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音量 6, 問題 5 (2017)

症例報告

Comparative Analysis of Surrogacy in the Northeast region of the U.S

Ana Arias-Oliveras

Advancement in the science of Artificial Reproductive Therapies (ART) has led to an increase of children born pursuant surrogacy arrangements. It is considered to be a form of family building for couples or individuals who are unable to carry a pregnancy. Within the United States, there are two surrogacy models, Gestational and Traditional. Gestational surrogacy is when the intended parents obtain a surrogate host who will carry the fetus until delivery. As part of the agreement, the surrogate relinquishes parental rights prior to the birth of the child. Traditional surrogacy is when the intended parents obtain a surrogate host who will agree to provide an ovum and carry the fetus until delivery. The embryo is a product of the surrogate and the husband of the commissioning couple, thus creating a genetic link between the surrogate and child. Parental rights are relinquished by the surrogate at the time of delivery, but due to the variability in adoption laws, may not be official for up to several years. Surrogacy as a viable option for infertile couples should be taken into consideration when one of the following circumstances are present: it is biologically impossible for one or both intended parents and/or is medically contraindicated to carry a baby regardless if this condition is congenital or acquired.

研究論文

The Effects of Self-help Manual in Addressing Burnout among Nurse Managers

Warren Kemuel M Pan

High levels of burnout have been documented among nurse managers. This study utilized quasi-experimental design that aims to determine the effectiveness of self-help manual composed of short stories as therapeutic modality for nurse managers experiencing burnout. Thirty-two nurse managers employed in a tertiary hospital in Manila who satisfied the inclusion criteria were assigned to the control and experimental groups. The intervention was given to the experimental group for five days while the control group was asked to continue with their regular routines. Data were collected using Maslach Burnout Inventory – Human Service Survey before and after the intervention which determined the respondents' levels in the three dimensions of burnout. The mean difference for the experimental group yielded a p-value of 0.12 for Emotional Exhaustion, 0.89 for Depersonalization, and 0.06 for the Personal Accomplishment dimension. This study showed that self-help manual is not effective in relieving burnout among nurse managers.

研究論文

Development of a Self-Report Workbook for Identifying Cancer Patients Knowledge Expectations

Vaartio-Rajalin Heli*, Leino-Kilpi Helena and Puukka Pauli

Patient-centeredness in patient education presupposes collaboration with the patient in the assessment of his/her knowledge expectations. In practice, there is no systematic approach to this assessment. Purpose: To describe the development process of a self-report workbook intended to assist adult cancer patients to identify and communicate their knowledge expectations during the illness trajectory. Design and methods: The workbook structure and content design was based on focus group interviews of cancer patients (n=37), in-depth individual interviews (n=16) and survey data in two countries (n=332+483). The initial version of the workbook was validated in a sample of cancer patients (n=91). Findings: The usability of the workbook was found good: patients found it relevant, logical and easy to fill in. The content validity of the workbook was shown to be good: all ten subscales were rated as rather or very clear on scale 1-4. Content validity index for subscales (S-CVI) varied from 0.40 to 1.00 and content validity index on item level (ICVI) from 0.76 to 0.94. Internal consistency was established as good: Cronbach’s alphas varied from 0.58 to 0.96. Conclusion: From the patients’ perspective, the self-report workbook is a promising aid for identifying individual patients’ perspectives to patient education and its outcomes during the illness trajectory.

研究論文

Clinical Teaching of Nurses in Southern Chile Hospitals: Practical Wisdom and Inter subjectivity

Juan Mansilla Sepúlveda*, Alejandra Ricouz Moya and Claudia Huaiquián Billeke

Purpose: The purpose of this study was to describe the significance of the intersubjectivity that is present in clinical educators in selected hospitals in La Araucanía, Los Lagos and Los Ríos regions.

Methods: A qualitative, exploratory, contextual and descriptive design was used and this approach was regarded as the most appropriate for this study. The population of this study consisted of thirty clinical educator nurses from three hospitals in southern Chile to the clinical teaching role.

Data collection: Data was collected by means of focus group discussion interviews during which participants were able to describe their experiences of the clinical placement in the real life setting and the support received from the professional nurses. Data were collected until data saturation was reached.

Data analysis: The researcher used the process of bracketing and remained neutral, setting aside previous knowledge and beliefs about the phenomenon under investigation. The researcher listened to the audiotapes used for data collection several times until the researcher completely satisfied with the interpretation of the verbatim data. The codes established are as follows: otherness valuation, motivation and learning by mistake, support need, professional experience valuation, value settlement, practical and theoretical articulation, comprehension and otherness, ethics of the host, pedagogical model, ethical-moral responsibility, subjectivity formation, face-to-face interaction and support need.

Ethical consideration: The research is based on the Singapore Declaration and has the informed consent of the nurses interviewed.

研究論文

Workplace Stress Induced among Nurses at Mbarara Regional Referral Hospital, South West Uganda

TOR Salome Shiden*, Ndie Elkenah Chubike and Ofuti William

This study aimed at assessing the factors contributing to stress in nurses’ workplace was conducted at Mbarara Regional Referral Hospital, South West Uganda. Random sampling method was used to select 50 nurses out of 180 that were on duty when data was collected. The data was collected using self-structured questionnaire. The results show that 25 (50%), said that their job condition is stressful, 5 (5%) said fair, 10% said they have a very poor job condition. 40% agreed that job promotion is done on merit, 20% of the respondents noted that promotion is done based on performance. 20% agreed that it’s done depending on experience while 8% said it’s done basing on vacancies and 12% were other factors. It was concluded that the working condition at Mbarara Referral Hospital present many stressor to nursing staff which include irregular working hours ,poor remuneration, poor communication and co-ordination by the administration. It was recommended that the hospital administration should regularize the working hours, improve on the salary of workers and also improve the communication channels with the nurses.

症例報告

Management of Occupational Exposure to Latex: A Nurse with Latex Allergy, Health Problems, Workplace Change

Yasemin Yurt* and Meral Turk

A 30 year old male patient has been a nurse intensive care for 6 years. The patient has had rashes, dryness and itching in the workplace for the last 5 years. There was nasal obstruction, increased breathing at work. Dry and ulcerative lesions were observed on the external surface of both hands. Total IgE was high. Latex specific IgE was positive. Skin prick test was positive and patch test was positive. The nurse's respiratory function test was assessed normally. The bronchial provocation test was evaluated as positive at 1 mg/mL. Current findings suggest that latex sensitivity and related rhinitis, asthma, urticarial are considered. The medical treatment of the patient was arranged. The workplace change of the kisin was made. He concluded that there is a marked reduction in complaints of shortness of breath, urticaria and rhinitis, which are the result of workplace change.

Latex exposure can be through skin contact and respiration. For exposure precautions, latex-free gloves should be used in persons with contact dermatitis. Latex should not be present in the air where the latex aeroallergens hang in the air to treat symptoms such as allergic rhinitis, conjunctivitis and asthma. For this reason, workplace change must be applied to this person.

In our present situation, workplace changes have been made and a marked improvement in the symptoms of job change outcome has been observed.

研究論文

"You Can't Feel Healthier than Your Caregiver" - The Ripple Effect of Trust and Empathy for Patients and Health Care Staff, Cultivated through Cultural Activities

Christina Grape Viding*, Walter Osika and Eva Bojner Horwitz*

Introduction: Stress-related problems, including burnout, cause personal suffering, disability and result in costly sick leave. The use of different cultural activities within a health care system may help to prevent burnout, but very few studies have focused on what happens after such activities.

Methods: Interventions with different cultural activities were conducted for burn out patients in four primary health care settings during three months. Focus group interviews were conducted with patients, cultural producers and health care nurses. The aim was to provide a description of the participant’s experiences after the activities.

Results: The cultural activities were found to affect both participants' emotions and behaviour and created a sense of belonging and equality among them. Positive 'spill-over' effects were also seen on nurses of health care management.

Conclusion: We find that the cultural activities help to create a trustful and empathic health care environment where the wellbeing of staff and that of patients have an impact on each other. We suggest the incorporation of arts into health care as a possible contributor to the development of a sustainable health care system.

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