Burnout is reflected in pathological emotional depletion and maladaptive detachment that is a secondary result of exposure prolonged occupational stress. It is comprised of three dimensions, namely, emotional exhaustion, depersonalization and reduced personal accomplishment. It is becoming increasingly recognized as one of the most serious occupational hazards for nurses who work in critical care units. The objectives of this study are to assess the prevalence of burnout among a sample of nurses who worked in the critical care units in a particular hospital in Kenya, to analyze factors that contributed to the development of burnout and to identify measures for the mitigation of burnout. For this study, the researcher utilized a mixed methods research design in two phases. Phase one assessed the prevalence of burnout in nurses working in the critical care units by making use of the Maslach Burnout Inventory – Human Services Survey. Focus groups discussions were then held in Phase two to investigate the factors that the nurses perceived as the main causes of burnout and to solicit their ideas about it could be mitigated. Convenience sampling and purposive sampling were used in the two phases of the study respectively. / Health Studies / M.A. (Health Studies)

This qualitative descriptive research study was conducted to understand nurses’ experiences caring for patients from communities of low income and low resources in hospital-based ambulatory clinics during the COVID-19 pandemic. Examination of the literature revealed research on the importance of ambulatory care nurses, their bond with the communities they serve, and the need for ambulatory settings for underserved communities. The review also explored the fierce strike of the COVID-19 pandemic on these communities and the social justice implications of serving low-income and low-resource patients. No literature was found on this specific dissertation topic: ambulatory nurses’ experiences working in underprivileged communities during the COVID-19 pandemic. The sample used for this study consisted of 25 registered nurses who worked in ambulatory settings during the inception of the COVID-19 pandemic. In particular, the time period spanned February 2020 through the end of June 2020. The communities consisted of poorly resourced neighborhoods. The narrative description and accounts of nurses interviewed for this study will facilitate an understanding of nurses’ experiences caring for patients from communities of low income and low resources in hospital-based ambulatory clinics during the COVID-19 pandemic. The researcher used a qualitative methodology, qualitative descriptive, to frame the stories. Qualitative content analysis methods, specifically thematic analysis, were used to understand the nurses’ reflections and experiences. Roy’s Adaptation Model (RAM) was the theoretical framework to guide the open-ended interview questions. The researcher developed questions based on the four modes of RAM: the physiologic mode, the self-concept mode, the role function mode, and the interdependence mode. Thematic analysis was used to identify themes from the interview transcripts. A thematic analysis strategy is an approach used to identify and analyze patterns of meaning from interview data (Braun & Clarke, 2006). A thorough overview was made of all the data, including initial notes. The notes were obtained by reading and rereading the transcripts and highlighting interesting phrases or statements called meaningful units. These units were then compiled into sub-themes, and ultimately themes were comprised after highlighting parts of the transcripts that generated similar content. Themes were developed by identifying patterns among meaningful units and data relevant to each theme. Themes were then reviewed to ensure they accurately represented the data after highlighting, constant review, and compounding them in meaningful units that identified and generated the final set of themes. The researcher developed and kept reflexive journal notes, which were reviewed constantly throughout the study to maintain best-practice qualitative methodology (Ortlipp, 2008). The thematic analysis revealed multiple themes. The themes discovered were crying, protector vs. moral distress, resilience vs. compassion fatigue, family vs. bereavement, and self-concept vs. self-care. An overarching theme of struggle was also manifested within this research.

This study reports the effects of a 4-week online mindfulness meditation practice in a sample of undergraduate and graduate nursing students. Self-reported levels of mindfulness, depression, stress, and anxiety were measured pre- and post-intervention. A randomized pretest posttest control group design was implemented, and members of the National Student Nurses Association were invited via email to participate. A total of 145 participants completed the study.During the study the active control group received audio modules reporting nursing news and the experimental group received audio meditation modules. Meditation modules were created and recorded by the researchers. Participants in both groups were asked to utilize the audio modules at least three times a week. All participants completed the 21-item Depression, Anxiety, and Stress Scale and the 39-item Five Facet Mindfulness Questionnaire online before and after the intervention. Results revealed a statistically significant interaction between group and time of test for all four outcome variables. Simple main effects analyses showed a reduction in symptoms of depression, stress, and anxiety, as well as a significant increase in reported feelings of mindfulness in the experimental group. Findings of the study support the need to better recognize mental health challenges in nursing students and to consider the use of meditation practice in nursing programs to improve psychological outcomes.

Nurses have been on the front line of the COVID-19 pandemic and experienced direct impacts over the last few years. Many encountered additional stressors of isolation from loved ones and the challenges of parenting school-age children. Additionally, due to the recent and significant departure of nurses from bedside nursing, there has been greater need for remaining nurses to precept new staff coming into the hospital. Some nurses assumed a preceptor role in addition to their direct care responsibilities. It has been reported that combined home and work-life burdens put nurses at higher risk of burnout, resulting in poor health outcomes and increased depression, anxiety, and stress. Mindfulness meditation is an evidenced-based tool to help acknowledge surroundings and to help to lower or decrease perceived stress. A randomized controlled design with a two-group pretest-posttest was used to evaluate the impact of a mindfulness smartphone application on the perceived levels of burnout, stress, anxiety, depression, and mindfulness of nurses. After taking a pretest, participants were randomized to either a waitlist control group or an intervention smartphone group. The waitlist group did not have any intervention during the 30 -day study period. The intervention group was asked to complete sessions via a smartphone mindfulness app for 30 days. The instruments used in this study were the Maslach Burnout Inventory (MBI), Depression, Anxiety, and Stress Scale 21 questions (DASS-21), Mindfulness Attention Awareness Scale (MAAS), and the Mobile Device Proficiency Questionnaire 16 questions (MDPQ-16). This dissertation includes three reports based on the same dataset. The first report analyzed the effects of a smartphone mindfulness application on burnout in nurse preceptors. Results of the study indicated that a smartphone application can reduce burnout in the subscales of Personal Accomplishment and Depersonalization but not in Emotional Exhaustion. The second report examined the impact of a smartphone mindfulness application on scores of depression, anxiety, and stress of nurses. The study results indicated a significant improvement in the smartphone application group compared to the waitlist group for the variables of depression and stress. The third report evaluated the impact of the smartphone mindfulness application on the mindfulness levels of participants and the relationship between their technology proficiency to their interaction with the application. The smartphone group's mindfulness scores increased significantly compared to the waitlist group. However, mobile proficiency was not significantly related to the participants’ use of the mindfulness application. The findings of this study indicate that the use of a smartphone application can effectively increase mindfulness when used by nurses at the bedside. The smartphone mindfulness app also showed potential benefits in reducing self-perceived levels of several aspects of burnout, depression, and stress in nurses. Hospitals could choose to embed mindfulness principles into the hospital environment's culture or provide staff opportunities to practice mindfulness through a smartphone application during the day. Such mindfulness may decrease the consequences of burnout, which include increased nurse turnover, decreased quality of care, and high costs of recruiting and training new nurses. Further research is needed to study the long-term impact of using the smartphone application and the time required daily to show results

Advances in science and technology have made nursing practice in acute care settings complex, rapid and demanding. Hospital visiting hours and rules are established for the comfort and safety of patients and their loved ones. In addition, there is the need to focus on the needs of 'the customer'. The researcher adopted a descriptive, exploratory approach to determine the perceptions and preferences of patients, family members/friends and nurses of visiting time in ICUs. The aim was to recommend mechanisms and measures with regard to the desired visiting schedule that would enhance patient-centred integrated care in ICUs. The study found that patients and family members/friends preferred extended visiting time and perceived this as beneficial to them, while the majority of the nurses preferred scheduled visiting time. / Health Studies / M. A. (Health Studies)

The aim of this study is to explore and describe the coping skills of registered nurses in a changed working environment. The research is conducted in the City Health clinics. The objectives of the study are:  to identify strategies which nurses use to cope with the changes in the health care services;  to explore appropriate support systems that will enhance the coping skills of registered nurses in clinics in the City Health Department; and  to deduce guidelines on how to support staff from the literature study and the results of the research. The research problem is the following: nurses in primary health care facilities do not adequately cope with major changes in health care delivery. A qualitative approach for the research was chosen. Personal interviews and focus group discussions were used to identify the coping skills of registered nurses. Data analysis was done manually. Transcriptions of recordings of the individual interviews and group discussions were done. Themes were organized and categorized into meaningful links and relationships. The findings indicate that the following factors improve the coping skills of registered nurses:  team-work and support;  to voice your opinion when necessary and good communication between staff;  regular breaks during working hours;  inherent factors for example strong spiritual and emotional strength that assist registered nurses to cope;  family support;  the provision of quality care is rewarding;  the assistance and support from the church (congregation);  the effective re-organisation of health services;  continuous support programs for staff; and  continuous education to develop skills of registered nurses. / Advanced Nursing -- Psychological aspects / M.A.

The study sought to gain an in-depth understanding of the knowledge and skills regarding rehabilitation of mental health care users of nurses who work at a psychiatric rehabilitation centre, in order to design a continuing professional development plan for registered and enrolled nurses. The researcher used a qualitative, exploratory descriptive design to explore the knowledge and skills of nurses who practise in a psychiatric rehabilitation centre dealing with the rehabilitation of mental health care users. Four themes emerged from the data that were collected from four focus groups: knowledge of the rehabilitation process; the need for continuing professional development; nursing skills required for the implementation of psychiatric rehabilitation and means of communication within psychiatric rehabilitation. The researcher devised a continuing professional development plan, including topics on the management of the mentally ill, the problems associated with mental illness and rehabilitation appropriate to the mental illness. / Health Studies / M. A. (Health Studies)

Thesis (MA (Psychology))--University of Stellenbosch, 2007. / Much research has focused on the social and psychological dimensions of nursing; yet we have not identified the thoughts and feelings of health care professionals as a priority in trying to understand a variety of nursing phenomena. There is a need to explore how nurses understand their social and psychological worlds, specifically with regards to the phenomena of violence, abuse and neglect within health care. Therefore, this study has attempted to answer the following research question: How do nurses understand and talk about the occurrence of violence towards patients? The research question demanded the use of qualitative methods to collect and analyse data. In-depth interviews, consisting of open-ended questions were conducted. 11 female participants were enlisted from a tertiary hospital labour ward in Cape Town by means of convenience sampling. Data were transcribed and analysed using a combination of methods. In addition to more traditional methods, I have also included autoethnography in this thesis.

The purpose of the study was to develop a behavioral nursing intervention strategy for specific deficits in grooming performance of elders with dementia. A quasi-experimental two-group design using switching replications with removed intervention was employed. Three residents with severe cognitive impairments and three residents with mild cognitive impairments were chosen from a special dementia care unit of a long-term care facility. Three residents among six residents were randomly selected to receive the behavioral intervention early. Baseline and post-intervention assistance was provided by nurse aides. Each resident was asked to wash hands, brush teeth, wash face, and comb hair in a sequence. Ten intervention sessions were conducted by the trained intervener for two consecutive weeks. The intervention consisted systematic prompting and social reinforcement. A total of 21 sessions were collected in the morning using videotape recordings. Interobserver agreement for the instruments designed by the investigator was measured by the trained observers. Data were analyzed in two phases. First, the quantitative data were analyzed to determine the independent functional behaviors of individuals, and the change in the intensity of nursing effort associated with grooming of elders with dementia. Data were examined by individual graphic display throughout the three phases (baseline, nursing intervention, post-intervention). Second, the qualitative data were analyzed to determine the antecedents, consequences, and resident responses associated with grooming, the caregiver problem behaviors, and resident problem behaviors associated with grooming performance. The results show that the functional behaviors of even severely demented elders can be promoted, indicating the effectiveness of nursing care strategies on the ADL task of grooming. The data in this research suggest that maintaining or improving functional ability is possible with a behavioral nursing intervention, which was a highly structured and systematic approach that involved modifying the environmental and behavioral context, through strategies such as prompting and social reinforcement, when necessary. Furthermore, through the qualitative analysis, the functional relationships between antecedents, consequences, and behaviors of demented elders allowed the investigator to analyze the caregiver problem behaviors and resident behavior problems associated with grooming.

Abstract not available