Caring behaviour signifies the vital and ultimate qualitative nursing behaviour, which promotes self-transcendence and thereby well-being. These findings are important for clinical nursing that intends to increase patients' well-being.
Nursing management and leaders must take in consideration that work culture is crucial for improving quality of care in nursing homes, and this study can be used to increase the focus on the work culture among healthcare personnel in nursing homes. Changes are necessary to increase healthcare personnel's job satisfaction, empowerment, autonomy and influence in nursing homes. Giving empowerment to the healthcare personnel working in nursing homes is both an organisational and an interpersonal issue. Being given empowerment and influence over their own work situation, the healthcare workers can be more committed and involved in the goal of obtaining best possible care to the residents.
Aims and objectives. To investigate the long-term effect of a nurse-led hospital-based patient education programme combining group and individual education for patients with chronic inflammatory polyarthritis. Background. Patient education interventions have shown short-term effects, but few studies have investigated whether the effects are sustained for a longer period. Design. Randomised controlled trial. Methods. Patients with rheumatoid arthritis, psoriatic arthritis and unspecified polyarthritis were randomised to the intervention group (n = 71) or a waiting list (n = 70). Primary outcomes were as follows: Global Well-Being and the Arthritis Self-Efficacy Other Symptoms Subscale. Secondary outcomes were as follows: patient activation, physical and psychological health status, patients' educational needs and a Disease Activity Score (DAS28-3). Results. The intervention group had a statistically significant higher global well-being than the controls after 12 months, mean change score 8Á2 (95% CI, 1Á6-14Á8; p-value = 0Á015), but not in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change score 2Á6 (95% CI, À1Á8 to 7Á1; p-value = 0Á245). Within each group, analyses showed a statistically significant improvement in DAS28-3, mean change -0Á3 (95% CI, À0Á5 to À0Á1; p-value = 0Á001), in the intervention group from baseline to 12 months, but not in the controls. The controls had a statistically significant deterioration in the Arthritis SelfEfficacy Other Symptoms Subscale, mean change À5Á0 (95% CI, À8Á6 to À1Á3; p-value = 0Á008), Arthritis Impact Measurement Scales -2 Social, mean change 0Á3 (95% CI, 0Á1-0Á5; p-value = 0Á008), and Hospital Anxiety and Depression Scale total, mean change 1Á4 (95% CI, 0Á3-2Á5; p-value = 0Á013). Conclusion. A combination of group and individual patient education has a long-term effect on patients' global well-being. Relevance to clinical practice. Nurses should consider whether a combination of group and individual patient education for patients with chronic inflammatory polyarthritis is an alternative in their clinical practice. This combination is less timeconsuming for the patients, and it includes the benefit of group learning in addition to focusing on patient's individual educational needs.
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