primary care nurse

  • 文章类型: Journal Article
    接种COVID-19疫苗的决定主要是受多种因素影响的个人选择。护士对疫苗的接受程度和对疫苗接种的积极态度会影响患者的疫苗接种意愿。评估初级保健护士的COVID-19疫苗接种覆盖率,并关联社会人口统计学因素,合并症,自我评估的健康,和不健康的生活方式,决定接种疫苗,我们在2023年3月至5月进行了一项在线横断面研究,使用自我管理问卷.采用概率抽样方法选择32个健康中心,并通过电子邮件邀请护士。在完成调查的560名参与者中,78.3%和50.8%接受了初次两剂疗程和至少一次加强剂量的COVID-19疫苗,分别。年龄≥41岁的初级保健护士,身体不那么活跃,在统计学上,超重人群选择初次疫苗接种的频率显著增加(分别为p=0.00,0.015和0.017).初级保健护士的教育和生活环境并没有显着影响接受两种主要COVID-19剂量的决定。同样,良好的自评健康状况和合并症对接种决定没有显著贡献.接种加强剂量疫苗的护士明显更经常超重(p=0.034)和≥41岁(p=0.000)。
    The decision to vaccinate against COVID-19 is primarily a personal choice influenced by numerous factors. Vaccine acceptance and a positive attitude towards vaccination among nurses have an impact on patients\' willingness to vaccinate. To assess COVID-19 vaccination coverage among primary healthcare nurses and to associate socio-demographic factors, comorbidity, self-rated health, and unhealthy lifestyle with the decision to be vaccinated, we conducted an online cross-sectional study from March to May 2023 using a self-administrated questionnaire. Probability sampling was used to select 32 health centers and nurses were invited via email. Among the 560 participants who completed survey, 78.3% and 50.8% received the primary two-dose course and at least one booster dose of COVID-19 vaccine, respectively. Primary care nurses who were ≥41 years of age, physically less active, and those who were overweight opted statistically significantly more often for the primary vaccination scheme (p = 0.00, 0.015 and 0.017, respectively). Education and the living environments of primary care nurses did not significantly influence the decision to receive two primary COVID-19 doses. Likewise, good self-rated health and comorbidity did not contribute significantly to the vaccination decision. Nurses that were vaccinated with booster doses were significantly more often overweight (p = 0.034) and ≥41 year of age (p = 0.000).
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  • 文章类型: Journal Article
    初级护理护士非常适合为常见的精神障碍提供护理管理,但是他们的做法取决于上下文。可以考虑各种策略来改善护理经理活动的采用,但实施研究的数据很少涉及战略制定。
    分析情境因素对策略制定的影响,以改善初级保健护士对护理经理活动的采用。
    在三个初级保健诊所中进行了定性的多案例研究。通过个人访谈(n=32)和观察(n=7)收集数据,工作组会议,和相关文件。进行了专题分析。
    情境因素通过组织对变革的准备程度影响战略制定,这是由于变革的张力和感知的组织实施变革的能力。变化的张力是通过患者需求和服务可用性之间的差距而产生的,与护士工作环境的感知兼容性,以及他们对执行护理经理活动或获得必要技能的能力的评估。
    未来的研究应充分关注实施策略的制定,并在促进对初级保健中常见精神障碍采用循证实践时考虑组织变革准备的动态作用。
    UNASSIGNED: Primary care nurses are well-suited to provide care management for common mental disorders, but their practices depend on context. Various strategies can be considered to improve the adoption of nursing care manager activities, but data from implementation studies rarely address strategy formulation.
    UNASSIGNED: To analyze the influence of contextual factors on strategy formulation to improve the adoption of care manager activities by primary care nurses.
    UNASSIGNED: A qualitative multiple case study in three primary care clinics was carried out. Data were collected through individual interviews (n = 32) and observations (n = 7), working group meetings, and relevant documents. Thematic analysis was conducted.
    UNASSIGNED: Contextual factors influenced strategy formulation through organizational readiness for change, which resulted from tension for change and perceived organizational ability to implement change. Tension for change was generated through the perceived gap between patient needs and service availability, perceived compatibility with the nurses work environment, and their assessment of their capacity to perform care manager activities or acquire the necessary skills.
    UNASSIGNED: Future studies should give sufficient attention to implementation strategy formulation and consider the dynamic role of organizational readiness for change when facilitating the adoption of evidence-based practices for common mental disorders in primary care.
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  • 文章类型: Journal Article
    OBJECTIVE: To determine whether primary care nurses with no prior experience can, after training, provide effective supervised pelvic floor muscle training (PFMT) by a three-group parallel randomized controlled trial (RCT): primary care nurse, urogynaecology nurse specialist and controls undertaken in 11 primary care/general practices, covering urban and rural settings in SW England. The sample consisted of 337 women with weak pelvic floor muscles (Modified Oxford Score 2 or less) in a randomly sampled survey.
    METHODS: Following detailed instruction and training, primary care nurses recruited patients who were randomized to PFMT provided by them, a urogynaecology nurse specialist or a \'no training\' control group. The primary outcome measure to assess the effectiveness of training was pelvic floor muscle strength as measured by perineometry.
    RESULTS: Two hundred forty women aged 19 to 76 (median 49) years were recruited. After 3 months there was an increase in strength in both intervention groups compared with controls: median differences (95% CI) were 3.0 (0.3, 6.0) cmH2O higher for the primary care nurse group (n = 50) compared to the control group (n = 56; p = 0.02) and 4.3 (1.0, 7.3) cmH2O for the urogynaecology nurse specialist group (n = 53) compared to control (p < 0.01); there was no difference between the primary care nurse and urogynaecology nurse specialist groups [1.3 (-2.0,4.7; p = 0.70].
    CONCLUSIONS: PFMT provided by trained primary care nurses achieved improvements in pelvic floor muscle strength compared with controls (and comparable to that of a urogynaecology nurse specialist). This could have implications for the provision of PFMT for all women and potentially help in the prevention of pelvic floor dysfunction.
    BACKGROUND: Registered with ClinicalTrials.gov; Identifier NCT01635894. This was done retrospectively to conform to current registration requirements. When the trial commenced (2003), there was no requirement to register; this was introduced in 2005. The International Committee of Medical Journal Editors (ICMJE) decided that from July 1, 2005, no trials would be considered for publication unless they are included on a clinical trials registry, hence the retrospective registration.
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  • 文章类型: Journal Article
    Introduction: The attitude to immunization and the issue of vaccine hesitancy in health care workers (HCWs) have been studied in a former survey performed by ECDC (European Centre for Disease Prevention and Control). Aim: Our aim was to study the immunization attitude of primary care paediatricians, general practitioners and primary care nurses in Hungary. Method: We studied vaccine hesitancy in HCWs by way of a questionnaire, developed on the basis of a recent similar survey by ECDC in four countries. The online survey has been performed between May and July 2017. Altogether 765 questionnaires have been returned: 189 primary care paediatricians, 375 general practitioners working in adult or mixed practices, and 201 primary care nurses. The sample has been weighted to the country-specific features - e.g., location of the practice, residence and age of the HCWs - within each of the three groups, so from this aspect it can be considered representative. Results: Our results did not differ substantially from the international ECDC data. Approximately 2/3 of the primary care doctors and about 50% of the primary care nurses were convinced of the benefit and value of vaccines. Data on vaccine hesitancy were consolingly low, though the data on recommended vaccines were somewhat higher compared to the age related/NIP (National Immunization Plan) vaccines. The well-known vaccine scares - e.g., autism-MMR, etc., known also from the literature - could hardly been detected, and it can be explained by the voluntary participation in the study. The least supported vaccine is BCG, while the highest hesitancy rates are related to MMR in Hungary. Conclusion: The need to improve immunization-related communication among primary HCWs could clearly been detected - both in gradual and in post-gradual training programs. Orv Hetil. 2019; 160(48): 1904-1914.
    Absztrakt: Bevezetés: Az Európai Betegségmegelőzési és Járványvédelmi Központ (European Centre for Disease Prevention and Control, ECDC) korábbi nemzetközi felmérése az egészségügyi dolgozók védőoltásokkal kapcsolatos fenntartásait, vakcinációs bizonytalanságát tárta fel. Célkitűzés: A magyar alapellátásban dolgozó felnőtt-, vegyes és gyermek- (háziorvosi praxisban dolgozó) szakorvosok, valamint a védőnők védőoltásokkal kapcsolatos attitűdjeinek vizsgálata. Módszer: Az egészségügyi szakemberek védőoltással kapcsolatos fenntartásait saját fejlesztésű kérdőívvel vizsgáltuk, amelynek alapjául az ECDC négy országos nemzetközi kutatása szolgált. Az adatfelvétel 2017 májusától júliusáig zajlott, online kérdőíves megkereséssel. A kérdőívet összesen 765 egészségügyi szakember: 189 házi gyermekorvos, 375 felnőtt-, illetve vegyes praxisú háziorvos, valamint 201 védőnő töltötte ki. A mintát a munkavégzés helyének régiója, településtípusa, valamint a szakember életkora szerint súlyozással igazítottuk az országos megoszláshoz az egyes szakmai csoportokon belül, így ezen szempontok mentén reprezentatívnak tekinthető. Eredmények: Megállapítható volt, hogy a vizsgált témakörökben kapott válaszok nem különböztek érdemben az ECDC hasonló, más országokban talált eredményeitől. Az alapellátó orvosok mintegy 2/3-a, a védőnők fele van meggyőződve a védőoltások nyújtotta előnyökről és értékekről. Megnyugtatóan alacsony arányban vannak fenntartásaik a védőoltások biztonságosságát illetően, bár az ajánlott védőoltásoknál az értékek némileg magasabbak voltak az életkor szerint kötelezőkhöz – a Nemzeti Immunizációs Programban adott oltásokhoz – képest. A szakirodalomból is jól ismert kifejezett oltásellenes rémhírek – autizmus–MMR stb. – fellelhetők ugyan, de elenyésző arányban, ám ez összefüggésben állhat a vizsgálatban való önkéntes részvétellel is. Az életkor szerint előírt oltások közül a leginkább elutasított a BCG-oltás, míg a legtöbb kétely az MMR-oltást övezi. Következtetés: Az alapellátók védőoltásokkal kapcsolatos kommunikációs készségeinek fejlesztését szolgáló képzésekre igény van, mind a graduális, mind a posztgraduális stúdiumokban. Orv Hetil. 2019; 160(48): 1904–1914.
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  • 文章类型: Journal Article
    OBJECTIVE: To explore the feasibility and acceptability of nurse-led chronic disease management and lifestyle risk factor reduction interventions in primary care (general practice/family practice).
    BACKGROUND: Growing international evidence suggests that interventions delivered by primary care nurses can assist in modifying lifestyle risk factors and managing chronic disease. To date, there has been limited exploration of the feasibility and acceptability of such interventions.
    METHODS: Integrative review guided by the work of Whittemore and Knafl ().
    METHODS: Database search of CINAHL, Medline and Web of Science was conducted to identify relevant literature published between 2000-2015.
    METHODS: Papers were assessed for methodological quality and data abstracted before thematic analysis was undertaken.
    RESULTS: Eleven papers met the inclusion criteria. Analysis uncovered four themes: (1) facilitators of interventions; (2) barriers to interventions; (3) consumer satisfaction; and (4) primary care nurse role.
    CONCLUSIONS: Literature supports the feasibility and acceptability of nurse-led interventions in primary care for lifestyle risk factor modification. The ongoing sustainability of these interventions rests largely on organizational factors such as funding, educational pathways and professional support of the primary care nursing role. Further robust research around primary care nurse interventions is required to strengthen the evidence base.
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  • 文章类型: Journal Article
    The aim of this study was to investigate the actual and the potential role of the primary care nurse (PCN) in the prevention of cancer. International studies have indicated that a range of strategies can have an impact on the incidence of cancer. Due to their frequent front-line contact with the public, PCNs can play an important role in the primary prevention of cancer. Nonetheless, there is a lack of information on their actual and potential role in cancer prevention. A sequential confirmatory mixed methods approach was used. Postal questionnaires were administered to PCNs [n = 500; 225 returns (response rate 45%)] followed by semi-structured interviews (n = 15). PCNs provided high levels of cancer prevention activities, specifically focusing on smoking cessation, obesity and cervical screening. They considered that their cancer prevention role could be improved through additional practice-based training and more collaborative inter-professional working. They also identified the need for a better understanding of how to change people\'s attitudes and behaviours regarding cancer prevention. Evidence from this study provide important insights into the potential of the PCN to empower individuals to take responsibility for their own health and make more informed lifestyle choices.
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