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

描述(由申请人提供)： 医学研究所(IOM)关于“护理的未来”的报告(2011年)强调，注册护士(RN)需要保持人与人之间的联系，并提供“超越身体健康需求的、以病人为中心的整体护理”，以满足其病人的保健需求(第172页)。根据国际移民组织的建议，VHA 2013-2018年的战略目标包括需要“为退伍军人提供个性化、主动性和以患者为导向的医疗保健”(Krejci，2013，第1页)。弗吉尼亚州的以病人为中心的护理(PCC)模式(Planetree，2013)鼓励护士与病人在一起，作为实现PCC的一种手段(Frampton&Charmel，2009)。恶劣的工作条件与护士工作满意度下降和情绪衰竭增加有关(GelSema等人，2006)，从而导致压力。需要有减少工作场所压力和职业倦怠的策略。其中一种策略是Mantram重复计划(MRP)，这是一种心理-身体-精神管理压力的方法。以前的研究已经证明了MRP在减少医护人员的感知压力、改善正念和存在的精神健康(Bormann，Becker等人，2006；Bormann，阿曼等人，2006)和减少职业倦怠(Yong，Kim，Park，Seo&Swinton，2011)方面的有效性。MRP的减压策略包括Mantram Repeat(MR)、减慢和单点注意。这些练习会引发放松反应。本试点项目的目的是评估为照顾住院退伍军人的注册护士实施基于互联网的Mantram重复计划(I-MRP)的可行性，并探讨其对注册护士及其提供的护理的影响。本研究的第一个目的是评估在护理住院退伍军人患者的RNS中实施AN-MRP的可行性。这项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认知。最后，第三个目标是评估护士的i-MRP对退伍军人患者结果的影响，包括对护理和护理存在的感知和满意度。本项目将使用多方法方法，包括测试前/测试后设计，以描述I-MRP和RNS对职业生活质量和护理存在的自我报告之间的关系。这项研究还将探索在完成I-MRP的相同RN中，退伍军人对护理的感知满意度和护理存在之间的关系。在小爱德华·海因斯的4个内外科护理单元和他们的60名病人中工作的20名RN。弗吉尼亚医院将被邀请参加这项研究。RNS将完成专业素质 参加I-MRP前、后2个月的生活质量量表、护理存在量表-RN、正念注意知晓量表、精神健康量表。退伍军人将完成施密特护理感知调查和护士存在量表。为了支持量化数据的有效性，所有注册护士和资深受试者将被邀请参加面对面、录音的半结构化访谈，以分享他们对与PCC经验相关的I-MRP的看法。每组15名参赛者。

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.