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Dreams and disappointments regarding nursing: student nurses’ reasons for attrition and retention. A qualitative study design (Nurse Education Today, 2017 Apr. Epub)

In the Netherlands, hundreds of students register annually for a nursing programme, but not all of these students manage to complete their training. The main aim of this study was to examine which factors affect student nurses’ decision to leave or complete their programme.
Student nurses started their studies with many dreams, such as caring for people and having the opportunity to deliver excellent nursing care. When their expectations were not met, their dreams became disappointments which caused them to consider stopping and even to leave (attrition). The role of lecturers and mentors seems invaluable in protecting and guiding students through their programme and placements. Optimal cooperation between lecturers and mentors is of paramount importance to retain student nurses in their training programmes.

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Influence of Nurse Manager and Peer Group Caring Behaviors as Perceived by Nurses on Intention to Retention (J Korean Acad Nurs Adm. 2017, 23(2), p. 191-200)

This study was conducted to identify the influence of nurse manager and peer group caring behaviors as perceived by nurses on intention to retention. The scores for ‘manager and peer group caring behaviors’ and intention to retention were all at a moderate level, although the subjects perceived ‘peer group caring behaviors’ as higher compared to ‘manager caring behaviors’ To improve nurses’ intention to retention, it may be necessary to alter the transfer and arrangement strategies of their working environments to better consider nurses’ aptitude and competence, and thereby increase both manager and peer group caring behaviors.

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The Baptist Health Nurse Retention Questionnaire: A Methodological Study, Part 1 (Journal of Nursing Administration, 2017, vol 47(5), p. 289-93)

The purposes of this study were to develop and test the Baptist Health Nurse Retention Questionnaire (BHNRQ) and examine the importance of nurse retention factors. The results of the principal components analysis revealed 3 subscales: nursing practice, management, and staffing. Analyses demonstrate that the BHNRQ is a reliable, valid and clinically useful instrument for measuring important factors related to nurse retention.

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The effectiveness of and experience with an innovative split-sleep schedule in healthy nurses: a mixed method study.

Shift work is currently becoming increasingly more common, however it has two major hazards: It increases the risk of occupational accidents and injuries, as well as the development of (chronic) disease. This masters thesis reports on an innovative split-sleep schedule which appears to be promising for the majority of shift workers. The split-sleep schedule is beneficial shortly after a night-shift series as well. Important implementation strategies are personalizing the split-sleep schedule and informing society about split-sleep and its advantages. However, current results are preliminary and further research is therefore needed.

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The experiences of people with young-onset dementia: A meta-ethnographic review of the qualitative literature. (Maturitas, 2016, vol 92, p. 102-9)

Dementia is usually diagnosed in later life but can occur in younger people. The experiences of those with older-onset dementia are relatively well understood but little is known about the experiences of those with young-onset dementia (aged less than 65 years). Diagnosis felt unexpected, ‘out of time’ and led to changes in self-identity, powerlessness and changes in relationships

Social exclusion was common. Loss of meaningful activity exacerbated a difficult situation. However, the diagnosis did not mean people’s lives were over and many with YOD try to regain control by seeking connections with others with the same condition – sometimes a very important source of support. Overall, people living with YOD face unique social challenges which go beyond those of older people living with dementia and which result in an even greater negative impact on their lives. Interventions that facilitate peer support and allow people with YOD to engage in meaningful activity should be developed and could perhaps be provided by the voluntary sector.

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Montessori-based activities among persons with late-stage dementia: Evaluation of mental and behavioral health outcomes (Dementia, 2017 Apr. Epub)

Literature regarding Montessori-based activities with older adults with dementia is fairly common with early stages of dementia. Conversely, research on said activities with individuals experiencing late-stage dementia is limited because of logistical difficulties in sampling and data collection. Given the need to understand risks and benefits of treatments for individuals with late-stage dementia, specifically regarding their mental and behavioral health, this study sought to evaluate the effects of a Montessori-based activity program implemented in a long-term care facility.
Improvements observed for quality of life and problem behaviors may yield promise for Montessori-based activities and related health care practices. The rapid physiological and cognitive deterioration from late-stage dementia should be considered when interpreting these results.

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An innovative approach to hydration for a patient with dementia. (Nurs Older People, 2017, 29(4) p. 26-29)

Nursing older people in acute settings involves the provision of complex care, including the maintenance of good hydration. Dehydration is a serious condition that may contribute to the development of pressure ulcers, urinary tract infections, acute kidney injury and venous thromboembolism. If oral hydration methods are not successful, the alternatives are intravenous (IV) or subcutaneous fluid hydration therapy. These are invasive methods and may not be tolerated by all patients.

This article uses a case study to explore an innovative approach to oral hydration. The intervention was developed for Roy, a patient with advanced Alzheimer’s disease, who had a reduced fluid intake and who became agitated when staff or family members attempted to assist him with nutrition and hydration. It involved consultation with Roy’s family and the introduction of a flavoured drink to encourage the patient to drink. His weekly fluid intake doubled as a result and the intervention avoided the use of alternative invasive rehydration therapy. Although this was a local initiative developed for one patient, it is an example of how a person – entred, collaborative approach can have a positive effect for patients.

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Family caregivers experiences of formal care when caring for persons with dementia through the process of the disease. (Scand J Caring Sci, 2016, 30(3) p. 526-34)

Family caregivers’ experiences of formal care when caring for persons with dementia through the process of the disease is sparsely investigated. Family caregiving requires collaboration with formal care to get support adjusted to the individual’s needs, specific to the stages of dementia. Caregivers experience a transition process with three main turning points: the dementia diagnosis; when they realise increased need for formal care to continue caring at home; and when the person with dementia is moved into a nursing home. The interviewed caregivers experience formal care reactive to their needs and this often promoted unhealthy transitions. Formal care needs to be proactive and deliver available care and support early on in the dementia trajectory. Interventions should focus on facilitating a healthy transition for family caregivers through the trajectory of the dementia disease to ensure their well-being.

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Comparison of the adaptive implementation and evaluation of the Meeting Centers Support Program for people with dementia and their family carers in Europe; study protocol of the MEETINGDEM project. (BMC Geriatr, 2017, 17(1) p. 79)

The MEETINGDEM study aims to implement and evaluate an innovative, inclusive, approach to supporting community dwelling people with mild to moderate dementia and their family carers, called the Meeting Centers Support Program (MCSP), in three countries in the European Union (EU): Italy, Poland and United Kingdom. Demonstrated benefits of this person-centered approach, developed in The Netherlands, include high user satisfaction, reduced behavioral and mood problems, delayed admission to residential care, lower levels of caregiving-related stress, higher carer competence, and improved collaboration between care and welfare organizations.
An overall evaluation will draw together findings from the three countries to develop recommendations for successful implementation of MCSP across the EU. If the Meeting Centers approach can be widely implemented, this could lead to major improvements in dementia care across Europe and beyond.

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The occurrence and persistence of thoughts of suicide, self-harm and death in family caregivers of people with dementia: a longitudinal data analysis over 2 years. (Int J Geriatr Psychiatry, 2017 Apr. Epub)

Family caregivers of people with dementia often report high levels of stress and depression, but little is known about those who contemplate suicide or self-harm. This study explores thoughts of suicide, self-harm and death in dementia caregivers and investigates the characteristics that distinguish them from those without such thoughts.
Caregivers with suicidal thoughts had more severe depressive and anxious symptoms, had a lower sense of competence and mastery, felt less happy and experienced more health problems, less family support and more feelings of loneliness than caregivers who had not.

Suicidal thoughts are present in dementia caregivers and can persist across the care trajectory. Various psychological and social characteristics significantly distinguish caregivers with suicidal thoughts from those without. More research is needed to enable the identification of high-risk caregivers and provide an evidence base for the development of preventive strategies and interventions.

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