Cultural adaptation and psychometric evaluation of the Chinese version of the nurse-specific end-of-life professional caregiver survey: a cross-sectional study

Background Nurses’ palliative and hospice care-specific education is associated with the quality of palliative and hospice care that influences health outcomes of patients with life-limiting illnesses and their caregivers. However, China lacks measures available to assess nurses’ educational needs in palliative and hospice care. The End-of-Life Professional Caregiver Survey (EPCS) is a psychometrically reliable self-reporting scale to measure multidisciplinary professionals’ palliative and hospice care educational needs. This study was performed to explore the psychometric properties of the Chinese version of the EPCS (EPCS-C) among Chinese nurses. Methods We translated and culturally adapted the EPCS into Chinese based on Beaton and colleagues’ instrument adaptation process. A cross-sectional study design was used. We recruited 312 nurses from 1482 nurses in a tertiary hospital in central China using convenience sampling to complete the study. Participants completed the EPCS-C and a demographic questionnaire. Exploratory and confirmatory factor analysis was carried out to test and verify the construct validity of the nurse-specific EPCS-C. Cronbach’s alpha coefficient was used to appraise the reliability of the nurse-specific EPCS-C. Results A three-factor structure of EPCS-C was determined, including cultural, ethical, and national values; patient- and family-centered communication; and effective care delivery. The exploratory factor analysis explained 70.82% of the total variances. The 3-factor solution of the nurse-specific EPCS-C had a satisfactory model fit: χ2 = 537.96, χ2/df = 2.96, CFI = 0.94, RMSEA = 0.079, IFI = 0.94, and GFI = 0.86. Cronbach’s alpha coefficient of the overall questionnaire was 0.96. Conclusions The nurse-specific EPCS-C showed satisfactory reliability and validity to assess nurses’ palliative and hospice care educational need. Further research is required to verify the reliability and validity of the EPCS-C in a larger sample, especially the criterion-related validity.

Benefits of Computer Engagement in Older Adults with Dementia

Objectives: Two pilot studies aimed to determine the effects of individual computer engagement on behavioral health outcomes in individuals with dementia. The focus was on participants’ mental health, challenging behaviors, antipsychotic medications, and professional caregiver stress. Methods: Two pilot randomized control trials were conducted. First trial involved residents with advanced dementia in a long-term care facility. The second trial involved residents with mild dementia in an assisted living setting. The participants in the experimental group in both studies were provided with guided iN2L computer engagement followed by unrestricted use. Results: Statistically reliable improvements were found in both studies for participants’ emotional well-being and professional caregiver stress. Reliable improvements in cognition and depression were found in the mild dementia study, but not in the advanced dementia study. No statistically reliable changes were observed for antipsychotic medications or challenging behaviors. Discussion: Computer engagement was associated with improvements in participants’ emotional well-being and with a reduction in professional caregiver stress. Results should be interpreted with caution in the context of high attrition. Future studies may build upon these pilot findings and examine effects of technology use on mood and cognition in larger samples of older adults across a wider range of outcome measures.

Palliative Care Conversations for Heart Failure Nurses: A Pilot Education Intervention

Introduction Heart failure is a progressive condition affecting 6.2 million Americans. The use of palliative and supportive care for symptom management and improved quality of life is recommended for persons with heart failure. However, 91% of nurses believe they need further training to have palliative care conversations. The purpose of this pilot education intervention was to determine if providing nurses with education on the timing and content of palliative care conversations would improve their perceived skill and knowledge. Methods This was a pilot study of an online educational intervention. Data were electronically collected from 13 participants using validated questionnaires delivered via Qualtrics. Participants completed a demographic survey and End-of-Life Professional Caregiver Survey (EPCS) before and after completing an online, asynchronous education module. Results Mean scores were higher on all posttest measures. Independent samples t-tests revealed statistically significant differences on the Effective Care Delivery (ECD) scale ( t[32] = −2, p = .05) and total EPCS scale scores ( t[32] = −2.2, p = .03) from pre- to posttest. Conclusion Scores increased on all dimensions pretest to posttest with statistically significant differences in ECD and total scores. Providing asynchronous online education on timing and content of palliative care conversations to nurses caring for people with heart failure is a feasible and effective way to improve perceived knowledge and skill of palliative care conversations.

Efficacy of Doll thErapy compared with standard treatment in the control of behavioral and psychologic Symptoms and CaRegIver Burden in dEmentia: DESCRIBE a randomized, controlled study

Behavioral and psychologic symptoms of dementia (BPSD) are frequent and represent a burden for patients and caregivers; in particular, the presence of agitation and aggression (A/A) has an important impact on patients’ quality of life. As psychotropic drugs can induce severe collateral effects, the use of a first line non-pharmacologic approach is highly recommended. Here we evaluate the effect of doll therapy (DT) on A/A in geriatric patients with moderate to severe dementia hospitalized in an acute geriatric unit. We enrolled fifty-two acute in-patients with dementia and A/A. Subjects were randomized to DT (26) or standard treatment (ST, 26), we measured agitation and caregiver burden with standard clinical scales at baseline and during treatment. In order to evaluate the effect of DT withdrawal, we carried out a telephonic follow-up interview after 1 and 4 weeks from hospital discharge. DT is more effective than ST in the control of agitation, but not in reducing the professional caregiver burden. The use of pro re nata psychotropic drugs was reduced in patients treated with DT. After DT withdrawal, A/A progressively increased. In conclusion we show that DT may be more effective than ST in the control of A/A in acute geriatric in-patients affected by dementia. Our results suggest that, in patients affected by severe to moderate forms of dementia with A/A, DT may be used as a first line treatment, not only in nursing home residents, but also in acute care geriatric in-patients.

NARASI TENTANG AUTISM DI FACEBOOK (Studi Autoetnografi pada Status K.W)

The narrative of a mother who is directly involved in living with a child with an autistic child's lifetime is worth noting because it can complement the narrative of the Professionals (doctors, psychiatrists, psychologists, educators). Especially if the narrative is done openly on social media such as Facebook. Social Media gives the opportunity of public voices that were originally being repossessed by large narratives. Thus the purpose of this research is to interpret the narrative of the subject about autism based on daily experience (everyday life). Narrative is the way someone tells his experience. The narrative about Autism, commonly referred to as "disability", is not necessarily the same as the people's narration or family. The narrative of experts and the general public about defects is often done in a dichotomistic, i.e. only when defects – including autism – are seen as sadness or suffering, and when a defective individual is successful with extraordinary achievement. This research was conducted on a Facebook social account, which is a KW account – a single-parent mother claiming to have five children, of which three of them (15 years old, 10 years old and 7 years old) were autistic. The choice on the subject of the study because the KW handled the children's autism with a full involvement with no shadower nor professional caregiver. Secondly, KW is capable of conducting autism narrative through social media (Facebook) which is open. The results showed (1) Narrative about the nature, attitudes, and principles of Autism, (2) narrative on the achievement of autism.

Translation, cultural adaptation, and validation of the Brazilian Portuguese version of the End-of-Life Professional Caregiver Survey

ObjectivesThe aim of this study was to translate, culturally adapt, and psychometrically evaluate the Brazilian version of the “End-of-Life Professional Caregiver Survey” (BR-EPCS).MethodThis is an observational cross-sectional study. The sample was composed of 285 Brazilian healthcare professionals who work or worked in the palliative care area. A minimum number of 280 participants were established, following the recommendation of 10 subjects for each instrument item. The European Organisation for Research and Treatment of Cancer — Quality of Life Group Translation Procedure protocol was used for the translation and the cultural adaptation. For the precise/reliable evaluation of factors measured by the BR-EPCS, Cronbach's alpha (α) and composite reliability coefficients were used. The factorial analyses were made by means of the exploratory structural equation modeling methods and confirmatory factor analysis. We have conducted a multiple linear regression analysis to evaluate the sociodemographic variables' capabilities in the result prediction measured by BR-EPCS factors.ResultsThe factorial analysis showed the relevance of two factors: Factor 1 — “Given care effectiveness” (18 items; Cronbach's α = 0.94; Composite Reliability = 0.95) and Factor 2 — “Mourning and ethical and cultural values” (10 items; Cronbach's α = 0.89; Composite Reliability = 0.88). Multiple linear regression analyses revealed that the working time, sex, palliative care training, and its own advance directives are predictors of the constructs assessed by the BR-EPCS.Significance of resultsThe BR-EPCS is a reliable, valid, and culturally appropriate tool to identify the educational needs of healthcare professionals who work with palliative care. This instrument can be used for educational and research reasons.

Pelaksanaan Discharge Planning oleh Profesional Pemberi Asuhan (PPA) di Ruang Rawat Inap

Background: Discharge planning in hospital still not optimal on its implementation, so it could affect quality of hospital service and result in rehospitalization patient, especially for hospital with high relapse number. Discharge planning is an integrated manner involving professional caregiver such as doctor, nurse, nutritionist, clinic pharmacy, and physiotherapy.Objective: This research aims to identify implementation of discharge planning by professional caregiver.Methods: This research type descriptive observasional with survey approach. Research Population 208, with proportionate stratified random dsampling data collection method that starts from 07.00 WIB until 17.00 WIB. With 68 implementation of discharge planning patient admission until to go home with minimum care for 2 days. Instrument use format of discharge planning assessment which modified with integrated education format.Results: The results showed that implementation of physician 67,6% implemented, 77,9% of nurses implemented, 94,1% of nutritionists implemented, 67,6% of clinical pharmacy implemented, and 58,8% physiotherapyimplemented. For the most not action is about the usage of tools for home care needs in physiotherapy items with percentage of 100%.Conclusion: Implementation of discharge planning by Professional Caregiver on Inpatient Room showed 60.3% implemented. Therefore it is necessary to monitoring and government of nursing managers for implementation of discharge planning can be implemented with good and improve services in patients so it can be give our satisfaction in patients.