Search

Objective: To develop a self-management instrument for organ transplant recipients that incorporates self-regulations skills and to determine its measurement properties. Methods: The instrument includes concepts from social cognitive models: problem awareness, attitude, self-efficacy, motivation, social support, goal setting, goal pursuit, skills and goal affect. The measurement properties were evaluated based on the COSMIN guidelines. Face and content validity were determined through patient assessment, Three-Step Test-Interview and expert assessment using the Content Validity Index. Structural validity and reliability were tested using exploratory factor analysis and Cronbach's alpha. Construct validity was tested by comparing subscales with the Health Education Impact Questionnaire (heiQ). Results: After face and content validity assessment 47 items were entered into the exploratory factor analysis. The analysis showed two meaningful factors, with internal consistency of 0.90 and 0.89. Spearman correlations between the subscales and heiQ were moderate (0.55; 0.46). The final version consists of 21 items, divided into two scales: ‘Setbacks’ and ‘Successes’. Conclusions: The Self-regulation skills instrument in transplantation (SSIt) is a valid and reliable instrument to asses necessary skills for self-management after transplantation and may be useful for other patients as well. Practice implications: Insight into self-regulation competencies can help healthcare professionals to tailor self-management support.

AIM: To gain insight into which elements of the interpersonal care relationship (IPCR) are perceived as occurring (less) frequently and as (not) disturbing from the perspective of hospitalized older patients. DESIGN: A cross-sectional study in three Belgian hospitals. METHODS: A convenience sample of patients aged 75 years or older admitted to a non-geriatric ward were recruited between May 2017 and April 2019. The Interpersonal Geriatric care relationship (InteGer) tool was used to identify elements of the IPCR and was completed by the researchers through structured patient interviews. RESULTS: The mean total scale score for frequency was 3.74 (SD 1.51) [range 0-12]. On subscale level, the highest mean score was in the accessibility and the lowest mean score in the humanization subscale. Statistically significant differences between the hypothesized and experienced disturbance were observed in 18 of the 30 items. Ten items score in the category 'no action needed' (not occurring, not disturbing), nine items in the category 'remain attentive for patient experiences' (occurring, not disturbing), 10 items in the category 'further analyses or monitoring needed' (not occurring, disturbing) and one item in the category 'urgent action needed' (occurring and disturbing). CONCLUSION: Participants report mostly positive experiences related to the four subscales of the InteGer, that is, humanization, attentiveness, interest and accessibility. Insights from this study provide important opportunities in the context of care optimization for each category with the main focus on items with high experienced disturbance. IMPACT: The InteGer can be used for monitoring IPCR and formulating action points at ward and hospital level to further improve the IPCR and quality of care.

Mental health nurses are struggling to describe their nursing identity as professional discipline in a changing mental health care. Measuring nurse-sensitive patient outcomes and demonstrating nursing's effect(s) experienced by patients contribute to (re)discover the specific nursing identity. However, a valid and reliable scale is currently lacking. The aim of this study was the development and psychometric evaluation of the Mental Health Nurse-Sensitive Patient Outcome Scale (MH-NURSE-POS) for inpatient psychiatric hospital settings. This three-staged study resulted in a scale capturing how inpatients experience the contribution of nurses in their treatment in psychiatric hospitals. First, a draft questionnaire was developed based on a literature review, an independent expert's advice, and an experts panel. Second, the content validity was tested in a two-round Delphi-procedure and focus groups with patients. A pilot test, based on cognitive interviews, confirmed the feasibility of the questionnaire. Third, the psychometric properties of the mental health nurse-sensitive patient outcomes were determined in a sample of 353 patients. The cross-sectional study included a convenience sample of five psychiatric hospitals (Belgium). The factor structure (Kaiser-Meyer-Olkin measure of sampling adequacy 0.924; Bartlett's test of sphericity χ2 = 4162.537; df = 231; P < 0.001), convergent validity by the Individualized Care Scale (Pearson correlation 0.660; P < 0.001), and reliability (Cronbach's Alpha 0.854) were evaluated. The factor analysis resulted in a four-factor solution representing growth, expression, control, and motivation. The Mental Health Nurse-Sensitive Patient Outcome Scale is a valid and reliable tool to measure the effectiveness of mental health nurses from the patient perspective.

Suicide prevention and treatment opportunities often depend on interpersonal contact between patients and professionals. Presently, there is a lack of valid and reliable instruments to obtain the perspective of patients with suicidal ideation regarding their contact with professionals in mental health wards. This was a three-stage study to develop and psychometrically evaluate a questionnaire: the Contact with Nurses from the perspective of Patients with Suicidal ideation (CoNuPaS). First, the construct was defined by a systematic review, qualitative study, and face validity among experts. Second, the content was validated through a Delphi procedure with professional experts (n = 14) and cognitive interviews with hospitalized patients (n = 12). Third, using a sample of adult patients with suicidal ideation in the past year (n = 405), the psychometric properties were assessed by an exploratory factor analysis, a test-retest procedure, and the internal consistency. The CoNuPaS comprises 23 items and two subsections, to examine patients' perceptions of contact experiences with nurses (CoNuPaS-experience) and what they find important in that contact (CoNuPaS-importance). The subsections comprise four components: encountering a space to express suicidal thoughts and explore needs, being recognized as a unique and self-determining individual, encountering nurses' availability/information-sharing/transparency on expectations, and trusting nurses in communication about suicidality. Content validity scores were excellent (0.78-1.00); test-retest intraclass correlation coefficient and internal consistency were >0.90. Thus, the CoNuPaS demonstrated good psychometric properties. The availability of a valid questionnaire to examine patient-nurse contact in mental health wards is central to improving understanding of nurses' contributions to suicide prevention and suicidal ideation treatment., Funding Agency:FWO 1150117N

AIM: To develop and psychometrically test the Interpersonal Geriatric care relationship tool. BACKGROUND: The quality of nursing care is highly influenced by the quality of the interpersonal care relationship, yet there are no tools available that capture the conceptual breadth of the interpersonal care relationship. DESIGN: Instrument development and psychometric testing of the content and construct validity, factor structure and reliability. METHODS: A four-phased validation procedure was conducted (January 2016-April 2019): defining the construct measured by the tool, tool development, content validation and psychometric evaluation. RESULTS: The 30-item Interpersonal Geriatric care relationship tool was subjected to exploratory factor analysis. Four components (humanization, attentiveness, interest and accessibility) were extracted. The tool demonstrated discriminating power and good internal consistency. Cronbach's alphas for the components ranged between 0.69 and 0.84. CONCLUSION: The Interpersonal Geriatric care relationship tool is a valuable measure that can be used by scientists, educators and healthcare professionals to benchmark the interpersonal care relationship culture in hospitals and optimize the quality of care.

Nurses play an important role in supporting patients in self-managing their chronic conditions. However, it is uncertain how nurses define their success and what might create feelings of disillusionment. This exploratory qualitative study sought to understand the origin, meanings, and processes underlying nurses' feelings of success in supporting patients to self-manage their life with a chronic illness. Semi-structured interviews were held with 16 nurses who were purposively sampled. Data were iteratively collected and analyzed (November 2017-September 2018). The origin and meaning of nurses' feelings of success in supporting patients in self-management converged around the intertwining of "maintaining and promoting health" as a primary goal in chronic care, while an "intrapersonal conflict" arises. Patients maintaining physical health by optimal medical management boost nurses' feelings of success, whereas patients dealing with sub-optimally provoke "an intrapersonal conflict". When nurses observe unhealthy patient behavior, this is difficult to accept as it conflicts with their normative ideas of good care and health. Nurses' perception of success is refined by three interconnected processes, namely "keeping on track", "considering own role," and "protecting self". Nurses experienced and processed success differently depending on whether they interacted with patients from a more directive approach or an attuning approach. This study highlighted the fact that nurses expect compliance from patients, and thereby often feel empty-handed. By adopting a broader perspective of what successful patient behavior is, nurses might be able to provide a more comprehensive meaning to their own success regarding the care of patients living with a chronic illness.