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Surveys and questionnaires in nursing research
Abstract
Surveys and questionnaires are often used in nursing research to elicit the views of large groups of people to develop the nursing knowledge base. This article provides an overview of survey and questionnaire use in nursing research, clarifies the place of the questionnaire as a data collection tool in quantitative research design and provides information and advice about best practice in the development of quantitative surveys and questionnaires.
... Self-administered questionnaires are widely used in nursing research either as a single tool for collecting data or as part of a collection of tools. A well-developed and validated questionnaire provides a highly effective, inexpensive and efficient method of collecting information such as knowledge, beliefs, attitudes and behaviours (Timmins 2015). ...
... The use of a previously developed, reliable and validated questionnaire is preferred, as it ensures findings are credible, builds on existing knowledge and enables the findings to be generalised to other populations and settings (Timmins 2015). ...
... It is recommended to use or refine an existing questionnaire rather than develop a new one, to ensure findings are credible (Timmins 2015). However, if one does not exist, using a structured process to develop a questionnaire, as described here, ensures important concepts such as comprehension, question styles and acquiescent bias are addressed. ...
Background:
Using a structured process to develop a self-administered questionnaire provides a robust tool for collecting data that enhances the credibility of the results. Describing this process mitigates any complexity and confusion for the nurse researcher which can be generated by many sources of information that either lack detail or have complex statistical approaches.
Aim:
To discuss the development of a self-administered questionnaire with a focus on face, content, construct validity and reliability testing.
Discussion:
Adopting a well-established, sequential, five-step approach ensures that important concepts of questionnaire development are addressed: assessing existing tools and qualitative data, if available; drafting of the questionnaire with consideration for question styles, comprehension, acquiescent bias and face validity; expert panel review to establish content validity and inter-rater reliability; pilot testing to assess construct validity; and exploratory factor analysis to establish reliability testing. This approach results in a robust and credible tool for collecting data.
Conclusion:
This article provides nurse researchers with a structured process for developing self-administered questionnaires.
Implications for practice:
Investing time and effort to assess a newly developed questionnaire for validity and reliability and consider question styles, comprehension and acquiescent bias results in an improved and strengthened tool for collecting data. This in turn enhances the quality and credibility of a study's findings.
... Likewise, the purpose and the goals of the research and questionnaire should be associated (Timmins, 2015). ...
... According to Timmins (2015), the most viable and direct approach to either modify or build up a questionnaire survey is to utilize the data picked up from a literature review to create fundamental questions or statements. A theoretical framework that is utilized to portray, clarify or anticipate specific conditions or events may have come out of the literature review. ...
... Though, a questionnaire reliability is not reliant on its validity (Tavakol & Dennick, 2011). Reliability is the consistency with which subjects respond to the questionnaire survey items, and whether the questionnaire would create similar outcomes in any other situations (Timmins, 2015). Asabere et al. (2017) showed that validity and reliability are two essential issues to take into account when creating and testing any instrument (for example, a questionnaire ) utilized in a study. ...
What are the varying factors that encourage physics instructors to use virtual lab simulations?
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... On a preliminary fashion, nursing students were introduced to the survey by the nurse educator. A brief note outlining the aim of the study, the anonymity and the privacy ensured in data handling, the informed consent statement, and the invitation to complete the survey (Timmins, 2015) was reported on the first page of the questionnaire. Nursing students were free to decline to participate or, if participating, they were free to decline to answer one or more questions (Timmins, 2015) without any academic negative or positive repercussions (e.g., penalties or rewards). ...
... A brief note outlining the aim of the study, the anonymity and the privacy ensured in data handling, the informed consent statement, and the invitation to complete the survey (Timmins, 2015) was reported on the first page of the questionnaire. Nursing students were free to decline to participate or, if participating, they were free to decline to answer one or more questions (Timmins, 2015) without any academic negative or positive repercussions (e.g., penalties or rewards). ...
... The questionnaire takes from 10 to 15 min to be completed, in agreement with the optimal completion time to increase response rates in surveys (Timmins, 2015). ...
Contextual Factors (CFs) have been documented to influence nursing interventions and patients' outcomes triggering placebo/nocebo effects. However, given that no studies to date have explored the beliefs and the use of CFs among nursing students, a cross-sectional study was undertaken. Two Italian nursing programmes were involved and a self-administered survey tool was used. A total of 510 students participated. The majority (266; 52.2%) defined CFs as an intervention without a specific effect on the condition being treated, but with a possible nonspecific effect. They reported a substantial level of confidence in CFs and in using them more than twice/week in addition to nursing interventions to optimise clinical outcomes. Physiological and psychological therapeutic effects were mostly reported by participants in treating insomnia (n = 351; 68.8%) and chronic pain (n = 310; 60.8%). The use of CF was considered ethically acceptable when it exerted beneficial psychological effects (n = 188; 36.8%). Participants communicated to patients that a CF is a treatment that can help and will not hurt (n = 128; 25.1%). Students are aware of the value of CFs. Increasing their emphasis in nursing programmes can promote nursing students' consideration with regards to their use, their underlying mechanisms, their potential effects, as well as their ethical and comunicative implications.
... Pengembangan kuesioner mempertimbangkan struktur dan isi kuesioner dan saran dari para ahli di bidangnya, serta hasil uji coba atau pengujian ulang (pilot study) (Timmins, 2015). Jika kuesioner tidak diuji, risikonya dapat secara langsung menyebabkan masalah selama fase pengumpulan data, dan tidak ada peluang untuk mengatasi masalah ini sebelum studi utama. ...
... Anda dapat menemukan bahwa satu pertanyaan tidak berfungsi, dengan peserta tidak menjawab pertanyaan atau menjawabnya dengan salah. Jenis masalah ini dapat diselesaikan dengan cepat dan sederhana pada tahap pilot study (Timmins, 2015). Oleh karena itu, beberapa peneliti menyarankan bahwa pengujian merupakan langkah penting dalam desain kuesioner, sejauh memenuhi harapan (Coughlan et al 2013). ...
Latar Belakang: Perawat memiliki peran yang sangat penting dalam memberikan informasi yang meliputi pengetahuan tentang kemoterapi dan mampu menjelaskan apa yang akan terjadi selama pasien menerima kemoterapi, termasuk kemungkinan efek samping dan penanganannya. Salah satu ukuran yang dapat digunakan untuk mengukur perilaku caring perawat adalah kuesioner. Pengembangan kuesioner mempertimbangkan struktur dan isi kuesioner dan saran dari para ahli. Penelitian lain juga menginformasikan bahwa uji coba sering dilakukan untuk menguji kelayakan teknik, metode, kuesioner, wawancara dan bagaimana metode tersebut berfungsi bersama dalam konteks tertentu. Tujuan: Untuk menguji instrumen (kuesioner) yang telah dikembangkan oleh peneliti, sebelum dilakukan uji validitas dan reliabilitas. Metode: Penelitian ini merupakan penelitian cross sectional, dimana instrumen yang akan diuji didistribusikan kepada 30 pasien kanker yang menjalani kemoterapi di RS Stella Maris Makassar. Pemilihan sampel penelitian menggunakan metode non probability sampling, dengan purposive sampling. Hasil: Mayoritas responden memahami butir-butir pernyataan yang terdapat dalam instrumen (kuesioner). Namun pada kolom saran/komentar yang disediakan, beberapa responden berkomentar bahwa ada 6 item pernyataan yang maknanya tidak dipahami oleh responden saat mengisi instrumen. Berdasarkan komentar dari responden dan dengan mempertimbangkan rekomendasi dari beberapa panel ahli metode Delphi pada langkah kedua, peneliti memutuskan untuk mengubah item pernyataan yang menggunakan kalimat negatif menjadi kalimat positif. Kesimpulan: Hasil akhir instrumen setelah direvisi berjumlah 27 item pernyataan. Tidak ada item pernyataan yang ditambahkan atau dikurangi. Namun peneliti merevisi 6 item pernyataan sebelumnya yang negatif, sehingga hasil akhir dari uji coba ini adalah keseluruhan item pernyataan pada instrumen ini adalah item pernyataan yang bermakna positif.
... Questionnaires are the most commonly used instruments for collecting data on health and in surveys [7,8]. The items included in a measurement instrument need to be related to the objectives of the study and it is essential that they are appropriate to answer the research question [9,10]. ...
Background: Good posture is characterised by neutral spinal alignment with high physiological and biomechanical efficiency together with low stress and strain. The purpose of this study was to assess the validity and reproducibility of the adult version of the Aristegui questionnaire in university students. Materials and methods: The study was conducted in two parts. The first part assessed content validity of the questionnaire where five experts provided their feedback on the content of the questionnaire. The second part evaluated the reliability of the questionnaire among a convenience sample of 10 university students in a test–retest study. Results: The content validity of the questionnaire was found to be excellent. Twenty-five out of twenty-seven items had an item content validity index higher than 0.79 (appropriate) and the scale content validity index was 0.93 (high). For the reliability, almost perfect agreements were found for nine items, substantial agreement for three questions, moderate agreement for one item and fair agreement for one item. The kappa coefficients ranged from 0.00 (slight) to 1.00 (perfect) for the items on behaviour. Conclusions: The questionnaire was found to be a valid and reliable tool to measure the university students’ knowledge regarding ergonomics and posture and postural behaviour as well as prevalence of musculoskeletal pain.
... The answers to the questionnaire were collected before receiving sexual and reproductive health training during the nursing degree, thus avoiding the possible influence that this training could have had on the results (O'Connor, 2022;Timmins, 2015). As this study dealt with sensitive data such as sexual identity, declared gender or attitudes towards different behaviours and sexual adherences, it had been decided to anonymize the questionnaire from the collection and to remove elements that would allow the identification of the student; thus, the answers are more honest and he responses that are socially accepted or expected on such a controversial topic minimized. ...
Aim:
To know the attitudes towards sexuality of nursing students and those sociodemographic and cultural factors that can influence it.
Design:
An observational study was carried out on Nursing degree students. One hundred and eighteen nursing degree students who were going to take the sexual and reproductive health nursing course.
Methods:
A self-administered online questionnaire. This questionnaire had several parts specifically designed to collect sociodemographic variables. In order to determine the attitudes towards sexuality, the questionnaire based on the ATSS (Attitudes Towards Sexuality Scale). The Double Standard Scale (DSS) was also used. This scale evaluates double standards within the area of sexuality. The Rape Supportive Attitude Scale (RSAS), was included to determine beliefs about rape, rapists and their victims.
Results:
The ATSS shows a statistically significant association with religious beliefs (p = 0.005), with mean scores of 113.84 (SD = 9.81) for non-believers (no religion), 108.36 (SD = 15.68) for non-practicing believers and 102.32 (SD = 17.87) for believers (those who practice their faith). The mean score in the DSS shows a statistically significant association with alcohol consumption (p = 0.001). The mean score on the RSAS is statistically significantly associated with the place of residence (p = 0.050), the means were 44.32 (SD = 9.26) for those who lived in the city, 34.94 (SD = 19.21) if the place of residence was between 10,000 and 5000 inhabitants and 32.54 (SD = 15.01) if the family home was in a town with less than 5000 inhabitants.
Conclusion:
Religious beliefs reduce liberalism and positive attitudes towards sexuality, whereas sporadic alcohol consumption increases them.
Patient or public contribution:
No patient or public contribution.
... Finding out if a scale is accurate and correct requires a reliability test [39]. The instrument's stability and internal consistency were found to be adequate according to the reliability findings. ...
Introduction
To improve cancer patients’ quality of life, palliative care is necessary. The growth of palliative care, along with the assistance of the government and the collaboration of specialists, also relies on the knowledge and attitude of people. In Iran, there is no tool available to gauge patient attitudes about palliative treatment. The Persian version of the Palliative Care Attitude Scale (PCAS-9) was translated and psychometrically validated in this research among cancer patients.
Methods
This methodological study was conducted in two stages: translation stage and psychometric validation stage. The method of translation was based on that proposed by Polit and Yang. Utilizing a qualitative approach, the scale’s face and content validity were investigated. 162 cancer patients who required palliative care based on expert diagnosis participated in the confirmatory factor analysis to establish construct validity. Stability and internal consistency provided evidence of reliability. The data was examined using SPSS18 and AMOS.
Results
The “Palliative Care Attitudes Scale” translated well across cultures. Validity on both the face and the content was acceptable. Confirmatory factor analysis (CFA) revealed a good fit for the original three-factor structure. The intra-class correlation coefficient (ICC) was equal to 0.89, while the internal consistency (Cronbach’s alpha) reliability of the whole scale was equal to 0.77.
Conclusions
Persian version of the “Palliative Care Attitudes Scale” was acceptable and adequate in cancer patients. Using this tool makes it easier to assess how patients feel about receiving palliative care and how well training sessions are working to change patients’ views.
... Questionnaires collect data through written questions which require written answers (Moule, Aveyard and Goodman, 2017). Research questionnaires have a legacy of being successfully adapted for accessibility (Timmins, 2015), which may explain why the method was commonly selected, although this is not stated explicitly by the authors. ...
Purpose: To investigate the current situation of oral care for people with a learning disability, using residential services with nursing, by reviewing the existing literature base, and to derive potential areas for improvement in care.
Method: A literature search was conducted using three healthcare databases. Four published papers demonstrating effective research methods were identified, then reviewed with the support of an academic critiquing tool.
Findings: There is limited research regarding the provision of oral care for younger people with a learning disability. Oral care should be an explicit part of nursing care plans. Oral care training for health, social care and school staff teams is needed.
Conclusions: Indications of ritualistic oral care such as the use of lemon-glycerine swabs still feature in UK nurses’ daily duties. Constraints experienced by care staff, and the views of people with a learning disability, are under-represented. Targeted and participatory research, oral health education, and integrated care planning approaches have the scope to improve practice.
... The phase 1 questionnaire was designed using Qualtrics (2015) The questionnaire ended with an invitation to participate in phase 2. As a unique questionnaire the questions were derived from the literature on the topic (Timmins, 2015). Face and content validity were tested using a pilot study, when the questionnaire was ...
Aims
To scope the key performance indicators (KPIs) used in nursing and midwifery across the United Kingdom and Republic of Ireland and explore how they influence practice in healthcare organizations.
Design
The study adopted a sequential, exploratory mixed-methods design.
Methods
Phase 1 incorporated a multiple-choice questionnaire completed by 77 Directors of Nursing recruited using voluntary response sampling. In phase 2, 35 nurses and midwives who were working at executive, senior manager and clinical levels, participated in semi-structured interviews. Data collection of both phases was conducted from January 2016 to October 2016.
Findings
Quantitative data revealed over 100 nursing and midwifery-specific KPIs. National requirements were a deciding factor in KPI selection, while clinical involvement was mainly through data collection. Respondents stated that they used patient experience KPIs, but only one was assessed as valid. Thematic analysis identified two themes: The leadership challenge (including ‘voiceless in the national conversation’, ‘aligning KPIs in the practice context’ and ‘listening to those who matter’); and taking action (including ‘establishing ownership and engaging staff’, ‘checks and balances’ and ‘closing the loop’).
Conclusion
The large volume of KPI measurement taking place makes meaningful evaluation of performance and quality of care difficult, both in and across organizations. Nurses and midwives require enhanced knowledge of the nature and purpose of KPIs, as evidence gained from KPI data collection is insufficient to lead to improvements in practice. A practice context that encourages collective leadership, where multiple sources of evidence are gathered and everyone is included in KPI evaluation and subsequent decision-making, is key.
Impact
This study adds to the body of evidence on KPI understanding. It informs the future effective management of indicators that will facilitate the delivery of meaningful care and reduce the cost, time and effort invested in the implementation of KPIs and data management.
... Essa técnica de levantamento utilizando um comitê de juízes por e-mail ou Internet é um procedimento relativamente recente, que possui vantagens como a rapidez na distribuição dos questionários e a coleta e o processamento de dados são feitos rapidamente. Para o respondente, há a facilidade de responder às questões quando julgar pertinente e sem a necessidade de um encontro presencial (Timmins, 2015). ...
As doenças crônicas não transmissíveis (DCNT) figuram-se mundialmente como importante problema de saúde pública, sendo a alimentação inadequada um de seus principais determinantes. Dessa forma, a qualificação dos profissionais de saúde para realização de ações de promoção da alimentação adequada e saudável, que sejam práticas, efetivas e viáveis, é essencial. O objetivo deste artigo foi realizar o estudo de avaliabilidade, considerando a descrição da intervenção (implantação do Programa de Promoção da Alimentação Adequada e Saudável – PPAAS na Atenção Primária à Saúde brasileira), a elaboração do modelo lógico e a identificação e validação das questões avaliativas. Adotou-se como referencial o sistema de sete elementos proposto por Thurston e Ramaliu. Foram realizadas análises de documentos, revisão teórica, reuniões para elaboração do modelo teórico lógico do Programa e a identificação das questões avaliativas, que resultou no instrumento de medidas multidimensional para avaliar sua implantação. A validação de conteúdo das questões avaliativas foi realizada por técnica Delphi. O modelo lógico desenvolvido foi essencial para compreender as premissas teóricas básicas do PPAAS, condensando em uma imagem as peculiaridades dos seus componentes e constituindo um produto que pode ser utilizado em pesquisas avaliativas posteriores. O instrumento multidimensional apresentou um índice de validação de conteúdo de 91%. O estudo fornece um modelo lógico e um instrumento multidimensional válidos, imprescindíveis para o planejamento da avaliação propriamente dita da implantação do PPAAS.
... Para os juízes, há a facilidade de responder aos itens quando julgar pertinente e sem a necessidade de um encontro presencial. (18) Por outro lado, embora a tecnologia tenha ajudado positivamente a condução da coleta de dados, ocorreu um aumento das taxas de não respondentes ou de respostas parciais. (20) O IVC foi calculado a partir da somatória das respostas "2" (iten representativo) de cada juiz em cada item do checklist, dividido esta soma pelo número total de respostas e multiplicado por 100 (IVC = número de respostas "2"/número total de respostas x 100). ...
O estudo teve por objetivo desenvolver e validar conteúdo e aparência de um checklist para avaliação do desempenho do Sistema de Informação de Imunização brasileiro nas salas de vacinação. Trata-se de um estudo metodológico com abordagem quantitativa, que conduziu a validação de conteúdo e aparência dos itens de um checklist, estruturado em duas dimensões, estrutura e processo. A
técnica Delphi foi utilizada para a validação dos itens segundo os critérios de relevância, objetividade e clareza. Foi calculado o índice de validação de conteúdo e o coeficiente alfa de Cronbach para analisar a consistência interna do checklist. O checklist é composto por 7 itens na dimensão estrutura e 17 na dimensão processo,
este subdividido em 3 componentes: gestão do sistema de informação de imunização; registro do vacinado; movimento dos imunobiológicos. Considerando as duas dimensões, o índice de validação de conteúdo total do checklist foi 89,6 %. Obtevese
na dimensão estrutura um índice de validade de conteúdo médio de 89,9 % e 89,2 % na dimensão processo, sendo obtido no componente gestão do Sistema de Informação de Imunização um índice de validade de conteúdo médio de 86,2 %; 92,6 % no Registro do vacinado e 88,9 % no movimento dos imunobiológicos. O
checklist mostrou-se consistente internamente, apresentado um valor para o alfa de Cronbach total de 0,97 e valores de 0,86 e 0,97 para as dimensões estrutura e processo, respectivamente. Quanto à validação de aparência, o instrumento foi considerado inteligível. O estudo fornece um checklist com conteúdo e aparência válidos para avaliar o desempenho do Sistema de Informação de Imunização brasileiro e subsidia a supervisão e o monitoramento das funcionalidades deste
sistema nas salas de vacinação.
... The collection of data from the committee of judges by e-mail or internet is a recent procedure that, however, has some advantages, such as a rapid collection and processing of data, considering that questionnaires are easily distributed. Besides, for the respondents is easy to answer the questions when appropriate and without the need for an in-person meeting (21). In the sequence, an e-mail with the link to access the online questionnaire was sent to participants. ...
Objective:
To develop and to test the validity of content and layout of a multidimensional tool to evaluate maintenance of the cold chain for immunobiological conservation.
Method:
A methodological study carried out in three steps: integrative review; development of theoretical and logical model for the development of the tool; implementation of the Delphi Technique to test the validity of content and layout. The Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated considering appropriate those values greater than or equal to 75% and 0.4, respectively.
Results:
The instrument consisted of 7 questions about structure and 20 about process, subdivided into three components: Transportation/Reception (n=3); Storage/Handling (n=13); Supervision/Permanent education (n=4). The cvi value was 87.4%, with values equal to 85.7% and 89% in the structure and process dimensions, respectively. The process components obtained cvi values equal to 88.9, 88.9 and 89.2%, respectively. The CVR was 0.8, with values equal to 0.7 and 0.8 in the structure and process dimensions. As for the layout validation, the questionnaire was considered intelligible.
Conclusion:
The study provides an instrument with validity of content and layout for health professionals in charge of the supervision of activities of immunobiological conservation, ensuring the maintenance of the immunogenic quality of the products offered to the population.
... A systematic and previously reported approach was used to design and develop the survey. 12,13 Firstly, a literature review was undertaken to scope current evidence regarding neonatal incubator imaging. The literature reviewed was carried out in conjunction with a small focus group, this aided in the identification of themes/ items for the survey. ...
Introduction:
There is limited and confusing evidence within the literature regarding the optimal techniques when imaging neonates within incubators; in particular, whether to place the image receptor directly behind the neonate or in the incubator tray. For this reason, radiology departments across Wales and North West England were surveyed to explore existing working practice with regards to incubator imaging.
Method:
A self-designed survey was developed using a systematic approach. The survey was sent to 31 radiology departments across Wales and North West England whom had a neonatal unit in order to assess existing techniques used when imaging neonates within the incubator. The survey was split into three main domains: 1) general/demographics, 2) exposure factors and technique, and 3) incubator design.
Results:
Nineteen departments responded (64%) demonstrating a wide variation in practice for incubator imaging. The minimum and maximum exposure factors used for neonatal chest x-ray imaging varied from 55 kV to 65 kV and 0.5 mAs-2 mAs. Fifty-eight percent of departments used the incubator tray as standard practice with the remaining forty two percent not using the tray for various reasons including, image quality, artefacts and misalignment. Sixty-three percent of departments use the maximum achievable SID for incubator imaging which demonstrates wide variability as the SID would be dependent upon: incubator design, portable machine and radiographer height.
Conclusion:
The survey demonstrates a wide variation in existing practice for neonatal incubator imaging.
Implications for practice:
This study supports the need for standardisation and further optimisation work to ensure best practice for this vulnerable patient group.
... The web-based survey was developed by the study investigators after a careful review of the literature. [17][18][19][20][21][22][23][24][25] Much of the survey content was based on pain management standards of organizations such as the American Pain Society, the World Health Organization, and the Agency for Healthcare Research and Quality. It was further reviewed by other clinicians who were considered content experts. ...
Background:
In view of the recent opioid crisis, ways to promote safe and effective opioid-related practices are needed. Faster intravenous (iv) opioid infusion rates can result in increased adverse effects and risk for nonmedical opioid use. Data on best practices regarding safe iv opioid administration for cancer pain are limited. This study examined iv opioid bolus infusion practices and perceptions about opioids in cancer pain among 4 groups of inpatient oncology nurses.
Methods:
An anonymous cross-sectional survey was conducted among oncology nurses working in medical, surgical, intensive care unit (ICU), and emergency department (ED) settings. An iv opioid bolus infusion speed less than 120 seconds was considered too fast.
Results:
The participant response rate was 59% (731 of 1234). Approximately 58%, 54%, and 58% of all nurses administered morphine, hydromorphone, and fentanyl, respectively, in less than 120 seconds. The median morphine infusion speeds were 55, 60, 60, and 85 seconds for ICU, surgical, ED, and medical unit nurses, respectively (P = .0002). The odds ratios for infusing too fast were 2.04 and 2.52 for ED (P = .039) and ICU nurses (P = .003), respectively, in comparison with medical unit nurses, and they were 0.27 and 0.18 with frequent (P = .003) and very frequent use of a timing device (P = .0001), respectively, in comparison with no use.
Conclusions:
More than half the nurses working in the inpatient setting reported administering iv opioids too fast. ICU nurses administered opioids the fastest. Nurses who frequently used a timing device were less likely to infuse too fast. Further research is needed to standardize and improve the safe intermittent administration of iv opioids to patients with cancer.
... Lack of guidelines on e-questionnaires also has consequences in health research, especially for nurses (ideal users of this survey tool) [46]. Questionnaires, in nursing research, are useful tools also in simple research studies [47]. ...
Background
Nursing and health care research are increasingly using e-questionnaires and e-forms for data collection and survey conduction. The main reason lies in costs, time and data-entry errors containment, increased flexibility, functionality and usability. In spite of this growing usage, no specifc and comprehensive guidelines for designing and submitting e-questionnaires have been produced so far.
Objective
The aim of this review is to collect information on the current best practices, taking them from various fields of application. An evaluation of the efficacy of the single indication is provided.
Method
A literature review of guidelines currently available on WebSM (Web Survey Methodology) about electronic questionnaire has been performed. Four search strings were used: “Electronic Questionnaire Design”, “Electronic Questionnaire”, “Online Questionnaire” and “Online survey”. Articles’ inclusion criteria were English language, relevant topic in relation to the aim of the research and the publication date from January 1998 to July 2014.
Results
The review process led to identify 48 studies. The greater part of guidelines is reported for Web, and e-mail questionnaire, while a lack of indications emerges especially for app and e-questionnaires.
Conclusion
Lack of guidelines on e-questionnaires has been found, especially in health care research, increasing the risk of use of ineffective and expensive instruments; more research in this field is needed.
... Lack of guidelines on e-questionnaires also has consequences in health research, especially for nurses (ideal users of this survey tool) [46]. Questionnaires, in nursing research, are useful tools also in simple research studies [47]. ...
... Modifications were made and then the final questionnaire was submitted to the head of department and the practice development nurse of the target unit to ensure appropriate terminology was used. The questions were mostly in a closedresponse format to allow ease of analysis (Timmins, 2015), but respondents were invited to elaborate on any topic if they wished. The questionnaire included a section recording the respondent's demographic data, including nursing band, critical care experience, and any previous education on ICU delirium. ...
Aims:
The aim of this study was to examine perceived barriers to assessment of delirium for critical care nurses, and the impact of education on their knowledge and practice.
Background:
Delirium is a significant problem in critical care, leading to increased morbidity and mortality. Many authors have found variations in assessment by critical care nurses, but there has been limited analysis of the reasons for this. Education on the topic improves knowledge and practice, but the best approach has not been examined.
Design:
A questionnaire survey design.
Methods:
A self-reported questionnaire was distributed to critical care nurses (n=31) at a district general hospital. Data were analysed with descriptive statistics.
Results:
Knowledge and practice were variable, but correlation was seen between nursing band and years of experience with better scores. Any type of education led to significantly improved scores. Several barriers to assessment were found, with the most common being lack of knowledge and difficulty in assessing intubated patients.
Conclusion:
It is essential to improve practice in delirium assessment and management. Education is vital to improve the knowledge and practice of critical care nurses regarding delirium.
Background and Purpose: Electronic surveys are an essential data collection method in survey research but there are pros and cons. The purpose of this literature review was to understand the advantages and disadvantages of electronic surveys in research. Methods: An integrated literature review was performed. Results: Twenty publications met the criteria and were analyzed. The advantages of electronic surveys include speed, cost, convenience, flexibility, ease of analyses, global reach, reduced errors, and question diversity. The disadvantages of electronic surveys are response outcomes (nonresponse, item-nonresponse/poor completion rates, and careless responding errors) and digital literacy requirements. Conclusions: The advantages of electronic surveys outweigh their disadvantages, but researchers must understand the problems associated with electronic surveys and avoid them.
Introduction: Few studies have investigated nursing practice in relation to delirium in acute care settings, and no studies have investigated the care of unlicensed assistive personnel (UAPs) in this context. As a result, it becomes challenging to support the delivery of optimal care and thereby improve delirium-related patient outcomes.
Objective: This manuscript reports on the development of two survey tools and a study protocol that aims to (1) describe the current practices of nurses and UAPs in the context of nursing care in delirium and to (2) highlight the barriers and facilitators to the delivery of optimal delirium care.
Methods: This multi-method study aims to recruit nurses and UAPs. During an initial quantitative phase, participants will answer two survey tools designed respectively for nurses and UAPs. These tools were developed using a modified Delphi technique and a guide based on Burns et al. (2008) and Eysenbach (2004). They examine delirium knowledge, practice, collaboration, confidence, and the impact of the COVID-19 pandemic on practice relatively to delirium. Descriptive and inferential statistical analyses will be performed on this data. The qualitative phase will include focus groups and interviews with nurses and UAPs to explore topics from the survey tools more in-depth. Thematic analysis will be performed on the transcripts. Data from both phases will answer the two study aims.
Discussion and Research Spin-offs: This study will be the first to report on the delirium care offered by UAPs. The survey tools developed can identify nurses’ and UAPs’ practices, and the barriers and facilitators to optimum nursing care for people with delirium.
Online surveys are increasingly popular in research given their cost-effectiveness and potential reach. However, low response rates remain a key contributor to bias and the overall quality of results. Having a well-designed survey, providing financial remuneration, sending personalized invitations, having regular reminders, and using more than one recruitment strategy are evidence-based approaches to improve response rates. Given the potential for illegitimate responses, approaches that minimize illegitimate participation are discussed.
Background
The opioid crisis is a global public health issue, especially present in the United States. Limited research addresses pharmacists’ opioid medication counseling practices particularly their risk and safety counseling practices.
Objectives
The objective of this paper is to categorize pharmacists based on their opioid risk and safety counseling practices to inform future interventions and research to improve practice. The percent of pharmacists falling into each of these underlying, unobservable subgroups is identified using latent class analysis.
Methods
This study was conducted as a statewide survey of pharmacists using the modified Dilman technique. The survey consisted of ten items about pharmacists’ opioid risk and safety practices when dispensing an opioid medication. Descriptive statistics were conducted followed by latent class analysis. This approach categorized pharmacists based on their responses to the survey items.
Results
Responses from 216 pharmacists were used in this study. In the three-class model which was deemed the best fit, the first class shows a profile of pharmacists who counsel on almost all opioid risk and safety topics and composed 16.75% of the total respondent population. The second class shows a profile of pharmacists who hardly counsel on any opioid risks and safety topics and comprised 39.80% of the respondent population. The third class shows a profile of pharmacists counseling on opioid risk and safety topics mostly for new or long-term prescriptions, but not for refill or short-term prescriptions. This group constituted 43.45% of the respondent population.
Conclusion
This study identifies distinct classes of pharmacists in terms of the frequency with which their opioid counseling does or does not include key elements of risk and safety topics. A small minority usually include the risk and safety issues. Training and resource interventions targeting pharmacists who do not counsel patients about opioid risks are important to help them become more comfortable and adept as opioid risk and safety educators.
Background
Pediatric living donor liver transplantation (LDLT) is the only way to save children with end-stage liver disease. The donor for liver transplantation (LT) may have a complicated psychosocial condition.
Purpose
This review aims to identify the domains of the donor psychosocial questions that should be addressed and summarize the aspects and tools future psychosocial assessments should include.
Methods
We searched the PubMed, Medline, Cochrane Library, Embase, Web of Science, and Google Scholar databases for the terms pediatric, liver transplantation, donor, and psychosocial. We used the Joanna Briggs Institute Critical Appraisal Tool to appraise reporting quality. Two researchers independently selected the papers and performed data extraction and quality appraisal.
Results
The articles included in this review contain 26 quantitative studies and 2 qualitative studies. The study quality was moderate to high. Donors have ambivalence, anxiety, the need for family and social support, the need for adequate information, distress, and low self-esteem during the preoperative period. In the postoperative period they have poor psychological condition, panic disorder, conversion disorder and substance use/abuse disorder, abnormal family functioning, better psychosocial outcome, or among others. The assessment methods consisted of the questionnaire survey and semi-structured interview. Among the 28 studies, 17 different psychosocial domains were mentioned. The most frequently referred to was family and social support.
Conclusion
The contents of the psychosocial assessment must include anxiety or depression, family and social support, ambivalence, information, and positive psychosocial characteristics. Assessment methods should use the questionnaire survey and semi-structured interview. According to this review, future research can develop a specific psychosocial assessment tool for pediatric LT donors.
Surveys help health care professionals gather meaningful data that can guide decision making and improve practice. Individuals creating surveys should follow survey design and item development guidelines, such as those described in this article, to ensure the accuracy of the data gathered. [J Contin Educ Nurs. 2020;51(6):248-249.].
Prevalentie en beoordeling van (geïnfecteerde) chronische wonden.
Nederlandse samenvatting
De studies in dit proefschrift zijn opgezet om achtereenvolgens de prevalentie van (geïnfecteerde) chronische wonden in Nederlandse verpleeghuizen te onderzoeken en om de vraag te beantwoorden of een wond swab een valide en betrouwbare methode is ter beoordeling van een infectie van een chronische wond. Tot slot is een kostenanalyse gemaakt van de kosten van behandeling in het Kenniscentrum Wondbehandeling in Venray.
Normaliter treedt wondgenezing op in een voorspelbare volgorde (reactie-, regeneratie-, en rijpingsfase). Wanneer de genezing van een wond op zich laat wachten en de anatomische en functionele integriteit van de huid niet binnen 3 weken bereikt is, wordt de wond als chronisch of ‘hard-to-heal’ beschouwd.
Chronische wonden, zoals doorligwonden (decubitus), een open been (beenzweer, ulcus cruris) en een diabetische voet, zijn vaak pijnlijk en leveren beperkingen en handicaps op waardoor een patiënt vaak een vermindering van zijn levenskwaliteit ervaart. Chronische wonden zijn ook geassocieerd met hoge kosten. Wereldwijd worden de kosten geschat op 2-4% van het gezondheidszorgbudget. In de komende 40 jaar, zullen de kosten van behandeling van chronische wonden naar verwachting nog verder stijgen. Oorzaak hiervan is de toename van het aandeel 80-plussers binnen de groep mensen van 65 jaar en ouder (’de dubbele vergrijzing’) en een stijging van de incidentie van obesitas en diabetes mellitus.
Om onder andere zorgverleners, managers, beleidsmakers en ook politici bewust te maken van de omvang van het probleem van (geïnfecteerde) chronische wonden zijn gegevens zoals prevalentiecijfers hierover nodig. Tot nog toe zijn deze gegevens over (geïnfecteerde) chronische wonden in Nederland maar beperkt beschikbaar.
Chronische wonden kunnen geïnfecteerd raken waarbij de wondinfectie leidt tot een vermeerdering van micro-organismen, die op hun beurt zorgen voor een langdurige en heftige ontstekingsreactie, een vertraagde collageensynthese en een vertraagde epithelialisatie. Wondinfectie leidt tot weefselschade. Een effectieve en efficiënte antimicrobiële behandeling bij een geïnfecteerde wond is daarom essentieel. Door een dergelijke behandeling genezen wonden niet alleen sneller, maar leveren zij ook minder zorgkosten op en minder productieverlies door ziekteverzuim. De klinische beoordeling van een infectie van een chronische wond is echter moeilijk. De symptomen van een geïnfecteerde chronische wond zijn minder gemakkelijk te interpreteren dan de infectiesymptomen van een acute wond.
In aanvulling op een klinische evaluatie van een geïnfecteerde wond wordt daarom vaak een microbiële analyse van het aantal en soort aanwezige micro-organismen verricht. Met behulp van deze kwantificatie en kwalificatie van bacteriën zou men beter in staat zijn om een wondinfectie vast te stellen en de wond ‘op maat’ te behandelen.
Mierlo-van den Broek gaf naar aanleiding van haar ‘Verkenning van de wondbehandeling in Nederland’, in 2011 het advies om in Nederland de behandeling van chronische wonden.
anders te organiseren. De belangrijkste elementen van haar voorstel zijn: het creëren van een snelle verwijzing van een patiënt met een chronische wond naar een team van specialisten / wond expertise centrum; de optie voor een multidisciplinaire beoordeling, gevolgd door een specifieke en goed geregisseerde behandeling. In navolging van een aantal goede voorbeelden in het Verenigd Koninkrijk in de jaren ’90, werd in Nederland in Venray (2009), het Kenniscentrum Wondbehandeling (KWB) opgericht. Het KWB lijkt inhoudelijk te voldoen aan het advies van Mierlo-van den Broek. Het was echter niet duidelijk of de behandeling en zorg die vanuit het KWB geleverd wordt, kosteneffectief is.
Hoofdstuk 1 geeft een algemene inleiding en achtergrondinformatie van de begrippen ‘chronische wond’ en ‘wondinfectie’. Daarnaast worden de verschillende doelstellingen en de opzet van het proefschrift besproken.
In hoofdstuk 2 is een cross-sectioneel beschrijvend onderzoek beschreven om de soort en het voorkomen van chronische wonden in Nederlandse verpleeghuizen te onderzoeken. De studie had ook tot doel om een indruk te krijgen over het aantal wonden dat door specialisten ouderengeneeskunde (voorheen verpleeghuisartsen genoemd) als geïnfecteerd geduid wordt. 361 specialisten ouderengeneeskunde (SOs) werden gevraagd de door hen gebruikte infectiesymptomen te selecteren en te rangschikken in een top vijf. Selectie gebeurde op basis van een aan hen van tevoren verstrekte lijst met symptomen. 139 artsen retourneerden de vragenlijst waarvan er 121 bruikbaar waren voor analyse. De resultaten werden vervolgens vergeleken met de selectie en rangorde gemaakt door een Delphi-panel bestaande uit een multidisciplinaire groep van internationale erkende experts in 2005.
Uit de enquête bleek dat 73,5% van de SOs, tenminste één chronische decubitus wond (PU) behandelde op dat moment. 31,6% van de SOs behandelde ten minste één, maar niet meer dan twee chronische postoperatieve wonden. Chronische open benen en een diabetische voet werden door SOs minder vaak behandeld dan doorligwonden en postoperatieve wonden. Van de doorligwonden, werden er 53% geduid als geïnfecteerd. De andere chronische wonden werden minder vaak als geïnfecteerd beschouwd. Het bleek dat de SOs meer dan de internationale experts gebruik maken van 'traditionele' criteria zoals 'pus/ abces' en ‘onwelriekende geur' om een aanwezige infectie van een chronische wond te duiden.
In hoofdstuk 3 is de prevalentie van chronisch (geïnfecteerde) wonden uitgebreider beschreven, evenals de symptomen die gebruikt werden om een mogelijk infectie van een chronische wond te beoordelen. In april 2012, werd als onderdeel van de jaarlijkse Landelijke Prevalentiemeting Zorgproblemen van de Universiteit Maastricht (LPZ) een multicenter, cross-sectionele, punt-prevalentie meting uitgevoerd. Tevens werden een aantal kwaliteitsindicatoren gemeten. De resultaten toonden aan dat in 21 deelnemende verpleeghuizen met 61 afdelingen en 1.514 patiënten, 63 patiënten in totaal 72 chronische wonden hadden. Dit betekent een prevalentie van 4,2%. Bijna de helft (46%) van deze wonden betrof doorligwonden, gevolgd door postoperatieve wonden (9,5%). 22% (n = 16) van deze 72 chronische wonden werd klinisch als geïnfecteerd beoordeeld. Toename van wondvocht/pus (81,3%; n = 13), ‘roodheid’ (68,8%; n = 11), ‘pijn’ (56,3%; n = 9) en ‘vertraagde genezing ’ (56,3%; n = 9) werden als diagnostische symptomen van een geïnfecteerde chronische wond genoemd. Op het niveau van de zorginstelling werd aan de meeste kwaliteitsindicatoren voldaan. In alle instellingen was een verantwoordelijke die het protocol /de richtlijn chronische wond up-to-date houdt, werden chronische wonden centraal geregistreerd en werd minstens elke twee jaar een bijscholing of themabijeenkomst georganiseerd. Op afdelingsniveau werd echter minder vaak voldaan aan deze kwaliteitsindicatoren.
De doelstelling van de literatuurstudie in hoofdstuk 4 was om na te gaan of een wond swab (de Levine of Z-techniek) , in vergelijking met een biopsie, een betrouwbare methode is, om vast te stellen of een chronische wond geïnfecteerd is. De elektronische databanken PubMed, de Cumulatieve Index of Nursing en Allied Health Literature (CINAHL) en Medline werden hiervoor systematisch doorzocht. 6 artikelen voldeden aan de inclusiecriteria. De diagnostische betrouwbaarheid van een wond swab afgenomen met de Levine techniek bleek, in vergelijking met de biopsie als ‘Gouden standaard’, hoger dan bij afname met de Z-techniek. De Levine techniek detecteert meer organismen in zowel acute wonden als chronische wonden dan de Z-techniek. Bij een drempel van 3.7x104 micro-organismen per wond swab had de Levine techniek een sensitiviteit van 90 %, een specificiteit van 57% en een positieve voorspellende waarde en negatieve voorspellende waarde van respectievelijk 0,77 en 0,91. Uit de internationale literatuur bleek ook dat de beschrijving van de methode van afname van een wond swab sterk varieert.
Vervolgens werd in hoofdstuk 5 in een prospectieve studie de Levine techniek gebruikt om te onderzoeken of een microbiologische wond analyse de klinische beoordeling van het wel of niet geïnfecteerd zijn van een chronische wond kan ondersteunen. Bij deze beoordeling werd gebruik gemaakt van de 13 symptomen die beschreven zijn in het internationale consensus document van de World Union of Wound Healing Societies (WUWHS) in 2008. Gestandaardiseerd werden wond swabs afgenomen met de Levine techniek. De microbiologische resultaten van de wond swabs werden vergeleken met de klinische beoordeling. Uit de resultaten bleek dat de bacteriologische uitkomsten van de afgenomen wond swabs niet met de klinisch beoordeling overeen kwam. Dit gold ook voor de chronische wonden van diabetici of van patiënten met perifeer arterieel vaatlijden (PAD). De conclusie van deze studie was dan ook dat afname en microbiologische analyse van wond swabs bij chronische wonden een verspilling van tijd en geld is. Wond swabs blijken in deze studie de klinische beoordeling van het wel of niet geïnfecteerd zijn van een chronische wond niet te ondersteunen.
In hoofdstuk 6 is een kostenanalyse van de behandelingen in het Kenniscentrum Wondbehandeling (KWB) in Venray uitgevoerd, vanuit het perspectief van de zorgverzekeraar. Hiervoor werd een observationele cohort studie uitgevoerd. De zorgkosten van cliënten één jaar voorafgaand aan het eerste consult in het KWB werden vergeleken met de kosten gemaakt in het jaar daarna. Patiënten werden geïncludeerd na hun 1e consult mits zij verzekerd waren bij zorgverzekeraar Coöperatie Volksgezondheidszorg (VGZ). Om de kosten te berekenen werd gebruik gemaakt van een gestandaardiseerde zes-stappen procedure. De niet-Gaussiaanse verdeling van de kosten, was aanleiding om niet-parametrische bootstrapping te gebruiken om op aanwezige statistische verschillen te toetsen. De resultaten toonden aan dat wondbehandeling voor chronische wonden in het KWB, niet alleen therapeutisch effectief was (106 van de 172 patiënten genazen volledig) maar ook kosteneffectief. Het verschil in kosten tussen de zorgverlening het jaar voorafgaand en het jaar daarna liet in de base case analyse een vermindering van € 2.621 per patiënt per jaar zien. De kostenanalyse in deze studie was de eerste die verricht is in een 1e lijns wondkliniek. Op basis van de resultaten lijkt een 1e lijns wondkliniek zoals deze is georganiseerd in Venray een manier om zowel therapeutisch als financieel aan de verwachte toename in aantal chronische wonden tegemoet te kunnen komen.
Hoofdstuk 7 geeft een overzicht en bespreking van de belangrijkste resultaten die in de eerdere hoofdstukken van dit proefschrift aan bod zijn gekomen. Theoretische en methodologische beschouwingen worden gegeven. De gevolgen voor de dagelijkse praktijk en toekomstig onderzoek worden beschreven. Bovendien worden de volgende aanbevelingen gedaan:
1) Meet regelmatig de prevalentie van chronische wonden. Dit kan leiden tot meer bewustwording en focus bij managers en verzorgers én zal de dagelijkse zorgactiviteiten voor cliënten met chronische wonden ondersteunen: een betere registratie in de dossiers van de patiënten, multidisciplinaire besprekingen, evenals andere verbeteringen in de zorg voor patiënten met chronische wonden.
Door toepassing van de Landelijke Prevalentiemeting Zorgproblemen van de Universiteit Maastricht, kunnen de meetresultaten ter vergelijking binnen eigen zorginstelling, maar ook tussen verschillende zorginstellingen, gebruikt worden.
2) Valideer de symptomen omschreven door de World Union of Wound Healing Societies (2008). Momenteel lijkt het klinische oordeel de best mogelijke diagnostische optie om een infectie van een chronische wond vast te stellen.
Er is daarnaast wel behoefte aan meer innovatief onderzoek naar objectieve diagnostische mogelijkheden, zoals de DNA-sequencing techniek. Deze is echter door zijn complexiteit en hoge kosten (nog) géén optie voor grootschalig gebruik in bijvoorbeeld verpleeghuizen
Background:
While questionnaires and scales are some of the simplest methods of collecting data, their development requires a rigorous process. In recent years, several new questionnaires and scales have been developed. Although various papers have outlined how to develop questionnaires, their use in survey research, as well as how to ensure their validity and reliability, the actual development of scales - including the generation of items, scaling, the testing of validity and reliability, and refinement of the scale - is missing in the literature.
Aim:
To outline a systematic and rigorous process for developing scales for survey research and to differentiate between three interchangeably used terms: scale, questionnaire and inventory.
Discussion:
Developing a valid and reliable scale is daunting because of the challenges associated with the conceptualisation, contextualisation and operationalisation of the phenomenon of interest. Researchers should use multiple approaches at each step of development to tackle these challenges.
Conclusion:
This paper provides a step-by-step approach to developing scales by providing explicit instructions and practical examples. This six-step process can enable nurse researchers to develop a scale applicable to their study's intended population, which is also valid and reliable for measuring the phenomenon of interest.
Implications for practice:
Rigorous nursing research demands that instruments be valid and reliable measures. Systematic development of scales is key to ensuring that nurse researchers accurately measure abstract concepts when conducting surveys with a given population. This paper is a first step in addressing the gap in the methodological literature and will contribute to greater rigour in research.
The planning stage of any research project is one of the most important stages in the research process. This article offers insight into the important issues a researcher needs to consider when planning his or her research, including how to develop a research protocol, obtaining research funding, seeking academic, peer and social support, gaining research ethics and governance approval and planning a research schedule. Careful planning ensures that the research project is achievable and can be completed on time, with the funding available.
Medical educators attempt to create reliable and valid tests and questionnaires in order to enhance the accuracy of their assessment and evaluations. Validity and reliability are two fundamental elements in the evaluation of a measurement instrument. Instruments can be conventional knowledge, skill or attitude tests, clinical simulations or survey questionnaires. Instruments can measure concepts, psychomotor skills or affective values. Validity is concerned with the extent to which an instrument measures what it is intended to measure. Reliability is concerned with the ability of an instrument to measure consistently.1 It should be noted that the reliability of an instrument is closely associated with its validity. An instrument cannot be valid unless it is reliable. However, the reliability of an instrument does not depend on its validity.2 It is possible to objectively measure the reliability of an instrument and in this paper we explain the meaning of Cronbach’s alpha, the most widely used objective measure of reliability.
Antenatal education is recommended to prospective parents, yet little is known about the educational preparation of the facilitators of this education, or of the educational practices they use. The aim of this study was to investigate the educational preparation and practices of antenatal educators in Ireland. Data were collected using a questionnaire structured on the three components (abilities, opportunities, and means) of Stamler's theoretical framework of enablement. Eighty-four of the 120 antenatal educators responded (70%), and this included midwives, public health nurses, physiotherapists, and private antenatal educators. Findings describe a picture of varied educational preparation for the antenatal educator with a range of educational practices being used. Within public antenatal classes, large class size was a barrier to providing a participatory educational approach.
Nurses are not averse to applying research findings to their clinical practice; however, there appears to be a number of barriers to achieving this. Generally, barriers include lack of time and the need to provide more education surrounding the use of research. While these are both valid points, the authors suggest that perhaps the solution to the problem is looking at how research is 'sold' to practitioners. For example, the use of jargon in research is off-putting to many practitioners, which creates an impression that research is associated with academia, rather than a tool for practitioners. Also, there may be an unrealistic expectation of what 'using research' might mean. Research is seen as the pinnacle of evidence, and not a part of evidence-based practice. In this article, the authors propose that teaching and expectations of research should focus on the application of research to practice. Reviewing and critiquing of research should serve the purpose of helping to make decisions about its practical applications, rather than for academic use.
Most nosocomial infections are thought to be transmitted by the hands of health care workers. The aim of this work was to assess the knowledge, attitude and practice of hand washing among health care workers (HCW) in Ain-Shams University hospitals and to investigate the presence of the necessary facilities and supplies required for hand washing (HW) in ten wards. A cross-sectional descriptive and observational study was conducted for six months from June till November 2006. Observation of the HCW for hand washing practice was done at any opportunity of contact with the patients in the different wards by members of the infection control team. Knowledge & attitude of HCW towards hand hygiene was done through self-administered questionnaire to HCW in 10 different departments. The total opportunities observed were 2189 opportunities. Doctors showed a significantly higher compliance (37.5%) than other groups of HCW (P = 0.000), however only 11.6% of the opportunities observed for doctors were done appropriately. The most common type of HW practiced among HCW was the routine HW (64.2%) and the least was the antiseptic HW (3.9%). Having a short contact time and improper drying (23.2%) were the most common errors that lead to inappropriate HW. Most of the wards had available sinks (80%) but none of them had available paper towels. The mean knowledge score was higher in nurses compared to doctors (42.6 +/- 1.7 versus 39.1 +/- 10.5). Most of the nurses (97.3%) believe that administrative orders and continuous observation can improve hand washing practices. Implementation of multifaceted interventional behavioral hand hygiene program with continuous monitoring and performance feedback, increasing the supplies necessary for HW and institutional support are important for improving the compliance of hand hygiene guidelines.
One of the goals of the American Academy of Orthopaedic Surgeons (AAOS) is to disseminate patient education materials that suit the readability skills of the patient population. According to standard guidelines from healthcare organizations, the readability of patient education materials should be no higher than the sixth-grade level. We hypothesized the readability level of patient education materials available on the AAOS Web site would be higher than the recommended grade level, regardless when the material was available online. Readability scores of all articles from the AAOS Internet-based patient information Web site, "Your Orthopaedic Connection," were determined using the Flesch-Kincaid grade formula. The mean Flesch-Kincaid grade level of the 426 unique articles was 10.43. Only 10 (2%) of the articles had the recommended readability level of sixth grade or lower. The readability of the articles did not change with time. Our findings suggest the majority of the patient education materials available on the AAOS Web site had readability scores that may be too difficult for comprehension by a substantial portion of the patient population.
This article examines how to synthesise and critique research literature. To place the process of synthesising the research literature into context, the article explores the critiquing process by breaking it down into seven sequential steps. The article explains how and why these steps need to be kept in mind if a robust comprehensive literature search and analysis are to be achieved. The article outlines how to engage in the critiquing process and explains how the literature review needs to be assembled to generate a logical and reasoned debate to examine a topic of interest or research in more detail.
Background:
Holistic care that encompasses a spiritual dimension is an expectation in modern healthcare (Rothman, 2009). Increasing attention is being paid to the role of nurses in providing spiritual care to patients. However nurses lack specific skills and expertise in this area (Lundmark, 2006; Timmins, 2010; RCN, 2011), and the extent to which their undergraduate education prepares them for this role is unclear. There is often an absence of clear direction about what to teach undergraduate nursing students. The extent to which core textbooks direct student studies in this area is not known. There is some evidence that some of these fundamental core textbooks provide insufficient direction (Pesut, 2008), thus gaps in knowledge and care provision in this field could be exacerbated.
Aim:
The aim of this study is to examine the extent to which spiritual care concepts are addressed in core nursing textbooks.
Methods:
Five hundred and forty three books were sampled from the Nursing and Midwifery Core Collection list (UK) (Tomlinsons, 2010) representing 94% of the total (n=580). A survey, the Spirituality Textbook Analysis Tool (STAT), was developed and used to collect data.
Findings:
One hundred and thirty of the books included content related to spirituality and religion. However there was little consistency in the core nursing textbooks with regard to direction for providing spiritual care. Thirty eight percent of the books defined spiritual care and 36% provided an outline of the role of the nurse in providing this. While some books advocated the assessment of patients' spiritual needs (32%) few referred specifically to assessment tools.
Discussion:
It is essential that nurses are adequately prepared to address the spiritual needs of patients. While there are numerous spiritual care texts that deal solely with this issue for nurses, there is an argument emerging that core nursing texts used by nursing students ought to encompass spiritual care elements. Lack of specific focus on this field, by these key textbooks might infer that this important element of holistic care is less important than other matters in nursing. True holistic care ought to permeate across textbooks and as such spirituality and spiritual care ought not to be sequestered to specialised texts. Core nursing texts need to be strengthened through consistency of application and inclusion of spirituality and spiritual care where relevant.
The nurses' role in providing spiritual care to in-hospital patients is not clearly outlined in the Republic of Ireland (ROI). This and other deficits reveal that there are current gaps in nurses' knowledge and confidence in this area. In response, an educational innovation has been developed and this article reports on its development.
Depression is recognised as a major health problem for people with diabetes and is associated with morbidity, mortality and a poor quality of life. This article outlines how depression is diagnosed, its consequences and how to screen for and treat it. It also gives some practical tips with diabetes who have depression.
To evaluate the social networking site Twitter™ as a vehicle for recruitment in online health research and to examine how the Twitter community would share information: the focus of our study was the antenatal experience of mothers of advanced maternal age.
One result of growth in worldwide Internet and mobile phone usage is the increased ability to source health information online and to use social media sites including Facebook and Twitter. Although social media have been used in previous health research, there is a lack of literature on the use of Twitter in health research.
A cross-sectional survey.
We report a novel recruitment method via a social networking site between May and August 2012. Through a Twitter account, we tweeted and requested other Twitter users to retweet our invitation to be involved in the study. Tweets contained a unique URL directing participants to an online survey hosted on the Survey Monkey™ website.
Over 11 weeks, 749 original tweets were posted by the researcher. A total of 529 mothers accessed the survey as a result of 359 researcher tweets and subsequent retweets that were seen by Twitter users. The survey was fully completed by 299 (56·5%) participants.
Twitter is a cost-effective means of recruitment, enabling engagement with potentially difficult-to-reach populations, providing participants with transparency, anonymity and a more accessible method by which to participate in health research.
Introduction:
Hospitality sector employees constitute one of the key groups with respect to their secondhand tobacco smoke exposure at work. This study aimed to detect urinary cotinine and breath carbon monoxide (CO) levels among bar and restaurant employees in Ankara, as well as the employees' opinions on the new antitobacco law, changes in smoking behavior, and subjective health status before and after the law entered into force.
Methods:
This before-after study was conducted in 19 premises, with the participation of 65 employees before implementation and 81 employees 3 months after implementation of the new antitobacco law in the hospitality sector. Data in both phases were collected through face-to-face surveys, breath CO measurements, and urinary cotinine analysis. Descriptive statistics were used to summarize data, whereas chi-square test, paired and unpaired t tests, and analysis of variance were used to compare groups.
Results:
Most of the restaurant and bar employees were male and below 35 years old. Before-after comparison showed that health complaints of the hospitality sector employees such as watering and itching in the eyes, difficulty in breathing, and cough (p < .001), as well as breath CO (p < .001) and urinary cotinine levels (p < .001) decreased significantly 3 months after implementation of the law. Among the smoking employees, mean number of cigarettes smoked was also found to decrease (p = .012). Majority of the employees (83.8%) were found to support the smoking ban in enclosed public places.
Conclusions:
Results of this study provide solid evidence on the positive health effects of smoke-free laws and employees' support for smoke-free workplaces.
Developing culturally competent researchers
Background. Whilst we live in multicultural societies most health researchers tend to take the cultural perspective of the majority ethnic group at the expense of the perspective of minority ethnic groups.
Aim. This paper discusses the need for the development of culturally competent health researchers in all areas of research and proposes a model for the achievement of this.
Design. A snapshot review of research textbooks used in nursing curricula was conducted to identify whether culturally competent research was being promoted.
Results. The review found that whilst a few textbooks touched on ethnicity, race and culture, none of them addressed the issue of cultural competence. Subsequently the authors adapted their existing model of culturally competent health care practice, and in this paper they propose it as a model for the development of culturally competent researchers.
Discussion. The model put forward by the authors consists of four concepts: cultural awareness, cultural knowledge, cultural sensitivity and cultural competence. A culturally competent researcher is one who is able to apply the related skills and knowledge in project design, data collection, analysis, report writing and dissemination. Furthermore, the authors identify two layers of cultural competence, those of culture-generic (knowledge and skills that are applicable across ethnic groups) and culture-specific competence (knowledge and skills that relate to a particular ethnic group). The relationship between these two layers is a dynamic and spiralling process as illustrated by the model.
Conclusion. Current health policy in many developed countries focuses on inequalities of health and managing diversity, including ethnicity. Thus the authors conclude that the development of culturally competent researchers will lead to both valid research and culturally competent practice by health care professionals.
Background Despite the recent focus on improving the quality of patient information, there is no rigorous method of assessing quality of written patient information that is applicable to all information types and that prescribes the action that is required following evaluation.
Objective The aims of this project were to develop a practical measure of the presentation quality for all types of written health care information and to provide preliminary validity and reliability of the measure in a paediatric setting.
Methods The Ensuring Quality Information for Patients (EQIP) tool was developed through a process of item generation, testing for concurrent validity, inter-rater reliability and utility. Patient information managers and health care professionals tested EQIP in three annual audits of health care leaflets produced by a children's hospital.
Results The final tool comprised 20 items. Kendall's τ B rank correlation between EQIP and DISCERN was 0.56 (P = 0.001). There was strong agreement between intuitive rating and the EQIP score (Kendall's τ B = 0.78, P = 0.009). Internal consistency using Cronbach's α was 0.80. There was good agreement between pairs of raters (mean κ = 0.60; SD = 0.18) with no differences based on types of leaflets. Audits showed significant improvement in the number of leaflets achieving a higher quality EQIP rating over a 3-year period.
Conclusions EQIP demonstrated good preliminary validity, reliability and utility when used by patient information managers and healthcare professionals for a wide variety of written health care information. EQIP uniquely identifies actions to be taken as a result of the quality assessment. Use of EQIP improved the quality of written health care information in a children's hospital. Wider evaluation of EQIP with written information for other populations and settings is recommended.
In spite of the growing body of literature, the reality of getting research into practice remains problematic.
The present study aimed to establish contemporary levels of research awareness among nurses in Ireland. POPULATION, SAMPLE, SETTING: A random sample of 234 registered nurses (RNs).
A self-report survey Research Awareness Questionnaire (RAQ) was used to collect data in March 2005. Results: Most agreed (92%) that research can improve patient care and 93% agreed that it is the way forward to change clinical practice. Most nurses' perceived research as being integral to their role. However, 71% of the nurses within the present study indicated that they had insufficient support and encouragement from peers and professionals. Similarly, 69.2% indicated insufficient support from management.
Consistent with other countries, nurses in Ireland have a positive attitude towards evidence-based nursing but face many obstacles which include a lack of time, support, knowledge and confidence.
Nurse managers have a vital role in the use and dissemination of research among staff. It is imperative that nurse managers have clinical expertise, research awareness training, and awareness to promote research-based practice and attempt to provide positive role modelling in addition to protected time for research efforts.
The questionnaire used for the U.S. Listening to Mothers II survey was translated and culturally adapted to measure Japanese women's experience during the period of pregnancy planning through early postpartum. Methods included expert panels and two phases of cognitive interviews with 20 postpartum Japanese adult women. The number of problems with the translated questionnaire effectively decreased in the iterative process. Most problems were found in the question-interpretation stage of cognitive processing, such as wording/tone. Culture-specific concepts and unclear items were adapted to prevent erroneous interpretations in future studies. The future use of this questionnaire to generate data sets will be useful for professionals interested in developing evidence-based practices. The knowledge from this study can be helpful in improving health-care services and education for women with diverse languages and cultural backgrounds.
This paper presents the preliminary descriptive findings from an online survey commissioned by the Royal College of Nursing to ascertain members' perceptions of spirituality and spiritual care.
There is a professional requirement for nurses to achieve competence in the delivery of spiritual care and to assess and meet the spiritual needs of their patients. Recently, the area of spirituality has come under criticism bringing into question the role of the nurse with regard to the provision of spiritual care.
A descriptive online survey was conducted with all Royal College of Nursing members to obtain their perceptions of spirituality and spiritual care in an attempt to identify what action they feel is required with regard to this aspect of nursing practice.
An online survey consisting of a five-part questionnaire was developed incorporating the Spirituality and Spiritual Care Rating Scale. Members were asked to complete the survey during a three-week period in March 2010.
Overall, 4054 Royal College of Nursing members responded, making this probably the largest UK survey ascertaining nurses' perceptions of spirituality and spiritual care. Descriptive statistics, frequencies and percentages were used to identify key findings. A Cronbach's alpha of 0·80 was obtained for the Spirituality and Spiritual Care Rating Scale. The preliminary analysis confirms that nurses across the full health economy in the United Kingdom consider spirituality to be a fundamental aspect of nursing.
The findings indicate that nurses recognise that attending to the spiritual needs of patients enhances the overall quality of nursing care. However, despite all the attention given to the spiritual dimension, the majority of nurses still feel that they require more guidance and support from governing bodies to enable them to support and effectively meet their patients' spiritual needs.
To examine the psychometric properties of the Hospital Anxiety and Depression Scale in selected research to determine the suitability of this instrument for use in an alcohol-dependent population.
Anxiety and depression represent a significant comorbid problem encountered with alcohol dependency. Effective screening for clinically relevant anxiety and depression is crucial for tailoring effective treatment intervention. However, no guidance exists to suggest the most appropriate screening measure in this clinical group.
Narrative review.
Three criteria were used: factor analysis, test-retest reliability and internal consistency reliability.
Factor analysis studies highlighted a mostly bi-dimensional model or a tripartite model, with only a couple of exceptions. Test-retest reliability came from only five studies, and while they all showed significantly positive correlated scores, only one study fulfilled criteria for a good or efficient reliability measure. The last evaluation, internal consistency reliability, faired much better in terms of recommended scores for reliability. Nearly all the studies showed a high level of internal consistency reliability.
It is concluded that the Hospital Anxiety and Depression Scale is likely to be a suitable screening tool for use in an alcohol-dependent population.
Effective screening for anxiety and depression can significantly enhance treatment efficacy when working with those patients presenting with alcohol dependency. This review suggests that the Hospital Anxiety and Depression Scale may be an appropriate instrument to use in this group based on observation of the tools measurement characteristics.
A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
Although nursing research literature in the area of patient education is rich in number, methodologies used have limited generalizability and cohesiveness. Previous theoretical work has suggested an enablement framework for patient education across content areas. This study approaches patient education from the participant's view and engages the recipients in describing their goals for the process. Seven primiparous women taking childbirth education were asked about their reasons/goals for attending, anticipated roles and tasks during the birth process, and whether or not the educational experience assisted them in meeting their self goals. Semi-structured interviews were used, with each woman being interviewed three times, allowing comparison of data across time, and pre- and post-birth. Content categories were identified, and found to be consistent across time. Implications for practice and research are provided.
This research study illustrates nurses' concern about spiritual care and the author demonstrates why this issue needs to be researched more fully to prepare nurses to fulfil this role appropriately.
This study explores absenteeism patterns and trends among a group of third-year student nurses. A questionnaire was used to elicit information about absence behaviour from 110 students at two hospital sites. Retrospective analysis of attendance records of 70 of these students, covering a period of 123 weeks, was also performed to determine absenteeism trends. The findings of the study reveal that 1567 days were lost because of absenteeism during this period on 1027 episodes. This represents a time lost index, which is the amount of days lost expressed as a percentage of total days available, of 4% among the group. Most absenteeism episodes lasted 3 days or less, with 73% of episodes lasting only 1 day. Absenteeism commencing either on Mondays or Fridays accounted for more than half of the absenteeism episodes in the group. Voluntary absence was a reported feature of this group, which occurred more frequently from lectures than wards. The main reasons cited for absence from both lectures and ward duties were personal and social commitments and stress. Students' views on nursing as a career and responses to factors that may cause stress were examined and revealed an association with reported absence behaviour.
This paper reports a study describing the assertive behaviour of a group of professional nurses and midwives and exploring potential barriers and facilitators to the use of assertiveness skills in the workplace.
As nurses and midwives move away from traditional roles, it is increasingly being recognized that they need to behave in an assertive manner. Much literature supports the use of assertive behaviour in clinical practice. Although specific individual assertive behaviours and skills have been examined in many settings, little empirical evidence exists about the frequency and use of assertiveness skills by nurses and midwives in the workplace. While there is evidence on barriers to the use of assertive skills, there is little information about factors that may facilitate their use.
A survey design was adopted, using a 44-item questionnaire to collect data from a 2.5% random sample of nurses/midwives registered with the National Nursing Board of Ireland. The data were collected in 2003.
While respondents frequently complimented their colleagues and often allowed them to express opinions, they were less accomplished at expressing their own opinions or making requests. Assertive behaviours were used more frequently with nursing/midwifery colleagues than with management/medical colleagues. Most used assertiveness skills with other grades of staff in their own profession. Responsibility to patients/clients emerged as a supporting factor for using assertive behaviour. Managers, the work atmosphere and fear were viewed as obstacles.
Nurses and midwives needs to learn how to behave assertively, and this should be included in both pre- and post-registration education programmes. As use of assertiveness skills was reported to be least frequent with nurse/midwife managers, local policies and guidelines may be needed to encourage clinical practitioners to act autonomously and as client advocates.
Chest drains are a common feature of patients admitted to acute respiratory or cardio-thoracic surgery care areas. Chest drains are either inserted intraoperatively or as part of the conservative management of a respiratory illness or thoracic injury. Anecdotally, there appears to be a lack of consensus among nurses on the major principles of chest drain management. Many decisions tend to be based on personal factors rather than sound clinical evidence. This inconsistency of treatment regimes, together with the lack of evidence-based nursing care, creates a general uncertainty regarding the care of patients with chest drains. This study aimed to identify the nurses' levels of knowledge with regard to chest drain management. The research objective of this study was to describe the nurses' levels of knowledge regarding the care of the patient with chest drains. The data were collected using survey method. The results of the study revealed deficits in knowledge in a select group of nurses. Several service-led options exist with regard to improving knowledge in this area, such as service study days as well as ward-based tutorials. However, in an era of increasing accountability together with the impetus for each nurse to provide evidence-based care, it is crucial for individual nurse responsibility in the pursuit of knowledge in this area. Nurses must be supported by local practice development and through personal portfolio use to identify gaps in knowledge and seek appropriate training and resources.
In the UK, Europe and the USA conceptual models of nursing are features of many undergraduate nursing curricula [Alligood MR. The nature of knowledge needed for nursing practice. In Alligood MR, Marriner-Tomey A, editors. Nursing theory utilisation and application. London: Mosby, 2002, Tierney AJ. Nursing models extant or extinct? J Adv Nurs 1998;8(1):77-85] and commonly used in practice. However, UK nurses in practice continue to be dissatisfied with conceptual model use [Griffiths P. An investigation into the description of patients' problems by nurses using two different needs-based nursing models. J Adv Nurs 1998;28(5):969-977, Mason C. Guide to practice or 'load of rubbish'? The influence of care plans on nursing practice in five clinical areas in Northern Ireland. J Adv Nurs 1999;29(2):380-387, Murphy K, Cooney A, Casey D, Connor M, O'Connor J., Dineen B. The Roper, Logan and Tierney Model: perceptions and operationalization of the model in psychiatric nursing within one health board in Ireland. J Adv Nurs 2000;31(6):1333-1341]. An association with increased paperwork and documentation together with a belief that these abstract concepts do not quite fit with the practice setting has resulted in a generalised apathy towards their use in some areas [Timmins F. Critical care nursing in the 21st Century. Intensive Crit Care Nurs 2002;18:118-127]. In an era of concerns about both cost and quality, together with an increased impetus towards multi-professional working patterns and role expansion, alternative models of care, such as critical pathways and care pathways are gaining increased favour in the clinical setting [Johnson S, editor. Pathways of care. Oxford; Blackwell Science 1997]. The aim of this paper is to consider whether or not the traditional conceptual models of nursing are apt for today's practicing coronary care nurse. Specific questions to be addressed are: what is the research evidence that informs conceptual model use in coronary care and what are the conceptual models that commonly inform contemporary practice in coronary care nursing? Suggested ways forward for conceptual model use within nursing are also proposed.
Research into Practice: Essential Skills for Reading and Applying Research in Nursing and Health Care
- N Mathers
- Y C Huang
Mathers N, Huang YC (2004)
Evaluating quantitative research. In
Crookes PA, Davies S (Eds) Research
into Practice: Essential Skills for
Reading and Applying Research
in Nursing and Health Care.
Second edition. Baillière Tindall,
London, 95-112.
Nursing Research: Generating and Assessing Evidence for Nursing Practice
- D F Polit
- Tatano Beck
Polit DF, Tatano Beck C (2012)
Nursing Research: Generating
and Assessing Evidence for
Nursing Practice. Ninth edition.
Lippincott Williams and Williams,
Philadelphia PA.
Essentials of Nursing Research: Appraising Evidence for Nursing Practice
- D F Polit
- Tatano Beck
Polit DF, Tatano Beck C (2014)
Essentials of Nursing Research:
Appraising Evidence for Nursing
Practice. Fourth edition. Lippincott
Williams & Wilkins, Philadelphia PA.
Quantitative research
- R Watson
Watson R (2015) Quantitative
research. Nursing Standard.
29, 31, 44-48.
Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education. www.nmc.org.uk/standards/ additional-standards/standards-forpre-registration-nursing-education (Last accessed
- B Moult
- L S Franck
- H Brady
Moult B, Franck LS, Brady H (2004)
Ensuring quality information
for patients: development and
preliminary validation of a new
instrument to improve the quality
of written health care information.
Health Expectations. 7, 2, 165-175.
Nursing and Midwifery
Council (2010) Standards for
Pre-registration Nursing Education.
www.nmc.org.uk/standards/
additional-standards/standards-forpre-registration-nursing-education
(Last accessed: May 14 2015.)
Nursing and Midwifery Council
(2015) Joining the Register.
www.nmc.org.uk/registration/
joining-the-register (Last
accessed: May 14 2015.)