PeerJ Preprints: Nursinghttps://peerj.com/preprints/index.atom?journal=peerj&subject=5500Nursing articles published in PeerJ PreprintsSupply-side barriers to maternal health care utilization at health sub-centres in Indiahttps://peerj.com/preprints/23622016-08-162016-08-16Aditya Singh
Introduction: There exist several barriers to maternal health service utilization in developing countries. Most of the previous studies conducted in India have focused on demand-side barriers, while only a few have touched upon supply-side barriers. None of the previous studies in India have investigated the factors that affect maternal health care utilization at Health Sub-Centers (HSC) in India, despite the fact that these institutions, as the nearest available public healthcare facilities in rural areas, play a significant role in providing affordable maternal health care. Therefore, this study aims to examine the supply-side determinants of maternal service utilization at HSCs in rural India.
Data and Methods: This study uses health facility data from the nationally representative District-Level Household Survey, which was collected in 2007–2008 to examine the effect of supply-side variables on the utilization of maternal healthcare services across HSCs in rural India. Since the dependent variables (the number of antenatal registrations, in-facility deliveries, and postnatal care services) are count variables with considerable dispersion, the data has been analyzed using negative binomial regression instead of Poisson regression.
Results: The results show that those HSCs run by a contractual auxiliary nurse midwife (ANM) are likely to offer a lower volume of services when compared to those run by a permanent ANM. The availability of obstetric drugs, weighing scale, blood pressure equipment is associated with the increased utilization of antenatal and postnatal services. The unavailability of labor/examination table and bed screen is associated with a reduction in the number of safe deliveries and postnatal services. The utilization of services is expected to increase if essential facilities, such as water, telephone, toilet, and electricity, are available at HSCs. Monitoring of an ANM’s work by the Village Health and Sanitation Committee (VHSC) and the in-service training of ANMs appear to have a positive impact on the utilization of services. The distance of an ANM’s actual residence from the sub-center village where she works is negatively associated with the utilization of delivery and postnatal services. These findings are robust to the inclusion of several demand-side factors.
Conclusion: To improve maternal healthcare utilization at sub-centers, the government should ensure the availability of basic infrastructure, drugs, and equipment at all sub-centers. Monitoring of ANMs’ work by VHSCs could play an important role in improving healthcare utilization at the HSCs; therefore, it is important to establish VHSCs in each sub-center village. The issue of the relatively low utilization of maternity services in the HSCs that are run solely by contractual ANMs needs to be investigated further.
Introduction: There exist several barriers to maternal health service utilization in developingcountries. Most of the previous studies conducted in India have focused on demand-side barriers, while only a few have touched upon supply-side barriers. None of the previous studies in India have investigated the factors that affect maternal health care utilization at Health Sub-Centers (HSC) in India, despite the fact that these institutions, as the nearest available public healthcare facilities in rural areas, play a significant role in providing affordable maternal health care. Therefore, this study aims to examine the supply-side determinants of maternal service utilization at HSCs in rural India.Data and Methods: This study uses health facility data from the nationally representativeDistrict-Level Household Survey, which was collected in 2007–2008 to examine the effect of supply-side variables on the utilization of maternal healthcare services across HSCs in rural India. Since the dependent variables (the number of antenatal registrations, in-facility deliveries, and postnatal care services) are count variables with considerable dispersion, the data has been analyzed using negative binomial regression instead of Poisson regression.Results: The results show that those HSCs run by a contractual auxiliary nurse midwife (ANM) are likely to offer a lower volume of services when compared to those run by a permanent ANM. The availability of obstetric drugs, weighing scale, blood pressure equipment is associated with the increased utilization of antenatal and postnatal services. The unavailability of labor/examination table and bed screen is associated with a reduction in the number of safe deliveries and postnatal services. The utilization of services is expected to increase if essential facilities, such as water, telephone, toilet, and electricity, are available at HSCs. Monitoring of an ANM’s work by the Village Health and Sanitation Committee (VHSC) and the in-service training of ANMs appear to have a positive impact on the utilization of services. The distance of an ANM’s actual residence from the sub-center village where she works is negatively associated with the utilization of delivery and postnatal services. These findings are robust to the inclusion of several demand-side factors.Conclusion: To improve maternal healthcare utilization at sub-centers, the government shouldensure the availability of basic infrastructure, drugs, and equipment at all sub-centers. Monitoring of ANMs’ work by VHSCs could play an important role in improving healthcare utilization at the HSCs; therefore, it is important to establish VHSCs in each sub-center village. The issue of the relatively low utilization of maternity services in the HSCs that are run solely by contractual ANMs needs to be investigated further.Transferability of the Assessment of Positive Occupation 15 in elderly people with physical disabilitieshttps://peerj.com/preprints/22192016-07-032016-07-03Takuya NoguchiMakoto Kyougoku
Purpose
The present study aimed to verify the reliability and validity of the Assessment of Positive Occupation 15 (APO-15) in elderly individuals with physical disabilities in health science.
Methods
The study sample comprised 761 elderly individuals with physical disabilities residing in community dwellings, hospitals, and group homes. They completed the APO-15 and Kessler Psychological Distress Scale (K6) evaluations. We analyzed the psychometric properties of the APO-15, polyserial correlation coefficient, and average extracted variance, which included a confirmatory factor analysis (CFA), entropy, Cronbach’s α coefficient, Pearson’s product–moment correlation coefficient, item response theory (IRT), cut-off point, and latent rank values.
Results
The study outcome supported the APO-15, a 15-item, 4-factor model incorporating positive relationships, achievement, meaning, and engagement. The validity of this model was supported by various results; for example, each item score of polyserial correlation coefficient and entropy of APO-15 was the reference value was confirmed as being higher. The structural validity of APO-15 was assessed by CFA, which indicated a good model fit. Hypothesis testing revealed good values for the convergent and discriminant validity of the APO-15, and Cronbach’s α coefficient analysis revealed acceptable internal consistency. These results showed that the 4-factor structure of APO-15, which assumes has been established. Cut-off points for APO-15 of 51-point sensitivity (0.512) and specificity (0.704) yielded good results. The latent rank theory of APO-15 exhibited a good fit in all four rank values. The item reference profile suggested that an effective occupation promotes well-being.
Conclusion
The APO-15 exhibited good psychometric properties with respect to measuring positive occupations in individuals, including elderly individuals, with physical disabilities. This important tool will facilitate participation in occupations that promote daily well-being.
PurposeThe present study aimed to verify the reliability and validity of the Assessment of Positive Occupation 15 (APO-15) in elderly individuals with physical disabilities in health science.MethodsThe study sample comprised 761 elderly individuals with physical disabilities residing in community dwellings, hospitals, and group homes. They completed the APO-15 and Kessler Psychological Distress Scale (K6) evaluations. We analyzed the psychometric properties of the APO-15, polyserial correlation coefficient, and average extracted variance, which included a confirmatory factor analysis (CFA), entropy, Cronbach’s α coefficient, Pearson’s product–moment correlation coefficient, item response theory (IRT), cut-off point, and latent rank values.ResultsThe study outcome supported the APO-15, a 15-item, 4-factor model incorporating positive relationships, achievement, meaning, and engagement. The validity of this model was supported by various results; for example, each item score of polyserial correlation coefficient and entropy of APO-15 was the reference value was confirmed as being higher. The structural validity of APO-15 was assessed by CFA, which indicated a good model fit. Hypothesis testing revealed good values for the convergent and discriminant validity of the APO-15, and Cronbach’s α coefficient analysis revealed acceptable internal consistency. These results showed that the 4-factor structure of APO-15, which assumes has been established. Cut-off points for APO-15 of 51-point sensitivity (0.512) and specificity (0.704) yielded good results. The latent rank theory of APO-15 exhibited a good fit in all four rank values. The item reference profile suggested that an effective occupation promotes well-being.ConclusionThe APO-15 exhibited good psychometric properties with respect to measuring positive occupations in individuals, including elderly individuals, with physical disabilities. This important tool will facilitate participation in occupations that promote daily well-being.What are the possible determinants of urinary incontinence during pregnancy? Results of a pilot studyhttps://peerj.com/preprints/18982016-03-252016-03-25Nejat DemircanÜlkü ÖzmenFürüzan KöktürkHamdi KüçükŞevket AtaMüge Harmaİnan İlker Arıkan
Objectives: This study was conducted to determine the frequency, predisposing factors and impact of urinary incontinence (UI)during pregnancyon quality of life (QOL). Materials and Method: A preliminary cross-sectional survey was carried out among pregnant women from January to June of 2014. A total of 132 pregnant women were enrolled. We used a questionnaire form for sociodemographic features, ICIQ-SF-Turkish version to determine the occurrence and characteristics of UI and Wagner’s Quality of Life scale to assess impact on QOL. Results: Urinary incontinence was present in 56 out of 132 pregnant women (42.4%); these women were referred to as the UI-present group. The remaining 76 women comprised the UI-absent group. The overall mean age was 27.5 ± 5.1 y (p=0.780), median height in UI-present group was 160 cm (min-max: 153-176, p=0.037 <0.05) and median BMI was 28.7 kg/m2(min-max: 22.4-50.0, p=0.881).For women in the UI-present group, urine leakage occurred once a week (n=18, 32.1%) to twice or thrice a week (n=8, 14.3%), few times a day (n=14, 25%), once a day (n=5, 8.9%) and always (n=8, 14.3%). The pregnant women in the UI-present group mainly reported a small amount of urine leakage (n=33, 58.9%) or a moderate amount of leakage (n=4, 7.1%). There were statistically significant relationships between QOL scores and frequency of UI (p=0.002 <0.05) as well as the amount of leakage (p=0.002 <0.05). Impact on QOL scores ranged from mild (n=33, 58.9%) or moderate (n=4, 7.1%) to severe (n=4, 7.1%) levels. QOL has ‘mildly deteriorated’. The following features were found to favour the onset of UI: age of pregnant woman (OR= 0.845, 95% CI 0.268-2.669), occupational status (OR=1.800, 95% CI 0.850-3.810), anaemia (OR=0.939, 95% CI 0.464-1.901), parity (OR=0.519, 95% CI 0.325-0.829), miscarriage in previous pregnancies (OR=1.219, 95% CI 0.588-2.825) and living in rural vs urban settlement (OR=1.800, 95% CI 0.887-3.653).Heigt (p= 0,037<0.05), educational status (p=0.016 <0.05), miscarriage, parity and place of living (p=0.002, p=0.006, p=0.020 <0.05 respectively)were significant in favour of UI-present. Conclusions: Urinary incontinence was frequently encountered among pregnant women (42.1%). Urinary incontinence distorted the QOL in pregnant women at a mild level and caused life style changes. Frequency and amount of UI were the significant factors in deterioration. Age, parity, miscarriage, being housewife, place of living (rural) and anaemia were the factors in favour of onset of UI during pregnancy. Among them, height, educational status (primary-intermediate school graduate), place of living (rural), miscarriage and parity were statistically significant predictors. It is necessary to pay attention to UI and its impact on women’s health during pregnancy.
Objectives: This study was conducted to determine the frequency, predisposing factors and impact of urinary incontinence (UI)during pregnancyon quality of life (QOL). Materials and Method: A preliminary cross-sectional survey was carried out among pregnant women from January to June of 2014. A total of 132 pregnant women were enrolled. We used a questionnaire form for sociodemographic features, ICIQ-SF-Turkish version to determine the occurrence and characteristics of UI and Wagner’s Quality of Life scale to assess impact on QOL. Results: Urinary incontinence was present in 56 out of 132 pregnant women (42.4%); these women were referred to as the UI-present group. The remaining 76 women comprised the UI-absent group. The overall mean age was 27.5 ± 5.1 y (p=0.780), median height in UI-present group was 160 cm (min-max: 153-176, p=0.037 <0.05) and median BMI was 28.7 kg/m2(min-max: 22.4-50.0, p=0.881).For women in the UI-present group, urine leakage occurred once a week (n=18, 32.1%) to twice or thrice a week (n=8, 14.3%), few times a day (n=14, 25%), once a day (n=5, 8.9%) and always (n=8, 14.3%). The pregnant women in the UI-present group mainly reported a small amount of urine leakage (n=33, 58.9%) or a moderate amount of leakage (n=4, 7.1%). There were statistically significant relationships between QOL scores and frequency of UI (p=0.002 <0.05) as well as the amount of leakage (p=0.002 <0.05). Impact on QOL scores ranged from mild (n=33, 58.9%) or moderate (n=4, 7.1%) to severe (n=4, 7.1%) levels. QOL has ‘mildly deteriorated’. The following features were found to favour the onset of UI: age of pregnant woman (OR= 0.845, 95% CI 0.268-2.669), occupational status (OR=1.800, 95% CI 0.850-3.810), anaemia (OR=0.939, 95% CI 0.464-1.901), parity (OR=0.519, 95% CI 0.325-0.829), miscarriage in previous pregnancies (OR=1.219, 95% CI 0.588-2.825) and living in rural vs urban settlement (OR=1.800, 95% CI 0.887-3.653).Heigt (p= 0,037<0.05), educational status (p=0.016 <0.05), miscarriage, parity and place of living (p=0.002, p=0.006, p=0.020 <0.05 respectively)were significant in favour of UI-present. Conclusions: Urinary incontinence was frequently encountered among pregnant women (42.1%). Urinary incontinence distorted the QOL in pregnant women at a mild level and caused life style changes. Frequency and amount of UI were the significant factors in deterioration. Age, parity, miscarriage, being housewife, place of living (rural) and anaemia were the factors in favour of onset of UI during pregnancy. Among them, height, educational status (primary-intermediate school graduate), place of living (rural), miscarriage and parity were statistically significant predictors. It is necessary to pay attention to UI and its impact on women’s health during pregnancy.Depression, anxiety, and stress in partners of Australian combat veterans and military personnel: A comparison with Australian population normshttps://peerj.com/preprints/18762016-03-222016-03-22Gail V MacDonellNavjot BhullarEinar B Thorsteinsson
Partners of Australian combat veterans are at an increased risk of experiencing mental health problems. For a comparative analysis of mental health of partners of veterans with that of their non-military counterparts, the study sample comprised female partners of (a) Australian combat veterans (Sample 1: n = 282, age M = 60.79, SD = 5.05), (b) a random sub-sample of partners of Australian combat veterans from the previous sample (Sample 2: n = 50; M = 60.06, SD = 4.80), (c) partners of Special Air Services Regiment (SASR) personnel (Sample 3: n = 41, age M = 34.39 SD = 7.01), and (d) partners of current serving military (non-SASR) personnel (Sample 4: n = 38, age M = 32.37, SD= [i]6.20). Respondents completed measures to assess their reported levels of depression, anxiety, and stress. The two samples (Samples 1 and 2) for partners of Australian combat veterans reported significantly poorer symptoms of depression, anxiety, and stress than the comparative population norms. The sample of SASR personnel partners reported significantly greater levels of depression and anxiety, while the sample with non‑SASR personnel partners reported a significantly poorer symptomatology in stress than the comparative norms. Lessons and protective factors can be learnt from groups within the current military as to what may assist partners and families to maintain a better level of psychosocial health.
Partners of Australian combat veterans are at an increased risk of experiencing mental health problems. For a comparative analysis of mental health of partners of veterans with that of their non-military counterparts, the study sample comprised female partners of (a) Australian combat veterans (Sample 1: n = 282, age M= 60.79, SD = 5.05), (b) a random sub-sample of partners of Australian combat veterans from the previous sample (Sample 2: n = 50; M = 60.06, SD = 4.80), (c) partners of Special Air Services Regiment (SASR) personnel (Sample 3: n = 41, age M = 34.39 SD= 7.01), and (d) partners of current serving military (non-SASR) personnel (Sample 4: n = 38, age M = 32.37, SD= [i]6.20). Respondents completed measures to assess their reported levels of depression, anxiety, and stress. The two samples (Samples 1 and 2) for partners of Australian combat veterans reported significantly poorer symptoms of depression, anxiety, and stress than the comparative population norms. The sample of SASR personnel partners reported significantly greater levels of depression and anxiety, while the sample with non‑SASR personnel partners reported a significantly poorer symptomatology in stress than the comparative norms. Lessons and protective factors can be learnt from groups within the current military as to what may assist partners and families to maintain a better level of psychosocial health.Behavior of biomarkers during pregnancy and lactation through a biological multi-paradigm model. BECOME study protocolhttps://peerj.com/preprints/18782016-03-202016-03-20María José Aguilar-CorderoLaura Baena-GarcíaRaquel Rodríguez-BlanqueJuan Carlos Sánchez-GarcíaManuel Isidoro Capel-TuñónAntonio Manuel Sánchez-López
Background Despite of advances in research, at the moment, various points related to the physiology of gestation and the etiology of severe diseases that can be developed in the course of it remain unknown. One of those aspects is the behavior of biomarkers (triglycerides, prolactin, glucose and cholesterol) during pregnancy, which experience a gradual increase in their levels until they reach the peak of hypertriglyceridemia, a few days before delivery. Several studies have reported that biomarkers experience a higher elevation in diabetic and obese pregnant women and in those women who suffer preeclampsia. The description of their behavior in different population of pregnant women (healthy women and women at risk) would identify the relation of these with some of the alterations that occurs more frequently during pregnancy. Objective The aim of this study is to develop a multi-paradigm biological model of systems to determine triglyceride, prolactin, glucose and cholesterol levels during pregnancy and its relation with lactogenesis in healthy and risk pregnant women. Methods A prospective cohort study will take place with women during pregnancy and lactation. Participating women will be divided into two groups. One group will be integrated by healthy women and the other group by pregnant women with a risk medical history. The personal, family and a detailed medical history will be collected in each group. A study of all the variables which influence the level of the mentioned biomarkers (triglycerides, cholesterol, glucose and prolactin) will be done. The universe consists in 4,300 women, who constitute the historical average deliveries during the semester in the city of Granada (Spain). The sample collection will be made in medical office’s pregnancy control in Granada’s hospitals, in their respective health centers and during the second half of 2015. The sample will be stratified and probabilistic. Peculiarities of pregnant women will be taken into account when calculating the size of the study sample. This sample will be made up of 224 women who comply with the inclusion criteria and that have signed the informed consent. To achieve the project objectives an organization comprising six theoretical and practical phases enabling the scientific development of the project. During the first phase, the technical and administrative preparation of the project is constructed. Thereafter, the work is divided into two action areas which encompass the collection and data modeling. The creation of a biological multi-paradigm computer simulation model of the levels of biomarkers in different months of pregnancy and in the various pathologies of pregnant women can be very effective to know the risks that involve high levels of lipids for the mother and for the baby.
Background Despite of advances in research, at the moment, various points related to the physiology of gestation and the etiology of severe diseases that can be developed in the course of it remain unknown. One of those aspects is the behavior of biomarkers (triglycerides, prolactin, glucose and cholesterol) during pregnancy, which experience a gradual increase in their levels until they reach the peak of hypertriglyceridemia, a few days before delivery. Several studies have reported that biomarkers experience a higher elevation in diabetic and obese pregnant women and in those women who suffer preeclampsia. The description of their behavior in different population of pregnant women (healthy women and women at risk) would identify the relation of these with some of the alterations that occurs more frequently during pregnancy. Objective The aim of this study is to develop a multi-paradigm biological model of systems to determine triglyceride, prolactin, glucose and cholesterol levels during pregnancy and its relation with lactogenesis in healthy and risk pregnant women. Methods A prospective cohort study will take place with women during pregnancy and lactation. Participating women will be divided into two groups. One group will be integrated by healthy women and the other group by pregnant women with a risk medical history. The personal, family and a detailed medical history will be collected in each group. A study of all the variables which influence the level of the mentioned biomarkers (triglycerides, cholesterol, glucose and prolactin) will be done. The universe consists in 4,300 women, who constitute the historical average deliveries during the semester in the city of Granada (Spain). The sample collection will be made in medical office’s pregnancy control in Granada’s hospitals, in their respective health centers and during the second half of 2015. The sample will be stratified and probabilistic. Peculiarities of pregnant women will be taken into account when calculating the size of the study sample. This sample will be made up of 224 women who comply with the inclusion criteria and that have signed the informed consent. To achieve the project objectives an organization comprising six theoretical and practical phases enabling the scientific development of the project. During the first phase, the technical and administrative preparation of the project is constructed. Thereafter, the work is divided into two action areas which encompass the collection and data modeling. The creation of a biological multi-paradigm computer simulation model of the levels of biomarkers in different months of pregnancy and in the various pathologies of pregnant women can be very effective to know the risks that involve high levels of lipids for the mother and for the baby.Guideline compliance related to indwelling urinary catheters in 34 Norwegian nursing homes - findings and implicationshttps://peerj.com/preprints/18202016-03-072016-03-07Laila AarnesKarin HarrisÅse I SkareJohn R Andersen
Background For patients in health institutions urinary tract infections often have significant negative health consequences. Indwelling urinary catheters and inappropriate practice related to this is a strong risk factor for urinary tract infections. Thus, a national guideline promotes best practice for handling indwelling urinary catheters. The aim of this study was to assess the prevalence of patients with indwelling urinary catheters in 34 Norwegian nursing homes. Furthermore, we wanted to study whether health professionals followed the national guidelines related to indwelling urinary catheters. If the study reveals room for improvements, it may indicate interventions which can contribute to improvements in the health care institutions. Methods We conducted a quantitative survey in health care professionals who worked in nursing homes in from Sogn og Fjordane county (Norway), and asked them to which extent guidelines related to indwelling urinary catheters were used at their work place. The study also included data on the prevalence of indwelling urinary catheters in 830 patients (565 women and 265 men) in the 34 nursing homes. We also conducted a clinical audit in these nursing homes in order to study the how the guidelines were implemented. An overall assessment was made (satisfactory or not satisfactory) on whether 11 dimensions of the guidelines were followed (Table 2). When ≥ 80% of the nursing homes had a score = yes/usually to the items above it was considered satisfactory. The evaluations from the clinical audits were based on an overall judgment of the finding at the nursing homes. The study was approved by the Western Norway Hospital Trust as part of a quality assessment strategy. An approval from the regional ethical committee was not needed as the study was a quality assessment project and did not include any individual patient data. Results Our findings shows that 92 of 830 patients had a indwelling urinary catheter the day of prevalence assessment, and significantly more men (21.1%) than women (6.7%) had a indwelling urinary catheter (Fisher's exact test; P <0.001. Overall, the survey showed that compliance with the guidelines was unsatisfactory with one exception; the doctor prescribed the posting of indwelling urinary catheters (Table 2 and 3). Conclusions In conclusion, most areas we investigated need improvements. The survey itself may be a key to change the nursing staff`s attitudes and culture and to gain increased competence. In addition, it seems necessary to have good data solutions as well as leadership anchoring in further work on implementing best practice in handling indwelling urinary catheters.
Background For patients in health institutions urinary tract infections often have significant negative health consequences. Indwelling urinary catheters and inappropriate practice related to this is a strong risk factor for urinary tract infections. Thus, a national guideline promotes best practice for handling indwelling urinary catheters. The aim of this study was to assess the prevalence of patients with indwelling urinary catheters in 34 Norwegian nursing homes. Furthermore, we wanted to study whether health professionals followed the national guidelines related to indwelling urinary catheters. If the study reveals room for improvements, it may indicate interventions which can contribute to improvements in the health care institutions. Methods We conducted a quantitative survey in health care professionals who worked in nursing homes in from Sogn og Fjordane county (Norway), and asked them to which extent guidelines related to indwelling urinary catheters were used at their work place. The study also included data on the prevalence of indwelling urinary catheters in 830 patients (565 women and 265 men) in the 34 nursing homes. We also conducted a clinical audit in these nursing homes in order to study the how the guidelines were implemented. An overall assessment was made (satisfactory or not satisfactory) on whether 11 dimensions of the guidelines were followed (Table 2). When ≥ 80% of the nursing homes had a score = yes/usually to the items above it was considered satisfactory. The evaluations from the clinical audits were based on an overall judgment of the finding at the nursing homes. The study was approved by the Western Norway Hospital Trust as part of a quality assessment strategy. An approval from the regional ethical committee was not needed as the study was a quality assessment project and did not include any individual patient data. Results Our findings shows that 92 of 830 patients had a indwelling urinary catheter the day of prevalence assessment, and significantly more men (21.1%) than women (6.7%) had a indwelling urinary catheter (Fisher's exact test; P <0.001. Overall, the survey showed that compliance with the guidelines was unsatisfactory with one exception; the doctor prescribed the posting of indwelling urinary catheters (Table 2 and 3). Conclusions In conclusion, most areas we investigated need improvements. The survey itself may be a key to change the nursing staff`s attitudes and culture and to gain increased competence. In addition, it seems necessary to have good data solutions as well as leadership anchoring in further work on implementing best practice in handling indwelling urinary catheters.Psychometric properties of the Assessment of Positive Occupation 15 final version in individuals with mental disabilitieshttps://peerj.com/preprints/17222016-02-062016-02-06Takuya NoguchiMakoto Kyougoku
Purpose: To verify the reliability and validity of the Assessment of Positive Occupation 15 (APO-15) in individuals with mental disabilities living in communities or admitted in hospitals. Methods: A sample of 408 individuals with mental disabilities completed APO-15, the Japanese version of the Recovery Assessment Scale (RAS), the Japanese version of the Self-identified Stage of Recovery Part-B (SISR-B), and the General Health Questionnaire 12 (GHQ-12). We analyzed the psychometric properties of APO-15, including confirmatory factor analysis, entropy, polyserial correlation coefficient, average variance extracted, Cronbach’s α coefficient, Pearson’s product–moment correlation coefficient, item response theory, and cut-off point. Results: This study indicated the validity and reliability of APO-15 in a group of individuals with mental disabilities. The result of this study supported a four-factor model constructing of 15 items; includes a positive relationship, achievement, meaning, and engagement. Validity was supported by various results, i.e. the polyserial correlation and entropy were good, confirmatory factor analysis was a good estimate of the model fit, hypothesis testing was good convergent and discriminant validity, and concurrent validity also good. In addition, reliability was established by various analyses, i.e. the internal consistency reliability was good, and all items of APO-15 demonstrated satisfactory item response. The cut-off point became a 42-point sensitivity (0.770) and demonstrated good results with 1-specificity (0.441). That is, APO-15 can be used to appropriately measure the participation in occupation to promote the well-being of clients. Conclusion: APO-15 demonstrated good psychometric properties in measuring positive occupation in individuals with mental disabilities. APO-15 is an important tool to enable participation in activities that increase well-being in daily living.
Purpose: To verify the reliability and validity of the Assessment of Positive Occupation 15 (APO-15) in individuals with mental disabilities living in communities or admitted in hospitals. Methods: A sample of 408 individuals with mental disabilities completed APO-15, the Japanese version of the Recovery Assessment Scale (RAS), the Japanese version of the Self-identified Stage of Recovery Part-B (SISR-B), and the General Health Questionnaire 12 (GHQ-12). We analyzed the psychometric properties of APO-15, including confirmatory factor analysis, entropy, polyserial correlation coefficient, average variance extracted, Cronbach’s α coefficient, Pearson’s product–moment correlation coefficient, item response theory, and cut-off point. Results: This study indicated the validity and reliability of APO-15 in a group of individuals with mental disabilities. The result of this study supported a four-factor model constructing of 15 items; includes a positive relationship, achievement, meaning, and engagement. Validity was supported by various results, i.e. the polyserial correlation and entropy were good, confirmatory factor analysis was a good estimate of the model fit, hypothesis testing was good convergent and discriminant validity, and concurrent validity also good. In addition, reliability was established by various analyses, i.e. the internal consistency reliability was good, and all items of APO-15 demonstrated satisfactory item response. The cut-off point became a 42-point sensitivity (0.770) and demonstrated good results with 1-specificity (0.441). That is, APO-15 can be used to appropriately measure the participation in occupation to promote the well-being of clients. Conclusion: APO-15 demonstrated good psychometric properties in measuring positive occupation in individuals with mental disabilities. APO-15 is an important tool to enable participation in activities that increase well-being in daily living.Codes of conduct for Nursing students: bioethical commitment to higher education in Spainhttps://peerj.com/preprints/13252015-08-252015-08-25Jacobo Cambil-Martin
Background: As a profession, Nursing has its own code of ethics and codes of conduct which establish personal and professional behavior expected on Nursing professionals and students to be competent in their practice, learning and development. The Nursing and Midwifery Council has a Code of Professional Conduct for students of Nursing and Midwife. Considering that the diversity of values is a fact in the university community, it is necessary to explore the validity and meaning to implement Codes of Professional Conduct for Nursing students in the teaching and learning process. Objective: To identify and assess codes of conduct aimed at Nursing students to understand the commitment to Bioethics training of higher education in Spain. Methods: A literature review was conducted. Main elements of ethical codes and the dimensions of the attitudinal assessment template for Nursing students in clinical practice with the code of conduct of the English Council were compared. Results: The literature review brings two articles in Spanish language and according to the selection criteria. The journal “Etica de los cuidados” -indexed in “Cuiden” database- collects these studies reporting that both professionals and students know the Spanish Code of Ethics for Nursing and there is a need to establish a new teaching and learning framework in Bioethics; however, no specific articles provide knowledge about codes of conduct for Nursing students in Spain. Conclusion: In general, the standards of conduct for students of the Nursing and Midwifery Council are already implicit in the ethical rules, rights and duties of the Spanish code of professional ethics. So it is still necessary to consider the Code of Conduct of the Spanish Nursing Council and the White Paper of the Nursing Degree to understand the commitment to Bioethics training on Nursing.
Background: As a profession, Nursing has its own code of ethics and codes of conduct which establish personal and professional behavior expected on Nursing professionals and students to be competent in their practice, learning and development. The Nursing and Midwifery Council has a Code of Professional Conduct for students of Nursing and Midwife. Considering that the diversity of values is a fact in the university community, it is necessary to explore the validity and meaning to implement Codes of Professional Conduct for Nursing students in the teaching and learning process. Objective: To identify and assess codes of conduct aimed at Nursing students to understand the commitment to Bioethics training of higher education in Spain. Methods: A literature review was conducted. Main elements of ethical codes and the dimensions of the attitudinal assessment template for Nursing students in clinical practice with the code of conduct of the English Council were compared. Results: The literature review brings two articles in Spanish language and according to the selection criteria. The journal “Etica de los cuidados” -indexed in “Cuiden” database- collects these studies reporting that both professionals and students know the Spanish Code of Ethics for Nursing and there is a need to establish a new teaching and learning framework in Bioethics; however, no specific articles provide knowledge about codes of conduct for Nursing students in Spain. Conclusion: In general, the standards of conduct for students of the Nursing and Midwifery Council are already implicit in the ethical rules, rights and duties of the Spanish code of professional ethics. So it is still necessary to consider the Code of Conduct of the Spanish Nursing Council and the White Paper of the Nursing Degree to understand the commitment to Bioethics training on Nursing.Why do women choose to start, continue or stop breastfeeding? a qualitative phenomenological interpretive analysishttps://peerj.com/preprints/11662015-08-172015-08-17Jessica RyanAlyson Norman
The statistics from the National Health Service in the United Kingdom show that despite the current advice to breastfeed an infant exclusively for the first six months of life, less than 1% of mothers are actually doing this. Therefore, it is important it understand the barriers to breastfeeding experiences by women. The study aimed to investigate why some women choose to continue breastfeeding their infant, whilst other women do not. A qualitative semi-structured approach was employed recruiting eight participants interviewed one-to-one and three participants via one mini focus group. It was decided to use a qualitative approach in order to understand the experiences of women who have breastfed. Ethical approval was received from University of Plymouth, Faculty of Health and Human Sciences. Data was analysed using interpretive phenomenological analysis. The analysis identified four main themes centred on; social and cultural expectations of women, the impact of breastfeeding on maternal role, the perceived impact of breastfeeding on the mother’s attachment to her infant, and finally, the information provision from health care professional involved throughout pregnancy and after. The study only employed 11 participants. It is hoped that this study can be extended in the future to better understand the experiences of a wider range of breastfeeding women. Increased support and resources are needed to support women through the early stages of breastfeeding. Women need more appropriate help and support from professionals to enable them to breast feed without undue pressure, particularly when breastfeeding becomes problematic. Future research should investigate when different forms of information provision should be provided.
The statistics from the National Health Service in the United Kingdom show that despite the current advice to breastfeed an infant exclusively for the first six months of life, less than 1% of mothers are actually doing this. Therefore, it is important it understand the barriers to breastfeeding experiences by women. The study aimed to investigate why some women choose to continue breastfeeding their infant, whilst other women do not. A qualitative semi-structured approach was employed recruiting eight participants interviewed one-to-one and three participants via one mini focus group. It was decided to use a qualitative approach in order to understand the experiences of women who have breastfed. Ethical approval was received from University of Plymouth, Faculty of Health and Human Sciences. Data was analysed using interpretive phenomenological analysis. The analysis identified four main themes centred on; social and cultural expectations of women, the impact of breastfeeding on maternal role, the perceived impact of breastfeeding on the mother’s attachment to her infant, and finally, the information provision from health care professional involved throughout pregnancy and after. The study only employed 11 participants. It is hoped that this study can be extended in the future to better understand the experiences of a wider range of breastfeeding women. Increased support and resources are needed to support women through the early stages of breastfeeding. Women need more appropriate help and support from professionals to enable them to breast feed without undue pressure, particularly when breastfeeding becomes problematic. Future research should investigate when different forms of information provision should be provided.Safe Hands: teaching innovation project to improve hand hygiene in health sciences.https://peerj.com/preprints/12902015-08-102015-08-10Jacobo Cambil-Martin
Background: Since 2004, the World Alliance for Patient Safety brings proposing hand hygiene as the key measure of its international strategy in the fight against healthcare-associated infections. In Spain the Safe Hands Distinction of the Patient Safety Observatory recognizes the good practices on improving hand hygiene of the World Health Organization. Objectives: Apply the WHO multimodal strategy to improve hand hygiene at the Faculty of Health Sciences and maintain the culture of Patient Safety on hand hygiene by students and staff. Methods: A teaching innovation project called "Safe Hands" was developed in the Nursing Degree at the Faculty of Health Sciences of the University of Granada during the academic period 2013-2015. The tool "Guide to the Implementation of the WHO Multimodal Hand Hygiene Improvement Strategy" served to develop and plan the program to improve hand hygiene according to its five phases. In parallel, activities were implemented according to the three stages of the accreditation process "Safe Hands Distinction". Results: The Faculty of Health Sciences has become a dynamic secure environment that provides alcoholic gel for practice and training on hand hygiene, disseminates information and updated signage, reinforces the training of students and staff, and reinforces the quality assurance project. Study Limitations: It is necessary to complete the five years cycle of continuous improvement in quality of the WHO guide to establish an optimal strategy for improving hand hygiene. Conclusion: Safe Hands has launched the WHO multimodal strategy in an academic context. The Faculty of Health Sciences has got credited the Safe Hands Distinction, becoming the first Higher Education Center accredited in Spain to improve hand hygiene.
Background: Since 2004, the World Alliance for Patient Safety brings proposing hand hygiene as the key measure of its international strategy in the fight against healthcare-associated infections. In Spain the Safe Hands Distinction of the Patient Safety Observatory recognizes the good practices on improving hand hygiene of the World Health Organization. Objectives: Apply the WHO multimodal strategy to improve hand hygiene at the Faculty of Health Sciences and maintain the culture of Patient Safety on hand hygiene by students and staff. Methods: A teaching innovation project called "Safe Hands" was developed in the Nursing Degree at the Faculty of Health Sciences of the University of Granada during the academic period 2013-2015. The tool "Guide to the Implementation of the WHO Multimodal Hand Hygiene Improvement Strategy" served to develop and plan the program to improve hand hygiene according to its five phases. In parallel, activities were implemented according to the three stages of the accreditation process "Safe Hands Distinction". Results: The Faculty of Health Sciences has become a dynamic secure environment that provides alcoholic gel for practice and training on hand hygiene, disseminates information and updated signage, reinforces the training of students and staff, and reinforces the quality assurance project. Study Limitations: It is necessary to complete the five years cycle of continuous improvement in quality of the WHO guide to establish an optimal strategy for improving hand hygiene. Conclusion: Safe Hands has launched the WHO multimodal strategy in an academic context. The Faculty of Health Sciences has got credited the Safe Hands Distinction, becoming the first Higher Education Center accredited in Spain to improve hand hygiene.