The experiences of doctorally prepared nurses and doctoral nursing students with being mentored in the Nurse-Lead programme: A focus group study.

AIM: to explore experiences of being mentored and the contribution of the mentoring to leadership and professional development of doctorally prepared nurses and doctoral nursing students participating in the Nurse-Lead programme. BACKGROUND: Mentoring is considered important for career development of academic nurses. Doctorally prepared nurses need a wide range of professional competences to develop sustainable careers. Therefore, they may benefit from a larger network of mentors, outside their own organization, to support their professional development. Therefore, a web-based leadership and mentoring programme was developed - the Nurse Lead programme. DESIGN: A descriptive study with semi-structured focus groups. METHOD: Three focus groups were conducted during an on-site programme meeting in 2019 with twenty-one doctorally prepared nurses and doctoral nursing students. The interview guide included questions about mentoring relationships and meaning of mentoring for leadership and professional development. The interviews were thematically analysed. RESULTS: Five themes were identified: "Preferred characteristics of mentors", "Developing trusting relationships", "Engagement of the mentors", "Becoming a proficient researcher and team leader" and "Becoming an empowered and confident professional". CONCLUSION: Mentoring supported the leadership and professional development of doctorally prepared nurses and doctoral nursing students. Participants were engaged in rewarding mentoring trajectories. The results indicate that a similar approach could be followed when developing mentoring programmes in the future.

Hospitalised cancer patients' perceptions of individualised nursing care in four European countries.

The aim of this study was to describe hospitalised cancer patients' perceptions of individualised care in four European countries and compare these perceptions using the patients' socio-demographic characteristics and the Individualized Care Scale. The patients' socio-demographic characteristics used were: education, age, gender, type of hospital admission, previous hospitalisation and hospital length of stay. The Individualized Care Scale has two parts (1) nurses' support of individuality and (2) patients' receipt of individuality. Data (n = 599) were collected in Cyprus (n = 150), Finland (n = 158), Greece (n = 150) and Sweden (n = 141). Multivariate analysis of variance models were constructed and differences in perceptions of individualised care were analysed using the patients' socio-demographic characteristics as covariates. The level of support for individuality and receipt of individualised care was reported as moderate and good respectively. Generally, the highest assessments were made by the Swedish respondents and the lowest by those in Greece. This study revealed some between-country differences in patients' perceptions of care individualisation. These differences, for example, conceptual, educational, based in clinical practice or in the health organisation, require further research. Enquiry into the individualised care perceptions of health care providers and the families of cancer patients would also be useful.

Collaboration between hospital and primary care nurses: a literature review.

BACKGROUND: Nurses play an important role in the treatment and care of adults in both hospital and primary health care working within complex and fragmented organizational systems. As the nature of health care changes and hospital and primary care sectors become more closely associated, nurses in both sectors have an obligation to increase their collaboration. AIMS: This study aimed to increase the understanding of collaboration between nurses working with adults in hospital and primary health care, and to facilitate the future measurement of this collaboration. METHODS: A literature review was undertaken in July and August 2013 using CINAHL and MEDLINE databases from the earliest to August 2013. The searches produced 4951 citations that were reduced to 22 articles for review using a four-step inclusion strategy. Inductive content analysis was used to analyse the data. RESULTS: It is suggested that collaboration is a process that contains (1) collaboration precursors: the opportunity to participate, knowledge and shared objectives; (2) elements of collaboration: competency, awareness and understanding of work roles and interaction; and (3) processes and outcomes: the events or behaviours that are the consequences of the collaboration between hospital and primary healthcare nurses. CONCLUSIONS: The results indicate that collaboration between hospital and primary healthcare nurses is an important and integral part of the work of nurses and a process consisting of several predictable issues leading to useful care outcomes. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Current healthcare changes make it a requirement for hospital and primary healthcare nurses to collaborate when working with adults to continue to meet the needs of patients. The findings of this study can be used to improve collaboration in practice and to devise research to improve collaboration between hospital and primary healthcare nurses.

Nurses' knowledge about venous leg ulcer care: a literature review.

INTRODUCTION: There is an increasing prevalence of venous leg ulcers coinciding with increasing older people populations. They are therefore important health problems, which restrict daily activities and incur high costs. BACKGROUND: Efficient and comprehensive nursing care for people with venous leg ulcers requires knowledge of causes, presentations and characteristics, the effects that venous leg ulcers have on individuals and nursing care with evidence-based treatment. AIM: To identify the gaps between nurses' demonstrated knowledge of venous leg ulcers and the related nursing care treatment with evidence-based nursing care. METHOD: A computerized search using MEDLINE, CINAHL the COCHRANE LIBRARY was conducted. RESULTS: The initial search yielded 174 citations from which 16 relevant articles were included in this review. Four themes in venous leg ulcer nursing care emerged demonstrating nurses' knowledge gaps: assessment, physiology and the healing process, nursing care and dressings, and compression treatment. CONCLUSION: This review suggests that there is a lack of knowledge related to venous leg ulcer physiology, the healing process and how this influences care and treatment. Nurses may not be using the evidence base sufficiently well to support ulcer healing and patient well-being. IMPLICATIONS FOR NURSING AND HEALTH POLICY: There is a need for a positive work culture development and ongoing educational programmes aimed at improving nurses' knowledge of venous leg ulcer treatment and care, which address the themes within the results of this review.

Cypriot and Greek nurses' perceptions of the professional practice environment.

BACKGROUND: Research evidence supports that the role of the professional practice environment is crucial for the delivery of quality care as it is significantly correlated with patient and nurse outcomes. However, in countries sharing similar cultural and ethnic backgrounds, like Cyprus and Greece, as well as the increased mobility of patients and healthcare workers, there is a lack of information regarding this issue. The aim of this study is to explore and compare Cypriot and Greek nurses' perceptions of their professional practice environment. METHODS: A descriptive comparative survey was employed using a sample of nurses in Cyprus (N = 150) and Greece (N = 147). Information was collected with the Revised Professional Practice Environment Scale (RPPE). RESULTS: The results revealed significant differences between the two countries in three out of eight factors of the RPPE, with Greece's mean value being higher than Cyprus's: Handling Disagreements and Conflicts, Leadership and Autonomy in Clinical Practice, and Teamwork. CONCLUSIONS: The findings generate additional knowledge about the organizational context of care delivery that might help nursing leaders to understand how nurses perceive their work environment and how this influences their work, and consequently the care provided. The results can be utilized by nurse ward managers to improve the quality of nursing care provided. Further research is needed using different approaches to explore nurses' experience in more depth. IMPLICATIONS FOR NURSING OR HEALTH POLICY: Measuring nurses' perceptions of their professional practice environment may assist managers and policymakers in introducing interventions that contribute to a better practice environment and consequently to improved nursing, as well as patient, outcomes.

[Italian validation of the Patient Satisfaction Scale]. / Misurare la soddisfazione del paziente: validazione della versione italiana della Patient Satisfaction Scale.

Patient's satisfaction is a major outcome of the health care services and it is mainly determined by patients' perception of the nursing care received. Many instruments measuring patients' satisfaction are described in the literature. In this study the validation of the Patient Satisfaction Scale in the Italian context is documented. Content validity of the scale has been reached with forward-backward translation, achieving semantic equivalence with the original scale. The scale has been completed by 220 (response rate 91%) surgical patients during their hospitalization and has showed a good response variability and a high reliability (Cronbach alpha = 0.93). The Italian version of the PSS is considered valid and reliable; moreover the high response rate obtained indicates a good level of acceptability of the scale in clinical settings.

Individualised care and the professional practice environment: nurses' perceptions.

AIM: To describe individualised care and the professional practice environment from nurses' point of view and to explore the associations between them. BACKGROUND: There is an increasing emphasis on individualised nursing care within the literature and the health-care context. Preliminary evidence suggests that the implementation of individualised care is associated with the practice style of care, work organization and the practice environment. METHODS: An exploratory correlational survey was used. Data were collected using the Individualised Care Scale and Revised Professional Practice Environment instruments from nurses and nurse managers (n=207, response rate 59%) working in in-patient wards of three acute hospitals' 13 different units in Finland in 2008. Data were analysed based on descriptive statistics and Spearman's rho correlations. FINDINGS: Nurses perceived that they generally support patient individuality and that the care they provided was individualised. Nurses' perceptions about the support of individuality and views on individuality of care provided were associated with handling conflict, work motivation, control over practice, leadership and autonomy, relationships with physicians and cultural sensitivity. DISCUSSION: The findings support the perception that individualised care and the professional practice environment are associated. There is a need for further studies to examine these associations more closely. Manipulating aspects of the environment may possibly be used to increase the ability of the nurses to provide individualised care. Patient perspectives should be included in future studies. Because of the national data, the results are indicative only. CONCLUSIONS: The recognition of the associations between individualised care and professional practice environment elements may help to develop individualised clinical nursing care.

Patients' perceptions of patient education on psychiatric inpatient wards: a qualitative study.

This study describes patients' perceptions of different types of patient education interventions and areas where patient education should be improved on psychiatric wards. Thematic interviews were conducted with 16 patients who had completed the information technology (IT)-based patient education, conventional patient education with leaflets or patient education according to ward standards during their hospital stay. Data were analysed using inductive content analysis. Patients' perceptions of patient education varied depending on which patient education group they had participated in. Patients participating in IT-based or conventional patient education perceived education as a systematic and planned process. However, especially patients in the patient education group applying ward standard education perceived patient education as occasional information dissemination situations. To improve patient education, patients suggested that it should be based on their individual needs and offered with different methods systematically to all patients. The results indicate that patients find structured and systematic patient education programmes useful. Different educational methods should be used, not forgetting interaction between patient and nurse, which was reportedly as an essential element of patient education.

Orthopaedic and trauma patients' perceptions of individualized care.

BACKGROUND: Individualized care is a universal concept in nursing. An international collaboration of nurses, led by, and funded in, Finland was developed, including Sweden, Greece, USA and the UK, in order to test an Individualized Care Scale (ICS) for cross-cultural comparison. This paper reports the results from the UK survey. AIM: The study aimed to employ an ICS to describe orthopaedic and trauma patients' perceptions of individualized care. METHODS: A total of 159 orthopaedic and trauma patients, aged 18 years or over, admitted for over 48 hours as emergencies or for elective surgery, participated from one hospital in Central England using a two-part ICS. The data were analysed using both descriptive and inferential statistics. RESULTS: Sixty-three per cent of the patients (n = 82) strongly agreed that it was very important to be treated as an individual or unique person, and 55% (n = 72) experienced this type of care. The lowest rated assessments concerned the support (3.23 +/- 1.15) and perceptions (3.69 +/- 0.98) of personal life situation, and the highest concerned the perceptions of decisional control over care (4.25 +/- 0.72). The longer the patients stayed, the more they perceived individuality in their own care. Those less educated perceived higher levels of support regarding individuality in their care. CONCLUSIONS: These results could assist changes to individualized care processes in orthopaedic and trauma wards. Future research should focus on the evaluation of taking into account of patient's personal life situation as a foundation for individualized clinical care.

Patients' autonomy in surgical care: a comparison of nurses' perceptions in five European countries.

BACKGROUND: This report forms part of the results of an international comparative study funded by the European Commission (1998-2001). AIM: To describe and compare the maintenance of patients' autonomy on surgical wards, from the point of view of nursing staff, in five European countries (Finland, Spain, Greece, Germany and Scotland). Autonomy is defined in terms of information received and decision making by patients. METHOD: The data were collected using a questionnaire specifically designed for use in this study. Responses (response rate 66%) were obtained from 1280 nurses working on surgical wards. Data analysis was based on descriptive statistics, t-tests, analysis of variance (ANOVA) with posthoc Tukey's HSD test and logistic regression. RESULTS: There were clear between-country differences in nurses' perceptions, especially on a north-south axis (Finland and Scotland vs. Greece and Spain), regarding the extent to which the autonomy of surgical patients is supported by nursing staff. Training and ethics education, in particular, were associated with nurses' perceptions of the maintenance of patient autonomy in Finland and Greece. CONCLUSION: Further research is needed to establish whether the results obtained are caused by differences in cultures, nursing practices or roles of health-care personnel or patients in different European countries.

Occupational contact urticaria from diglycidyl ether of bisphenol A epoxy resin.

BACKGROUND: Epoxy resin (ER) is a common cause of occupational allergic contact dermatitis (ACD), but contact urticaria from ER is very rare. METHODS AND RESULTS: A plastic-product worker first developed ACD from diglycidyl ether of bisphenol A (DGEBA) epoxy resin, and subsequent exposure resulted half a year later in contact urticaria: first with edema of the lips and eyelids, and later an urticarial reaction on the upper chest, with strong swelling of the eyelids and tightness of the throat. The diagnosis was based on a positive skin prick test to his "own" ER compound, a positive prick test reaction to DGEBA, and a positive skin provocation test with the ER compound and DGEBA. The contact urticaria test reaction was strongly aggravated when the allergen was wiped off with an alcohol solution, apparently because the solution enhanced the penetration of the allergen. CONCLUSIONS: Our case is of interest, first, because contact urticaria from ER is very rare, and second, because this is the second report in which a strongly intensified contact urticaria reaction was provoked by an alcohol solution. We suggest that if the contact urticaria provocation test with low-molecular-weight chemicals is negative, a contact urticaria provocation test with alcohol (CUPTA) should be performed.

Cryosurgical methods for eyelid lesions.

Treatment of benign skin lesions commands a high demand for cosmetic outcome. Among the alternatives for the treatment of benign lesions, cryosurgery has many advantages: it is a safe office-based method, the predictable outcome is cosmetically good and the cost of treatment is relatively low compared with operative surgery or laser techniques for example. The controllability and the tissue selectivity of cryosurgery allow its use in and around the eyelids.

Individualized care in a Finnish healthcare organization.

This paper reports the findings of a study exploring the provision of individualized care in a regional hospital in Finland. Individualized care was defined in terms of how patient individuality was taken into account and how patient participation in decision-making was facilitated. The data were collected from hospitalized patients (n = 203) using a questionnaire specially developed for this study. The response rate was 89%. A strong support to facilitate patient participation in decision-making was reported. Most shortcomings concerning the provision of individualized care related to consideration of the patient's cultural background and the involvement of the patient's family in the planning of care. Patients' age and the type of ward were associated with the provision of individualized care: patients aged 65 or over were more satisfied than younger age groups with the way in which their personal life situation had been taken into account. Patients from the gynaecological ward thought, more than patients from the surgical ward, that their situation had been taken into account during hospitalization.

Developing and testing an instrument for the measurement of individual care.

This paper describes a preliminary study in which an instrument was developed for the measurement of individual care in adult patients and in which the reliability and validity of the instrument were evaluated. Individual care was defined in terms of how patient individuality was taken into account and how patient participation in decision-making was facilitated. The purpose here is to describe the process by which the individual care instrument (IC) was developed, the preliminary testing of the instrument and psychometric evaluation of the instrument in a sample of adult patients discharged from a Finnish general Hospital (n=203). Item analyses showed an acceptable level of internal consistency reliability and homogeneity in each scale of the IC, and Cronbach alpha values were high in every measurement. Exploratory factor analysis supported a three-factor solution. The psychometric evaluations suggested that the instrument is worthy of further development.

A double-blind, randomized study to compare the efficacy and safety of terbinafine (Lamisil) with fluconazole (Diflucan) in the treatment of onychomycosis.

In a randomized, double-blind, double-placebo, multicentre study, terbinafine 250 mg daily for 12 weeks was compared with fluconazole 150 mg once weekly for 12 or 24 weeks in the treatment of onychomycosis. A total of 137 patients with culture-confirmed onychomycosis was divided into three groups: group A received terbinafine for 12 weeks, group B received fluconazole for 12 weeks, while group C received fluconazole for 24 weeks. At completion of the study (week 60), the mycological cure rate was higher in the terbinafine group than in the fluconazole groups: 89% vs. 51% and 49%, respectively (P < 0.001). The length of unaffected nail increased until week 24 in group B and until week 36 in group C, but was still increasing in group A at the final visit (week 60). Complete clinical cure of the target nail at week 60 was 67% in the terbinafine group, compared with 21% and 32% in the fluconazole groups, respectively. The incidence of adverse events was low for both study agents. We conclude that terbinafine 250 mg daily for 12 weeks is significantly more effective in the treatment of onychomycosis than fluconazole 150 mg once weekly for either 12 or 24 weeks.

Human onychomycosis caused by Trichophyton equinum transmitted from a racehorse.

We report fingernail onychomycosis caused by Trichophyton equinum in a farmer who breeds racehorses. In addition to the thumbnail, T. equinum had infected one of the racehorses. Oral terbinafine cured the infection in the farmer.