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音量 4, 問題 6 (2015)

研究論文

Assessment of Factors Affecting Performance of Nurses Working at Jimma University Specialized Hospital in Jimma Town, Oromia Region, South-West Ethiopia

Temamen Tesfaye, Abebe Abera, Fikadu Balcha, Gugsa Nemera and Sena Belina

Background: Nurses performance remains long standing determinates of quality service rendered for patients admitted to hospitals. However, there is paucity of information on nurses’ performance level in study area. Therefore, the objective of the study was to assess factors affecting performance of nurses working at Jimma University Specialized Hospital.

Methods: Institution based cross-sectional study was conducted on 239 nurses working in Jimma University specialized hospital from January 20-25, 2015. The study participants selected using simple random sampling method. The data was collected using structured self-administrated questionnaires and facilitated by trained masters nursing students. The data was entered into SPSS for windows version 20. 0 and descriptive, Bi-variate and Multivariable logistic regression analyses were performed. Statistical level of significance declared at P<0.05.

Result: More than half 53.1% of respondents were males and the mean age of 27 years. The qualification of respondents showed that 54.4% had diploma in nursing and about half 49.8% of them had less than two years work experience. Around one third 32.2% of the nurses rated their performance as poor performance. Perceived level of knowledge and skill [Adjusted Odds Ratio of 14.0 at 95% Confidence Interval (6.1, 30.9)] and feedback on performance appraisal [Adjusted Odds Ratio of 4.6 at 95% Confidence Interval (1.8, 11. 2)] identified as factors affecting performance of nurses. Even though, lack of recognition, unsafe working environment and unsatisfactory numeration & benefit had no statistically significant, nurses’ rated them as factors hindering their performance.

Conclusion: Even though majority of nurses working in Jimma University Specialized Hospital rated their performance as good, there is still significant number of nurses who rated their performance below expected level. Perceived levels of knowledge & skill and feedbacks on performance appraisal were independent determinants of nurse’s performance level. Thus efforts should be made by the hospital to keep nurses’ up-to date through provision of in-service training on identified knowledge and skill gaps. In addition, the hospital should enhance provision of regular feedbacks on performance appraisal.

ミニレビュー

Ultrasound-Guided Epi® Technique, New Treatment for Degenerative Tendinopathy

Jose Manuel Sanchez-Ibanez

Tendinopathy is a common, painful, overuse disorder, and is associated with a failure of the tendon repair process they have a low potential for healing with the usual techniques. Although many different treatment methods have been described, there is no consensus regarding the optimal treatment for this condition. Therefore, new treatments for tendinopaties drawn from the existing literature as well as from their own experience dealing with this condition to deal with this delicate pathology have been developed over recent past decades. This brief review aims to update recent information on the treatment with the EPI® technique and tendinopathy resulted in a great improvement in function and a rapid return to the previous level of activity.

ミニレビュー

Modern Nursing in the Process of Ethical Changes in Surgery

Pelikan A, Pelikanova I, Vavra P1and Zonca P

The article discusses the ethical and social aspects of an elderly patient/client classified as a geriatric patient. It expresses the view on the surgical treatment from the field of the discipline of surgery, gerontology and nursing. The first author, a university professor of surgery, together with co-authors and a qualified nurse registered in the Czech Republic as well as in Great Britain, who works as a professional teacher of nursing, point to the required perspectives of health and functional status. They focus not only on the senior population in the Czech Republic in relation to a possible surgical intervention, but also on the sphere of its social problems. The article reflects the authors’ work experience gained in hospitals in the United Kingdom. The comprehensive approach to the surgical patients is emphasised and the required perspectives of health and functional status, particularly at a higher age with respect to maintaining the quality of life, are highlighted.

総説

Quality of Nursing Care in Saudi Arabia: Needs for Improvement

Abbas Al Mutair

Aims: To discuss the need to improve the quality of health care by nurses as well as the need to improve safety in the delivery of patient care and evidence based nursing practice in Saudi Arabia.

Background: Quality improvement in Saudi Arabia has become a major focus within health care, especially in the areas of regulatory quality, quality assurance, quality improvement and patient safety. The issues and trends affecting nursing care today are increasingly complex and dynamic.

Results: The need to improve quality is highly required in Saudi Arabian health care settings because many shortcomings are being reported every day like nursing and medical errors. The lack of quality is due to many reasons such as the absence of positive organizational climate and culture, no clear mission, vision, values and policies. The abovementioned weaknesses in quality improvement and patient safety emphasize the significance of evidence based practice in order to study their origins and overcome them. The implementation of evidence based practice would ultimately helps in promoting the professional image of nursing in the hospitals in Saudi Arabia and accordingly improves the nursing and hospital performance.

Conclusion and implications: The nursing departments should obligate to provide all people of Saudi Arabia a safe and caring environment and optimum nursing services to patients. The nursing departments are also required to demonstrate the highest quality of care supported by professional development. This should be collaborated with the other healthcare providers and supported by evidence based practice. Nurses provide the majority of patient care, they must be empowered to continuously improve care and service for meeting quality of patient care.

研究論文

Small is Insightful: A Method for the Microanalysis of Behaviour and Communication

Colin R Griffiths

The purpose of this article is to describe a method of examining observational data that is obtained through video recording, which allows for the identification of precise micro behaviors. The article describes the use of video as a data gathering tool, the associated transcription of the data into narrative format and the analytic method. Both verbal and non-verbal micro data were obtained and the capturing and analysis of both are discussed in detail. The data was composed of micro-behaviors and micro-communications of two communication dyads both of which consisted of one person with profound intellectual and multiple disability and one non-disabled teacher or nurse. Classic Glaserian grounded theory was used to analyse the narrative data. The method enabled the identification of behaviors of the participants, their communications, the sequences in which they occurred and the interrelationships at a micro level. Taken as a whole the method can reveal previously hidden information about what individuals do and how they behave in dyads and in groups and this has applications in nursing, special needs education and other fields in which human interaction is paramount.

研究論文

Virtual Patients in Emergency Nursing Training

Tudor Calinici

Emergency nurses are specialized to provide rapid assessment and treatment to patients in the initial phase of illness or trauma and often in life-threatening situations. They are required to have a lot of knowledge –not only in medical area - and to possess multiple abilities which will enable them to face different situation that may occur. Due to different constrains – time, money, ethical considerations, etc., the institutions which provide training for emergency nurses are forced to find alternative methods to reach all the outcomes required in real life situations. One of the methods is the use of virtual patients. The scope of this paper is to present the concept of virtual patients, to describe their main characteristics which recommend them to be used for training the emergency nurses and to present the main types of virtual patients.

研究論文

Heuristic Evaluation of Data Integration and Visualization Software Used for Continuous Monitoring to Support Intensive Care: A Bedside Nurses Perspective

Ying Ling Lin, Anne-Marie Guerguerian, Peter Laussen and Patricia Trbovich

The Intensive Care Unit (ICU) is a complex and technologically advanced healthcare setting. Technologies enable continuous monitoring through patient signals that are sensed, recorded and displayed at the bedside. Although such technologies have significantly decreased mortality rates in the ICU, the large amounts of data have contributed to clinician information overload. Critical care nurses spend more than half of their time scanning and assimilating information from disparate monitors, at the bedside to assess the patient status. Software that integrates and allows visualization of large data sets on a single screen are now available. In the present study, we evaluated software entitled T3™ (Tracking, Trajectory and Triggering). Such computationally powerful software has great potential to support nurses’ monitoring and decision-making tasks but the usability, efficiency, and effectiveness of the software are key to end-user adoption. As such, we conducted a Heuristic Evaluation, where the study’s evaluators interacted with the software interfaces and were asked to comment on it by describing the usability issues and if they were in compliance with established usability principles, or heuristics, specifically for medical device interfaces. A total of 50 usability issues associated with 194 heuristic violations were found. Identified issues included difficulty with choosing the time period of the patient data signals, distinguishing between several patient signals and appearance of patient values which were imperceptible to evaluators; both issues could lead nurses to misinterpret the timing and/or the physiological status of the patient (e.g., time of shock and exact value of vitals). Heuristic evaluation, an efficient and inexpensive method, was successfully applied to the T3™ software to identify usability problems that if left unresolved could lead to patient safety issues. These findings may have broad implications for the design of the T3™ and other continuous monitoring systems.

研究論文

Roma People Perception of Public Health System and a Classification into Homogeneous Groups Using K-Means Cluster Analysis

S Kotrotsiou, M Gouva, K Gourgoulianis, E Kotrotsiou, T Paralikas, M Malliarou1 and N Skenteris

This article presents perceptions, feelings and beliefs of Roma towards public health system. Participants were 361 Romani, living in central Greece. Shamer Scale, Experience of Shame Scale, State/Trait Anxiety Inventory (STAI), Family Environment Scale (FES), Symptom Check List 90 (SCL-90-R) and PBQ were used. Respondents exhibit higher levels of anxiety both trait and state. Feelings of abandonment and social discrimination corresponded to higher scores of shame. The inability to understand medical instructions and the need to be surrounded by relatives are correlated with psychopathology and shame whereas strong family structure corresponds to improved perceptions towards public health system. A cluster analysis was applied and a three group solution is proposed. Lack of education and harder living condition characterize the cluster with the most negative feelings towards public health system. The results of this paper may be useful in policy makers and persons looking to create interventions in this minority.

研究論文

Nonconventional Use of Substances among Youth in Nigeria: Viewpoints of Students in a Nigerian Tertiary Institution

Aliyu Danjuma, Adeleke Ibrahim Taiwo, Sunday Oluwafemi Omoniyi, Samaila Ayuba Balarabe, Silas Kolo, Solomon Lami Sarah, Yashi Garda Nassa

Introduction: The use of substances such as whitish end of lizard dung, hydrogen sulphide gas (sewer gas), seed of Zakami, Premium Motor Spirit (PMS), rubber solutions, nail polish cleaners, pawpaw leave and seed, Moringa (Zogale) leave, tear gas, gun powder, Mandara (Kafra) and gutter from toilet for nonconventional purpose among Nigerian youths has become a source of concern at various levels of the society.

Methods: A semi-structured questionnaire was administered to 220 participants recruited during two class sessions in the school.

Results: More than half (117, 58.2 %) of the participants were males and over two-fifth (87, 43.5%) were between the ages of 21 and 25 years. A greater portion (174, 87%) of participants had heard about nonconventional use of these substances; whitish end of lizard dung, hydrogen sulphide gas (sewer gas), Premium Motor Spirit (PMS), rubber solutions, nail polish, pawpaw leave, pawpaw seed, Moringa (Zogale) leave, seed of Zakami, tear gas, gun powder, Mandara (Kafra) and gutter from toilet. Participants’ education, age group and geopolitical zones were associated with awareness level, influencing factors and complication as a result of nonconventional substance use.

Conclusion: Most participants in this study affirmed that the use of nonconventional substances among youths in Nigeria is on the rampant, especially in the northern region.

談話記事

Moving Forward Towards a Positive Ethical Healthcare Climate in a Multicultural Context

Adel F Almutairi

Many countries around the globe are experiencing a demographic shift in their populations, due to several factors, including immigration, acculturation, mobility of workforces and so forth. These factors have contributed to the creation of multicultural environments characterized by differences in cultures, values, beliefs, ethical and moral perspectives, and languages, as well as historical, political and economic circumstances of their members. In healthcare settings, such diversity and the associated socio-political factors can pose ethical challenges for healthcare providers, and patients and their families alike. Almutairi’s model of critical cultural competence (CCC) is a promising approach designed to address the complexities that arise during cross-cultural interactions in healthcare settings. Healthcare settings are imbued with socio-political challenges related to class, racialization, poverty and gender. The ultimate goal of CCC is to provide a positive ethical climate that promotes cultural and physical safety as well as equity in health care environments. CCC approach can influence organizational policy, healthcare professional orientation and continuous professional educational initiatives.

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