynamic and interrelated,often mutually reinforcing each other to fortify various aspects of the social movement.Examples of defining attributes include an urgent need for action,collective action and collective identity.The concept analysis resulted in the development of the Social Movement Action Framework.Conclusions:Social movement action can provide a lens through which we view implementation science.Collective action and collective identity e concepts less frequently canvassed in implementation science literature e can lend insight into grassroots approaches to uptake and sustainability.Findings can also inform providers and change leaders on the practicalities of harnessing social movement action for realworld change initiatives.By mobilizing individuals,groups,or organizations through social movement approaches,they can engage as powered change agents and teams that impact the individual,organizational and health systems levels to facilitate knowledge uptake and sustainability.展开更多
Background:Dementia is a syndrome that affects a person’s ability to understand and express information.The higher prevalence of vision and/or hearing losses among persons with dementia in long-term care(LTC)faciliti...Background:Dementia is a syndrome that affects a person’s ability to understand and express information.The higher prevalence of vision and/or hearing losses among persons with dementia in long-term care(LTC)facilities interferes with the ability of nurses to provide optimal care because communication is compromised.Therefore,the detection and screening for sensory impairment is of the utmost importance in LTC facilities;however,there is currently no agreement among nursing professionals on how to best identify such losses for the purpose of further referral,and the need for a validated screening measure suitable for nurses in LTC facilities is clear.The present project aims to close this gap by investigating the screening recommendations of vision-and hearing-care professionals working with clients affected by dementia.Methods:Eleven experts in audiology,optometry,deafblindness,and technology participated in individual semi-structured interviews on the topic of tools and strategies that can be used to screen individuals with dementia for sensory loss.Interview transcripts were coded by two evaluators using verbal agreement and consensus building.Results:Three main themes emerged from the interviews with experts:barriers,facilitators,and strategies.Barriers to sensory screening were often mentioned,particularly impaired communication and lack of staff cooperation.Facilitators consisted uniquely of people,such as family members,intervenors,and nurses.Strategies for sensory screening in this population consisted of improving communication through repetition and encouragements;considerations based on familiarity;and inferring an impairment on the basis of patient behaviour.Few of our interviewees were knowledgeable on the topic of screening apps.Conclusions:Our findings,to be integrated with a similar environmental scan conducted among LTC nurses,can inform the administration of sensory impairment screening tests among a population with dementia in order to optimize care.展开更多
Objectives The objective of this study is to describe the clustering of medical,behavioural and social preconception and interconception health risk factors and determine demographic factors associated with these risk...Objectives The objective of this study is to describe the clustering of medical,behavioural and social preconception and interconception health risk factors and determine demographic factors associated with these risk clusters among Canadian women.Design Cross-sectional data were collected via an online questionnaire assessing a range of preconception risk factors.Prevalence of each risk factor and the total number of risk factors present was calculated.Multivariable logistic regression models determined which demographic factors were associated with having greater than the mean number of risk factors.Exploratory factor analysis determined how risk factors clustered,and Spearman’s r determined how demographic characteristics related to risk factors within each cluster.Setting Canada.Participants Participants were recruited via advertisements on public health websites,social media,parenting webpages and referrals from ongoing studies or existing research datasets.Women were eligible to participate if they could read and understand English,were able to access a telephone or the internet,and were either planning a first pregnancy(preconception)or had≥1 child in the past 5 years and were thus in the interconception period.Results Most women(n=1080)were 34 or older,and were in the interconception period(98%).Most reported risks in only one of the 12 possible risk factor categories(55%),but women reported on average 4 risks each.Common risks were a history of caesarean section(33.1%),miscarriage(27.2%)and high birth weight(13.5%).Just over 40%had fair or poor eating habits,and nearly half were not getting enough physical activity.Three-quarters had a body mass index indicating overweight or obesity.Those without a postsecondary degree(OR 2.35;95%CI 1.74 to 3.17)and single women(OR 2.22,95%CI 1.25 to 3.96)had over twice the odds of having more risk factors.Those with two children or more had 60%lower odds of having more risk factors(OR 0.68,95%CI 0.52 to 0.86).Low education and being born outside Canada were correlated with the greatest number of risk clusters.Conclusions Many of the common risk factors were behavioural and thus preventable.Understanding which groups of women are prone to certain risk behaviours provides opportunities for researchers and policy-makers to target interventions more efficiently and effectively.展开更多
文摘Shortage of nurses is a major concern across healthcare systems. One contributing factor that has received little attention is the shortage of adequately prepared nurse faculty. The nurse shortage will be exacerbated if the supply of adequately prepared nurse faculty is insufficient. Little is known about the factors that influence nurse faculty to remain employed. Focus groups were conducted in 2011 with nurse faculty from both colleges and universities in Ontario, Canada. Six focus groups including 37 participants were held with different groups of nurse faculty in geographically diverse areas of the province. Focus group transcripts were reviewed by five members of the research team using thematic analysis strategies to identify factors related to nurse faculty intention to remain employed. Nurse faculty members’ intention to remain employed was influenced by factors that fell into four thematic categories: personal characteristics, work environment and organizational support, job content, and external characteristics. Each thematic category includes several factors reported to influence nurse faculty intention to remain employed. The “Determinants of Nurse Faculty Intention to Remain Employed” Model is hypothesized. Strategies to address modifiable factors and support non-modifiable factors are suggested to promote retention of nurse faculty. Additional research is needed to test the hypothesized model of nurse faculty intention to remain employed.
文摘Background: The importance of adapting evidence-based health interventions to enhance their congruence with the beliefs of ethno-cultural communities is well recognized. Although a systematic cultural adaptation process is available, it lacks specific instructions on how to adapt interventions so that they are aligned with cultural beliefs. In this paper, we present an integrated strategy that operationalizes the adaptation process by describing specific practical instructions on how to align interventions with cultural beliefs. Methods: The strategy integrates concept and intervention mapping, and uses mixed methods for gathering data from community representatives. The data pertain to a community’s cultural beliefs and values related to a health problem, acceptability of evidence-based interventions targeting the problem, and aspects of the interventions that should be modified to enhance their fit with cultural beliefs. A step-by-step protocol is described to guide application of the integrated strategy for cultural adaptation. Conclusions: The strength of the integrated strategy relies on the use of concept and intervention mapping approaches for specifying a step-by-step protocol to actively engage community representatives in the cultural adaptation of interventions. Future research should evaluate the utility of this strategy.
文摘Until recently, older adults with a cognitive impairment (CI) who experienced a hip fracture were filtered from being admitted into active rehabilitation units. The increased complexity of care required for older adults with a CI may negatively influence the attitudes and job satisfaction of healthcare practitioners working with this population. The current study is a part of a larger intervention study allowing patients with CI following a hip fracture access to rehabilitation care and implementing a patient-centred model to facilitate caring for this new population. This new model required a substantial change in the skillset and knowledge of healthcare practitioners. The focus of this study was to explore the impact on the healthcare practitioners of adopting this new model for providing care to older adults with a CI following a hip fracture. The attitudes, dementia knowledge, job satisfaction, and work stress of healthcare practitioners were the focus of evaluation. Key study findings showed that stress due to relationships with coworkers, workloads and scheduling, and the physical design and conditions at work were moderated post-intervention. Staff responses also improved for job satisfaction, biomedical knowledge of dementia, and degree of hopefulness about dementia. Although we cannot state conclusively that the our model was solely responsible for all the staff improvements observed post-intervention, our findings provide further support to the argument that patients with CI should be allowed access to rehabilitation care. Rehabilitation units need to provide education that utilizes a person-centred approach accepting of patients with CI, and focuses on areas that can bolster staff’s positive, dementia-sensitive attitudes. Ultimately, the aim is to create a culture that provides the highest standard of care for all patients, reduces work-related stress, increases job satisfaction, and leads to the highest quality of life for patients during and after rehabilitation.
文摘The purpose of this study was to test and refine a model of part-time nurse faculty intent to remain employed in the academic organization. Cross-sectional survey methods were used. A total of 282 part-time nurse faculty working in colleges or universities in Ontario, Canada were invited to participate. Survey instruments and items measured demographic, workplace, nurse responses to the workplace, and external variables. Correlation, multiple regression, and mediation analyses were conducted using data from 119 participants (47.6% response rate). Of the 19 variables hypothesized to affect intent to remain employed in the academic organization, seven influenced intent to remain. The resulting model indicated that the older the part-time nurse faculty member, the lower the level of intent to remain and the more years worked in the organization, the higher the level of intent to remain. The more opportunities perceived to exist outside of the employing organization, the higher the level of intent to remain. Additionally, the more satisfied part-time nurse faculty were with their job overall, the higher their level of intent to remain. In the workplace, the more support from the leader, the more formal or informal recognition received, and the more fair work procedures were perceived to be, the higher levels of part-time nurse faculty intent to remain employed in the academic organization, mediated by job satisfaction. Although age, organizational tenure, and external career opportunities are non-modifiable variables, deans and directors can encourage part-time nurse faculty to remain employed in their academic job by focusing on enhancing overall job satisfaction. Effective strategies may include formal or informal acknowledgement of good performance, consistent verbal and behavioural support, and implementation of procedural practices, such as performance evaluations and pay raises in a fair manner.
基金This work was supported by Health Commission of Zhejiang Province(grant number WKJ-ZJ-1925 and 2019ZD034)The authors thank all investigators and participants who participated in the study.
文摘Objectives:To examine the effects of the Roy Adaptation Model-based interventions on adaptation in persons with heart failure.Methods:A quasi-experimental study was conducted in Hangzhou,China,from March 2018 to November 2019.A convenience sample of 112 participants with heart failure from a multi-campus hospital was enrolled.Participants were allocated into an intervention group(n=55)and a control group(n=57)according to their hospitalized campus.A culturally-tailored care plan intervention based on the Roy Adaptation Model was performed in the intervention group.The control group received bedside patient education and a regular booklet for HF home care before discharge.Heart ultrasound,Minnesota Living with Heart Failure Questionnaire(MLHFQ),a knowledge survey,Self-care Heart failure Index(SCHFI),and Coping and Adaptation Processing Scale-Short Form(CAPS-SF)were used to measure patients’levels of adaptation of physical function,self-concept,role function,and interdependence at baseline and six months after discharge.Results:Ninety-one participants with complete data,43 in the intervention group and 48 in the control group,were included in the analysis for the primary endpoints and showed adaptive improvement trends.Most patients in the intervention group completed 60%or more of the given interventions.At the sixth month after discharge,compared with the control group,the intervention group had improved adaptive behaviors showing higher scores of the MLHFQ(70.90±22.45 vs.54.78±18.04),heart failurerelated knowledge(13.79±2.45 vs.10.73±4.28),SCHFI maintenance(57.67±13.22 vs.50.35±10.88),and CAPS-SF(40.23±4.36 vs.38.27±2.60)at the six-month follow-up(P<0.05).There were no significant differences between the two groups in the scores of left ventricular ejection fraction,scores of SCHFI management and SCHFI confidence subscales(P>0.05).Conclusions:The findings reported evidence of positive adaptation in patients with heart failure,indicating that the Roy Adaptation Model is an effective guide for developing an implemented framework for the nursing practice of the patients.The culturally-tailored care plan intervention is helpful to improve adaptation of patients with heart failure.
基金supported by Health Commission of Zhejiang Province(grant number WKJ-ZJ-1925 and 2019ZD034).
文摘We appreciate the question raised in a discussion with a reader and the editor about an instrument for outcome measure of the quality of life among people with chronic heart failure[1].We recognized that we should have described more details about how to convert the score of the Minnesota Living with Heart Failure Questionnaire(MLHFQ).Lack of scoring details might lead to some confusion to understand the results of this study.We thank the International Journal of Nursing Sciences for the opportunity to provide further information to clarify the process of data analysis and research findings.
文摘Context: Higher income countries have an average physician density of 300 physicians per 100,000 people. In stark contrast, lower income countries have an average physician density of 17 physicians per 100,000 people. A major cause of this discrepancy is the migration of healthcare professionals from lower income to higher income countries, a phenomenon colloquially known as the “brain drain”. Objective: To explore factors that led International Medical Graduate (IMG) physicians to leave their home countries and migrate to Canada. Methods: An anonymous questionnaire with a mix of open- and close-ended questions was sent to 500 randomly selected IMG physicians practicing in Ontario, Canada. Results were analyzed using a mixed-method design utilizing both descriptive statistics and a thematic analysis approach. Results: 39 physicians met inclusion criteria and completed the survey. The majority were 50 years or older, and over 60% were male. The most common reason for emigration from their home country was the socioeconomic and/or political situation, and the most common reason for selecting Canada was family issues. Suggestions for how brain drain could be stemmed fell into three broad categories: 1) more accurate information about lack of opportunities in Canada, 2) more continuing medical education opportunities in home countries, and 3) address issues such as safety and quality of life in home countries. Conclusions: This survey provides insights into the reasons for emigration and immigration for international medical graduates. The results of this survey can assist stakeholders in working toward appropriate and acceptable solutions to the brain drain.
文摘Objectives:To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in health-care.Methods:We applied Walker and Avant method to clarify the concept of social movement in the context of knowledge uptake and sustainability.Peer-reviewed and grey literature databases were systematically searched for relevant reports that described how social movement action led to evidence-based practice changes in health and community settings.Titles,abstracts and full texts were reviewed independently and in duplicate,resulting in 38 included articles.Results:Social movement action for knowledge uptake and sustainability can be defined as individuals,groups,or organizations that,as voluntary and intrinsically motivated change agents,mobilize around a common cause to improve outcomes through knowledge uptake and sustainability.The 10 defining attributes,three antecedents and three consequences that we identified are dynamic and interrelated,often mutually reinforcing each other to fortify various aspects of the social movement.Examples of defining attributes include an urgent need for action,collective action and collective identity.The concept analysis resulted in the development of the Social Movement Action Framework.Conclusions:Social movement action can provide a lens through which we view implementation science.Collective action and collective identity e concepts less frequently canvassed in implementation science literature e can lend insight into grassroots approaches to uptake and sustainability.Findings can also inform providers and change leaders on the practicalities of harnessing social movement action for realworld change initiatives.By mobilizing individuals,groups,or organizations through social movement approaches,they can engage as powered change agents and teams that impact the individual,organizational and health systems levels to facilitate knowledge uptake and sustainability.
文摘Background:Dementia is a syndrome that affects a person’s ability to understand and express information.The higher prevalence of vision and/or hearing losses among persons with dementia in long-term care(LTC)facilities interferes with the ability of nurses to provide optimal care because communication is compromised.Therefore,the detection and screening for sensory impairment is of the utmost importance in LTC facilities;however,there is currently no agreement among nursing professionals on how to best identify such losses for the purpose of further referral,and the need for a validated screening measure suitable for nurses in LTC facilities is clear.The present project aims to close this gap by investigating the screening recommendations of vision-and hearing-care professionals working with clients affected by dementia.Methods:Eleven experts in audiology,optometry,deafblindness,and technology participated in individual semi-structured interviews on the topic of tools and strategies that can be used to screen individuals with dementia for sensory loss.Interview transcripts were coded by two evaluators using verbal agreement and consensus building.Results:Three main themes emerged from the interviews with experts:barriers,facilitators,and strategies.Barriers to sensory screening were often mentioned,particularly impaired communication and lack of staff cooperation.Facilitators consisted uniquely of people,such as family members,intervenors,and nurses.Strategies for sensory screening in this population consisted of improving communication through repetition and encouragements;considerations based on familiarity;and inferring an impairment on the basis of patient behaviour.Few of our interviewees were knowledgeable on the topic of screening apps.Conclusions:Our findings,to be integrated with a similar environmental scan conducted among LTC nurses,can inform the administration of sensory impairment screening tests among a population with dementia in order to optimize care.
基金a Canadian Institutes of Health Research Healthy Life Trajectories Initiative grant(grant#HLC-154502)。
文摘Objectives The objective of this study is to describe the clustering of medical,behavioural and social preconception and interconception health risk factors and determine demographic factors associated with these risk clusters among Canadian women.Design Cross-sectional data were collected via an online questionnaire assessing a range of preconception risk factors.Prevalence of each risk factor and the total number of risk factors present was calculated.Multivariable logistic regression models determined which demographic factors were associated with having greater than the mean number of risk factors.Exploratory factor analysis determined how risk factors clustered,and Spearman’s r determined how demographic characteristics related to risk factors within each cluster.Setting Canada.Participants Participants were recruited via advertisements on public health websites,social media,parenting webpages and referrals from ongoing studies or existing research datasets.Women were eligible to participate if they could read and understand English,were able to access a telephone or the internet,and were either planning a first pregnancy(preconception)or had≥1 child in the past 5 years and were thus in the interconception period.Results Most women(n=1080)were 34 or older,and were in the interconception period(98%).Most reported risks in only one of the 12 possible risk factor categories(55%),but women reported on average 4 risks each.Common risks were a history of caesarean section(33.1%),miscarriage(27.2%)and high birth weight(13.5%).Just over 40%had fair or poor eating habits,and nearly half were not getting enough physical activity.Three-quarters had a body mass index indicating overweight or obesity.Those without a postsecondary degree(OR 2.35;95%CI 1.74 to 3.17)and single women(OR 2.22,95%CI 1.25 to 3.96)had over twice the odds of having more risk factors.Those with two children or more had 60%lower odds of having more risk factors(OR 0.68,95%CI 0.52 to 0.86).Low education and being born outside Canada were correlated with the greatest number of risk clusters.Conclusions Many of the common risk factors were behavioural and thus preventable.Understanding which groups of women are prone to certain risk behaviours provides opportunities for researchers and policy-makers to target interventions more efficiently and effectively.
