Surgical Patient Preoperative Readiness: Translation into French, Cultural Adaptation for Switzerland and Cross-Sectional Exploratory Study in a Tertiary Hospital.

PURPOSE: Preoperative evaluation of elective surgery patients traditionally focuses on somatic and organizational aspects of the situation. Patient feelings of readiness, called preoperative readiness (PR), impacts postoperative outcomes, and yet is rarely evaluated. The Preoperative Assessment Tool (PART) is a validated and reliable 15-item questionnaire available in Filipino and English. A reliable tool is essential for evaluating PR within the Swiss health context to offer optimized and comprehensive perioperative care. The aim of this study was to both translate into French and adapt culturally the Preoperative Assessment Tool for Switzerland's francophone population, and to explore patient PR in the preoperative consultation within a Swiss tertiary hospital. DESIGN: A mixed design with methodologic phases and descriptive study. METHODS: A mixed design in two phases with a methodologic phase with (1) translation and (2) cultural adaptation for Romandie of the PART, following Wild's 10 steps methodology (n = 11) and (3) a cross-sectional exploratory descriptive study with pilot testing of the translated version in a general elective preoperative consultation in a tertiary hospital in Romandie (N = 88). FINDINGS: Translation and cultural adaptations are well accepted and understood by the participants (n = 9/11), modifications are accepted by the authors and deemed adequate by the participants (n = 11/11). Time of completion is short (m = 69.06 seconds) and adapted to clinical context. The translated version has a Cronbach (α = 0.85) comparable to the original validated scale (α = 0.86). CONCLUSIONS: The translation and cultural adaptation for Switzerland of the PART was achieved, and PR was explored. Further psychometric testing of the PART-FrenCH must be conducted to assess fully the tool before its use in a clinical setting. Including PR in preoperative evaluations could enhance patient-centered approaches and lead to improvement in the quality of care.

Assessing Dietary Salt Intake and Pilot-Testing a Home-Based Intervention to Lower Salt Intake Among Filipino College Students.

PURPOSE: To assess the knowledge, attitude, and behaviors related to dietary salt intake and develop a home-based intervention that helps lower salt intake among Filipino college students. DESIGN: Two-phase program development study utilizing descriptive and quasi-experimental design. METHODS: Phase 1 determined the knowledge, attitude, and behaviors alongside the frequency of dietary salt intake of a consecutive sample (n = 118). Phase 2 involved the development and pilot-testing of a home-based intervention wherein a random sample (n = 35) selected from Phase 1 joined for pilot-testing. The study was conducted from October - November 2021 and utilized valid and reliable measures to test the knowledge, attitude, and behavior of the participants. FINDINGS: Initial assessment showed knowledge regarding health risks of high salt intake and positive attitude toward health-promoting behaviors. Post-intervention showed improvement in attitude (p = 0.0004) and behavior (p = 0.001) related to dietary salt intake alongside health literacy (p = 0.036). There was no significant change in knowledge (p = 0.054). CONCLUSION: The home-based intervention involving the use of health education materials is successful in improving dietary salt intake patterns. CLINICAL EVIDENCE: Community health nurses may utilize home-based interventions to help develop health-promoting behaviors among young adults.

Predisposing, Reinforcing, and Enabling Factors of Nicotine Dependence Among Young Adults in a Rural Community.

OBJECTIVES: The aim of this study was to determine the influence of predisposing, reinforcing, and enabling factors of nicotine dependence among young adults in a rural community. STUDY DESIGN: A quantitative, predictive-correlational cross-sectional study was done among 190 young adults in a rural community utilizing compact segmental sampling. METHODS: Data were collected from August to October 2018 utilizing a validated robotfoto, adapted determinants of smoking questionnaire, and Fagerström test to assess nicotine dependence. Stepwise multiple linear regression was used in predicting the relationship between the predictors and nicotine dependence. RESULTS: Reinforcing and enabling factors influenced nicotine dependency. The influence of other relatives (ß = .179, p = .023) and radio advertisements (ß = -.224, p = .008) as well as availability (access) to cigarettes (ß = .228, p = .003) were significant predictors of nicotine dependency in the rural community. CONCLUSION: Identified predictors can help form policies that can help address the availability of cigarettes and advertisements (radio) that can influence nicotine dependence among young adults in a rural community. Furthermore, the influence of other relatives (extended family) can be a factor that can increase the development of nicotine dependence.

Resilience, Social Support, Loneliness and Quality of Life during COVID-19 Pandemic: A Structural Equation Model.

AIM: To determine the parsimonious model of the interrelationships of personal resilience, social support, loneliness and quality of life (QoL) and to identify the mediating effect of loneliness among nursing students amidst the pandemic. BACKGROUND: The coronavirus 2019 (COVID-19) pandemic led to control measures which increased loneliness among students due to disrupted social connections and sudden shift to virtual learning. During these changes, resilience and social support can significantly influence how learners deal with pandemic-related stresses thus, minimizing loneliness and enhancing QoL. Although studies posited the influence of resilience and social support with loneliness and QoL, these were conducted prior the COVID-19 pandemic wherein loneliness and feelings of isolation play a crucial part. DESIGN: Correlational, theory testing using covariance-based structural equation modeling METHODS: A total of 550 nursing students from a comprehensive university in Manila, Philippines were recruited from September to October 2021 and answered four standardized, validated scales. RESULTS: A good and parsimonious model (x2/df = 2.84, RMSEA = 0.058, GFI = 0.999, CFI = 0.999, PNFI = 0.048) highlighted the mediating effect of loneliness between social support, personal resilience and QoL. While personal resilience positively influenced the physical and psychological domains of QoL, social support positively affected the social relationships and environmental domains. Loneliness was a strong, negative predictor of the psychological and social domains of QoL and had a moderate, negative effect on the physical domain. Personal resilience also mediated the influence of social support on loneliness and QoL. CONCLUSION: Social support and personal resilience positively affected QoL, while loneliness had a negative effect. Through the mediation of loneliness, the effects of social support on QoL decreases. However, the mediation of resilience further decreases loneliness and improves QoL. The presented model assists nurse educators and administrators in developing strategies to enhance social support, resilience and QoL among students while mitigating the negative effects loneliness during the pandemic. TWEETABLE ABSTRACT: Loneliness and Resilience are mediators of student nurses' quality of life during COVID-19 pandemic. Social support is the common predictor.

Systematic Review of Preoperative Patient Readiness.

Preoperative readiness indicates the patient's capacity to process information, consider possible outcomes, and decide to undergo a surgical procedure. This systematic review examines how the term "patient readiness" is used in the literature and synthesizes how preoperative interventions address readiness. A medical librarian searched five electronic databases to identify articles published between July 1, 2008, and June 30, 2019, that address studies including adult patients scheduled for surgery who participated in programs designed to foster readiness or studies that explored surgical readiness. After extracting 28 studies, the authors assessed the articles for quality and thematically synthesized them to describe actions and indicators of patient readiness according to the Perioperative Patient Focused Model. Readiness can positively influence surgical outcomes (eg, pain, satisfaction); however, there is a paucity of high-level, quality evidence that discusses surgical readiness for perioperative care. Nurses should use the information in this review to improve patient-centered preoperative care.

Exploring the challenges and needs of home caregivers of hemodialysis patients in the Philippines: A mixed methods study.

OBJECTIVES: Although the importance of home caregivers of chronic kidney disease patients has been increasingly recognized, their perceived caregiving difficulties and requisites remain underexplored. This study investigated the challenges and needs of home caregivers of hemodialysis patients in the Philippines. METHODS: We utilized a mixed-method (QUAN + qual), explanatory sequential design. Data were collected from July 2017 to May 2018 from 46 home caregivers of hemodialysis patients. A three-part researcher-made survey were developed from literature search, personal values and cultural context, while some items were generated from a standardized tool that measures caregiver infrastructure and needs of those caring from frail US veterans. The tool developed gathered the participants' profile, caregiving characteristics, and related needs. The tool was validated and pretested for reliability. Fifteen participants were also interviewed to explore caregiving challenges and needs. Descriptive and χ2 statistics were used for quantitative outcomes, while thematic analysis was employed for qualitative data. RESULTS: Participants provided moderate assistance to patients, spending an average of 10.65 h/day and 5.08 days/week in caregiving. The most difficult caregiving circumstances were having costly expenses (78.26%); missing work (50.00%); and experiencing negative feelings (47.83%), stress (43.48%), and physical difficulties (34.78%). They also had the lowest confidence in deciding when to contact health providers (x̅ = 3.31, SD = 0.94) and finding patient care services (x̅ = 2.93, SD = 1.08). Qualitative findings further revealed caregiving needs and challenges in cost management, physical and psychological health, assumption of multiple roles, lifestyle adjustment, and reinforcement of carer knowledge, skills, and attitudes. CONCLUSION: Supportive strategies are needed to address the challenges encountered by home caregivers of hemodialysis patients. Findings can be utilized in developing appropriate interventions for home caregivers in low-resource settings where home caregiving and healthcare system issues, such as lack of access to resources and social support, are prevalent.

The mediating role of pre-operative patient readiness on surgical outcomes: A structural equation model analysis.

AIMS: To determine the mediating role of surgical readiness on patient characteristics (surgical risk, type of surgery, pre-operative anxiety, and health literacy) and its influence on surgical outcomes (pain, postoperative complications, and surgical experience). DESIGN: Correlational, theory testing using structural equation modelling. METHODS: A total of 376 consecutively selected surgical patients from four tertiary hospitals were recruited and followed-up 48-72 hr postoperatively from May-October 2017. Consenting respondents answered questionnaires measuring basic surgical information, health literacy, anxiety, surgical readiness, pain score, and surgical experience. Further, records review was conducted to identify occurrence of any postoperative complications and use of additional analgesics. RESULTS: A good fit and parsimonious model (χ2 /df = 0.75, RMSEA = 0.00, GFI = 0.99, CFI = 1.00, PNFI = 0.50) highlighted the mediating effect of pre-operative readiness between patient characteristics and surgical outcomes. The type of surgery (curative) influenced patient readiness, surgical complications, and use of additional postoperative analgesics. Higher health literacy negatively influenced patient readiness; can decrease the use of postoperative analgesics; and lessen postoperative pain. Further, pre-operative anxiety decreased patient readiness and increased postoperative pain and negatively influenced the surgical experience. CONCLUSION: Patient readiness is beyond the physiological aspect of pre-operative preparation and it is influenced primarily by the mental and emotional state of a patient. Addressing issues such as anxiety and health literacy can improve pre-operative readiness that can enhance pain management and surgical experience. Hence, the mediating role of readiness in improving surgical outcomes emphasizes the need to deliver a patient-centred and individualized approach to patient preparation with a key focus on their readiness for surgery. IMPACT: This study demonstrates the difference between preparing patients and promoting readiness for surgery. Surgical readiness requires patient-centred approach in promoting a more engaged and confident patient who is capable to use appropriate health information and how it can lead to better surgical outcomes.

Cross-Cultural Validation Into Filipino of the Consumer Assessment of Health-Care Providers and Systems Surgical Care Survey (S-CAHPS).

Surgical experience is increasingly being recognized; however, Consumer Assessment of Health-Care Providers and Systems Surgical Care Survey (S-CAHPS), the tool for surgical experience, is available in English and Spanish only. To measure surgical experience among Filipinos, a culturally appropriate version should be validated. This study culturally adapted the S-CAHPS into Filipino. A five-step cross-cultural validation study was conducted. Language experts conducted forward translation, back translation, and panel reconciliation. Pretesting included content validation and pretesting of the Filipino S-CAHPS. Field testing involved 55 purposively selected postoperative patients who completed a 3-part survey from March to July 2018. The English S-CAHPS was reduced to 34 items to account cultural variations, yielding an item content validity index (I-CV) of 1.00. One-sample t test and Bland-Altman plots showed good linguistic equivalence. Correlation coefficients were ≥0.30, suggestive of good conceptual equivalence. Cronbach's alpha values were 0.83 and 0.85 indicative of good reliability. The Filipino S-CAHPS showed acceptable psychometric properties. It is a valid and culturally appropriate instrument to measure surgical experience among Filipinos which can be utilized for quality improvement measures on both practice and policy levels.

Occupational determinants of compassion satisfaction and compassion fatigue among Filipino registered nurses.

AIMS AND OBJECTIVES: To determine the prevalence and to identify the occupational determinants of compassion satisfaction and compassion fatigue among general medical-surgical registered nurses. BACKGROUND: Compassion fatigue and compassion satisfaction are caring concepts that have been explored among nurses in specialised hospital units. However, there is paucity of studies exploring the occupational determinants among general medical-surgical registered nurses. DESIGN: Cross-sectional. METHODS: From August-November 2017, 121 consecutively selected general medical-surgical registered Nurses from five hospitals completed a four-part survey packet composed of the participant information sheet, the Professional Quality of Life Version 5, the McCloskey-Mueller Satisfaction Scale and the Eden Warmth Survey-Employee Questionnaire. Stepwise-forward multiple linear regression was employed to identify the occupational determinants of compassion fatigue and compassion satisfaction. The STROBE checklist was followed in reporting this study (see Appendix S1). RESULTS: The prevalence of moderate to high levels of compassion satisfaction was 90.09% while burnout and secondary stress, the facets of compassion fatigue, had a prevalence of 74.38% and 83.47%, respectively. Among the identified occupational determinants, only job satisfaction and nurse colleague relationship positively influenced compassion satisfaction. In contrary, although higher monthly income positively influenced both dimensions of compassion fatigue, nurse colleague relationship had the strongest negative effect. CONCLUSION: Among the occupational determinants of compassion fatigue and compassion satisfaction, nurse colleague relationship had the strongest influence. This result highlights the importance of positive nurse colleague relationships and paves way for the development and initiation of appropriate strategies. RELEVANCE TO CLINICAL PRACTICE: The findings of this study paves way for the development of institutional policies and individualised programmes geared towards building rapport and communication among registered nurses assigned in general medical-surgical units. Likewise, the high prevalence of compassion fatigue needs further exploration to develop appropriate measures to mitigate its development among general medical-surgical nurses.

Fluid distribution timetable on adherence to fluid restriction of patients with end-stage renal disease undergoing haemodialysis: Single-blind, Randomized-Controlled Pilot Study.

AIM: To determine the effects of a fluid distribution timetable on adherence to fluid restriction of patients with end-stage renal disease undergoing haemodialysis. BACKGROUND: Fluid restriction is necessary among patients with chronic kidney disease. However, treatment adherence remains a challenge. DESIGN: Single-blind, randomized-controlled pilot study. METHODS: From September - December 2016, 24 consecutively-selected patients with end-stage renal disease from a single dialysis clinic were randomly assigned using computer-generated sequences of randomly permuted blocks stratified according to gender to receive the fluid distribution timetable or standard care. Adherence to fluid restriction was measured using two indicators-thirst and interdialytic weight gain- and were compared using One-way RM-MANOVA and MANCOVA. Secondary outcomes included baseline patient demographic and clinical characteristics and were compared according to treatment allocation. Both groups were followed-up for 4 weeks, assessing outcome measures during the second haemodialysis session for each week. RESULTS: At baseline, the demographic and clinical characteristics and indicators of adherence to fluid restriction were comparable between the two groups. Thirst scores, however, were statistically lower in the treatment group than the control group on the fourth week follow-up. There was also a remarkable decrease from baseline thirst and interdialytic weight gain scores in the treatment group, with partial eta-squared of 0.43 and 0.39, respectively. CONCLUSION: The fluid distribution timetable was an effective adjunct treatment strategy in promoting adherence to fluid restriction. However, since this is just a pilot study, further investigation must be conducted to determine the effects of fluid distribution timetable. TRIAL REGISTRATION: NCT03582592.

Scale Development and Psychometric Evaluation of the Preoperative Assessment of Readiness Tool.

PURPOSE: Technology has greatly advanced surgical capacity; however, the patient's perspective of surgical readiness remains unexplored. There is also a paucity of psychometrically sound instruments quantifying surgical readiness. Hence, this study developed and psychometrically evaluated the Preoperative Assessment of Readiness Tool (PART). DESIGN: A methodological study. METHODS: An initial 25-item questionnaire was developed after preliminary interviews and literature review. Psychometrics included content and construct validity and internal consistency. PART was tested on 210 purposively selected preoperative patients and preliminary factor analyses examined two random halves of the sample. FINDINGS: The questionnaire was reduced to 21 items after content validation and was further reduced to 15 items after preliminary factor analyses. Final factor analysis extracted two factors: quality information acquisition and supportive interpersonal care assimilation. Scale reliability was 0.97 with acceptable subscale reliability. CONCLUSIONS: The 15-item Preoperative Assessment of Readiness Tool demonstrated satisfactory psychometrics in assessing perceived surgical readiness. Nonetheless, further analysis is warranted to guarantee robust cross-cultural and cross-geographical comparisons.

Development and psychometric appraisal of the Pain Management Self-Efficacy Questionnaire.

AIM: The aim of this study was to develop and psychometrically evaluate the Pain Management Self-Efficacy Questionnaire. BACKGROUND: Pain management competence and confidence are important in rendering safe and effective patient care. However, there is a lack of psychometrically sound instruments measuring pain management self-efficacy. DESIGN: Triphasic, prospective psychometric study. METHOD: A 55-item Pain Management Self-Efficacy Questionnaire was initially developed after extensive theoretical and literature review. The questionnaire was evaluated by content experts for content validity and a consensus was achieved after two iterations. After pretesting, the Pain Management Self-Efficacy Questionnaire was distributed to 420 randomly selected pre-graduate student nurses and registered nurses from a nursing institution and a tertiary hospital. Data collection was conducted from January 2015 - 2016. Assessment parameters included basic item analysis, reliability analysis, floor and ceiling effects and construct validity using factor analysis and "known groups" technique. Replication analyses scrutinized two random halves of the sample. RESULTS: The initial 55-item questionnaire was reduced to 42 items after two iterations of validation. After preliminary factor analyses, the Pain Management Self-Efficacy Questionnaire was reduced to 21 items. Final factor analysis produced a three-factor model: Comprehensive, Evaluative and Supplemental Pain Management Self-Efficacy. Construct validation using Kruskal-Wallis and Mann-Whitney tests showed group differences according to years of clinical experience and receipt of pain management training. CONCLUSION: The 21-item Pain Management Self-Efficacy Questionnaire demonstrated satisfactory psychometric properties and can be used to measure pain management self-efficacy among nurses. Nevertheless, further psychometric validation is warranted accounting differences in culture and clinical practices.

Social media use profile, social skills, and nurse-patient interaction among Registered Nurses in tertiary hospitals: A structural equation model analysis.

BACKGROUND: Social media has become increasingly important over the past decades and has been integrated in various environments, including the healthcare setting. Yet, the influence of social media use on the social skills and nurse-patient interaction of nurses is an area in nursing that requires further studies. This study determined the interrelationships among social media use profile, social skills, and nurse-patient interaction of Registered Nurses in tertiary hospitals. METHODS: Employing structural equation modeling, a descriptive-correlational study was conducted among 212 consecutively-selected nurses from two tertiary hospitals. Consenting respondents completed a two-part survey composed of the respondent profile sheet and the Social Skills Inventory. The respondent profile sheet assessed demographic profile and social media use profile in terms of the mode, frequency, and duration of utilization. Three trained team members observed each nurse-patient dyad and completed the Nurse-Patient Bonding Instrument. RESULTS: A good fit model illustrated the negative effects of frequent social media use to patient openness (ß = -0.18, p < 0.05) and engagement (ß = -0.11, p ≤ 0.05). Longer use of social media on a daily basis, however, positively affected both dimensions of social skills. Accessing social media platforms using non-handheld devices showed the most influential positive effects to social skills and nurse-patient interaction. Additionally, although verbal social skills positively affected most dimensions of nurse-patient interaction, non-verbal social skills negatively influenced patient engagement (ß = -0.19, p = 0.019) and nurse openness (ß = -0.38, p ≤ 0.05). CONCLUSION: The structural model illustrates the effects of using social media on the social skills and nurse-patient interaction of nurses and emphasizes the need for implementing institutional policies on the judicious use and application of social media in the workplace. Further, social skills development programs geared toward having a balanced social skill must be implemented.

Assessment of Research Capacity Among Nursing Faculty in a Clinical Intensive University in The Philippines.

BACKGROUND: Many nursing studies are conducted in the United States, Europe, and Australia, where only a fourth of the world's population resides. There is a need to promote nursing research in Asia to enhance the contextual relevance of their evidence-based nursing interventions. A first step toward this goal is to determine the perceived research capacity among nursing faculty in academic settings in the Philippines. METHODS: This study described the perceived research capacity among nursing faculty of the University of Santo Tomas - College of Nursing, Manila, Philippines. The study used a survey that contained four sections: subject demographics; knowledge and skill on research designs and research process; research involvement, services, and incentives; and factors affecting research involvement. Chi-square test of homogeneity and MANOVA analyzed the gathered data. RESULTS: Findings showed that the faculty perceived themselves as knowledgeable and skillful in conducting research. However, current teaching assignments hindered their capacity to conduct research. University-sponsored incentives and college-based research services had also remained underutilized despite their availability. Overall, heavy teaching load was the greatest hindrance to research endeavors. CONCLUSION: Actions must be taken to reconfigure effort allocations with careful consideration of existing university and institutional bylaws.

Family Presence During Resuscitation Benefits-Risks Scale (FPDR-BRS): Instrument Development and Psychometric Validation.

UNLABELLED: Family presence during resuscitation (FPDR) is a growing health care practice; nevertheless, countless controversies surround this medical principle. Several studies have investigated the perceptions of health care professionals toward FPDR, yet psychometrically sound instruments assessing family members' perceptions of FPDR are scarce. Hence we aimed to develop and psychometrically validate the Family Presence During Resuscitation Benefits-Risks Scale (FPDR-BRS). METHODS: Using a methodological design, an initial 27-item questionnaire was developed after extensive literature and theoretical review. Psychometric validation assessed content validity through a 2-step process involving expert nurses and doctors, basic item analysis, internal consistency using Cronbach's α, and construct validity via exploratory factor analysis. After acquiring Ethics Review Board approval, the FPDR-BRS was tested on 130 randomly selected eligible family members from a tertiary government hospital in the Philippines. RESULTS: The initial 27-item questionnaire was reduced to 23 items after content validation, yielding an item content validity index and scale content validity index/Ave rage of 1.00. Basic item analysis revealed acceptable inter-item and item-scale correlations. Exploratory factor analysis extracted 4 factors, namely, personnel risks, personal risks, insight-building benefits, and connection-forming benefits. Cronbach's α for the entire scale was 0.90, with high subscale reliability coefficients. DISCUSSION: The 23-item FPDR-BRS exhibited satisfactory psychometric properties and may be used to quantitatively measure a family member's perception towards witnessing the resuscitation of his or her significant other. Further comprehensive psychometric evaluations are warranted to ensure robust cross-cultural comparisons.