Effectiveness of a self-management retraining program improving the quality of life of people receiving continuous ambulatory peritoneal dialysis.

People receiving continuous ambulatory peritoneal dialysis (CAPD) are often faced with technical difficulties while performing self-dialysis, which can compromise outcomes and health-related quality of life. This mixed-methods exploratory sequential study aims to implement a repeated-measures experimental design to assess the effectiveness of a self-management retraining program. The sample consisted of 41 participants living with chronic kidney disease aged 20 to 80 years who were receiving CAPD. Participants were purposively selected and randomized into experimental and control groups. The experimental group received the self-management retraining program. The control group received standard care. We compared health-related quality of life, self-management behavior, and perceived self-management self-efficacy levels at baseline and 3 and 6 months after enrollment. Participants demonstrated statistically significant increases in self-management behavior (medical adherence) and mental health status. Perceived self-efficacy in self-management was improved; however, this change did not reach statistical significance. We conclude that an self-management retraining program can improve self-management, self-efficacy behaviors, and health-related quality of life in persons receiving CAPD.

[Prediction and Prevention of Dropouts in Vocational Retraining]. / Prognose und Verhinderung von Abbrüchen bei Qualifizierungen in der beruflichen Rehabilitation.

UNLABELLED: Principal objective: To verify if a psychological intervention targeting individuals with high resignation tendency prevents dropouts in vocational retraining. For individuals with high resignation tendency a high risk of dropping out was assumed under regular conditions. METHOD: Data was collected at 2 adult education institutes. At the beginning of vocational training the occupational inventory Work-related Behaviour and Experience Patterns (AVEM) was used. The questionnaire allows to classify 4 types of coping behaviour. G: healthy-ambitious, S: unambitious, A: excessively ambitious, B: resigned. Using a quasi-experimental design, the effect of resilience building was verified by comparing a treatment group with a control group. Control group was offered the usual treatment of the education institute. The treatment group was additionally offered two individual meetings and a work-related group treatment focussing on coping behaviour. RESULTS: Given a very high resignation tendency in both groups, dropping out of rehabilitation was less frequent in the treatment group. Other individuals tended to drop out more frequently, but this is not statistically significant. CONCLUSION: The study shows that work-related resilience building helps to minimize risk of dropping out of vocational rehabilitation in the case of extremely resigned coping behaviour.

[Recommendations for the Stepwise Occupational Reintegration: Can the Characteristic of the Patients Explain the Differences Between the Rehabilitation Centers?]. / Nachsorgeempfehlungen zur stufenweisen Wiedereingliederung: Inwieweit erklären Rehabilitandenmerkmale die bestehenden Unterschiede zwischen den Einrichtungen?

BACKGROUND: The first step to initiate a stepwise occupational reintegration (SOR) is the recommendation of the rehabilitation centers. Therefore rehabilitation centers have a significant impact on the use of SOR. There is evidence that the recommendation rate between the rehabilitation centers differs clearly. The present survey therefore analyses in detail the differences of the recommendation rate and examines which patient-related factors could explain the differences. METHODS: This study is based on analysis of routine data provided by the German pension insurance in Baden-Württemberg (Rehabilitationsstatistikdatenbasis 2013; RSD). In the analyses rehabilitation measures were included if they were conducted by employed patients (18-64 years) with a muscular-skeletal system disease or a disorder of the connective tissue. Logistic regression models were performed to explain the differences in the recommendation rate of the rehabilitation centers. RESULTS: The data of 134 853 rehabilitation measures out of 32 rehabilitation centers were available. The recommendation rate differed between the rehabilitation centers from 1.36-18.53%. The logistic regression analysis showed that the period of working incapacity 12 month before the rehabilitation and the working capacity on the current job were the most important predictors for the recommendation of a SOR by the rehabilitation centers. Also the rehabilitation centers themselves have an important influence. DISCUSSION: The results of this survey indicate that the characteristic of the patients is an important factor for the recommendation of SOR. Additionally the rehabilitation centers themselves have an influence on the recommendation of SOR. The results point to the fact that the rehabilitation centers use different criteria by making a recommendation.

[Are Two-Year Vocational Retraining Programs Really Better than One-Year Programs? Findings of a Propensity Score Matched Analysis]. / Sind Vollqualifizierungen wirklich besser als Teilqualifizierungen? Ergebnisse einer Propensity Score gematchten Analyse.

AIM OF THE STUDY: To analyze if one- and 2-year vocational retraining programs achieve similar effects on employment. METHODS: Analyses were performed with longitudinal administrative data. We included persons aged 18-59 years, who started their retraining between January and June 2005. One- and 2-year program participants were matched by propensity scores. RESULTS: The matched groups were balanced regarding all baseline scores (one-year program: n=514; 2-year program: n=514). 4 and 5 years after start of the vocational retraining program, annual income, the duration of welfare benefits and the risk of a disability pension were comparable in both groups. However, the accumulative income between 2005 and 2009 was 9 294 Euro higher (95% CI: 3 656-14 932 Euro) in one-year retraining participants. Moreover, participants of one-year programs received less welfare benefits. CONCLUSION: The development of a vocational rehabilitation strategy needs to consider the accumulative advantage of one-year programs.

Perceived facilitators and barriers to baccalaureate degree completion among registered nurses with an associate's degree.

BACKGROUND: A strong movement is underway in the United States to increase the percentage of baccalaureate-prepared registered nurses (RNs). However, the percentage of associate's-prepared RNs who go on to pursue baccalaureate education remains low. The authors sought to determine facilitators and barriers that associate's-prepared RNs experience in progressing toward baccalaureate nursing education. METHOD: A convenience sample (n = 81) of associate's-prepared RNs was used to collect data on perceived facilitators and barriers to progression toward baccalaureate nursing education. RESULTS: Facilitators included a desire for personal growth, professional and career enhancement, programmatic and articulation friendliness, and encouragement by others. Barriers included family and job constraints, financial concerns, and lack of differential treatment between associate's-prepared RNs and baccalaureate-prepared RNs. CONCLUSION: Although at first glance the identification of four facilitators and three barriers may appear to indicate an advance toward progression to baccalaureate education, the magnitude of the barriers may outweigh that of the facilitators. Therefore, the magnitude of both facilitators and barriers is worthy of future study.

Returning to health visiting practice: completing the circle.

One strategic health authority, NHS London, initiated a pilot return to health visiting/nursing practice scheme in London in 2010. This paper reports on the experiences of the first three cohorts of returnees on the City University London programme, one of the London programmes, and the adaptations that have been made to the programme to help provide returnees with the theory base and practice experience to equip them to work in today's health visiting. Written evaluation forms were completed by the returnees and information gathered from their application forms. This information was supplemented for Cohort 1 with some interviews with practice teachers and lecturers and a mid-stage questionnaire to the returnees. Of the 54 students in the three cohorts over half were still on one or both Nursing and Midwifery Council registers, which had not been anticipated at the start of the programme and led to modifications to the programme after Cohort 1 with an increase in the health visiting specific content. The returnees had a wide range of experience to bring back to health visiting reflecting the fact that a large number had been out of health visiting for more than 11 years. The evaluation shows that providing support by the university to the practice placement areas; ensuring that the taught element is current and useful to health visiting practice and having a relevant but not too onerous assessment process are critical.

[Analysis of job retraining rulings issued by evaluating doctors and medical comissions of the social insurance institution]. / Analiza orzeczen o celowosci przekwalifikowania zawodowego wydanych przez lekarzy orzeczników i komisje lekarskie w zakladzie ubezpieczen spolecznych.

BACKGROUND: Training pension was introduced into the Polish social security system on September 1, 1997. It is granted to a person who has permanently lost the ability to work in his or her current vocation, but after an appropriate retraining may do another profession. The aim of this study was to assess the compatibility between ruling of job retraining and medical certification rules. An effort was also made to evaluate the "effectiveness" of issued recommendations expressed by the number of retrained people. MATERIAL AND METHODS: In total, 300 cases of retraining ruling issued by an evaluating doctor or medical commission, registered in 2009, were analyzed. Retraining pension was granted to 219 persons. RESULTS: Of the 300 rulings under study, over 35% were found groundless. In 52 cases (23.74%) (219 of them were awarded a retraining pension) there is information about completed retraining (training) and in 24 (10.95%) about referral to a specific course and its duration, but there is no information whether the insured person has completed the training course. In 2 (0.91%) cases the insured persons continued to collect retraining pension (from 21 and 30 months). 141 people were not retrained even though they had been granted a training pension. CONCLUSIONS: A significant percentage (over 35%) of rulings were issued improperly. It is caused by the ignorance of the rules of medical certification and binding regulations in this area. The number of training courses on the principles of issuing retraining rulings and current laws should be increased.

Evaluación de un programa blended-learning para el desarrollo de la competencia trabajar en equipo / Evaluating a blended-learning program on developing teamwork competence

Los conocimientos, habilidades y destrezas para trabajar en equipo son clave en el desempeño eficaz de un gran número de posiciones laborales. Las organizaciones pueden acceder a estas habilidades a través del desarrollo de las mismas mediante programas formativos. Diferentes estudios muestran cómo a través de metodologías de formación presencial las habilidades para trabajar en equipo pueden ser desarrolladas en los alumnos. Sin embargo, la formación presencial puede ser complementada con la formación on-line en programas blended-learning que aúnen las ventajas de ambas aproximaciones. En el trabajo que se presenta se valora, a través de los niveles de evaluación de la formación de Kirkpatrick, un programa de formación blended-learning especialmente diseñado para el desarrollo de las habilidades para trabajar en equipo. Realizado con 102 profesionales, los resultados muestran una alta satisfacción de los alumnos con el curso, un alto nivel de aprendizaje de conocimientos, tanto declarativos como procedimentales, y un moderado nivel de transferencia de lo aprendido al puesto de trabajo (AU)

The knowledge, skills and abilities that are required to work optimally in teams are critical for many types of work. Organizations can provide access to these skills by means of training programs. Diverse studies show how traditional in-site training methodologies can improve teamwork knowledge, skills and abilities. Nevertheless, in-site methods can be complemented with on-line strategies that result in blended learning programs. The aim of this work is to analyze, following Kirkpatrick’s assessment levels, the effectiveness of a blended-learning program of teamwork training in an organizational context. Carried out with 102 professionals, the results show participants’ satisfaction with the program, high level of learning (of both declarative and procedural knowledge), and a moderate level of transfer of learning to the job (AU)

A hybrid classroom-online curriculum format for RN-BSN students: cohort support and curriculum structure improve graduation rates.

As more registered nurses (RNs) return to school to obtain a bachelor of science in nursing (BSN), innovative ways must be found to support them in this endeavor. Barriers for RNs who return to school include scheduling of coursework and fear of failure. One school of nursing with a traditional BSN program reviewed its RN-BSN track, with its low retention and graduation rates. With input from nursing leaders and nurses in the community, the school applied for and was awarded a 3-year Health Resources and Services Administration grant to redesign the RN-BSN program. A hybrid classroom-online curriculum is offered in a structured, sequential format so that the RNs are admitted once a year and must complete the courses as a group, in a cohort. Data collected from evaluations showed that program support, technology support, and social support from peers encouraged the RNs to "stay the course," and 100% completed the requirements to graduate.

Academic integrity in an online registered nurse to baccalaureate in nursing program.

BACKGROUND: The number of nursing programs offering online courses continues to expand. This is a relatively new method of instruction that has not been extensively evaluated. Academic integrity in the online classroom is one area of concern. This study compared academic integrity in both an online and a traditional classroom registered nurse to baccalaureate in nursing (RN-BSN) program. METHODS: A comparative descriptive design was used to evaluate academic integrity in the two RN-BSN cohorts. RESULTS: The traditional classroom RN-BSN students reported higher levels of cheating compared with the online students. Self-reported cheating behaviors were higher among younger students in the traditional classroom. CONCLUSION: This study did not support contemporary concerns that cheating is more prevalent in online courses.

Re-entry residency training: opportunities and obstacles.

OBJECTIVE: To identify and quantify the reasons general practitioners and family physicians consider retraining and their reasons for not pursuing further training. DESIGN: Population-based mailed survey. SETTING: British Columbia. PARTICIPANTS: Family physicians and general practitioners identified by the College of Physicians and Surgeons of British Columbia. MAIN OUTCOME MEASURES: Practising physicians' level of awareness of the University of British Columbia's re-entry training program, the number and demographic characteristics of those who had considered retraining, their specialties of interest, and the barriers and possible inducements to retraining. RESULTS: Only half of the survey respondents were aware of the re-entry training program at the University of British Columbia. A small but substantial number of practising general practitioners and family physicians were interested in taking specialty training from the Royal College of Physicians and Surgeons of Canada. While several training programs were particularly popular (ie, anesthesia and psychiatry--18.5% of respondents for each), almost every specialty training program was mentioned. Physicians identified the length and hours of training, financial issues, family issues, and the need for relocation as obstacles to retraining. The availability of part-time training, regional training, and return-of-service financial assistance were all identified as potential inducements. CONCLUSION: To meet the needs of practising physicians, re-entry training programs will need to consider flexibility, where feasible, with regard to choice of specialty, intensity, and location of postgraduate training.

[Stay in, dropout of and re-entry into the nursing profession of nurses under the aspect of specific types of nursing professionals in Austria]. / Berufsverbleib, -wiedereinstieg und -ausstieg diplomierter Pflegender in Osterreich unter Berücksichtigung spezifischer Berufsgruppen.

BACKGROUND: In Austria, a short to very short employment period of registered nurses has been recognised. On closer inspection, however, one can see that there is hardly any scientific data available on this topic. AIM: The aim of the study was to gather data on the duration of the employment period andto investigate the reasons for the stay in, dropout of, and re-entry into the profession by registered nurses in Austria. Another objective was to find out whether there are correlations between specific individual types of registered nurses and their professional careers. METHOD: Registered nurses, who obtained their nursing degree in Austria between 1965 and 2003, were surveyed through a questionnaire that had been elaborated within the framework of a focus group. RESULTS: The analysis revealed a considerably longer stay than reported in German-speaking literature. Furthermore, we were able to identify five different types of individuals with regard to the stay in, dropout of and re-entry into the nursing profession.

Motivating registered nurses to return for an advanced degree.

Master's-prepared nurses are required as faculty and educators in the hospital setting to meet the increasing demands of today's health care environment. A non-experimental, descriptive study design was used to examine nurses' preferences for organizational incentives and rewards that might motivate them to return for an advanced nursing degree. Using findings from this research study, a grant was developed and funded to address the need to both fill expected vacancies in the nursing work force and reduce the clinical nursing instructor shortage through a strategic academia and service partnership. A cohort model and mentorship program to identify nurses and then encourage and assist them in matriculating and completing an advanced degree in nursing was developed. One expected outcome of the proposed collaborative arrangement is to increase the number of registered nurses prepared at the graduate level to create a pool of individuals qualified to serve as clinical instructors, faculty, and preceptors while maintaining their hospital positions. Another expected outcome is to provide a path for nurses to pursue graduate education.

[Predicting the success of occupational retraining using the occupational aptitude test battery]. / Vorhersage des Umschulungserfolgs durch die Berufseignungsdiagnostik.

In vocational retraining centres, a test battery including several performance tests is generally administered to assess the occupational aptitude of rehabilitants and to predict their success in occupational retraining. This paper presents the multiple regressions of a set of achievement scores on "grades of retraining" and "grades of final examination", respectively, concerning retraining to become an office management assistant. It was shown that only few variables are adequate to clarify a maximum of variance of the criterions. Four different regression models were identified; each of them could clarify about 25% of variance. Significant predictors were indicators for verbal skills and basic numeracy. In each model a measurement for nonverbal intelligence had to be taken into account as a suppressor variable. To put all in a nutshell, in order to predict the success of vocational retraining to become an office management assistant it is more important to focus on strengthening school knowledge than on general intelligence.

A comparison of second-degree baccalaureate and traditional-baccalaureate new graduate RNs: implications for the workforce.

The purpose of this study was to describe the differences between traditional-baccalaureate graduates (TBGs) who had a baccalaureate degree in nursing and no other academic degree or diploma and second-degree baccalaureate graduates (SDGs) who had both a baccalaureate degree in nursing and a baccalaureate or higher degree in a field other than nursing. Using a sample of 953 newly licensed registered nurses (NLRNs), we compared SDGs and TBGs on demographic and work characteristics, including attitudes toward work, intent to stay in their current job, and whether they are searching for a job. TBGs worked slightly more hours per week and were more likely to provide direct care. SDGs were more likely to plan to stay indefinitely in their first job and were less uncertain of plans to stay. SDGs experienced higher family-work conflict and lower workgroup cohesion. Full-time SDGs earn over $2,700 more income per year. Potential explanations for the salary difference are the greater human capital that SDGs bring to the job and their older age. Understanding the workforce productivity of these two groups is important for both organizational planning and policy for recruitment and retention.

Transitioning foreign-educated physicians to nurses: the New Americans in Nursing accelerated program.

The innovative New Americans in Nursing accelerated program targets foreign-educated physicians (FEPs) residing in the United States who are either unemployed or underemployed and desire to become nurses. With a five-semester baccalaureate nursing curriculum, students are awarded credit for general education and science prerequisite courses completed in medical school and matriculate for 63 credits of nursing courses. Measurement of program outcomes provides evidence that FEPs socialize to nursing at the same level, exhibit significantly greater critical thinking skills, and have higher NCLEX-RN pass rates than generic baccalaureate nursing students. The program is a valuable option not only in addressing the critical and continuing nursing shortage, but also in diversifying the nursing workforce in response to health disparities and the increasing diversity of the U.S. population.

Maintaining microneurosurgical ability via staying active in microneurosurgery.

The aim of this study was to evaluate the effect of staying inactive for well-trained microneurosurgical hand and to determine the critical time period in the decreasing of this special ability (microneurosurgery). For this purpose we planned a case-based and time-dependent study. This study was done on a microneurosurgeon who previously worked very actively in a department of neurosurgery (at least one operation in a day). He received a new appointment which included staying inactive in another department for a certain period of time, like a medical doctor. He did hand practice everyday and scored his ability in the aspect of total beauty and harmony of the work. The total performance of work was graded as bad, good and excellent. A bad grade was scored as 1 point, a good grade as 2 points, and an excellent grade as 3 points. The inactive time period was divided into three equal periods of 30 days. The total numerical values were calculated and a mean score was estimated for each 30-day period. The differences among the first, second, and third periods were enumerated based on the mean scores. The mean score in the first 30 days was estimated as 2.56+/-0.49, in the second 30 days as 2.16+/-0.37, and in the third 30 days 1.66+/-0.47. The differences between these values were statistically significant. The result of this study revealed that neurosurgeons may gradually lose their well trained microneurosurgical ability through staying inactive from daily practice. The maintenance of trained microneurosurgical ability should be preserved by staying active in neurosurgical operative practice.