Empowerment programs focusing on chronically ill older persons remain limited, fragmented, complex in approach, and lacking in nursing theoretical background. The aim of the study was to test the effects of the goal attainment theory-based empowerment (GATE) on self-efficacy and health empowerment among chronically ill older persons in the community. This is a quasi-experimental with non-equivalent control group pre-test post-test study. Older persons aged 60 years old and above living in an urban community with at least one chronic condition namely hypertension, coronary artery disease and diabetes mellitus were recruited in two health centers. The participants were randomized into control and intervention groups. The GATE intervention integrated Imogene King's goal attainment theory and empowerment principles in a phone-assisted follow-up. Data were collected at baseline and four weeks after the intervention. A total of 59 participants completed the study. Both intervention (n= 30) and control groups (n= 29) were homogenous in baseline characteristics except for personal monthly income. The intervention group had significantly higher health empowerment than the control group after four weeks. Although self-efficacy did not differ between the groups, there was a significant increase in the intervention group from baseline. Preliminary findings showed that GATE improves health empowerment and self-efficacy of chronically ill older persons in the community. Goals of chronic disease management should be shaped by the older person's health goals and life situation. Further studies are needed to explore the use of nursing theory, empowerment framework and technology in caring for older persons with chronic conditions.

Human ; Male ; Female ; Aged ; Coronary Artery Disease ; Self Efficacy ; Goals ; Nursing Theory ; Diabetes Mellitus ; Hypertension ; Chronic Disease

Given the complex nature of heart failure (HF), nurses in clinical practice and nurse educators should employ a methodical approach in providing effective health education to the patient and their families even remotely. However, the limited training programs available and unprecedented nature of COVID-19 has rendered nurses less prepared to deliver heart failure self-care education. The purpose of this article is to describe the development, implementation, and evaluation of a training program which aim to equip nurses with specific skills in delivering heart failure self-care education using information and communication technologies (telenursing) in the context of the physical restrictions brought by the COVID-19 pandemic. Four phases of program development and implementation were done: (1) Phase I: Planning Phase; (2) Phase II: Needs Assessment; (3) Phase III: Designing the Health Program; and (4) Phase IV- Implementation and Evaluation. Twenty-three nurses from a tertiary private hospital participated via video conferencing in the pilot implementation of the program led by doctorate students. Using Kaufman’s approach in qualitative evaluation, participants reported the training content, materials, and the method of delivery which were valuable, meaningful, and acceptable to them. They perceived the program further enhanced their competencies, and improved patient and organizational outcomes. Taking on a proactive role, nurses should explore measures of enhancing nurses’ knowledge and skills in self-care education through information and communication technologies (ICT). This training program based on participative planning and collaboration between academia and practice proves to be feasible and requires further empirical studies to test its effectiveness in real-word settings.
Heart failure ; program development ; COVID-19 ; motivational interviewing ; telenursing

Background: Being at the frontline, nurses working in hospital settings are vulnerable to a range of experiences that impact their wellbeing. Measures to protect their health and welfare during the COVID-19 pandemic have been the focus of discussion among policymakers and administrators. There is a need to collectively understand their personal experiences to inform relevant policy decisions. Objective: To synthesize and present the best available evidence describing the experiences of nurses working in hospital settings during the COVID-19 pandemic. Design: This is a rapid review using Tricco's seven stage process. Data sources: A structured search using PubMed, CINAHL, Scopus, and a local database Herdin was conducted. Review Methods: A rapid review of studies published from January to August 2020, describing nurses' experiences of working in hospital facilities during the COVID-19 pandemic were included regardless of methodology. Following data screening and extraction, a narrative synthesis of the findings was conducted. Results: Nineteen articles were included in the review. The experiences of nurses described in these articles generated a total of fifteen categories, based on similarities of meaning. Four synthesized findings were identified from the categories: (a) supportive nursing culture; (b) physical, emotional, and psychological impact of frontline work; (c) organizational responsiveness; (d) and maintaining standards of care. Conclusions Nurses' experiences working in hospital settings during the COVID-19 pandemic are diverse, profound, and dependent on the context of practice and prevailing healthcare system and organization. These experiences reflect personal encounters and shifts in healthcare delivery that ensure protection and safety while maintaining standards of care. Robust studies are needed to capture and explore the breadth of these experiences and heighten the discussions that advocate for nurses' welfare and safety during pandemics.
COVID-19 ; Pandemics

Incivility creates an environment of hostility among healthcare providers in the workplace, and undermines a culture of patient safety. Although this phenomenon is pervasive in the profession, nurses tolerate or ignore its occurrence due to inadequate knowledge, fear and lack of institutional policies. There are no empirical studies in the local context which explore incivility among nurses in the hospital setting. This study examined the sources and forms of incivility among nurses working in a hospital according to nurse-related variables. A descriptive, cross-sectional design was utilized. Respondents were asked to answer Nurse's Profile and Nursing Incivility Scale. A stratified random sampling was used. A sample of 280 nurses from different clinical nursing units in a national tertiary hospital completed the questionnaire. Incivility outcome was analyzed using One-way Analysis of Variance (ANOVA) according to nurse-related variables such as nursing designation, practice setting, type of clinical nursing unit and length of hospital work experience. Post-hoc analysis was performed using Tukey's Honestly Significant Difference. Data were collected from September to October 2017.

Majority of the participants are female (78 %) and single (50 %) with an average age of 36 years old (SD= 9.96, range 21-62). They are employed in the hospital for an average of 9 years (SD = 8.82). Most of the sample works in general clinical nursing units (68 %) in a service/ charity setting (57 %). More than half of the respondents are staff nurses (67%) who provide direct care (Nurse I/II) followed by charge nurses (Nurse III) (19%) and head and chief nurses (IV/VI) (13%). Significant in civil interactions were reported between nurses and their colleagues at work, physicians and patients and their families according to the nursing designation, practice setting, type of clinical nursing unit and length of work experience. The moderately in civil interactions were exhibited in the forms of inconsistent behaviors, hostile climate and displaced frustrations. Nurse-related variables have significant impact on in civil interactions in the hospital setting. Understanding the sources and forms of incivility is of paramount importance in mitigating its impact on healthcare delivery and patient outcomes, and developing relevant policies and interventions that protect the welfare of nursing workforce.

Human ; Male ; Female ; Adult (a Person 19-44 Years Of Age) ; Interprofessional Relations ; Incivility

The COVID-19 pandemic has put the delivery of vital health and nursing services uniquely challenged. Restrictions in social mobility, fear of contraction, and risks of transmission posed by this pandemic prompted healthcare institutions to deliver health care services remotely using information and telecommunications technologies, also known as telehealth. Telenursing is one of the components of telehealth. Although there are several strides in the use of nursing-related technologies in the country, telenursing is not a mainstream nursing service. Exploring telenursing and articulating the roles of nurses in this care delivery model is imperative given the current paradigm shift to telehealth and telemedicine in the healthcare system. This article provides a context for telenursing use in the local setting by providing factors affecting its implementation. A literature search was conducted to identify the benefits, challenges, requirements, competencies, activities, and outcomes of telenursing. Despite the limitations posed by this pandemic, telenursing offers a viable, cost-effective, and patient-centered approach in health services delivery. The implications in nursing practice, education, and research are explained.
Telenursing ; Telemedicine ; COVID-19 ; Nursing Care

Objectives: Majority of the existing patient safety culture tools are designed for healthcare workers. Despite the claims that this patient safety tools are patient-centered, limited attention was given to the patients’ perspectives and cultural considerations in the development. Local studies are not available in extant literature that capture patient perspectives on being safe during hospitalization. The goal of the study was to develop and provide preliminary psychometric analysis on a tool that measures patients’ perception of safety culture in a hospital setting. Methods: The study was a quantitative methodological study. The instrument was developed in three phases, conceptualization and item generation through literature review, clinical observation, and focus group discussion, two rounds of expert panel review, and pilot testing. The tool was tested on 122 eligible patients admitted in a tertiary hospital. Factor analysis of the items was done to determine the underlying factor under each item. Cronbach’s alpha was used to test the degree of internal consistency of the scale. Results: The Patient Perceptions on Safety Culture in Hospital Setting Scale consists of 25 items. The analysis yielded four factors explaining a total of 69.23% of the variance in the data. Items were grouped in four dimensions: Hospital workforce (4 items), Hospital Environment (5 items), Heath Management and Care Delivery (7 items), and Information Exchange (9 items). Each factor registered a Cronbach’s alpha of 0.81, 0.78, 0.91, 0.94, respectively. The overall Cronbach’s alpha of the scale is 0.95. Conclusion The study offers preliminary evidence on the psychometric properties of a newly developed tool that measures patient perceptions on hospital safety culture. Subsequent studies on larger samples need to be conducted to determine the reliability and validity of the tool when applied to different population and contexts as well as determining valid cut-off points in scoring and interpretation.
Patient Safety ; Patient Participation