American Research Journal of Nursing

1*Maria Maniou, 2Christos Klisiaris, 3Sofia Zyga, 4Georgios Tsikritsakis, 4Katerina Anathreptaki, 5Constantinos Togas, 4Maniola Naska

Suicide is among the ten most common causes of death for all ages. Anxiety is a major risk factor for suicidal behavior in adolescents.

Mg. Sandra Sandoval-Barrientos

Health is a concept that involves not only the physical or psychological well-being of people, but also - among others - appropriating concepts such as empowerment, participation and social mobilization. In this line, photovoice is a method and at the same time a qualitative research technique that allows pedagogically the possibility that the people themselves can change their environments, situations or structures that limit the healthy experiences in which they are inserted. In this way, the photovoz facilitates the subjects, to be protagonist of their own health processes, looking for solutions from the resources with which they count and assuming personal and collective responsibilities. This paper presents in a synthetic way how this methodology is used and some experiences of graduate students and nurses who have successfully used this methodology.

1IbrahimMubarak Al Baalharith, 2P. Ester Mary, 3Hamad Salem Al Grad 4Abdullah Baraik S Al Awad   

 Background: Low Back Pain (LBP) among nursing profession is very common. The major causes of low back among nurses were attributed to the frequency of transfers as well as repositioning and handling of patients. In clinical nursing practice, low back pain has been reported in 56-80% of registered nurses. Aim: The aim of the study is to evaluate the Body mechanics, Ergonomic posture training and Education on Back injury prevention (BEEB) Intervention, on low back pain among Nurses. Objectives: To assess the level of low back pain among nurses in the experimental and control group and to evaluate the effectiveness of BEEB intervention on the level of low back pain among nurses in the experimental group and to find out the association between the level of low back pain with selected demographic variables in the experimental group. Methodology: The research approach used in the study was quantitative approach by using True -experimental research design. The study was carried out in two phases. The first phase was a descriptive survey which was carried out among nurses from various units from six randomly selected hospitals in Najran Region. Second phase: Experimental phase. A total of 560 nurses among 300 nurses with low back pain were assigned to two groups, namely, control group (150) and experimental group (150) The experimental group received a BEEB (Body mechanics Ergonomic posture training, Education on Back injury prevention ) intervention for 3 months, weekly 2 sessions and follow up and the control group received routine follow up care. Their low back pain level was assessed by McCaughey pain scale before as well as after the intervention in both groups. The tools used for the data collection was demographic variables, McCaughey pain scale and a self-administered questionnaire on BEEB intervention. Data were analyzed by using descriptive and inferential statistics through SSP statistical package. Results: In total, we included 300 nursing staffs from the control group (150) and experimental (150) samples. The pre- test of the experimental group 44(29.3%) had severe back pain and 66(44%) had moderate back pain and 40(26.6%) had mild back pain, respectively in experimental post -test 32(21.3%) had severe back pain and 46(31%) had moderate back pain and 72(48%) had mild back pain .In control group pre- test 38(25.3%) had severe back pain 66(44%) had moderate back pain and 46(31%) had mild back pain, respectively in control group in post- test 31(21%) had severe back pain 63(42%) had moderate back pain and 56(37%) had mild back pain. The comparison of pain level in the control and experimental group pre and post- test. The pre-test mean value of experimental group was 6.16 with 1.192 SD and the post-test mean value was 4.12 with 2.143 S.D respectively the mean of control pre-test was 6. 464with 2.327 (p=0.1164) and the difference was not statistically significant. After the intervention, the control group post -test mean value was 6.212 with 2.213 S.D and experimental post -test mean 4.12 with 2.143 T=2.04 (P<0.001).The difference was highly significant (P<0.001).The control group pre and post test was compared by the paired test and it was not significant (p=0.0561). 

1*Linda Basso Melodia, DNP, RN, 2Barbara Penprase, PhD, RN, 3Linda L. Strong, EdD, RN

Background: Job satisfaction and feelings of empowerment positively impact home health care nurses by improving patient safety and patient outcomes. The project objective determined whether an empowerment educational module improved the feelings of empowerment and job satisfaction of registered nurses at a home health care agency. Methods: A quantitative, pre-test/post-test research study was conducted to measure the success of an empowerment educational module. Laschinger’s (2008) Nursing Worklife questionnaire was administered to 92 participating nurses, 46 were assigned to an experimental group and 46 were assigned to a control group. Participants in the experimental group were queried about their perceptions towards empowerment in home health care environments and their reactions towards the teaching module. Results: The educational module did not significantly impact the participants’ sense of empowerment and seemed to weaken the empowerment at times, albeit in statistically insignificant numbers. Six themes emerged from this discussion. 

Fernanda RE Gimenes1*, PhD, RN, Patricia B Marck2, PhD, RN, Elisabeth Atila3, RN, Mayara Carvalho Godinho Rigobello1, Ms, RN, Ana Paula Gobbo Motta1, Ms Student, RN, Emanuel Nunes4, RN, Rosana Aparecida Pereira5, Ms student, RN

Objectives: To gain a comprehensive understanding of medication safety and potential improvements in a Brazilian intensive care unit (ICU), we included an exploration of related workarounds. Methods: We adapted participatory photographic research methods from the field of ecological restoration to study a Brazilian ICU. Using focus groups, nurse-led photo-narrated walkabouts, and photo elicitation in iterative phases of data collection and analysis, we identified a theme of ‘living with workarounds on a day-to day basis’. Results: Participants recognized barriers within their work environment that might contribute to perpetuating medication workarounds, and the visual methods enabled them identify ideas to minimize workarounds related to these processes of care. Conclusions: The participatory photo methods helped participants and researchers to develop in depth discussions to understand how nurses work around systemic vulnerabilities to optimize the delivery of patient care. The methods also increased participants’ awareness of such behaviors and provided opportunities to identify ideas to reduce risk. We expect that similar methods could be successfully used in the future in a variety of practice settings to improve medication processes and other patient safety issues.

Chiara Tosin1, Amabile Bonaldi2, Paolo Biban3, Dr. Salco Andrea4 Dr. Chinchiolo Paola5

Aim: The paper aims to describe the development and test of the Nursing Competencies Assessment Tool (NCAT), an indicator framework thought to support nursing professional development. It is argued that the NCAT application method can represent a worthwhile tool to assess nursing competences on novice, advanced beginner, competent and proficient nurses. Background: Several elements composing nursing competency profile have been examined by many authors. Actually managers needed practical and user-friendly instruments that respected specific characteristic of different settings. Methods: The presented pilot study exploited a mixed methods approach, including: a literature review to create an indicator framework, self-administered questionnaires submitted to expert nurses, consensus meetings to elaborate the integration program and a final control group comparison. NCAT was before tested in a Pediatric Intensive Care Unit, later we retested NCAT in a pediatric unit with a semi–intensive area. Results: All indicators have been considered pertinent and relevant by expert nurses. Every nurses found the integration plan easy to understand and useful for their work. The control group comparison emphasized the importance in nurses’ group opinions. Conclusion: The NCAT implementation method represents a reliable and reproducible tool aimed to evaluate nurses’ competence profiles respecting the specific context. Further studies are now needed to evaluate the chance to transfer in a profitable way the emerged indicators in several other adults and pediatrics contexts.

 John E. Scarbrough, PhD, PT, RN, CNEa; Joe Tomaka, PhDb

Along the U.S.-Mexico border, significant disparities exist in the incidence, prevalence, diagnosis, and treatment of diabetes mellitus and hypertension in the Hispanic population, especially males. The target population suffers from the sequelae of lack of long-term management to a greater degree than the general population. The first step in efforts to minimize the consequences of poor disease identification and management (cardiac disease, stroke, limb amputation, etc.) is to screen at-risk individuals and encourage their engagement with positive self-care behaviors. Early detection and effective interventions have the greatest ability to decrease existing morbidity and mortality disparities for Hispanic males in the U.S-Mexico border region. The project utilized screening and brief intervention methodologies in locations convenient to the target population, seeking to increase both identification and follow-up care for Hispanic men with type 2 diabetes and hypertension. All participants were screened for type 2 diabetes, hypertension, and body mass. The experimental group received 1:1 motivational interviewing seeking to encourage follow-up and discussion of the results, and the control group received a standard, plain text printout of results with no motivational interview. Follow-up telephone calls and return of stamped, pre-addressed postcards were used to capture follow-up data. The project identified significant incidence of type 2 diabetes and hypertension within the population and also validated correlation between the two conditions and obesity. Further research is indicated to enhance data capture upon conclusion the brief intervention, for which follow-up contact results were inconclusive due to limited follow-up participation.

Anna-Carin Uttermalm, MSc, RPTa, Anna von Wachenfeldt, MD, PHDb Elisabet Lidbrink, MD, PHDc, Aina Johnsson, MSW, PHDc,d

 Breast cancer is the most common female cancer worldwide. In the majority of cases, the breast tumour is hormone receptor-positive and the woman is prescribed 5 years of adjuvant anti-hormonal therapy. Many women experience side effects from the treatment. Symptoms can be so severe that some women choose to discontinue treatment. This study was conducted in order to find methods to support women treated with adjuvant anti-hormonal breast cancer therapy to complete their treatment, by elucidating how they experience the side effects and how they act and reflect on coping and on rehabilitation- related issues. The study includes twelve women from two focus group interviews. The recorded interviews were analysed using qualitative content analysis with an inductive approach. The women felt alienated from their body, which they felt had aged a lot. They reported symptoms from the joints and muscles, such as pain, aching and stiffness, and muscle cramps. They also reported fatigue and menopausal symptoms. The bodily changes were strong hindrances when they tried to live and work as before. They felt that they had been given insufficient information about the anti-hormonal therapy and its side effects. They also felt they lacked support from the health care providers in how to cope with the symptoms. They furthermore had a sense of a large obstacle in the way of getting started with any physical activity. Overall, the women had an impaired self-reliance on the body. The fact that women, when offered rehabilitation, experienced it positively and managed it well can motivate those providing medical care to develop rehabilitation programmes adapted to the individual’s needs. Better rehabilitation programmes and improved information about the therapy and its side effects may make it easier for women with breast cancer to complete the anti-hormonal therapy.

Janet Wilson

 This paper describes one component; professional socialisation, from the findings of a larger study exploring the responses of Registered Nurses and healthcare support workers to patient death in an acute hospital setting. Professional socialization involves the acquisition of knowledge and skills of a particular profession, and the adoption of values and norms leading to the development of behaviours and self-concept that are indicative of the characteristics necessary for the role taken at work. It is recognised that there is a strong desire for nurses to feel part of a team and as a result conform to existing practices and routines in order to be accepted. A Heiddegarian phenomenological approach was used to gather and analyse data through individual interviews. Participants were recruited through purposive sampling from two medical wards in a large teaching hospital in the United Kingdom. It was found that recently qualified Registered Nurses felt they should not show their emotions or discuss their feelings with certain colleagues. In order to be accepted by established staff on the ward they felt they needed to conform to behaviours they believed would be acceptable. Some of the more experienced Registered Nurses and healthcare support workers showed their emotions and talked about events to colleagues expressing the benefits they perceived of doing this for both themselves and others. This demonstrates that newly qualified staff were not always correct in their assumptions of what was considered the norm in these situations. Some of the newer Registered Nurses felt they needed to be more rigid in their behaviours, and were reluctant to challenge medical staff regarding active treatments. These differences could be due to established Registered Nurses feeling secure and comfortable in their professional roles, and being clear on the values they hold. More inexperienced Registered Nurses could be lacking in both knowledge and skills, as well as being unsure of their professional role.  

Atef M. Darwish MD PhD

 This case report describes successful laparoscopic extraction of a viable tubal pregnancy with some technical tricks to control bleeding