Aims To describe the associations between dysphagia and malnutrition risk and to identify predictors for dysphagia in a group of persons at risk of malnutrition in hospitals and nursing homes. Design A secondary analysis of cross‐sectional data from the years 2012–2016. Methods The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool for Adults (MUST). The data were compared regarding malnutrition risk and dysphagia. Regression analyses were conducted to identify variables that were associated with the risk of malnutrition and dysphagia. Results Patients (N = 17,580) were included in the study sample. The prevalence of dysphagia was 6.6% and the prevalence of malnutrition risk was 18.9%. A multivariable logistic regression analysis resulted in the identification of dysphagia and cancer as variables with the highest odds ratios with regard to malnutrition risk. Patients with cancer, stroke or respiratory diseases represent a high‐risk group for the co‐occurrence of dysphagia and risk of malnutrition. Conclusions Screening for dysphagia should be carried out on patients at risk of malnutrition as an integral part of their admission to a healthcare institution and especially on the higher risk group of patients with cancer, a stroke or a respiratory disease. Impact What problem did the study address? This study identified the relationship between dysphagia and malnutrition risk and associated factors. What were the main findings? Dysphagia among patients in the research sample was associated with more than two times higher prevalence of the malnutrition risk. Where and on whom will the research have an impact? Thorough malnutrition risk and dysphagia screening lead to better nursing care.
The objective of this study was to assess burdens placed on and consequences of the COVID‐19 pandemic on nursing home staff. Design We conducted a qualitative descriptive interview study. Methods We interviewed 18 nurses, nursing aides and care aides from five different nursing homes by using a semi‐structured interview guideline between June and September 2020. Data were analysed with a qualitative content analysis method by combining an inductive and deductive coding frame. Results Results show that the qualitative work load and work organization were major concerns. Regarding the qualitative work load, participants stated that they were required to perform additional tasks to care for residents, because the pandemic interventions placed the residents under stress and dealing with relatives presented significant challenges. Nursing home staff reported that psychological consequences such as uncertainty, fear and stress represented major effects of the COVID‐19 situation. Conclusion We could show that qualitative workloads were assessed and perceived differently. Most nursing home care staff members experienced the changes in working conditions as both physically and psychologically challenging. Impact We highly recommend that nursing home staff receive support in such pandemics by being allowed, for example personal protective equipment breaks. Individually tailored programs need to be established to enhance wellbeing and decrease psychological stress and fear in such challenging times.
Background: The results of several projects on the effects of personal protective equipment (PPE) have been published since the outbreak of COVID-19. It is known that wearing PPE, and specifically face masks, has physcial consequences like headache and pain, which can increase stress among nursing staff. However, none of these studies placed a focus on PPE and nursing staff, although nurses are the only members of the health care profession who are at the patients bedsides 24/7, and PPE is the only way to protect them from a COVID-19 infection. Therefore, this study was carried out to investigate the association between the use of PPE and stress among nursing staff during the COVID-19 pandemic. Methods An online, cross-sectional survey was conducted, which we distributed using snowball sampling techniques. The questionnaire was developed on the basis of (inter-)national recommendations as well as the international literature. We used the perceived level of stress scale to measure the nursing staff members stress levels. Results We included data collected from 2600 nurses in this analysis. Nearly all nursing staff wore face masks. We showed that more than two-thirds of the nurses had moderate to high levels of stress. No statistically significant association between the use of PPE and stress was detected. However, we show a statistically significant association between the duration of mask usage and stress. Discussion and conclusions Nearly all participating nurses wore face masks or FFP masks to protect themselves from COVID-19 infection. This observation might indicate that Austrian nurses display a high level of compliance with national and international regulations and play a key role in such pandemics. Our results also show that increased mask-wearing time led to increased stress levels. These results suggest that (inter-)national regulations on how and when to use PPE should include a maximum duration of time for wearing each type of mask. Such regulations could help to prevent work-related stress, particularly in the case of future epidemics, and avoid burnout among nursing staff or even nurses leaving their jobs. The consequences of both of these negative outcomes should be considered in light of the predicted expected future shortage of health care workers.
This cross‐sectional, multicentre study was conducted in hospitals to investigate nutritional interventions conducted in patients aged 70 years or older with (risk of) pressure injuries. A total of 1412 patients from 33 hospitals with 208 wards participated in the study. A standardised questionnaire was used to collect demographic data and data on care dependency, malnutrition risk, risk for/prevalence of pressure injuries, and nutritional interventions. Data analyses were conducted by using descriptive statistics, chi‐square tests, or independent t‐tests. According to the Braden Scale, 678 (48.0%) of the patients were at risk of developing pressure injuries, and 71 patients (5.0%) had at least one pressure injury (assessed by skin inspection). The most frequently conducted nutritional interventions in patients with pressure injuries were providing support during mealtimes (50.7%), food specifically desired by the patient (40.8%), and conducting a malnutrition screening (39.4%). One quarter of the patients with pressure injuries were referred to a dietitian. The provision of an energy‐enriched/protein‐enriched diet (18.3%), energy‐enriched/protein‐enriched snacks (12.7%), or oral nutritional supplements (8.5%) was rare. Nutritional care in older patients with risk of pressure injuries is suboptimal. Health care professionals need to raise awareness regarding the importance of nutrition in the management of patients with pressure injuries.
Aim This study gives insights into the association between the use of personal protective equipment (PPE), wearing time of masks and stress among frontline nursing staff during the COVID‐19 pandemic. Background PPE can have physical consequences like headache and pain, which could result in increased nurse stress levels. Methods A total of 2600 nurses participated in this online survey. The questionnaire is based on literature and includes the perceived level of stress scale. Results We found no significant association between the use of PPE and stress. Nurses who wore masks for more than 8 h had significant higher stress levels than those who used the masks for a shorter period. Conclusions The duration of wearing masks is associated with nurse's stress level. Our findings can help nurses to argue a higher frequency of breaks and a maximum duration of mask usage in their organisations. Implications for Nursing Management We recommend that nursing managers implement practical strategies such as a mask break task force. This task force could promote awareness for mask breaks and recommend and allocate rooms or locations such as balconies for mask breaks.
Background Working as a nurse means being able to provide high-quality care 24/7. Studies have shown that the average number of working hours per week is a significant predictor of stress and that the severity of the coronavirus disease 2019 (COVID-19) pandemic has increased the nurses’ stress levels. Objective The aim of this study was to investigate the influence of the nursing staff’s working hours during the COVID-19 pandemic on the perceived level of stress. Method We carried out an online cross-sectional survey and measured the stress level with the perceived stress scale. Results Most of the nurses experienced a moderate level of stress. We identified a statistically significant association between increased numbers of working hours per week and the nurses’ perceived stress level. In addition, 15% of the nurses who had worked more than 40 h reported experiencing a high level of stress. Conclusion These results reflect the negative consequences of prolonged working hours. For this reason, a (inter)national discussion is needed on the topic of restricting the working hours of healthcare workers during such pandemics. This discussion can improve the health and safety of healthcare workers, patients and members of the general population.
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