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Recognising metastatic spinal cord compression (MSCC) and knowledge of its management are important skills for health professionals, including nurses, working within palliative and end-of-life care. Metastases to the spine occur in about 3-5% of all patients with cancer, with 10% of these patients developing spinal cord compression. MSCC is considered an emergency because the consequences, if missed, are severely debilitating, resulting in irreversible paralysis and loss of sphincter function. This article will review the epidemiology, incidence, diagnosis and management of MSCC. It will focus particularly upon the recent guidance on MSCC from the National Institute for Health and Clinical Excellence. The key finding is that, although a relatively uncommon condition, MSCC has serious implications for the patient if missed. However, diagnosis is often delayed. A high index of suspicion should exist in at-risk cancer patients, i.e. those with multiple myeloma and cancers of the breast, prostate and lung. [ABSTRACT FROM AUTHOR]

This article discusses the holistic pain assessment and management of a 63-year-old man with endstage pancreatic cancer who was admitted to a large, inner-city, teaching hospital. The author works as a Liverpool Care Pathway (LCP) facilitator, offering support and education to front-line staff. She has found that staff lack education and skills in pain management, most notably at the end of life. In particular, staff are not aware of the concept of total pain and how patients' spiritual, psychological and social needs can lower their pain thresholds and make pain harder to control. The article uses a case scenario to highlight how the 'total pain' of a semi-conscious, dying man was assessed and treated. It highlights the need for good communication skills and the importance of including the patient's family in the assessment. The wider implications for palliative care nursing are described. All names have been changed to protect client and family confidentiality, in accordance with Nursing and Midwifery Council (2008) guidelines. [ABSTRACT FROM AUTHOR]

Endoscopic foreign body retrieval refers to the removal of ingested objects from the oesophagus, stomach and duodenum by endoscopic techniques. It does not primarily involve surgery, but rather encompasses a variety of techniques for grasping the foreign bodies, manipulating them, and removing them while protecting the oesophagus and trachea. Careful patient selection aids in determining the method of choice. The chosen strategy depends on the type and location of the foreign body, the length of time it has been in the oesophagus, and degree of experience of the endoscopist. All endoscopy units need to be prepared for such an eventuality as prompt treatment of a patient with a suspected oesophageal foreign body is crucial because of the potential for severe complications. This article looks at some of the common foreign bodies ingested and focuses on the techniques and equipment used to retrieve or manipulate them. Finally, the article discusses the vital role of the nurse in such a procedure. [ABSTRACT FROM AUTHOR]

Abstract: Decisional support is a multifaceted process of facilitating patients'' decision making regarding treatment choices. Effective decisional support practices of nurses in relation to the use of anticancer therapies in patients with advanced disease are central to quality cancer care. A recent qualitative descriptive study (n =21) exploring the decision making practices of doctors and nurses in one tertiary cancer centre in New Zealand identified many complexities associated with nurses and their participation in decisional support. The study revealed that cancer nurses had varied opinions about the meaning and importance of their roles in treatment related decision making. This variation was significant and led the researchers to undertake a detailed secondary exploration of factors that impacted on the nurses'' involvement in the provision of decisional support. Four key groups of factors were identified. These were factors relating to degree of knowledge, level of experience, beliefs and understandings about nursing roles and cancer therapies, and structural interfaces in the work setting. Understanding these factors is important because it allows modification of the conditions which impact on the ability to provide effective decisional care. It also provides some understanding of clinical drivers associated with nurses'' decisional support work with patients who have advanced cancer. [Copyright &y& Elsevier]

Research suggests that nurses have negative perceptions and subsequently negative interactions with patients diagnosed as having Borderline Personality Disorder (BPD). However, this research is mainly quantitative in nature and does not allow nurses to speak freely about their experiences of working with this client group. The purpose of this study was to explore nurses' relationships with BPD patients from their own perspective. Semi-structured interviews were used to elicit the participants' experiences of BPD patients and thematic analysis was used to raise themes from the data. One core theme and four major themes were identified. The core theme was: ‘Destructive Whirlwind’, which refers to the nurses perceiving these patients as a powerful, dangerous, unrelenting force that leaves a trail of destruction in its wake. The major themes were: care giving; idealized and demonized; manipulation and threatening. The study concludes that nurses experience BPD patients in a negative manner. This can be attributed to the unpleasant interactions they can have with them and feeling that they lack the necessary skills in working with this group. The results also indicate that nurses want to improve their relationships with BPD patients. [ABSTRACT FROM AUTHOR]

PURPOSE. We describe a multicomponent program for the systematic evaluation and treatment of depression in primary care. CONCLUSION. Primary-care nurses trained in clinical and therapeutic aspects of depression play a central role in care management, patient education, treatment adherence, and clinical monitoring. PRACTICE IMPLICATIONS. Diverse interventions, including organizational changes and the enhancement of the role of nurses, have been effective in improving depression outcomes in primary-care settings. [ABSTRACT FROM AUTHOR]

Abstract: Background: St. John''s, Newfoundland and Labrador is one of the smallest Canadian provincial capitals. Like other Canadian coastal communities, St. John''s has been affected by dramatic economic and institutional restructuring that negatively impacted community health. Marginalized populations including people who inject drugs are more negatively affected by the gap between health needs and available services. Methods: A mixed methods needs assessment began with a survey and key informant and focus group interviews to determine attitudes, knowledge, and practices of people with current or previous experience injecting drugs. An environmental scan of programmes and services was conducted followed by a community consultation with key stakeholders, community agencies, study participants, the media, and members of the public to share and validate findings, solicit feedback, and gather data about future knowledge transfer activities. Results: This paper examines two of the five barriers to health and health services for people injecting drugs: First, there was a discrepancy amongst people injecting drugs between awareness and use of safer practices, and second, there was a limited formalized network of health and social programmes and services. Conclusion: Accurate and timely information about safer practices, whilst an essential component of a harm reduction approach, is insufficient to reduce the risk of negative health outcomes for people injecting drugs. Funding new programmes and services, although desirable, is not always feasible in small urban centres with limited human and material resources. Recommendations for promoting health, reducing harm, and building local capacity must consider these limitations. Registered nurses are well positioned to provide leadership through collaborative community-based research, education and advocacy. [Copyright &y& Elsevier]

TOPIC. Developing evidence-based nursing roles. PURPOSE. This study examined a unique nursing role in the United States Air Force to determine if it had been well institutionalized and to identify barriers and facilitators during the implementation process. SOURCE OF INFORMATION. Individuals functioning in the role were surveyed to measure time spent on specific job-related tasks, additional duties, and positive and negative experiences. CONCLUSIONS. Eighty-seven percent of the respondents (n =  45) indicated that the role had been well implemented, although wide variation existed in tasks performed and major organizational barriers identified. Findings of this study can be used to guide the development of other evidence-based positions. [ABSTRACT FROM AUTHOR]

The article presents a study which reviewed literature on cryopreservation of semen, or sperm banking, for adolescent and young adult males with cancer. Information on sperm banking and advances in in vitro fertilization technology is presented. It is stated that follow-up care for survivors of childhood cancer and the effects of therapy on the quality of survival are the focal points of the Cancer Survivorship Program at the Children's Hospital of Philadelphia. Also noted is the role of nurses in sperm banking programs.

A Gadamerian hermeneutic phenomenological methodology was selected to explicate the essence of spiritual care with six registered nurses working within hospital settings. Findings revealed that deep knowing of the patient was essential before registered nurses would engage in spiritual care. Furthermore, spirituality was understood as a private matter, with chaplains being seen as the most appropriate providers of such care. These findings suggest that within the culture of Danish nursing, a mandate to incorporate spiritual care into everyday nursing practice may be somewhat problematic. [ABSTRACT FROM PUBLISHER]

Nurses' patient advocacy can influence patient outcomes. There is a lack of reliable and valid instruments on patient advocacy. The purpose of this study was to develop an instrument to measure nurses' attitudes toward patient advocacy. Bu and Jezewski's theory of patient advocacy and Fishbein and Ajzen's definition of attitude were used to guide the development and evaluation of the scale. Seven experts evaluated scale content validity. Two samples (N = 200; N = 2,500) were randomly selected from the Oncology Nursing Society membership to allow us to examine psychometric properties of the scale. The scale possessed satisfactory psychometric properties. © 2007 Wiley Periodicals, Inc. Res Nurs Health 31:63–75, 2008 [ABSTRACT FROM AUTHOR]

There have been rapid changes in the management of gastrointestinal stromal tumours (GISTs) in recent years with the appearance of oral chemotherapy drugs that have extended survival rates dramatically. With these opportunities have come new challenges for nurses managing patients with these rare, but very serious cancers. While referral to a tertiary centre may be an option for some patients with GISTs, many patients will find themselves cared for on gastro and general medical wards, and it is important that all nurses are able to inform patients about the drugs they will take and how to take them. As these new medications are oral, one of the challenges is to encourage treatment concordance. Some of the medications have treatment 'holidays' built into the regimen, and others have unpleasant side-effects that they must be warned about in advance. This article discusses the etiology of GISTs, advances in treatment, and the need for nurses to assess what patients know and to provide them with information to maintain treatment concordance. [ABSTRACT FROM AUTHOR]

HIV/AIDS affects the lives of everyone who lives in sub-Saharan Africa. In the past 3.5 years, access to free antiretroviral therapy has increased dramatically as a result of the support of the President''s Emergency Plan for AIDS Relief. Health care must now include caring for those who will live with HIV/AIDS as well as those for whom HIV/AIDS is a terminal illness. This article discusses the contribution of nurse practitioners to the redesign of nurses'' work with HIV1 patients in sub-Africa, especially Uganda. Strategies currently being implemented and those planned for the future to increase access to care and improve the quality of nursing care that patients receive are discussed. [Copyright &y& Elsevier]

There are many ethical issues regarding kidney transplantation as the supply of cadaveric (deceased) organs does not meet the increasing demand for organs. The proportion of organs from living donors is increasing in the UK. This has many benefits for the recipient but raises many ethical issues. The aim of this article is to outline these ethical issues that the nurse and other members of the multidisciplinary team need to consider when caring for both donors and recipients of living kidney transplantations. [ABSTRACT FROM AUTHOR]

Copyright of Psycho-Oncologie is the property of PiscoMed Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To explore practice nurses’ perceptions of vestibular rehabilitation and its place in relation to their general role development. Background: Vestibular rehabilitation has been known for a long time to be effective for chronically dizzy patients in secondary care, but its use in primary care has been limited. A recent pragmatic trial of vestibular rehabilitation delivered by practice nurses in primary care has confirmed its utility in a community setting. This type of role is increasingly common for practice nurses, but few studies explore the nurses’ perspective. Methods: A qualitative study was undertaken; 19 nurses took part in focus group sessions. Participants discussed their views on vestibular rehabilitation and its potential for integration with their existing role. A thematic analysis of the data was undertaken. Findings: Four main themes were identified: creating a unique nursing role; the therapeutic role; responsibility and role boundaries; and time. Nurses were positive about developing extended roles, but sought ways to achieve this without eroding fundamental nursing skills. Vestibular rehabilitation was seen as fulfilling both the need for a distinct nursing identity and professional development. Concerns over responsibility for patient assessment and time management constraints are potential obstacles to overcome in the wider development of this therapy in primary care. Conclusions: Understanding the perspective of nurses will be vital in future development of chronic disease management within primary care. Whilst nurses may be positive about such role expansion, the implementation of services of this type will require clarity about nurses’ responsibilities and flexibility in managing workload. Relevance to clinical practice: Vestibular rehabilitation is simple, low-tech and appropriate for widespread development in primary care. Nurses wishing to provide vestibular rehabilitation or similar chronic disease management activities will need to work with medical colleagues to define role boundaries. [ABSTRACT FROM AUTHOR]

The following two articles explore the role of the nurse in caring for and educating the patient both pre- and post-renal transplantation. The nurse plays a pivotal role in assisting the patient facing the many challenges that are associated with transplantation. Renal transplantation is considered the optimal treatment of choice for patients with end stage renal failure (ESRF) and who are receiving dialysis. This first article will explore the role that nurses play regarding the care of the patient pre-transplant, including the physical, psychological and educational support required to assist the patient and family members deal with the many challenges associated with transplantation. [ABSTRACT FROM AUTHOR]

Community nurses are increasingly at the frontline in supporting patients in the management of long-term conditions. They are therefore likely to be involved in identifying and providing care for people who are affected by lymphoedema. Community practitioners will need to develop the skills to recognize patients who have, or are at risk of developing, lymphoedema. Aspects of the nursing assessment of lymphoedema include taking a detailed history and conducting a comprehensive physical and psychosocial assessment of the impact of this condition. The assessment is multifaceted and will often require intervention from other members of the multidisciplinary team. [ABSTRACT FROM AUTHOR]

Atopic eczema is a significant disease, being the most common skin disorder in children, affecting 12-15% of all school-age children (Emerson et al, 1998). It is an inflammatory skin condition, which is genetic in origin but is triggered by many factors, such as detergents, emotional distress or dust mites (Buxton, 1998) and often starts in the first year of life. It is characterised by dry and itchy skin. This often breaks down and becomes infected, partly as a result of the close relationship of atopic eczema and the organism Staphylococcus aureus, which is found on the skin of most children with atopic eczema (Goodyear, 1993). [ABSTRACT FROM AUTHOR]

This article reviews a specific finding from a research project that examined the experiences of students, teachers and clinicians involved in a nurse practitioner degree programme. The development of advanced clinical nursing roles has presented challenges to the professional structure of nursing, particularly in the area of the unregulated and confusing array of titles adopted by nurses that infer advanced clinical practice. Over a 2-year period, practitioner ethnography was used to examine a sample of 10 student nurse practitioners who were undertaking a clinical degree programme (BSc (Hons) Nurse Practitioner). Data were also collected from 11 other individuals involved in the degree programme: teachers, medical mentors and senior academics. The data were systematically analysed and structured, leading to the inductive identification of themes and frameworks. The sample's experience of the development of advanced clinical nursing roles led to consideration of the evolution of new career structures and identities associated with advanced nursing practice. This evidence enabled a view of advanced clinical nursing roles within a framework of advanced nursing practice. The development of advanced clinical nursing is dependent on the cooperation of clinical nurses, educators, managers, doctors and politicians. Nevertheless, that development can only succeed if strategic policy is backed by the development of a professional clinical nursing [ABSTRACT FROM AUTHOR]

In this paper we described our approach to the development of the role of a nurse within a stroke and cognition ambulatory clinic at Baycrest. In developing this approach we integrated Baycrest's commitment to clients and family-focused care, our focus on interdisciplinary collaborative practice, the position of the post-rehabilitation clinic in the continuum of care, the clinical experience of the nurse and director, and the relevant scholarly literature. The role of the nurses in the stroke and cognition clinic includes assessment, interdisciplinary care planning, client/family support, and knowledge transfer. [ABSTRACT FROM AUTHOR]

This article discusses the National Service Framework for Diabetes: Standards (Department of Health, 2001), with the main focus on Standard 9: diabetes and pregnancy. It concentrates on pre-conception care and support for women with pre-existing diabetes to optimize the outcome of their pregnancy. The rationale for this is the need to understand how this standard affects women with diabetes during childbearing age. Following an introduction to aetiology and epidemiology of diabetes, the author examines the importance of pre-conception care for women with diabetes. An acknowledgement of the deficits within the clinical environment aids recommendations on improvement of education and knowledge for nurses. Health promotion and patient support is emphasized to facilitate an understanding of the impact of diabetes on pregnancy and the necessity of the multidisciplinary team involvement before, during and after birth. INSET: KEY POINTS. [ABSTRACT FROM AUTHOR]

The European Best Practice Guidelines recommend that 85% of patients with standard causes of chronic renal failure should achieve a target haemoglobin concentration of ≥11 g/dL. However, patient outcomes need to be improved as many patients respond suboptimally to treatment and fail to reach these targets. Two multinational surveys of nursing practice in the management of renal anaemia in northern (with comparative data from Australia) and southern Europe were conducted. The aim was to assess variations in the role and amount of responsibility delegated to nurses in renal units throughout Europe and Australia. Patient care could be optimised by developing formal training and educational programmes for nephrology nurses and this has already occurred in many units in the UK. [ABSTRACT FROM AUTHOR]

This article revisits the various issues that surround the nurse caring for a patient with a stoma (colostomy, ileostomy or urostomy). Understanding the basic anatomy, reasons for stoma formation and the surgical operations, including variations such as continent stomas, can assist the nurse in caring for this patient group. The article discusses briefly the various stoma appliances that can he used by the nurse or ostomate (person with a stoma). Practical tips on pre- and postoperative nursing care of the patient with a newly-formed stoma are provided for the nurse. In some cases, unfortunately, complications may occur following stoma-forming surgery; these are discussed and nursing advice provided. One of the most important ways in which the nurse can support the patient is to teach the patient his/her stoma care, ensuring independence before discharge and showing empathy and compassion. [ABSTRACT FROM AUTHOR]

This article covers the nursing role within an ear care clinic in the hospital setting. The range of conditions managed in the clinic are listed and some of the current issues affecting ear care and ear, nose and throat (ENT) are discussed. The author conveys her enthusiasm for the appropriate management of wax encouraging colleagues to appreciate the negative affect wax impaction can have on patients. Hearing impairment is briefly mentioned and a screening list is provided to assess the hearing of older adults. Patient care is discussed and there are suggestions for the improvement of the provision of ear care within the community. The nurse practitioner discusses how to facilitate the sharing of knowledge with community practitioners. Study seminars, publications, the use of the hospital intranet site, treatment and discharge summaries can all be used to communicate new developments in patient care. INSETS: Ear care advice for patients;How to insert olive oil drops into the ear canal;Untitled;KEY POINTS [ABSTRACT FROM AUTHOR]

coombs m. & ersser s.j. (2004) Journal of Advanced Nursing 46(3), 245–252 Medical hegemony in decision-making – a barrier to interdisciplinary working in intensive care? Health care policy in the United Kingdom identifies the need for health professsionals to find new ways of working to deliver patient-focussed and economic care. Much debate has followed on the nature of working relationships within the health care team. This paper reports on an ethnographic study that examined the nursing role in clinical decision-making in intensive care units. This was chosen as a case for analysis due to the close doctor–nurse relationships that are essential in this acute and complex care setting. Data were collected during two-stages of fieldwork using participant observation, in-depth ethnographic interviews and documentation across three clinical sites. The findings revealed the different types of knowledge used for, divergence of roles involved in and degree of authority in clinical decision-making. Furthermore, conflict arose between doctors and nurses due to these differences and in particular because medicine dominated the decision-making process. The nursing role, whilst pivotal to implementing clinical decisions, remained unacknowledged and devalued. Medical hegemony continues to render nurses unable to influence substantially the decision-making process. This has fundamental ramifications for the quality of team decision-making and the effectiveness of new ways of inter-professional working in intensive care. [ABSTRACT FROM AUTHOR]

Background. An essential component of quality nursing care is nurses’ ability to work with parents in the hospital care of their children. However, changes in the health care environment have presented nurses with many new challenges, including meeting family-centred care expectations. Aim of the paper. To report a research study examining the experiences of parents who interacted with nurses in a hospital setting regarding the care of their children. Methods. A qualitative approach was employed for this study. In-depth audiotaped interviews were conducted with eight parents representing seven families. Data collection was completed over a 7-month period in 2001. Findings. Parents characterized their experiences with nurses caring for their children as interactions, and identified the elements of establishing rapport and sharing children's care as key to a positive perception of the interactions. These elements were influenced by parental expectations of nurses. Changes in nurses’ approach were reported by parents as the children's conditions changed. Conclusion. Nurses were able to work with families in the hospital care of their children in ways that parents perceived as positive. However, in parents’ views, their interactions with nurses did not constitute collaborative relationships. A deeper understanding of these interactions may provoke new thinking about how to promote an agency's philosophy, and how nurses enact this philosophy in practice. [ABSTRACT FROM AUTHOR]

WHAT IS KNOWN ON THE SUBJECT?: Frontline forensic mental health staff often face challenges when providing recovery-orientated care, as they must balance between caring for the forensic psychiatric patient and at the same time ensuring safety and security for all other patients and staff at the ward. Research shows that balancing between care and custody in everyday clinical practice is possible, but more practical nursing studies showing ways of balancing power relations are needed to guide clinical practice. Online video games are increasingly recognized as promising new tools to promote social relations, establish competencies and re-articulate power relations in therapeutic environments. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper provides insights into how using online video gaming interventions may influence the establishment of social power relations of staff and forensic psychiatric patients. It adds to existing research by providing a conceptual way to study and understand how mental health nurses may balance between care and custody, delivering care to accommodate patients' needs without compromising safety and security at the ward. This study answers a call in current research by providing qualified knowledge regarding the use of online video gaming to build and sustain therapeutic relations in mental health care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Our paper suggests that balancing between care and custody is possible by using online video gaming interventions in forensic psychiatry. It moreover provides practice-close knowledge that may inspire and guide clinical mental health nurses to further develop online video gaming interventions in mental health care for the benefit of their patients. ABSTRACT: Introduction In recovery-oriented care, forensic psychiatric nurses must engage in care relationships with forensic psychiatric patients (FPs) whilst focussing on ward security. Online video games (OVGs) may provide a platform for negotiating power and social relations. Studies showing how OVG interventions may influence power balances in forensic psychiatric care are needed to guide clinical practice. Aim Our aim was to study how power relations were articulated between FPs and staff in an OVG intervention in a Danish forensic psychiatric ward. Method Data consist of three months of observational data and interviews with three staff members and six patients. We used sociologist Pierre Bourdieu's framework of field, power and capital to analyze data. Results The OVG intervention consisted of two power fields, "in-game" and "over-game." In-game concerned the practice of gaming. Over-game described the organization of the gaming intervention. Specific logics, skills and symbolic capitals drove power in each field. Discussion Power in-game was open to FPs and staff, leading to symmetric power relations. Power over-game was open to staff only, resulting in asymmetrical power relations. Implications for practice Online video game interventions may facilitate power balancing in forensic psychiatry. These insights may guide the development of new OVG interventions for patients and nurses in mental health care., (© 2021 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.)

An innovative approach to post-treatment follow-up of lymphoma, Ambulatory Cancer Assistance (ACA) is a model of care shared between a general practitioner, a hematologist and a nurse coordinator. The role of the nurse coordinator is preponderant in this type of follow-up, which appears to be more effective in detecting medical, psychological and social events than standard follow-up. The AMA-AC helps patients return to their pre-cancer life., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Telemedicine changes clinical practice and introduces new ways of distributing tasks between physicians and nurses, and particularly the delegation of sensory assessments during remote physical examinations. As nurses become more involved in patient assessment and clinical decision-making, the quality of physician-nurse collaboration has been recognized as essential to ensure quality patient care. However, few studies have examined physician-nurse interactions during teleconsultations. This article presents the results of an empirical study of nurse-physician communication during remote physical examinations. In partnership with a university-affiliated hospital in Ontario, Canada, we observed and recorded 10 simulated postsurgical consultations in orthopedics (involving a physician, a patient, and an on-site nurse) and conducted auto-confrontation interviews with physicians. The results of the thematic analysis of the interviews informed the selection of consultation sequences for in-depth interaction analysis. The findings demonstrate the nurse's essential role during remote physical examinations and reveal specific practices accomplished by the nurse to ensure successful nurse-physician collaboration. The interview data shows how physicians view the nurse's role and contributions. The findings contribute to our understanding of the collaborative nature of sensory assessments during remote physical examinations in telemedicine and can inform the development of training programs for professionals focusing on communication skills. Implications for clinical practice are discussed., (© 2021 John Wiley & Sons Ltd.)

A multidisciplinary team is composed of various healthcare professionals that ensure a multifaceted approach on a group of patients. Standards for diabetes medical care note the importance of multidisciplinary diabetes care teams. We applied our model of multidisciplinary approach by structuring it in a determined five days hospitalization. The aim of this study was to determine if the interdisciplinary approach applied on a short hospitalization is of benefit in patients with poorly controlled diabetes mellitus. Sixty-seven patients were included and ensured a short hospitalization in which they received a multiple educational advice and a treatment adaptation. Sixty-one patients out of 67 (91%) were retained for evaluation with sufficient data at one year, i.e. 9% of patients with poor compliance. Evolution in glycosylated haemoglobin (HbA1c), weight and treatments was analyzed. After a 12 months follow-up, we observed significant improvement in HbA1c (-1.73%; p < 10 3 ) without weight loss (BMI=-0.42 kg/m 2 ), p=0.28). HbA1c mean levels correlated negatively to body mass index (BMI) during the regular follow-up (r=-0.22, p=0.05). More than 90% of patients with poorly controlled diabetes mellitus responded to the multi-disciplinary approach with a decrease in HbA1c., Competing Interests: The authors declare no competing interests., (Copyright: Ach Taïeb et al.)

Objectives: Health care has seen a shift towards person-centred care to encompass the entirety of a person's needs and preferences, but research is sparse on healthcare professionals learning and using person-centred care., Aim: To investigate nurses' experiences of learning and using the person-centred method guided self-determination (GSD) in three different gynaecological settings and to determine whether, and potentially, how new tasks introduced by the GSD method influence their professional identity., Design: A qualitative interview study conducted between January 2019 and January 2020., Method: We conducted 16 semi-structured interviews with nurses educated in using GSD. Applying inductive and deductive reasoning, we analysed the interviews using thematic analysis. The study was registered with the Danish Data Protection Agency (file no.: VD-2018-445, I-Suite no.: 6700)., Results: The analysis generated three main themes with two subthemes each: (a) prerequisites and barriers to learning and using GSD in terms of personal factors and organisational and method-related factors; (b) new knowledge and understanding of illness with the subthemes expanded understanding of illness and a different relationship; and (c) nursing undergoing change with the subthemes, a new role and a professional self shaped through interaction with other professions., Conclusions: Although other professionals may have either supported or challenged the use of GSD, most nurses indicated that it supplemented their professional role and identity as they gained new knowledge about person-centred challenges and felt more confident. When introducing GSD in nursing, the organisation must not only consider individual characteristics, multidisciplinary collaboration and communication but also plan individual education and supervision. This is necessary because all these factors affect how a new professional role is constructed and adopted, not to mention how it influences the nurses' perception of their professional identity and use of GSD. Establishing a helpful person-centred environment must also be considered., (© 2021 Nordic College of Caring Science.)

What Is Known on the Subject: Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors. Mental health nurses often describe role confusion in relation to other health professionals. Opportunities for interdisciplinary communication with other professionals may benefit health care., What the Paper Adds to Existing Knowledge: The current large-scale study is the first to investigate whether mental health and SUD nurses' perceptions of their opportunities to accommodate patients' needs are related to interdisciplinarity in the treatment unit and a nursing role with clearly defined responsibilities. Strong interdisciplinarity was associated with greater perceived opportunities to accommodate patients' psychosocial, somatic, and economic and legal needs, while strictly defined nursing roles/responsibilities were related to weaker opportunities to do so., What Are the Implications of Practice: The findings highlight the need to address how mental health and SUD nurses organize practice to meet patients' diverse needs Interdisciplinary teamwork could strengthen nurses' ability to address patient needs Finding the best possible balance of providing service in teams or individually could improve resource utilization at the same time as strengthening patient care, and making sure that the patients' various needs are met., Abstract: INTRODUCTION: Nurses' roles in specialist mental health and substance use disorder (SUD) treatment services are multidimensional and complex. Their responsibility, autonomy and interdisciplinary collaboration may be of importance for their perceived opportunities to accommodate patients' health needs. Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors, and included relatively small samples. The studies have also mainly been conducted in other sectors than the mental health and SUD nursing sectors., Aim/question: The aim of this study is to examine the associations between nurses' roles, interdisciplinarity and their perceived opportunities to accommodate patients' psychosocial, somatic and economic/legal needs., Method: A cross-sectional web-based questionnaire survey was conducted in a nationwide sample of Norwegian nurses in the mental health, SUD treatment and combined mental health and SUD treatment sectors. Of 5,501 contactable nurses (74% of the population), 1918 (35%) responded., Results: The results revealed that interdisciplinarity was significantly associated with greater perceived opportunity to accommodate patient needs, whereas strictly defined nursing roles/responsibilities were associated with less opportunity to accommodate these needs., Discussion/implication for Practice: Facilitation of interdisciplinary collaboration may improve quality of care for patients in mental health and SUD treatment services., (© 2021 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.)

The care pathway coordination nurse acts in close collaboration with the various professionals in the health, social and medico-social fields to improve the patient's pathway. His or her coordination of the care pathway, over a given period of time, promotes personalized support within the framework of structured care that also considers the patient's health and life paths., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

WHAT IS KNOWN ON THE SUBJECT?: Since the first decade of this century, few qualitative studies and literature reviews have reported consumers' experiences of psychosis and recovery. The findings from these studies need further exploration. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: New insights into consumers' experiences of psychosis were generated. Additionally, understanding of consumers' conceptions and experiences of recovery were reported. Consumers' insights into the enablers and barriers to recovery that they encountered were also identified. Gaps in the literature remain, particularly those related to the effects of gender and culture on consumers' experiences of and recovery from psychosis. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses' understanding of consumers' perspectives and experiences of psychosis is vital to enhancing the quality of mental health nursing when caring for people living with psychosis. To support user-based recovery, mental health nurses need to incorporate person-centred approaches and reduce their preferencing of medical understandings of recovery., Abstract: INTRODUCTION: Psychosis is a distressing disorder. Consumers' perspectives about their experiences of psychosis and recovery are essential aspects of mental health nursing., Aims: To review contemporary evidence related to consumers' experiences of and recovery from psychosis., Method: An integrative review was the method used; six databases were systematically searched. Of the 157 articles screened, 14 met the inclusion criteria and were assessed for quality using Joanna Briggs Institute Appraisal tools. Data were compared, classified and integrated., Results: Findings revealed that consumers' experiences of psychosis included issues with self-expression and language, psychosocial problems and stigma. Also, consumers' experiences associated with their recovery were reported, and this included their perspectives on the enablers and barriers that they encountered., Discussion: Consumer's experiences of and recovery from psychosis provide an essential basis for managing and working with people experiencing psychosis. Further research identifying the potential effects of gender and culture into consumers' lived experiences is required., Implications for Practice: Exploring the experience of someone with psychosis will help nurses to understand the impacts of this condition. This understanding can guide nurses to apply recovery-oriented practices. Specific aspects of psychosis experience, including gender and culture, should inform nurses' practices towards recovery., (© 2020 John Wiley & Sons Ltd.)

Mental health nurses, together with psychiatrists, are the healthcare professionals who display the highest levels of empathy and the best attitudes towards patients with mental disorders. However, burnout is a common problem among these professionals. The aim of our study is to describe the association between empathy, burnout, and attitudes towards patients with mental disorders among mental health nurses in Spain. A descriptive cross-sectional design was used involving a sample of 750 specialist nurses working in mental health facilities in Spain. An intentional, non-probability, non-discriminative, exponential snowball sampling method was used. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, and the Community Attitudes towards Mental Illness Inventory were used to measure the study variables. A positive correlation was observed between empathy and all the study variables, with the exception of the personal accomplishment dimension of burnout and the social restrictiveness and authoritarianism dimensions of attitudes towards mental illness, where a negative relation was observed. Our findings suggest that empathy is associated with an increase in positive attitudes towards patients with mental disorders, decreasing associated stigma, but did not act as a protective factor against burnout in the study sample.

Aim: This study aims at better understanding the relationships between nurses' enacted scope of practice, work environment and work satisfaction, missed care, and organizational indicators of performance., Background: The enacted scope of practice model describes the determinants and consequences of the actual enactment of the nursing scope of practice., Method: A correlational design was used to investigate nurses' enacted scope of practice in five Canadian healthcare centres., Results: Suboptimal enacted scope of practice were found in the current sample. Significant positive correlations were found between the total enacted scope of practice score, use of qualification, control over tasks, decisional latitude and psychological demand as well as role ambiguity. Moreover, a higher enacted scope of practice was correlated with lower organizational indicators of short-term absenteeism., Conclusion: Results suggest an insufficient deployment of nurses' enacted scope of practice, likely caused by some job characteristics, leading to lower work satisfaction and negative patients and organizational outcomes., Implications for Nursing Management: Optimizing nurses' enacted scope of practice would be a significant integrated strategy for improving organizational performance, patient care and nurses' satisfaction and well-being. Nurses and frontline managers must be involved in the decision-making process necessary to improve nurses' enacted scope of practice., (© 2021 John Wiley & Sons Ltd.)

Purpose: This study was conducted to determine the effect of nursing interventions to instill hope on the internalized stigma, hope, and quality of life., Methods: The study was conducted as a quasi-experimental study with the experimental and control groups and repeated measurements. The data were collected using the Personal Information Form, Internalized Stigma Scale in Mental Illnesses (ISMI), Herth Hope Index (HHS), and Quality of Life Scale (QLS) for schizophrenia patients., Results: The difference between ISMI, HHS, and QLS posttest and follow-up test average scores was found to be statistically significant between the experimental and control groups., Conclusion: It was determined that nursing interventions aimed at improving hope effectively decreased the internalized stigmatization level of patients with schizophrenia and increased hope and life quality levels., (© 2021 Wiley Periodicals LLC.)

Identifying and acquiring the nursing role is key to the development of nurses' professional identity. Understanding nursing students' perceptions in this regard will enable nursing educators to choose teaching strategies that lead to positive development of their students' professional identity. To describe how nursing students perceive the different components of the nursing role at the beginning of the nursing degree. Cross-sectional, descriptive, observational study. 106 first-year nursing students at the University of Huelva, Spain. Data on social and academic variables and variables relating to the instrumental and expressive roles were collected via an adapted, pilot-tested questionnaire assessed by experts. For participants, caregiving is the core of the nursing role in the clinical setting, including both technical execution and patient care aspects. They highlighted the disease prevention, health promotion, restoration, and education profiles of nurses rather than their teaching, professional, and technical profiles. They were acquainted with the concept of postgraduate professional development, but were unaware of the academic pathways leading to it. They considered nurses to be decision-makers, who are nevertheless subordinate to doctors. Students did not consider nursing to be an autonomous profession, although they highlighted its decision-making capacity. They placed greater emphasis on the traditional profile of primary care nurses than on their technical profile, and were able to identify the members of the multidisciplinary healthcare team. • Caregiving is the core of the nursing role. • The nursing profession is not perceived as autonomous. • Disease prevention, health promotion and restoration were the most popular profiles. • Raising awareness of postgraduate education and research appears to be crucial. • Nurse educators have a great responsibility in creating professional roles. [ABSTRACT FROM AUTHOR]

To examine existing published literature regarding nurses and antimicrobial stewardship, and their potential role and contribution, to identify what is known, to evaluate methodologies used in published research, and to review and integrate findings to inform practice and future priorities for research. Integrative review. The approach to this review was informed by Whittemore and Knafl's integrative review methodology. Electronic databases were searched for papers published since the start of the database to November 2019, with abstracts available, related to humans and published in English. Papers were included regardless of practice setting (acute, aged, and primary care) and if they were research based, included nurses as participants and reported specifically on results from nurses or that had implications for nursing practice. Excluded were conference abstracts, and papers focussed solely on nurse prescriber, nurse practitioner, or nurse manager roles. Fifty-two papers were included in the review. Identified themes were: i) nursing knowledge, learning needs and education; ii) nurse perceptions of the nursing role and motivations for involvement; iii) nursing brokerage and influence on information flow to and from patients; iv) nursing workflow, workload and workarounds; and v) nurse leadership. Methodological quality of the included papers varied, limiting transferability and applicability of findings for some of the included studies. Formal inclusion of nurses in antimicrobial stewardship activities has been associated with improved nurse knowledge, nurse confidence, and in some cases improved clinical outcomes for patients. The review reinforces nursing values as a motivator of nursing actions, and reveals the complex yet significant influence of nurses on antimicrobial prescribing. Potential opportunities to enhance nurses' participation and contribution to antimicrobial stewardship include; formal acknowledgement of the nurse role, educating nurses so that they are aware of how they can contribute, collaborating with nurses in planning and implementing local stewardship activities, and ensuring nurse leaders are involved. However, evidence on this topic remains limited. Research is needed to facilitate greater understanding about the nature, scope and influence of the nurse role in antimicrobial stewardship, how nurses enact and carry out their role, and nurses' support needs. Tweetable abstract: Integrative review explores #nurse role in #antimicrobialstewardship. Nurse contribution, influence significant, but not well understood. [ABSTRACT FROM AUTHOR]