BACKGROUND: Depression rates are particularly high in those with end-stage renal disease; however, there is limited insight into the range of stressors associated with haemodialysis treatment within the National Health Service contributing to such high rates, particularly those of a cognitive or psychological nature.
DESIGN: A qualitative approach was used to obtain rich, patient-focused data; one-to-one semi-structured interviews were conducted with twenty end-stage renal disease at a UK National Health Service centre.
METHODS: Patients were interviewed during a typical haemodialysis session. Thematic analysis was used to systematically interpret the data. Codes were created in an inductive and cyclical process using a constant comparative approach.
RESULTS: Three themes emerged from the data: (i) fluctuations in cognitive/physical well-being across the haemodialysis cycle, (ii) restrictions arising from the haemodialysis treatment schedule, (iii) emotional impact of haemodialysis on the self and others. The findings are limited to predominantly white, older patients (median = 74 years) within a National Health Service setting.
CONCLUSIONS: Several of the experiences reported by patients as challenging and distressing have so far been overlooked in the literature. A holistic-based approach to treatment, acknowledging all aspects of a patient's well-being, is essential if optimal quality of life is to be achieved by healthcare providers.
RELEVANCE TO CLINICAL PRACTICE: The findings can be used to inform future interventions and guidelines aimed at improving patients' treatment adherence and outcomes, for example, improved reliable access to mental health specialists.
BACKGROUND: Nurses constitute the majority of health care workers, and, compared with other professions, nursing profession is highly stressful and, hence, a cause of anxiety and depression. This may affect nurses' job satisfaction.
METHOD: Using self-administered questionnaires, Depression Anxiety and Stress Scale (DASS-21) and Job Satisfaction Scale for Nurses (JSS), a cross-sectional study of 932 nurses from the inpatient departments of a teaching hospital was conducted in December 2017. Descriptive analyses and multiple logistic regressions were used for the analysis. The STROBE guideline was used in this study.
RESULTS: The overall prevalence of psychological distress was 41%. The prevalence of stress, anxiety and depression were 14.4%, 39.3% and 18.8%, respectively. It was found that single and widowed nurses had a higher level of stress, anxiety and depression compared with married nurses. In addition, nurses in the age of 26-30 years had a higher level of depression than nurses in other age groups. Also, nurses who worked in the paediatric departments had a higher level of depression compared with nurses in other departments. The majority of the nurses were satisfied with their job at 92.0%. Those nurses who were not satisfied were found to be significantly associated with a high level of stress and depression.
CONCLUSION: This study revealed that the level of stress, anxiety and depression is high. Stress and depression were found to be associated with nurses' low job satisfaction.
RELEVANCE TO CLINICAL PRACTICE: Stress and depression can affect nurses' job satisfaction, it is important for nursing managers to institute strategies to address this issue.
BACKGROUND: Given the high incidence of coronavirus and shortage of nurses in Iranian hospitals, learning about nurses' intention to care for patients with COVID-19 is important.
DESIGN: In this cross-sectional study, 648 Iranian nurses were surveyed during March 2020. The online questionnaire consisted of two parts. The mediating role was explored for the following: job satisfaction and commitment in the association of workload, quality of supervisor, extra-role behaviours, and pay satisfaction with the intention to care. The study adhered to STROBE checklist for cross-sectional studies.
RESULTS: The results of this study show that job satisfaction and organisational commitment mediated the relationship of nurses' workload, quality of supervisor, extra-role behaviours, and pay satisfaction with the intention to care for patients with COVID-19.
CONCLUSION: The results of the study indicate the importance of job satisfaction and organisational commitment as mechanisms that help to understand the association of nurses' workload, quality of supervisor, extra-role behaviours and pay satisfaction with the intention to care during the COVID-19 pandemic.
RELEVANCE TO CLINICAL PRACTICE: Hospital managers need to attend to the role of nurses' job satisfaction and other organisational factors to ensure that they can cope with the challenges of the COVID-19 pandemic.
BACKGROUND: A literature review showed a lack of studies focused on the intention of nurses regarding physical restraint throughout the world. Considering that very little research on physical restraint use has been carried out in Malaysia, assessment of nurses' knowledge, attitude, intention and practice is necessary before developing a minimising programme in hospitals.
DESIGN: A cross-sectional study was used.
METHODS: A questionnaire to assess the knowledge, attitude, intention and practice was completed by all nurses (n = 309) in twelve wards of a teaching hospital in Kuala Lumpur.
RESULTS: Moderate knowledge and attitude with strong intention to use physical restraint were found among the nurses. Less than half of nurses considered alternatives to physical restraint and most of them did not understand the reasons for the physical restraint. Nurses' academic qualification, read any information source during past year and nurses' work unit showed a significant association with nurses' knowledge. Multiple linear regression analysis found knowledge, attitude and intention were significantly associated with nurses' practice to use physical restraint.
CONCLUSION: This study showed some important misunderstandings of nurses about using physical restraint and strong intention regarding using physical restraint. Findings of this study serve as a supporting reason for importance of educating nurses about the use of physical restraint.
RELEVANCE TO CLINICAL PRACTICE: Exploring the knowledge, attitude, intention and current practice of nurses towards physical restraint is important so that an effective strategy can be formulated to minimise the use of physical restraints in hospitals.
BACKGROUND: Early identification of delirium in intensive care units is crucial for patient care. Hence, nurses require adequate knowledge to enable appropriate evaluation of delirium using standardised practice and assessment tools.
DESIGN: This study, performed in Malaysia, used a single-group pretest-posttest study design to assess the effect of educational interventions and hands-on practices on nurses' knowledge of intensive care unit delirium and delirium assessment.
METHODS: Sixty-one nurses participated in educational intervention sessions, including classroom learning, demonstrations and hands-on practices on the Confusion Assessment Method-Intensive Care Unit. Data were collected using self-administered questionnaires for the pre- and postintervention assessments. Analysis to determine the effect of the educational intervention consisted of the repeated-measures analysis of covariance.
RESULTS: There were significant differences in the knowledge scores pre- and postintervention, after controlling for demographic characteristics. The two most common perceived barriers to the adoption of the intensive care unit delirium assessment tool were "physicians did not use nurses' delirium assessment in decision-making" and "difficult to interpret delirium in intubated patients".
CONCLUSIONS: Educational intervention and hands-on practices increased nurses' knowledge of delirium assessment. Teaching and interprofessional involvements are essential for a successful implementation of intensive care unit delirium assessment practice.
RELEVANCE TO CLINICAL PRACTICE: This study supports existing evidences, indicating that education and training could increase nurses' knowledge of delirium and delirium assessment. Improving nurses' knowledge could potentially lead to better delirium management practice and improve ICU patient care. Thus, continuous efforts to improve and sustain nurses' knowledge become relevant in ICU settings.