Search

Title. Fatigue in patients with rheumatoid arthritis: British and Dutch nurses’ knowledge, attitudes and management. Aim. This paper is a report of a study conducted to compare the knowledge, attitudes and current management of rheumatoid arthritis-related fatigue in British and Dutch rheumatology nurses. Background. After pain, fatigue is the most important symptom for patients with rheumatoid arthritis, but little is known about the current management of this fatigue by healthcare professionals. Methods. A questionnaire was mailed in 2007 to rheumatology nurses who were members of British Health Professionals in Rheumatology ( N = 267) and the Dutch Society of Rheumatology Nurses ( N = 227). Descriptive statistics, independent samples t-test and Pearson chi-square tests were used for statistical analysis. Results. A total of 494 nurses returned questionnaires (response rate 48%). In general, their knowledge about rheumatoid arthritis fatigue was in accordance with the literature and all indicated a positive attitude towards assessing and managing rheumatoid arthritis-related fatigue. However, respondents reported contradictory views about managing fatigue. Although they believed that other team members could help patients, they seldom referred patients on to other professionals. Although nurses believed that other advice besides pacing and balance between activity and rest might help, they did not offer this to patients. Despite acknowledging that there is poor communication about fatigue between patients and nurses, respondents reported that it is patients rather than nurses who raise the issue of fatigue in consultations. Conclusion. British and Dutch rheumatology nurses are sympathetic but do not know how to manage rheumatoid arthritis-related fatigue. Strategies to support self-management for this fatigue, and to increase communication between healthcare professionals and patients, should be initiated to help improve patient outcomes for rheumatoid arthritis-related fatigue. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study of the attitudes of Dutch nursing students towards people with physical or intellectual disabilities. Background. Attitudes of healthcare professionals are a major factor in the rehabilitation and self-acceptance of persons with disabilities. Consequently, it is important that nurses develop or maintain positive attitudes towards people with disabilities during their education. However, more knowledge is needed about current attitudes of nursing students and factors influencing these attitudes. Methods. A sample of Dutch nursing students (n = 81) and an age-matched group of non-nursing peers (n = 48) completed standardized scales measuring attitudes about physically or intellectually disabled people. Data were collected in 2006. Findings. Nursing students were more positive towards physically disabled people than their peers, and more strongly endorsed empowerment and similarity of intellectually disabled people. These attitudinal differences generally remained statistically significant after multivariate adjustment for demographic variables and experience and contact with individuals with disabilities. An important independent determinant of a positive attitude towards physically disabled people in the total sample was having a relative or friend with a physical disability. This association, however, was not apparent in attitudes towards intellectually disabled persons. Conclusion. Educational interventions aimed at improving attitudes towards people with disabilities should include focus on forms of contact beyond the context of formal care relationships. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to determine if satisfaction with irregular working hours that are a form of shiftwork operates as a mediator between work and home characteristics and health problems. Background. Shiftwork contributes to health problems, decreased well-being and poorer health habits. It also affects employees' decisions to leave the healthcare sector. Although many nurses voluntarily work shifts, there have been few studies of their satisfaction with irregular working hours when these are a form of shiftwork. Methods. A survey was carried out with 144 nurses working in three nursing homes and one care home in the Netherlands. Questionnaires were distributed in 2003 to 233 nurses who worked shifts (response rate 60%). The questionnaire contained items on work and home characteristics, satisfaction with irregular working hours that are a form of shiftwork and health. A new scale to measure satisfaction with irregular working hours was constructed. Results. All work characteristics, but no home characteristics, were associated with satisfaction with irregular working hours. The work characteristics 'job demands' and the home characteristics 'autonomy at home' and 'home demands' were associated with health. Satisfaction with irregular working hours did not mediate between work/home characteristics and health. Those reporting more social support, lower job demands and more job autonomy were more satisfied with their irregular working times that were a form of shiftwork. Conclusions. Satisfaction with irregular working hours is a useful construct that requires further longitudinal study. The results also underline the importance of considering home characteristics when predicting health outcomes. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to develop and test the psychometric properties of the On-the-job Learning Style Questionnaire for the Nursing Profession. Background. Although numerous questionnaires measuring learning styles have been developed, none are suitable for working environments. Existing instruments do not meet the requirements for use in workplace settings and tend to ignore the influence of different learning situations. Method. The questionnaire was constructed using a situation-response design, measuring learning activities in different on-the-job learning situations. Content validity was ensured by basing the questionnaire on interview studies. The questionnaire was distributed to 912 Registered Nurses working in different departments of 13 general hospitals in the Netherlands at the end of 2005. Findings. The response rate was 41% (372 questionnaires). The internal factor structure of the questionnaire was partly based on the learning activities in which nurses participate and partly on the learning situation in which they are performed. The internal consistency was good. The situation-response design of the questionnaire demonstrated its added value. Construct validity was estimated using intercorrelations between the scales, and criterion validity was estimated based on the relationships of the scales with perceived professional competence. Conclusion. The On-the-job Learning Styles Questionnaire for the Nursing Profession is well suited to describing nurses' learning styles in on-the-job settings and has satisfactory psychometric properties. [ABSTRACT FROM AUTHOR]

Title. Improving the clinical usefulness of a behavioural pain scale for older people with dementia Aim. This paper is a description of the process of item reduction as part of the construction of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate to assess pain in Dutch older nursing home residents with dementia. Background. A valid and reliable clinically useful tool is important for assessing pain in people with dementia. The Pain Assessment Checklist for Seniors with Limited Ability to Communicate has demonstrated good inter- and intra-rater reliability and evidence of construct validity. However, nurses found the scale too long for clinical use. Methods. In an observational study in 2005, nursing home patients ( n = 128) were observed while receiving an influenza injection, and a selection of patients were also assessed at a patient-specific pain moment. Internal consistency and Principal Component Analysis were used to refine the scale, to examine the psychometric quality and underlying factor structure of the scale. Results. A brief and manageable version of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate in Dutch was developed, with a three-component solution including 24 items. This version had high levels of internal consistency for the complete scale (Cronbach's alpha range 0·82–0·86) and for all subscales (alpha range 0·72–0·82). Social–emotional items played a significant role in detecting pain. Conclusion. It is important to have a valid, reliable, brief and manageable pain scale available for the nursing home setting. Further research is needed to examine the adequacy and effectiveness of the scale in daily clinical practice. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of the findings of a study into the role of district nurses in euthanasia and physician-assisted suicide in homecare organizations, conducted as part of a study into the role of nurses in medical end-of-life decisions. Background. Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Minister for Health reason to commission a study into the role of nurses in medical end-of-life decisions in hospitals, nursing homes and homecare organizations. This is the first quantitative study from the perspective of nurses. Previous quantitative studies were conducted under physicians and information on the role of nurses was obtained indirectly. Method. A questionnaire was sent in 2003 to 500 district nurses employed in 55 homecare organizations. The absolute response rate was 86.0% and 81.6% (408) could be used for analysis. Results. In 22.3% of 278 cases, the district nurse was the first with whom patients discussed their request for euthanasia or physician-assisted suicide. In about half (49.8%) of 267 cases nurses were not involved in the general practitioner's decisionmaking process, and in only 13.3% of 264 cases, did they attend the administration of the lethal drugs. District nurses had provided some degree of aftercare to the surviving relatives in 80.3% of 264 cases. Conclusion. Collaboration between general practitioners and district nurses needs improvement, particularly in relation to decision-making. Our Dutch data could help nurses in other countries to define their (future) role in euthanasia and physician- assisted suicide. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study exploring the role perceptions and current activities in evidence-based practice promotion of professional nurses’ associations in the Netherlands. Background. The promotion of evidence-based practice contributes to professional standards in nursing and good quality care for patients. As professional nurses’ associations can be key players in this process, the nature of their roles and current activities deserves to be explored. Methods. Roles and activities were explored for 43 professional nurses’ associations (83% of all national associations). Data were collected using interviews with the associations’ board members. Findings from the interviews were validated with those from an analysis of the associations’ policy reports and other publications in the previous 2 years. Results. Board members primarily thought that they had roles in the selection and distribution of evidence. The roles of participant ( n = 13) and performer ( n = 13) in selecting evidence, and those of facilitator ( n = 12), initiator ( n = 15) and performer ( n = 41) in the distribution of evidence were often addressed. A few respondents reflected on roles in generating evidence and implementing evidence-based practice in patient care. A majority of the associations was contemplating activities in the promotion of evidence-based practice. Specific activities for each of six relevant aspects in the promotion of evidence-based practice were found in fewer than five associations. Conclusion. Professional nurses’ association roles in the promotion of evidence-based practice need to be viewed in relation to the tasks to be accomplished, especially those of selecting and distributing evidence. Although many organizations expressed motivation, professional nurses’ associations have a long way to go in the promotion of evidence-based practice among their members. [ABSTRACT FROM AUTHOR]

This paper reports on the result of two studies conducted to further validate the Abu-Saad Paediatric Pain Assessment Tool, a Dutch-language questionnaire developed to assess pain in school-age children. Children of 5 to 15 years of age reported in the first study their post-operative pain before and after the administration of analgesic medication using word descriptors of pain, the 10-cm scale, the Oucher, and a visual analogue scale (VAS). Lower mean pain scores at 4-hourly intervals post-analgesia supported the construct validity of the tool. Convergent validity was supported in both studies when scores on all concurrently administered measures positively correlated with the pain tool. In the second study, the correlations between pain and fear, a concurrently used measure with the pain instruments, were low, substantiating the discriminant validity of the pain tool. The significance of the results in relation to instrument development and multidimensional pain assessment in children are further discussed and elaborated. [ABSTRACT FROM AUTHOR]

Arguments in favour of voluntary euthanasia tend to be put in utilitarian terms. This paper suggests an alternative, neo-Aristotelian argument justifying certain individual acts of both suicide and voluntary euthanasia. It goes on to examine the slippery slope arguments against legalizing euthanasia. It is suggested that such arguments cut both ways. However, the suggestion that we ought therefore to permit a social experiment in voluntary euthanasia is set alongside the Dutch experience. The latter seems to imply that if such experiments are to take place then great caution needs to be applied. [ABSTRACT FROM AUTHOR]

Highlights the European Congress of Gerontology in Amsterdam, Netherlands. Number of delegates; Provision of services for elderly people; Content of the plenary session.

Exploring the Nursing Minimum Data Set for The Netherlands using multidimensional scaling techniques Rationale. To fulfil the need for a systematic collection of nursing data that give insight in nursing care and its benefits and costs, a nursing minimum data set (NMDS) has been developed and validated for Dutch general hospitals. A NMDS provides data describing the diversity in patient populations and variability in nursing activities that can be analysed in various ways. Aim of the study. To explore and compare the fundamental underlying dimensions describing patient problems and nursing interventions in Dutch general hospital wards. Methods. Data of predominantly nominal and ordinal measurement level that were collected with the NMDS for The Netherlands on 15 Dutch hospital wards underwent two consecutive steps: first, they were transformed into metric data by means of RIDIT (relative to an identified distribution) analysis; secondly, they were analysed by means of multidimensional scaling. Results. Multidimensional scaling techniques yielded a fairly good three-dimensional solution of the NMDS data. Hospital wards could be distinguished from each other on the basis of patient problems and nursing interventions most common on some wards but not on others. The core aspects underlying patient problems concerned dependency problems, life threatening problems and endogenous–exogenous problems, while discriminating nursing interventions were cure–care activities, internally–externally oriented activities and psychosocial–physical interventions. Limitations. Not all types of hospital wards were represented, which limits the representativity of the results for Dutch general hospitals. Furthermore, the patient sample size over the 15 wards was relatively small. Conclusion. The constructs are consistent with NMDS findings in Belgium and findings from practice, which contributes to their content validity. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The present study focuses on opinions on the quality of nursing home care of family members of nursing home residents with dementia. Furthermore, we examined whether family members' appreciation of the care increased as a result of the implementation of emotion-oriented care. DESIGN: Randomized clinical trial. INSTRUMENT: An 18-item questionnaire was developed. The following subjects were addressed: communication activities between staff and family members; satisfaction regarding contacts with staff; the extent to which family members can participate in care; the contact that family members experience with the person with dementia, and opinions about the way in which nursing staff treat residents. RESULTS: Most family members already had a positive opinion on the nursing home care prior to the implementation of emotion-oriented care. The most positive assessment concerned the way in which nursing staff treated residents. The lowest scores concerned communication activities between ward staff and family members. Comparison of the first and end measurements showed that in general opinions on the quality of care did not change. STUDY LIMITATIONS: A large number of incomplete questionnaires made it impossible to conduct factor analysis on the classification of the questions in various sections and therefore allowed us only to make statements at the item level. CONCLUSIONS: For the most part family members had a positive opinion on the nursing home care. In general, implementation of emotion-oriented care did not lead to a more positive assessment. Despite the generally accepted notion that involving family members in care is important, family members were regularly treated as outsiders. This demonstrates that there is room for improvement in the communication by nursing home staff with family members (e.g. more frequent contacts and information about the illness). [ABSTRACT FROM AUTHOR]

Quality of life of nursing home residents is a critical consideration in international health care policies and health care decisions. Yet, there is little relevant research to support decisions about client-tailored and effective nursing care for this population. Because of the permanency of their stay, the care received affects the quality of daily life. This study investigated the quality of co-ordination of care and the way it is related to gaps between needs and care supply, the quality of life and health status of residents living in Dutch nursing homes. To assess the perceived quality of life and experienced discrepancies between needs and care supply, 337 residents of 10 different nursing homes were interviewed. The quality of co-ordination of nursing care was assessed by judgements of the residents and nurses and by analysing the care documents. The results showed a relation between the co-ordination of care and care discrepancies; the higher the quality of co-ordination of care, the fewer the gaps between residents' needs and the care they received. The psycho-social aspects in particular showed a gap between the needs and care supply. As regards the relation between co-ordination of care and quality of life, the strongest positive relations were found between taking case histories, patient allocation and dimensions of quality of life. No direct relations were found between the co-ordination of care and care discrepancies on the one hand and the health status of the residents on the other. In conclusion, this study showed that the quality of co-ordination of care can affect the perceived quality of life of nursing home residents. To meet the residents' needs it is important to assess their physical and psycho-social needs accurately. More research focusing on this assessment is needed in order to improve the quality of life of nursing home residents. [ABSTRACT FROM AUTHOR]

Liaison nurses, employed by a home care organization, were introduced into two Dutch hospitals to improve discharge planning for stroke patients. The main aim of the study presented was to gain insight into the effects of liaison nursing on the quality of the discharge process and related outcomes. After the introduction of liaison nursing, hospital nurses completed a questionnaire on satisfaction with the liaison nurse. In addition, both before and after the introduction of liaison nursing, two groups of discharged stroke patients were interviewed by telephone. The records of these patients were also studied with respect to background characteristics and duration of hospital stays. The hospital nurses were, generally, positive about the liaison nurse and the job she did (e.g. they found that home care was better organized). Further, after the introduction of liaison nursing, more patients stated that their post-discharge needs had been discussed not later than 48 hours prior to discharge, and more patients said their aftercare had been discussed with community nurses. However, the number of patients whose medication had arrived at home on time had decreased. The results also indicated that there was no significant difference in the duration of stay between the before and after group. The overall conclusion is that the liaison nurses have been moderately successful in their jobs. However, since the study was conducted in only two Dutch hospitals, findings may not be representative of other settings. Future research on liaison nursing is therefore recommended. [ABSTRACT FROM AUTHOR]

Rationale Currently, there is no systematic collection of nursing care data in the Netherlands, while pressure is growing from the profession, policy-makers and society to justify the contribution of nursing and its costs. A nursing minimum data set can provide data to demonstrate nursing's contribution to health care as it can be used to describe the diversity of different patient populations and the variability of nursing activities, and to calculate the associated nursing workload. Objective To identify categories and items for inclusion in the Nursing Minimum Data Set for the Netherlands. Design A multimethod, exploratory approach was used. This included interviews, document analysis, consensus rounds, seeking validation in the literature, and drawing up lists of most frequently occurring patient problems, interventions and outcomes of care. Eight hospitals, with a total of 16 wards, participated in the study. Results Relevant categories and items emerged after analysis and grouping of the material and included: five hospital-related items, six patient demographics items, seven medical condition items, 10 nursing process items, 24 patient problems, 32 nursing interventions, four outcomes of nursing care, and three complexity of care items. Almost every item could be located in the existing documentation systems, the lists of patient problems, outcomes and interventions, or in the literature. Conclusion A set of categories and items of nursing data has been identified. The content validity of this set is partly supported by its consistency with the literature, findings from practice and the judgement of potential users. Nursing outcomes need further development. The data set will be tested in practice to find out whether the categories and items are useful, and whether they can be minimized. [ABSTRACT FROM AUTHOR]

One of the necessary elements in an obstetric system of home confinements is well-organized postnatal home care. In The Netherlands home care assistants assist midwives during home delivery, they care for the new mother as well as the newborn baby, instruct the family on infant health care and carry out household duties. The growing demand for postnatal home care is difficult to meet; this has resulted in a short supply of the most popular day care programme and a level of provision which does not result in adequate services. This study acknowledges the patient perspective of maternity home care in order to contribute to its organization. The majority (79%) of service centres were willing to participate. A total of 1812 (81 %) women who recently gave birth to a child responded to a postal questionnaire addressing the quality of care according to five dimensions: availability, continuity, interpersonal relationships, outcome and assistant's expertise. Almost one-third of the new mothers rated the availability as inadequate while the assistant's expertise was rated positively. Postnatal maternity home care is personalized, small-scale, and recognizes childbirth as a life event. Furthermore, it is relatively inexpensive and contributes to the satisfaction of recipients. [ABSTRACT FROM AUTHOR]

Insomnia is an important nursing problem in hospitals. Although the use of sleep medication is often criticized, it is one of the commonest interventions with regard to sleep problems. In this study, the effect of the administration of sleep medication in Dutch hospitals on the use of sleep medication at home is investigated. Only patients were included who had never used sleep medication before admittance in hospital. Results show that patients who used sleep medication for at least 5 days in hospital (n = 233) used sleep medication more often at home after discharge than patients who did not use sleep medication in hospital (n = 55). Furthermore, the study showed that those patients who used at least 5 days' sleep medication, especially those patients who used sleep medication more often in hospital, also used sleep medication more often at home. This is in line with the addictive effects of sleep medication. From these results it can be concluded that the administration of sleep medication is not without danger. Therefore, it is recommended to search for alternative interventions, especially for patients who are in hospital for a longer period. [ABSTRACT FROM AUTHOR]

Nursing research is just gaining ground in The Netherlands, as it is in every European country. Therefore, this study had the purpose of discovering to what extent Dutch nurses in the clinical areas have acquired research-based knowledge since it was introduced into the country, in the 1970s. Questionnaires, which included provision for demographic data, were distributed to 110 nurses, comprising head nurses, recently qualified nurses and final-year student nurses. A 65% response was achieved and the findings revealed that nursing research as a concept was not new to the Dutch nurses. They claimed they had obtained their knowledge through nursing training, reading, conferences and other sources such as mass media. The head nurses were the most knowledgeable followed by the recently qualified nurses and then the student nurses. However, the respondents claimed that their knowledge was superficial. The need to extend nurses’ knowledge through support and encouragement in relation to nursing research seminars and conferences is recommended. [ABSTRACT FROM AUTHOR]

Focuses on the nursing science project at the State university of Utrecht and history of nursing science in the Netherlands. Goals of Utrecht nursing science project organization; Need for nursing science programs in the Netherlands; Aim of nursing research interest groups.

Insomnia is an important nursing problem in hospitals. Although sleep medication is often criticized, it is one of the commonest interventions with regard to sleep problems. In this study, the prescription and provision of sleep medication in three Dutch general hospitals is investigated. Results show that on a random day 47% of all patients (n = 1076) of the surgical and medical wards were prescribed medication. Thirty-four per cent actually received sleep medication that evening or night. The prescription and provision of sleep medication was higher on medical than on surgical wards. Furthermore, hospitals were shown to differ regarding the prescription and provision of as-needed sleep medication. The study also explores whether attitudes of nurses are related to the provision of as-needed sleep medication. Although their influence does not seem to be great, it is concluded that more attention has to be paid to possible effective nursing interventions in educational programmes. [ABSTRACT FROM AUTHOR]

Many countries have separate organizations for delivering nursing care to patients in the hospital and to patients at home in the community. This separation creates extra difficulties in organizing continuous care for patients discharged from hospital who need nursing aftercare (in The Netherlands, at a rough estimate, 10% of all hospital patients). Special arrangements have to be made to prevent these patients missing out completely. By means of a questionnaire sent to all Dutch regional community nursing organizations, this study makes an inventory of the organizational measures that have been taken in this field in The Netherlands and analyses a model of the effects these measures (and also the effects on contextual factors) have on the number of problems reported by the communty in respect of continuity of care. In The Netherlands, the initiative in arranging continuity of care is taken by the regional community nursing organizations or by their operational teams. In most cases, they have been able to make arrangements with the hospitals about the selection of aftercare patients and the transfer of information by transfer forms. Sometines special continuity nurses are appointed by the community, among other things to organize regular consultation with the hospitals. An eight-item Likert scale was developed to measure the extent of continuity problems. Analysis of the effect of several factors in the model by a stepwise multiple regression analysis, revealed that the consistent use of transfer forms by hospitals was an important tool in reducing the problems. Furthermore, regional community nursing organizations themselves had fewer problems compared with the operational teams to whom arranging continuity is sometimes delegated. Increased personnel capacity within the community is also beneficial. The effect of these last two factors (organizational level and personnel capacity) is, however, overruled, by the negative effect of the size of the regional community nursing organization: the more inhabitants, the more problems there are. [ABSTRACT FROM AUTHOR]

Describes changes in nursing education in The Netherlands. Alterations in nursing education in The Netherlands; Need for higher education in nursing; Example of the international nursing networking; Plans to establish master and doctoral degree programs in nursing.