Monday, 20 March 2017

What is the impact of shift work on the psychological functioning and resilience of nurses?

Roger Watson, Editor-in-Chief

Everyone who has worked as a nurse has worked shifts, including night shifts. There seems to be no way out of shifts and nothing is perfect. Either you do very long exhausting stints or many short ones, some very early, some very late...and then those nights. Some people love them, some people hate them. I hated them - yet I did them permanently for a while.

So what does this do to nurses? That was the focus of a study from Australia by Tahghighi et al. (2017) titled: 'What is the impact of shift work on the psychological functioning and resilience of nurses? An integrative review' and published in JAN which aimed to: 'synthesize existing research to determine if nurses who work shifts have poorer psychological functioning and resilience than nurses who do not work shifts.' This was a systematic review and 37 articles were reviewed.

The outcome was inconclusive and much more work is needed with better designed studies. The authors concluded: 'The majority of studies were correlational comparing different patterns of shift work schedules and utilized inconsistent outcome measures. Based on the current evidence, we cannot definitively conclude that nurses who work shifts have poorer psychological functioning than those who do not. Instead, the current evidence suggests that for some nurses, shift work is associated with negative psychological outcomes and these outcomes appear highly dependent on contextual and individual factors.

You can listen tom this as a podcast

Reference

TAHGHIGHI M., REES C.S., BROWN J.A., BREEN L.J. & HEGNEY D. (2017) What is the impact of shift work on the psychological functioning and resilience of nurses? An integrative review. Journal of Advanced Nursing doi: 10.1111/jan.13283

Monday, 13 March 2017

Existential aspects of protected mealtimes

Roger Watson, Editor-in-Chief

Are protected mealtimes worth the effort? My only involvement in a study in one of our local hospitals suggested they made no difference to nutrition. However, meals are more that just nutrition; they fulfil important social and, as this article discusses, existential functions.

The study is Danish by Beck et al. (2017) titled: 'Supporting existential care with protected mealtimes: patients’ experiences of a mealtime intervention in a neurological ward' and published in JAN. The aim of the study was: 'to explore the experiences of patients who were admitted to the neurological ward during an intervention – inspired by Protected Mealtime – that changed the traditional mealtime practice.' Protected mealtimes are times when any unnecessary interruptions by staff such as doctors or therapists is prevented during mealtimes to allow patients to eat peacefully and undisturbed. Interviews were held with 13 patients to find out what their experiences of protected mealtimes was.

Patients were positive about the experience of protected mealtimes and one said: 'They introduced what they call Quiet Please. Well, with that. . . you feel the vacuum of mealtime. That is where it all slows down. You get a break and get a refresher on what [the doctors] had been saying to us.' Another patient said: 'Before the project started, I think there was much more turmoil. I did not think about it, but when they started the project, you could feel the present. The turmoil was really uncomfortable, especially after you had tried the other thing. The authors concluded: 'Patients felt that mealtimes were meaningful and nourishing events that provided a calming and pleasant environment that made them feel embraced and recognized as humans.'

You can listen to this as a podcast

Reference

BECK M., BIRKELUND R., POULSEN I. & MARTINSEN B. (2017) Supporting existential care with protected mealtimes: patients’ experiences of a mealtime intervention in a neurological ward. Journal of Advanced Nursing doi: 10.1111/jan.13278

Response to commentary on Jøranson N. et al. (2016) Change in quality of life in older people with dementia participating in Paro-activity: a cluster-randomized controlled trial

Nina Jøranson PhD RN
Ingeborg Pedersen PhD
Anne Marie Mork Rokstad PhD RN
Camilla Ihlebæk PhD



Response to: Commentary on: Jøranson N., Pedersen I., Rokstad A.M.M. & Ihlebæk C. (2016) Change in quality of life in older people with dementia participating in Paro-activity: a cluster-randomized controlled trial


We would like to thank Dr. Jose M. Moran for noticing the unfortunate mistake of inserting an incorrect ClinicalTrials.gov Identifier in our published paper. We are pleased to be given the opportunity to clarify this mistake.

The ClinicalTrials.gov Identifier in the published paper, NCT 02008630 is connected to the project "Animal-assisted Interventions in Health Promotion for Elderly With Dementia", which refers to one of two completed studies in a large Norwegian intervention study by Norwegian University of Life Science. This particular study conducted animal-assisted interventions in day-care centres. This study investigated another sample, which was home-dwelling older people with dementia. Hence, other outcome measures were used, such as Berg balance test, as primary outcome.

However, the discussed study referred unfortunately to an incorrect ClinicalTrials.gov Identifier, an error producing confusion when checking ClinicalTrials.gov to investigate if studies are in adherence with the CONSORT guidelines. The discussed study has the correct ClinicalTrials.gov Identifier: NCT01998490 "Animal-assisted or Robot-assisted Interventions in Health Promotion for Elderly With Dementia" and refers to the study on robot-assisted interventions conducted in several nursing homes. This study should, and did, use BARS as primary outcome measure. We conducted the RCT on robot-assisted interventions in adherence with the CONSORT guidelines.

We are very sorry to have committed such an error.

On behalf of the authors:
Dr Nina Jøranson
Associate Professor, PhD
VID Specialized University, Faculty of Health Studies
Oslo, Norway


Reference

Jøranson N., Pedersen I., Rokstad A.M.M. & Ihlebæk C. (2016) Change in quality of life in older people with dementia participating in Paro-activity: a cluster-randomized controlled trial. Journal of Advanced Nursing 72(12), 3020–3033. doi: 10.1111/jan.13076


Friday, 3 March 2017

Get Healthy!

Rita Pickler, JAN Editor

The American Nurses’ Association (ANA) has declared 2017 “Year of the Healthy Nurse.”

A healthy nurse is one who focuses on “creating and maintaining balance and synergy in physical, intellectual, emotional, social spiritual, personal, and professional well-being” (ANA). That’s a tall order with a lot of creating and balancing. Leaders at ANA have argued, however, that healthy nurses are necessary not only their own well-being, but also in the best interests of those for whom they provide care. Healthier nurses are certainly likely to be better role models for their patients and the public. Healthier nurses, who may feel better and feel better about themselves, can also contribute to healthier work environments.

To help nurses become healthier, the ANA has provided a toolkit on its website with smoking cessation, limiting alcohol use, and improved nutrition, sleep, and exercise leading the agenda. Their Healthy Nurse/Healthy Nation Grand Challenge kicks off March 9, 2017 at the ANA Annual Conference in Tampa, Florida. There is certain to be a good deal of excitement about this among the over 3.5 million US nurses and perhaps worldwide. We also hope that health care systems and nurses’ employers are excited about this movement and find ways for nurses to get and stay healthy.

JAN is going to do its part as well. Next month, on World Day for Safety and Health at Work (April 28) we will make available a virtual issue of select papers recently accepted for publication that focus on some of the challenges nurses confront to getting and staying healthy as well as some strategies that may work to improve nurses health. We hope you check this space next month for a link to the virtual issue; the selected papers will be available at no cost for one month from the JAN website. In the spirit of Year of the Healthy Nurse, for the remaining months of 2017, JAN will highlight in this space one or two recently published papers on specific healthy nurse related topics.

For now, check out the ANA website. Then take a walk, relax with your loved ones, enjoy a healthy meal, and get some sleep!


Tuesday, 28 February 2017

Helping older people thrive in nursing homes

Roger Watson, Editor-in-Chief

What happens to older people once they enter nursing and residential homes is of increasing concern, as more older people are admitted to nursing homes and spend longer times in them. Essentially, do they thrive there or not? This study from Sweden by Björk et al. (2017) titled: ‘Residents’ engagement in everyday activities and its association with thrivingin nursing homes’ and published in JAN aimed to: ‘To describe the prevalence of everyday activity engagement for older people in nursing homes and the extent to which engagement in everyday activities is associated with thriving.’

This was a large study involving over 170 nursing homes and over 4000 residents. Standard questionnaires were sent to homes for completion by staff to find out what residents did and if they were thriving. One of the questionnaires was the Thriving in Older People Assessment Scale. The results of the study show which activities were most common for residents such as physical touch and hugs from staff and talking to relatives. The extent to which residents thrived was related to things like being involved in an activity and being nicely dressed.

The authors concluded: ‘This study found that resident engagement in activities was significantly associated with thriving. Engagement in everyday activities can be interpreted to support resident personhood by being connected to one’s life history, significant others, activities and interest.’

You can listen to this as a podcast

Reference

BJÖRK S., LINDKVIST M., WIMO A., JUTHBERG C., BERGLAND Å. & EDVARDSSON D. (2017) Residents’ engagement ineveryday activities and its association with thriving in nursing homes. Journal of Advanced Nursing doi: 10.1111/jan.13275

Monday, 27 February 2017

It's not easy for families to help adolescents avoid obesity

Roger Watson, Editor-in-Chief

If adolescents are going to avoid obesity, with its attendant health risks, then families need to support them. But this is not always easy as a Danish-Australian collaborative study by Eg et al. (2017) titled: 'How family interactions about lifestyle changes affect adolescents’ possibilities for maintaining weight loss after a weight-loss intervention: a longitudinal qualitative interview study' shows. The aim of the study was: 'to examine how family interactions related to lifestyle changes influence adolescents’ potential for maintaining weight loss after participating in a weight-loss treatment programme.'

Ten families with obese adolescents were followed over 5 years following a weight loss programme. Parents felt guilty at times when they knew they were not being helpful to their adolescent children, as one mother said: 'We just haven’t had the energy to go all-in and do the exercising and the slimming diet, because often we end up with these quick solutions, you know, when you come home and you’re kind of busy.' Another mother said: 'Often, I feel like an old schoolmarm, constantly scolding. Sometimes I get a bad conscience about telling him that he can’t have any more to eat. It makes you feel like some sort of watchdog.' Siblings not on a diet could make the situation more difficult: 'It can be difficult for him [the adolescent] to understand that he can’t necessarily eat the same things as [his brothers] can. Actually, I think that’s probably been the hardest thing for him to deal with.'

The authors concluded: 'It is fundamental that the entire family is supportive, regardless of family structure. Supporting the adolescent was far more difficult than families expected; more time-consuming and also a cause of family conflicts. In families with non-aligned expectations and effort levels it was difficult for the adolescent to maintain weight loss, especially when parents were divorced and not cooperating. Siblings not needing weight management seemed to play a major, but overlooked, role for the primary participant’s own weight management.'

You can listen to this as a podcast

Reference

EG M. , FREDERIKSEN K . , VAMOSI M. & LORENTZEN V. (2017) How family interactions about lifestyle changes affect adolescents’ possibilities for maintaining weight loss after a weight-loss intervention: a longitudinal qualitative interview study. Journal of Advanced Nursing doi: 10.1111/jan.13269