Nursing physical workload and mental workload in intensive care units: Are they related?

AIM: In order to ensure patient safety and quality of care, it is important to consider factors which may impact on nursing workloads. This study aimed to investigate the simultaneous physical and mental workload and any relationships between these concepts on nurses working in intensive care units. DESIGN: A cross-sectional design was undertaken. METHOD: Participants were nurses (N = 105) recruited from six adult intensive care units which met the inclusion criteria. Nursing Activities Score (NAS) to measure physical workload and NASA Task Load Index (NASA-TLX) to measure mental workload were used. Data were collected for each participating nurse in three shifts (morning, evening and night). Data were analysed using bivariate correlation and multivariable linear regression analysis. RESULTS: The mean (SD) of nurses' physical and mental workload was 72.84% (22.07%) and 70.21 (12.36), respectively. A significant relationship between physical and mental workload (p <.001) was identified.

Nursing workload in intensive care units and the influence of patient and nurse characteristics.

BACKGROUND: Understanding factors that can potentially influence patient care and nursing workload in intensive care units is important. Previous studies have shown contradictory outcomes about the relationships between nursing workload and patient and nurse characteristics. AIMS AND OBJECTIVES: This study aimed to investigate nursing workload in intensive care units and examine the association between this in relation to patient and nurse characteristics. DESIGN: A cross-sectional design was conducted. METHODS: All nurses who were working in the intensive care units of five hospitals and met the study criteria were enrolled in the study. Two demographic questionnaires collected nurse and patient demographic information. The Nursing Activities Score was applied to determine nursing workload in three shifts (morning, evening, night) for each nurse. Data were analysed using the independent sample t-test, one-way analysis of variance, and multivariable linear regression analysis. RESULTS: The Nursing Activities Score was calculated for 509 patients who were under the care of 105 intensive care unit nurses. The mean (SD) Nursing Activities Score was 72.84% (22.07%). Morning shifts, male patients, medical treatments, and referred patients from the emergency ward and other intensive care units imposed a higher workload for nurses. Specifically, female nurses, increased number of patients receiving care, and increased patient length of intensive care unit stay were directly associated with increased Nursing Activities Scores. Work in surgical and burn intensive care units were inversely associated with the Nursing Activities Score. CONCLUSION: This study suggests that the workload of nurses in intensive care units can be affected by both nurse and patient characteristics. RELEVANCE TO CLINICAL PRACTICE: The findings can be used to ensure appropriate staffing of intensive care units by nurses. However, nurse and patient characteristics should not be considered the only factors that influence nursing workload in intensive care units.

The effect of behavioral parent training on sleep problems of school-age children with ADHD: A parallel randomized controlled trial.

OBJECTIVE: The aim of this study was to examine the effect of behavioral parental training (BPT) on sleep problems in children diagnosed with ADHD. METHODS: This parallel randomized controlled trial was conducted in a psychiatric clinic in an urban area of Iran. Participants of this study were 58 school-age children who were diagnosed with ADHD, were receiving methylphenidate and had at least one problem in sleeping. They were randomly assigned into BPT or control groups. Participants' parents in the BPT group underwent a 5-week behavioral intervention program. Data were collected at baseline, immediately after the intervention, and two months after the intervention. Data were analyzed using Chi-square, Fisher's exact test, independent sample t-test, and repeated measure ANOVA test via the SPSS software. RESULTS: Children in the intervention group experienced a significant improvement in total sleep scores two months after the intervention compared to the control group (p = 0.03). Also, the findings showed a significant decline in total sleep problems in the intervention group compared to the control group over time (p = 0.01). CONCLUSION: The results suggest that BPT could be an effective method in improving sleep problems of school-age children diagnosed with ADHD undergoing methylphenidate treatment.

The Effect of "Creating Opportunities for Parent Empowerment" Program on Parents of Children With Epilepsy and Other Chronic Neurological Conditions.

OBJECTIVES: Parents taking care of children with epilepsy experience stress in their daily lives, which enhances their anxiety, changes their function, and eventually increases their children's behavioral problems. The present study aimed at investigating the effect of creating opportunities for parent empowerment (COPE) program on parents of children with epilepsy or other chronic neurological conditions. MATERIAL & METHODS: A quasi-experimental clinical trial was conducted on 88 mothers of hospitalized children with epilepsy aged 3 to 12 years. In the intervention group, the COPE program was conducted by the researcher in three phases and the usual care group received usual healthcare. The mothers' anxiety was assessed in three phases in both groups. RESULTS: Results of the present study showed that the effect of time and group-time interaction on the state anxiety and trait anxiety was significant in the intervention group; however, the effect of time was not significant in the usual care group (P = 0.12). The differences of state anxiety and trait anxiety were not significant between the two groups (P = 0.136), which depended on the baseline level of anxiety. By analyzing the covariance after controlling the two variables at baseline, it was observed that the score variations in the state anxiety and trait anxiety were significant at all studied time points. CONCLUSIONS: The results of the current study indicated the positive effect of the COPE program on the anxiety of parents of children with epilepsy. Since this technique is non-pharmacological, convenient, easy-to-apply, and cost-effective, it can be used to reduce the parents' anxiety.

Social Skills in Preschool Children from Teachers' Perspectives.

Preschool is one of the most important periods in a child's life, and it can influence their social development. A lack of attention to this important life period can increase the risk of serious injuries to a child's growth and development. The aim of this study was to examine the level of social skills in preschool children from teachers' perspectives and investigate the relationship between social skills and the child's environmental and cultural background. A cross-sectional study was conducted on 546 children studying in the preschool centers of Rasht city, Iran. They were selected using a multistage cluster sampling method. Data was gathered using the children's and teachers' demographic questionnaire and the Social Skills Rating System-Teachers (SSRS-T). Descriptive and inferential statistics were used for data analysis via SPSS software. It was found that the majority of children had moderate skills in terms of cooperation, assertion, self-control, and total social skills. Also, a statistically significant association was reported between total social skill scores and the mother's age, mother's education level, mother's job, family's income, teacher teaching experiences, and number of children in each classroom. The Iranian children were at a relatively low risk of problems with social skills. To improve children's social skills, more attention should be paid to factors related to familial and socioeconomic status such as income, parents' education level, maternal age, teacher's selection for this age group, and number of children in each classroom.

The effect of mothers' empowerment program on premature infants' weight gain and duration of hospitalization.

BACKGROUND: The readiness of mothers to take care for infants at discharge is a critical issue. Poor readiness of mothers in taking care of premature infants at the time of discharge is associated with potential adverse consequences. This study examined the effect of implementing mothers' empowerment program on the weight gain and duration of hospitalization in premature infants. MATERIALS AND METHODS: This study was a quasi-experimental before-after study with a control group, in which 80 mothers with premature infants who were hospitalized in NICU Level II of two hospitals were recruited in the study. Mothers' empowerment program was implemented as a three-stage training program for the intervention group. Mothers' readiness questionnaire was completed by the mothers before the intervention and at the discharge time. The changes in mean of mothers' readiness scores were compared in both the groups. RESULTS: The mean of daily weight gain in infants of the intervention group (3.95 g) was significantly higher than that of the infants in the control group (-0.9 g) (P = 0.003). The average duration of hospitalization for infants in the intervention and control groups was 15.45 days and 20.95 days, respectively, showing a statistically significant difference (P = 0.003). CONCLUSIONS: Providing training to the mothers regarding how to care for premature infants can be a useful and effective method in the process of weight gain of premature and low-birth newborns, and may shorten the duration of infants' hospitalization.

The effect of empowerment program on "perceived readiness for discharge" of mothers of premature infants.

OBJECTIVES: Poor readiness of mothers to take care of their premature infant at the time of hospital discharge is associated with potential adverse consequences. The aim of this study was to examine the effect of empowerment program on "perceived readiness for discharge" of mothers of premature infants at the time of discharge. METHODS: A quasi-experimental before-after study design with consecutive inclusion of all mother-child pairs was used to conduct the study. Eighty mothers and their premature infants (40 pairs of mother-infant in the experimental group and 40 pairs of mother-infant in the control group) were recruited in the study. The program to empower the parents was implemented as a 3-stage training plan for the experimental group. "Parent discharge readiness" questionnaire was completed by mothers before intervention and at discharge time, and was evaluated by nurses at discharge time. The groups were compared in terms of readiness for discharge according to the scores given by mothers and nurses. RESULTS: At discharge time, there was a statistically significant difference between technical readiness of control and experimental groups according to mothers' self-report (p < 0.001) and nurse evaluation (p < 0.0001). Also, there was a statistically significant difference between emotional readiness of mothers in control and experimental groups according to mothers' self-report (p < 0.0001) and nurse evaluation (p = 0.003). CONCLUSION: The implementation of empowerment program is an effective strategy to promote the readiness of mothers of premature infants at discharge time.