The Health Improvement Profile for people with severe mental illness: Feasibility of a secondary analysis to make international comparisons.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Individuals with severe mental illness (SMI) have elevated risks for physical health problems and low screening rates. No previous studies have compared the physical health promotion needs of people with SMI using the same screening tool across different international settings. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: It appears feasible to use the HIP to profile and compare physical health-related risks in people with SMI across different international settings. The HIP tool identified significant differences in areas of risk across the four countries. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The HIP could be used to identify unique clusters of health promotion needs in different countries. Use of HIP health checks may support implementation of individualized interventions. ABSTRACT: Introduction To date, no studies have contrasted physical health profiles of people with severe mental illness (SMI) in different countries. Aim To evaluate feasibility of using the Health Improvement Profile (HIP) to compare and contrast physical health and health behaviours of people with SMI from four countries. Method An observational feasibility study using secondary analysis of pooled health state and lifestyle data. Physical health checks using modified versions of HIP were administered in four countries. Results Findings suggest feasibility of HIP screening to profile and compare physical health and health behaviours of people with SMI across international settings. High overall numbers of risk items (red flags) were identified in all but the Thailand sample. Despite some commonalities, there were important differences in health profiles across countries. Discussion This is the first study to demonstrate feasibility of the HIP to compare health risks in individuals with SMI across countries. Future multi-national HIP studies should recruit a fully powered stratified random sample of people with SMI that is representative of each setting. Implications for practice It appears feasible to utilize the HIP to identify specific areas of health risk in different countries, which may help to better focus nursing interventions and use of resources.

The Relationship Among Change Fatigue, Resilience, and Job Satisfaction of Hospital Staff Nurses.

PURPOSE: The purpose of this study was to examine relationships between change fatigue, resilience, and job satisfaction among novice and seasoned hospital staff nurses. BACKGROUND: Health care is typified by change. Frequent and vast changes in acute care hospitals can take a toll on nurses and cause change fatigue, which has been largely overlooked and under-researched. DESIGN AND METHOD: A descriptive correlational design was employed with 521 hospital staff nurses in one midwestern state. Participants completed three online surveys: (a) Change Fatigue Scale, (b) Connor-Davidson Resilience Scale, and (c) McCloskey/Mueller Satisfaction Scale. FINDINGS: In a multiple regression model, job satisfaction had a statistically significant negative association with change fatigue (p < .001) and significant positive association with resilience (p < .001). A linear trend was found with hospital size (number of beds) and change fatigue (p = .001) and education level and resilience (p = .03). CONCLUSIONS: The results are consistent with job satisfaction among hospital nursing staff being negatively influenced by change fatigue and positively influenced by resilience, although reverse causal connections are also possible. Change fatigue may be increased by larger hospital size (number of beds), and resilience may be increased by higher educational level of hospital staff nurses. CLINICAL RELEVANCE: The study advanced the nursing knowledge on change fatigue, resilience, and job satisfaction of staff nurses working in acute care hospitals. Engaging in strategies aimed at preventing change fatigue in nursing staff can enhance workplace environments, job satisfaction, and retention of nurses.

Retrospective survey of long-term care staff: 12 conditions identified, evaluated, and reported as suspected adverse drug reactions.

OBJECTIVE: To examine the identification of conditions, the evaluation of these conditions as adverse drug reactions (ADRs), and the communication practices regarding suspected ADRs in a long-term care (LTC) facility. DESIGN AND SETTING: Health care providers completed a survey containing nine questions covering 13 conditions, about residents of a 99-bed LTC facility. PARTICIPANTS: Twenty-five health care providers (i.e., CNAs, LPNs, RNs, RPh, social workers, and an activities worker) reviewed residents on their units. A total of 67 residents were reviewed. RESULTS: The RPh was aware of fewer of the residents' conditions (16% of all conditions) compared with CNAs (34%), LPNs (38%), and RNs (45%). RNs and the RPh identified an equal percent of conditions that could be caused by a resident's medications (66.5% and 66.7% of all conditions, respectively). This was greater than LPNs (36%) or CNAs (9.9%). However, RNs and the RPh actually attributed a lower percentage of these conditions to the medications (43.9% and 41.7%, respectively) compared with LPNs (57.4%) and CNAs (90.0%). CNAs notified others in a higher percentage of the cases where they suspected an ADR (81.5%) compared with the RPh (60%), RNs (57.4%), or LPNs (10.3%). No notification was primarily attributed to "nothing could be done," the condition is an expected effect, others were aware of the condition, and the condition currently is being treated. CONCLUSIONS: These results illustrate the importance of a team approach to ensure that all health care providers are aware of conditions to properly evaluate and resolve them.