Sunday, 5 August 2018

Using a new interrater reliability method to test the modified Oulu Patient Classification instrument in home health care: Common mistakes and methodological issue


Mohammad Aghajani 1, 2, Fatemeh Sadat Asgarian 3*

1.      Lecturer, Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
2.      Phd Candidate, Student Research Committee, Kashan University of Medical Sciences, Kashan, IR Iran.
3.      Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran

Keywords: home health care, Reliability, nursing intensity

I read the study conducted by Jill Flo and colleagues published in the January 2018issue of nursing open (Flo J, 2018). The authors tried to evaluate to test the interrater reliability of the modified Oulu Patient Classification instrument, using a multiple parallel classification method based on oral case presentations in home health care in Norway (Flo J, 2018). They used Kappa coefficient in their analysis (Flo J, 2018), which is one of the common mistakes in reliability or reproducibility analysis repeatability, or precision is being assessed by different statistical tests such as Kappa coefficients, which is one of the common mistakes in reliability analysis. Two major weaknesses of the kappa value to assess agreement of a qualitative variable are as follows: It depending on the prevalence in each stratum, which means, it can be possible to have a different kappa value having the same percentage for both concordant and discordant cells. The kappa value also depends on the number of stratums, which means the higher the number of stratums; the more kappa value is less (Rothman KJ, 2010, Lawrence I, 1998). Generally, for quantitative variable, Intra Class Correlation Coefficient (ICC), and for qualitative variables, weighted kappa should be used with caution because simple kappa has its own limitation (Lawrence I, 1998; M.SzKlo, 2007).In conclusion, for reproducibility or precision analysis; appropriate tests should be applied by researchers.


Conflict of interest:
The author reports no conflicts of interest.


Corresponding Author:
*Corresponding Author: Fatemeh Sadat Asgarian Address: IRAN/Kashan, Ghotb Ravandi Highway, Kashan University of Medical Sciences, Faculty of Nursing and midwifery, Iran.
Tel: +983155540021
Fax: +983155546633
E mail: fatisadat@yahoo.com

Don't make me laugh!

Roger Watson, Editor

Being older and attending day care is no joke, nothing to laugh about - you may think. The aim of this study from Japan by Yoshikawa  et al. (2018) was to: 'the effect of laughter therapy on physiological and psychological function in older people.' To achieve this 17 older people attended 'Stand‐up comedy as laughter therapy was performed once a week for 4 weeks.'

Laughter therapy had beneficial effects including reduction in blood pressure and lower levels of depression. Cognitive status was not altered. The authors conclude: 'These data strongly suggest beneficial effects of laughter therapy on physiological and psychological functions, although laughter did not affect cognitive function. The present study supports the therapeutic advantage of laughter therapy and raises the possibility of a new approach to promote physical and mental health in older people.

Reference

Yoshikawa Y, Ohmaki E, Kawahata H, Maekawa Y, Ogihara T, Morishita R, Aoki M (2018) Beneficial effect of laughter therapy on physiological and psychological function in the elderly Nursing Open DOI: 10.1002/nop2.190

Wednesday, 4 July 2018

Depressive symptoms in patients undergoing percutaneous coronary intervention


Roger Watson, Editor

The aim of this prospective cohort study from Japan by Doi et al. (2018) was: 'to identify the association between possible factors and depression among post‐percutaneous coronary intervention patients with acute coronary syndrome.' Sixty‐eight post‐percutaneous coronary intervention patients with acute coronary syndrome were enrolled between January 2016 -June 2017. The Hospital Anxiety and Depression Scale scores at 1–3 months after discharge were regressed onto uncertainty in illness and other clinical factors based on the RoyAdaptation Model. Thirty‐six patients were included in the final analysis. Higher baseline depression scores, higher changes in uncertainty in illness and feeling annoyed by troublesome tasks after discharge were associated with higher depressive scores at 1 month after discharge. Careful observation and support of patients’ ineffective responses in self‐concept mode may be effective in preventing depression.
Reference

Doi M, Fukahory H, Oyama Y, Morita K (2018) Factors associated with depressive symptoms in patients with acute coronary syndrome undergoing percutaneous coronary intervention: A prospective cohort study Nursing Open DOI: 10.1002/nop2.171

Thursday, 5 April 2018

Afghanistan needs educated nurses

Roger Watson, Editor

Afghanistan is often in the news but rarely for any news about nursing. But a recent article titled: 'We need higher education: Voice of nursing administration from Kabul, Afghanistan' and published in Nursing Open raises the profile of nursing in this country better known for its troubles.

The study, by Qarani et al. (2108) aimed to: 'explore the educational profile of nursing managers and head nurses at public hospitals in Kabul, Afghanistan.' Nearly 90 senior nurses from across Kabul were surveyed and, as explained by the authors: '(i)t was found that, none of the participant was prepared with higher education in nursing; rather they had only diploma in nursing; and 84.9% of them had completed their nursing diploma before 2002.; 11.6% of participants were currently studying; and all were in non-nursing disciplines. On the other hand 100% of the participants expressed intention for further studies mainly in leadership and management, computer skill, English language, in-service nursing trainings and higher education in nursing.' They concluded: 'This study suggests that there is a dire need to design both short and long-term strategies for the capacity development of nursing leaders at public hospitals in Kabul, Afghanistan.'

Reference

Qarani WM, Jan R, Saeed KMI, Khyman L (2018) We need higher education: Voice of nursing administration from Kabul, Afghanistan Nursing Open doi: 10.1002/nop2.140

The robots are coming

Roger Watson, Editor

The ageing population, increasing care needs and shortage of healthcare professionals pose major challenges in Western societies. Special service robots designed for care tasks have been introduced as one solution to these problems. The aim of this study from Finland was to answer the question: 'How prepared healthcare professionals are to take robots as their assistants in terms of experience and acceptance?'

An article based on the study has been published by Turja et al. (2018) in Nursing Open titled: 'Finnish healthcare professionals’ attitudes towards robots: Reflections on a population sample'. Nearly 1000 nurses and nearly 4000 other health professionals and the general population were surveyed. The general population had more experience of robots than the healthcare professionals and more positive attitudes. However, healthcare professionals saw a limited role for robots, for example, heavy lifting and logistics.

The authors concluded: 'The most constant finding between the respondent groups was that individuals who have experience with robots, have more positive attitudes towards them. Healthcare professionals have fairly optimistic expectations towards robot assistance, but only with certain kinds of tasks.'

Reference

Turja T, Van Aerschot L, Särkikoski T, Oskanen, A (2018) Finnish healthcare professionals’ attitudes towards robots: Reflections on a population sample Nursing Open doi: 10.1002/nop2.138

Saturday, 24 March 2018

The persistent problems of weight loss and nutrition for older people in nursing homes

Roger Watson, Editor

The problems of weight loss and poor nutrition for older people in nursing homes - especially those with dementia - persists and research into these phenomena continues as shown by two recent articles in Nursing Open, one from Slovakia by Harsányiová & Prokop, and the other from Sweden by Backlund et al. (2018). The Slovakian study is titled: 'Living condition, weight loss and cognitive decline among patients with dementia' and the Swedish study is titled: 'A registry study of nursing assessments, interventions and evaluations according to nutrition for persons living in municipal residential care homes'.

The aim of the Slovakian study was: 'to investigate cognitive performance and BMI of patients with dementia living in their own homes with family members, nursing homes and alone' and the aim of the Swedish study was: 'to explore planned nursing interventions and evaluations of such interventions, in older people at risk for malnutrition living in municipal residential care homes'. The Slovakian study showed: 'Cognitive decline was significantly faster for patients living in nursing homes and for solitary patients. BMI consistently decreased in the follow-up examination this drop was stronger in patients living alone and in nursing homes' and the Swedish study showed: 'A larger proportion of women were estimated as being at risk for malnutrition compared with men. The three most common prescribed nursing interventions were nutritional treatment, dietary support and weight control; however, interventions were not prescribed for all participants at risk for malnutrition.'

The Slovakian authors concluded: 'Nursing homes and loneliness would seem to be statistically significantly associated with stronger progress in cognitive performance in patients with dementia' and the Swedish authors concluded: 'although interventions in older people at risk for malnutrition are often planned, they are not likely to be evaluated. Not all persons at risk for malnutrition had planned interventions. The current study argues that there is room for quality improvement concerning registration of interventions and evaluating interventions in elderly persons at risk for malnutrition.'

References

Backlund A, Holmbeck O, Kumlien C, Axelsson M (2018) A registry study of nursing assessments, interventions and evaluations according to nutrition for persons living in municipal residential care homes Nursing Open doi: 10.1002/nop2.144

Harsányiová M, Prokop P (2018) Living condition, weight loss and cognitive decline among
patients with dementia Nursing Open doi: 10.1002/nop2.137