Efficacy of an Internet Mantram Program on RN-delivered Patient Centered Care

互联网 Mantram 计划对 RN 提供的以患者为中心的护理的功效

• 批准号: 8780973
• 负责人: Carol Kostovich
• 金额: --
• 依托单位: EDWARD HINES JR VA HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-11-01 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8780973
• 关键词: Acute; Address; Affect; Attention; Awareness; Care given by nurses; Caregivers; Caring; Client satisfaction; Conscious; Data; Discipline of Nursing; Dropout; Effectiveness; Emotional; Enrollment; Future; Goals; Health Personnel; Healthcare; Hospitals; Human; Institute of Medicine (U.S.); Internet; Intervention; Interview; Job Satisfaction; Life; Location; Measures; Medical; Medical-Surgical Nursing; Methods; Modeling; Nurses; Nursing Staff; Operative Surgical Procedures; Outcome; Participant; Patient Self-Report; Patient-Centered Care; Patient-Centered Nursing; Patients; Perceived quality of life; Perception; Pilot Projects; Pre-Post Tests; Quality of Care; Quality of life; Recommendation; Registered nurse; Relaxation; Reporting; Research; Role; Self Perception; Strategic Planning; Stress; Structure; Surveys; Testing; Training Programs; Veterans; Work; Workplace; base; body-mind; burnout; care delivery; design; exhaustion; experience; improved; innovation; meetings; mindfulness; physical conditioning; programs; response; satisfaction; stress management

DESCRIPTION (provided by applicant): The Institute of Medicine's (IOM) report on "The Future of Nursing" (2011) emphasized the need for registered nurses (RNs) to preserve human connectedness and provide "holistic, patient- centered care that goes beyond physical health needs" to meet the health care needs of their patients (p. 172). In line with the IOM recommendation, the VHA strategic goals for 2013-2018 include the need "to provide Veterans personalized, proactive, and patient-driven healthcare" (Krejci, 2013, p.1). VA's model of patient centered care (PCC) (Planetree, 2013) encourages nurses to be present with their patients as a means to attain PCC (Frampton & Charmel, 2009). Adverse working conditions have been associated with decreased nurse job satisfaction and increased emotional exhaustion (Gelsema et al, 2006), contributing to stress. Strategies to reduce workplace stress and burnout need to be available. One such strategy is the mantram repetition program (MRP), a mind-body-spiritual approach to stress management. Previous studies have demonstrated the effectiveness of MRP in reducing health care workers' perceived stress, improving mindfulness and existential spiritual wellbeing (Bormann, Becker, et al, 2006; Bormann, Oman, et al, 2006), and reducing burnout (Yong, Kim, Park, Seo & Swinton, 2011). The stress reduction strategies of MRP include mantram repetition (MR), slowing down, and one pointed attention. These practices initiate the relaxation response. The purpose of this pilot project is to assess the feasibility of implementing an internet-based mantram repetition program (I-MRP) for RNs caring for hospitalized Veterans and to explore its impact on RNs and the care they provide. The first aim of this study is to assess the feasibility of implementing an -MRP for RNs caring for hospitalized Veteran patients. The second aim of this study is to assess the impact of an I-MRP for nurses on RN outcomes, including RN's self- perceptions of professional quality of life, nursing presence, mindfulness and spiritual wellbeing. Finally, the third aim is to assess the impact of an I-MRP for nurses on Veteran patient outcomes including perceptions of and perceived satisfaction with nursing care, and nursing presence. This project will use a multi-method approach, including a pre-test/post-test design to describe the relationships among I-MRP and RNs' self-reports of professional quality of life and nursing presence. The study will also explore the relationship among Veterans' perceived satisfaction with nursing care and nursing presence in those same RNs who completed the I-MRP. Twenty RNs working on 4 medical-surgical nursing units and 60 of their patients at Edward Hines, Jr. VA Hospital will be invited to participate in the study. RNs will complete the Professional Quality of Life Scale, Presence of Nursing Scale-RN, Mindfulness Attention Awareness Scale, and Spiritual Wellbeing Scale before and 2 months after participating in the I-MRP. Veterans will complete the Schmidt Perceptions of Nursing Care Survey and the Presence of Nursing Scale about their nurses. To support the validity of the quantitative data, all RN and Veteran subjects will be invited to participate in face-to-face, audio-taped, semi-structured interviews to share their perceptions of the I-MRP as it relates to the PCC experience. Fifteen participants in each group will be included.

描述（由申请人提供）： 医学研究所（IOM）关于“护理的未来”（2011年）的报告强调，注册护士（RN）需要保持人类的联系，并提供“超越身体健康需求的以患者为中心的整体护理”，以满足患者的医疗保健需求（第172页）。根据IOM的建议，VHA 2013-2018年的战略目标包括需要“为退伍军人提供个性化，主动和患者驱动的医疗保健”（Krejci，2013，第1页）。VA的以患者为中心的护理模式（PCC）（Planetree，2013）鼓励护士与患者一起出现，作为实现PCC的一种手段（Frampton & Charmel，2009）。不利的工作条件与护士工作满意度下降和情绪疲惫增加有关（Gelsema et al，2006），从而导致压力。需要制定减少工作场所压力和倦怠的策略。其中一个策略是mantram重复程序（MRP），这是一种心理-身体-精神的压力管理方法。以前的研究已经证明了MRP在减少医疗保健工作者的感知压力，改善正念和存在主义精神健康方面的有效性（Bormann，Becker等人，2006; Bormann，Oman等人，2006），以及减少倦怠（Yong，Kim，Park，Seo & Swinton，2011）。MRP的减压策略包括口头禅重复（MR）、放慢速度和集中注意力。这些练习启动放松反应。这个试点项目的目的是评估实施基于互联网的mantram重复程序（I-MRP）的RN照顾住院退伍军人的可行性，并探讨其对RN和他们提供的护理的影响。本研究的第一个目的是评估实施一个-MRP的RN照顾住院退伍军人患者的可行性。本研究的第二个目的是评估护士I-MRP对RN结果的影响，包括RN对职业生活质量、护理存在、正念和精神健康的自我感知。最后，第三个目的是评估的影响，一个I-MRP的护士退伍军人患者的结果，包括感知和感知满意度护理，护理存在。本研究将采用多方法的研究方法，包括前测/后测设计，来描述I-MRP和RN的专业生活质量和护理存在的自我报告之间的关系。该研究还将探讨退伍军人对护理的感知满意度与完成I-MRP的同一RN中的护理存在之间的关系。20名注册护士在4个内外科护理单位工作，60名病人在爱德华海因斯，小。将邀请VA医院参与本研究。RN将完成专业质量 在参加I-MRP前和参加I-MRP后2个月，使用生活量表、护理存在量表、正念注意力意识量表和精神健康量表。退伍军人将完成施密特护理感知调查表和护理存在量表。为了支持定量数据的有效性，所有RN和退伍军人受试者将被邀请参加面对面、录音、半结构化访谈，以分享他们对I-MRP与PCC经验相关的看法。每组将有15名参与者。