Gait and balance impairments are common after stroke. This study aimed to evaluate the effect of a music-based rhythmic auditory stimulation (RAS) in combination with conventional physiotherapy on gait parameters and walking ability in subacute stroke. This single-blind, historical controlled trial, included 55 patients who had suffered a stroke within the three weeks prior to enrolment. Patients from 2018 (n = 27) were assigned as the historical control group whereas 2019 patients (n = 28) received music-based RAS three times a week. Both groups received 11 h of conventional physiotherapy per week during hospitalization. Primary outcomes were gait and balance parameters (Tinetti test and Timed Up&Go test) and walking ability (Functional Ambulation Category scale). Secondary outcomes were trunk control, assistive devices, functional independence (Functional Independence Measure, Barthel index), and stroke severity and disability (modified Rankin scale, National Institutes of Health Stroke Scale). Results: No between-group differences were identified for gait and balance parameters nor for secondary outcomes. Significant between-group differences were observed in the Functional Ambulation Category: the intervention group (Δmean ± SD; 3.43 ± 1.17) showed greater improvement (p = 0.002) than the control group (Δmean ± SD; 2.48 ± 1.09). Compared with conventional physiotherapy alone, our results suggest that the walking ability of subacute stroke patients might be improved with music-based RAS combined with conventional physiotherapy, but this treatment is not more effective than conventional physiotherapy in obtaining gait and balance gains.
Chronic diseases are treated and cared for in different healthcare settings. Continuity of care and the case management model facilitate the integration of processes and care levels. However, there is little evidence regarding the satisfaction of nurses with this model. The purpose of this study was to examine nurses’ satisfaction with continuity of care and the case management model. A cross-sectional study was conducted. An ad hoc questionnaire was administrated to 437 Spanish nurses from the three health care settings that responded. This included items on socio-demographics, employment relationship, and satisfaction with continuity of care and case management. Descriptive analysis and linear regression models were performed. In total, 96.1% of the nurses expressed a high level of satisfaction with continuity of care and 80.7% with the case management model. Nurses in a primary care setting reported the greatest satisfaction with the case management model (B = 0.146, 95% CI = 0.139–0.694, p = 0.003). The nurses’ higher perception of patient satisfaction was associated with greater satisfaction with continuity of care (B = 0.466, 95% CI = −0.367–0.533, p < 0.000). Nurses identified the case management model as an optimal facilitator of continuity of care. While satisfaction with continuity is high, strategies are needed to improve it in primary care centers and aged care homes.
Aim We aim to describe the relationship between job satisfaction and compare levels of resilience among out‐of‐hospital emergency medical service professionals. Background The study of the impact of the working environment on health professionals has raised great interest. Job‐related variables and resilience can be a protective factor against stressful and demanding events at work. Methods A cross‐sectional survey comprising sociodemographic and job‐related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out‐of‐hospital emergency medical system in Spain. Resilience was self‐reported using the Connor‐Davidson Resilience Scale. Results Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p = .008). As age increased, resilience was lower (r = −.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02–1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55–11.73). Conclusion There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction. Implications for Nursing Management Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out‐of‐hospital emergency health care professionals.
Purpose The exchange of information between different healthcare settings through a nursing discharge plan is essential for safe care. However, the factors contributing to achieving the most efficient exchange have not been well studied. This study aimed to evaluate and explore the perceptions of a nursing discharge plan from the perspective of nurses in different healthcare settings. Methods A mixed methods approach comprising a specifically designed ad hoc questionnaire (n = 437) and a focus group session (n = 8). Findings Overall, 66.1% out of 437 nurses, and especially those working in nursing homes, were satisfied with the nursing discharge plan. Lack of time to complete the report and poor information about both nursing diagnoses and patients’ social assessment were identified as problem areas. Some proposals emerged from the focus group: providing sufficient time for its completion, giving the nursing discharge plan a more flexible structure permitting more open-ended responses, requiring more information to be provided about the social and psychological situation of the patients, training nurses to use standardized language to avoid possible misinterpretations, and getting nurses from the different health care settings to work together in designing continuity of care plans. Elderly and low-income patients are found to need greater attention when filling out nursing discharge plans. Conclusions The study has revealed key aspects that need to be improved and some recommendations in implementing the nursing discharge plan in our health area. These include that there should be more time provided to complete the NDP, and also specific details regarding the format, structure, content of the information that is communicated, and the prioritization of the patient profile.
Background: Fibromyalgia is a chronic and complex disease whose management by patients requires a high level of commitment. Patient empowerment therefore represents an important milestone in chronic disease treatment and control. We explored the impact of a peer social support network from the perspective of women with fibromyalgia. Methods: A generic qualitative design was proposed for the study, for which women who had been diagnosed with fibromyalgia were purposefully selected. Six semi-structured interviews were conducted, and the collected data were thematically analysed. Results: Three key themes emerged regarding the peer social support network: (1) empowerment (facilitating acceptance of the diagnosis and acting as a source of information); (2) effects on well-being and quality of life (attenuated the stigma, improved physical well-being, provided emotional support and was a socialization medium); and (3), valuable aspects (transmitted feelings of being understood and listened to and increased personal feelings of satisfaction). Conclusions: A peer social support network for women with fibromyalgia exerts positive effects on their physical, mental, and social well-being and empowers them to better manage their disease. Healthcare for women with fibromyalgia should include strategies that connect them through peer social support networks.
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