Facilitating and Managing Transitions: An Imperative for Quality Care

Being admitted to a hospital, preparing for discharge, receiving a chronic illness diagnosis, transferring from intensive care to regular care, moving to a nursing home, receiving a grave diagnosis, losing a family member, facing an environmental disaster, graduating and starting a new professional position­all of these scenarios may appear different, but ask yourself, what might they all have in common? They are all changes that trigger a transition process. While change is an event or a situation that is well defined and static in time, transition is a process with a range of responses. During transitions, individuals, families and communities experience unfamiliar environments, sensations and emotions, and confront different levels of uncertainty about what may come next. They may have expectations, realistic or uninformed, and experience disruptions in their daily lives and routines, all of which are influenced by and affect their health and wellbeing.

Ser admitido en un hospital, prepararse para el alta, recibir un diagnóstico de enfermedad crónica, pasar de cuidados intensivos a cuidados regulares, mudarse a un asilo de ancianos, recibir un diagnóstico grave, perder a un miembro de la familia, enfrentar un desastre ambiental, graduarse y comenzar un nuevo posición profesional: todos estos escenarios pueden parecer diferentes, pero pregúntese, ¿qué podrían tener en común? Todos son cambios que desencadenan un proceso de transición. Si bien el cambio es un evento o una situación bien definida y estática en el tiempo, la transición es un proceso con un rango de respuestas. Durante las transiciones, los individuos, las familias y las comunidades experimentan entornos, sensaciones y emociones desconocidos, y enfrentan diferentes niveles de incertidumbre sobre lo que puede ocurrir a continuación. Pueden tener expectativas, realistas o desinformadas, y experimentar interrupciones en sus vidas y rutinas diarias, todas las cuales están influenciadas por su salud y bienestar y las afectan.

Nurse educators' critical thinking skills: tool validation and an introductory guide development

The future belongs to those who learn to make the best of their brain power those who think critically. Critical thinking is the process of examining, analyzing, questioning, and challenging situations, issues, and information of all kinds. Critical thinking has come to the forefront in nursing following the mandate by the National League of Nursing [USA] the aim of this study is to: [1] Select an appropriate tool that measures critical thinking knowledge, skills and attitude among nurse educators. [2] Measure face, content and construct validity of the selected tool. [3] Test the reliability of the tool. [4] Explore nurse educators' awareness regarding Critical Thinking related concepts. [5] Develop an introductory guide to cover basic identified skills needed that enhance critical thinking skills. The study was conducted at one of the main, well established faculties of Nursing in Cairo, Egypt. A total of 111 nurse educators were recruited for this study: 31 were professors and assistant professors, 34 were lecturers and 46 were clinical instructors and assistant lecturers. The inclusion criteria were their approval to participate in the study and having not less than one year of experience A descriptive analytical design was implemented 1-A Critical thinking knowledge, Skills and Attitudes questionnaire: adopted from [Cottrell, 2005]. 2-An opinionaire sheet. The tool was tested for validity by a panel of nine experts' prior implementation. The tool was proved to be valid and reliable. 1- The reliability coefficient was as high as 0.97. Rotated Component Matrix Rotation using Varimax with Kaiser Normalization revealed that the loading of the skill component was the highest [0.89], and knowledge component was the lowest [0.35]. 2- Significant statistical differences, as well as positive correlations were detected between position held and the possession of critical thinking knowledge, skills and attitude specifically with study subjects' age, years of experience and attendance of training programs related critical thinking. The minimum score was reported among junior staff [clinical instructors and assistant lecturers]. An appropriate tool that measures critical thinking skills was developed. Face, content and construct validity as well as its reliability were ascertained. There is a deficit in relation to nurse educators' knowledge, skills and attitudes of Critical Thinking related concepts. There is a positive correlation between academic rank and the possession of critical thinking skills. An introductory guide that covers basic skills needed to enhance critical thinking skills was developed. 1] Integrating the developed "introductory guide to critical thinking" and teaching strategies for its enhancement among nurse students within the masters program curriculum. 2] Orientation program for junior clinical instructors should be conducted using critical thinking to enhance teaching strategies. 3] Staff development seminars and workshops should be conducted to allow full awareness of academic staff regarding critical thinking teaching strategies in nursing education periodically. 4] Replication of study with other larger populations would help strengthen these findings to reach generalization purposes. 5] Further researches should be conducted for the integration of critical thinking concepts and skills into nursing education curriculum

Tuberculosis at chest clinic of school students hospital in Alexandria : what is the current situation ?

This study was conducted to measure tuberculosis incidence rates and reveal epidemiological characteristics, clinical features and treatment outcome of tuberculosis [TB] cases among school students in Alexandria. A retrospective analysis of medical records was carried out for 609 registered consecutive tuberculosis cases who were attending tuberculosis center affiliated to chest clinic in Alexandria school students' hospital during 5 year-period [1997-2001]. Incidence of tuberculosis among school students declined from 16. 84/100, 000 in 1997 to 14. 69/100, 000 in 2001. The age of cases ranged from 5 to 20 with an average of 11. 55 +/- 3.65 years. The female/male ratio was 0.88. One third [33.0%] of cases were of extrapulmonary type. The remaining [67%] of cases were pulmonary TB, of which [9.85%] were smear positive cases. The average age of smear positive pulmonary TB cases was significantly higher than that of smear negative ones and that of extrapulmonary type [P<0. 00]. Females accounted for 60 % of smear positive cases [36 out of 60 cases]. All cases of this group received directly observed therapy. Treatment outcomes over 5-year period revealed 86.7% cure rate for smear positive cases, one case with drug resistant strains, one defaulter and death of one patient due to an associated illness. Despite an efficient tuberculosis-control program in this center as indicated by high cure rate, the relatively high incidence rate of new cases among school students indicates that tuberculosis is still a problem in schools. This calls for the importance of TB screening especially in secondary schools for early detection and proper management of smear positive pulmonary TB cases

Ser e tornar-se saudável: o amâgo do conhecimento de enfermagem / Being and becoming healthy: the case of nursing knowledge

A saúde tem sido descrita como um conceito central, e como a meta da enfermagem. Discute-se aqui a incongruência que existe entre essa centralidade em enfermagem e em outras disciplinas, e a visäo sustentada pelo público. Outros assuntos e pontos de vista sobre saúde säo também considerados, incluindo diversidade e unidade na conceitualizaçäo de saúde, a natureza social e as obrigaçöes societárias voltadas à saúde do indivíduo, a falta de congruência entre as visöes conceitual e empírica de saúde, e a saúde conforme é vista em enfermagem e em âmbito internacional. Säo articuladas várias condiçöes a serem incluidas nas tentativas das enfermeiras no desenvolvimento teórico de saúde. A necessidade de se focalizar numa compreensäo das necessidades de cuidado de saúde manifestas por populaçöes desfavorecidas, a vantagem potencial de se usar um marco de referência feminista, e a integraçäo entre uma concepçäo estática de ser saudável e uma concepçäo de saúde que é um processo dinâmico de tornar-se, säo algumas das estratégias que podem ser usadas para desenvolver uma concepçäo contextual de saúde.