Tuesday, 29 July 2014

Informal carers can predict when older people with dementia should be admitted to long-term care

Roger Watson, Editor-in-Chief

A pan-European study of dementia by a stellar team of European researchers from the UK, Netherlands, Finland, Sweden, Germany, Estonia and Spain titled 'Predicting institutional long-term care admission in dementia: a mixed-methods study of informal caregivers’ reports' has recently been published in JAN. The study is published on behalf of the RightTimePlaceCare consortium.

The study by Efram et al. (2014) had two aims, to investigate agreement between:
  1. expected reasons and actual reasons for admission of people with dementia according to informal caregivers
  2. scores on measurement instruments prior to admission and the actual reasons for admission according to informal caregivers.
The investigators wanted to know if informal carers were a reliable source of information on whether of not an older person with dementia in their care required admission to long-term care. The results were promising; in the words of the authors: 'Informal caregivers can be considered reliable sources of information regarding what causes the admission of a person with dementia. Professional care should anticipate informal caregivers’ statements and collaborate with them to strive for timely and appropriate admission.'


Reference

Afram B, Verbeek H, Bleijlevens MHC, Challis D, Leino-Kilpi H, Karlsson S, Soto ME, Renom-Guiteras A, Saks K, Zabalegui A, Hamers JPH on behalf of the RightTimePlaceCare consortium (2014) Predicting institutional long-term care admission in dementia: a mixed-methods study of informal caregivers’ reports Journal of Advanced Nursing doi: 10.1111/jan.12479


Companionship among cancer patients

Roger Watson, Editor-in-Chief

The era of the ‘expert patient’ is here and, while we often articulate the need to listen to patients and may emphasise the importance of mutual support groups, we still see ourselves - nurses - as the primary source of information for patients. After all, we’ve learned about the conditions we manage, we’ve seen hundreds of patients with the condition, we’re up to date with the latest in evidence-based practice and we know where to get information quickly and copiously. We often forget - and I recall no incidence from my clinical experience - that the expert is often sitting next to our patient…and it’s not us; it’s the other patient.

A recent Danish study by Andersen and Birkelund (2014) titled: ‘A companionship between strangers – learning from fellow cancer patients in oncology wards’ and published in JAN reports a study of how hospitalised patients with cancer can learn from each other. The study was use participant observation and interview. The 85 patients, who had a wide range of cancers and reasons for being hospitalised, reported several aspects to what could be learned from other patients from continuing to fight the disease through to acceptance of the inevitable.

In the words of the authors: ‘Learning from exchanges of experiences with fellow patients provided a better understanding about the disease and was valued because it was first-hand knowledge. Patients’ personal experience of disease is an underused resource in nursing’.


Reference

Andersen LS, Larsen BH, Birkelund R (2014) A companionship between strangers – learning from fellow cancer patients in oncology wards Journal of Advanced Nursing doi: 10.1111/jan.12490


Sunday, 27 July 2014

Nurse turnover is costly and inconvenient

Roger Watson, Editor-in-Chief

Christine Duffield
An Australian team led by Christine Duffield from the University of Technology, Sydney has published a study titled 'A comparative review of nurse turnover rates and costs across countries' in JAN.

Nurse turnover is expensive for health services in terms of both a loss of investment and the costs involved in hiring and investing new staff. It can also represent staff dissatisfaction with their workplace. High turnover and the subsequent vacancies and the need to integrate new staff can lead to further dissatisfaction.

The study by Duffield et al. (2014) is a review of the evidence on turnover from Canada, New Zealand, USA and Australia. The study recognises the variability in reporting turnover across the world and, from my own work in the area, I know that there are different definitions of turnover. Therefore, the study included only studies using a method called the Nursing Turnover Cost Calculation Methodology. Four papers were reviewed and they showed that Australia had the lowest turnover rates whereas New Zealand had the highest. What contributed towards costs differed across countries. In their own words the authors concluded that there is a: 'need for a minimum dataset to define and measure turnover across departments, hospitals, states and countries. In addition, a greater focus on nurse retention is suggested as findings indicate that a significant proportion of turnover costs are attributed to temporary replacement.'



Reference

Duffield C, Roche M, Homer C, Buchan J, Dimitrelis S (2014) A comparative review of nurse turnover rates and costs across countries Journal of Advanced Nursing doi: 10.1111/jan.12483

Monday, 21 July 2014

Personality and pregnancy

Roger Watson, Editor-in-Chief

There has been considerable interest in the relationship between issues related to childbirth and personality, much of it published in JAN (Brown 2014, Kenney & Bhattacharjee 2000, Wiklund et al. 2009) in recent years. This trend continues and a paper by Harville et al. (2014) titled 'Personality and adolescent pregnancy outcomes' investigates how personality factors measured using the ‘Big Five’ NEO-FFI personality inventory and published in JAN reports the following results (in the authors’ own words):
  
"Agreeableness and intellect/imagination were associated with a reduced likelihood of becoming pregnant as an adolescent, while neuroticism, conscientiousness and extraversion were all associated with an increased likelihood of becoming pregnant. Higher neuroticism was associated with lower birth weight and gestational age among Black girls, but not non-Black. Conscientiousness was associated with lower gestational age among non-Black girls. No relationships were found with extraversion or agreeableness and birth outcomes. Receiving late or no prenatal care was associated with higher intellect/imagination."


References

Brown A (2014) Maternal trait personality andbreastfeeding duration: the importance of confidence and social support Journal of Advanced Nursing 70, 587–598

Harville EW, Spriggs Madkour A, Xie Y (2014) Personality and adolescent pregnancy outcomes Journal of Advanced Nursing doi: 10.1111/jan.12481

Kenney JW, Bhattacharjee A (2000) Interactivemodel of women’s stressors, personality traits and health problems Journal of Advanced Nursing 32, 249–258

Wiklund I, Edman G, Larsson C, Andolf E, (2009) First-time mothers and changes in personality in relation to mode ofdelivery Journal of Advanced Nursing 65, 1636–1644