International journal of nursing studies
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Comparative Study
The quality of intensive care unit nurse handover related to end of life: a descriptive comparative international study.
Quality ICU end-of-life-care has been found to be related to good communication. Handover is one form of communication that can be problematic due to lost or omitted information. A first step in improving care is to measure and describe it. ⋯ Practices of end-of-life-handover communication vary greatly between units. However, room for improvement exists in all areas in all of the units studied. The total score was higher when quality of care might be deemed at greater risk (if the nurses did not know the patient or the patient was expected to die), indicating that nurses were exercising some form of discretionary decision making around handover communication; thus validating the measurement tool.
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The aim of this study was to identify predictors of parental post-traumatic stress symptoms following child hospitalization. ⋯ More than one quarter of parents of children hospitalized on pediatric (non-intensive care) wards experienced significant post-traumatic stress symptoms after their child's discharge. Parents' hospital-related anxiety, uncertainty and use of negative coping strategies are potentially modifiable factors that most strongly influenced post-traumatic stress symptoms. Further research is urgently needed to test the effectiveness of different methods to provide psychological, emotional and instrumental support for parents, focusing on increasing parent coping resources and reducing distress during hospitalization.
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Understanding minority nurses' job satisfaction is a critical first step to inform strategies designed to retain minority nurses and improve institutional climate to ensure sustained diversity. Yet, empirical evidence is limited in this regard, especially comparisons across racial and ethnic groups in a national sample in the U.S. ⋯ Moderate differences in job satisfaction were observed across racial and ethnic groups. More research is needed to understand factors underlying these differences, so that nursing and hospital administrators can develop effective strategies to improve job satisfaction and retain minority nurses.
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Caring for dying patients is stressful but an unavoidable responsibility of nurses. However, little is known about Chinese oncology nurses' experience of caring for dying cancer patients who are in their final days. ⋯ End-of-life care in China reflects and has been influenced by the traditional Chinese culture. Chinese nurses reported suffering but also benefiting from their experiences. End-of-life cancer care training is needed by Chinese oncology nurses, especially for those who are younger and less experienced.
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In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient's values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient's values. The shared decision-making model seems to be helpful in the integration of the individual patient's values in evidence-based practice. ⋯ Furthermore, the patient's willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making—integrated with evidence-based practice—can facilitate the shared decision-making process. We conclude that nurses as well as other health care professionals in chronic care should integrate shared decision making with evidence-based practice to deliver patient-centred care.