Evidence Based Essay Paper

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Evidence Based Essay PaperEvidence Based Essay PaperEvidence-based practice is defined as the conscious integration of best research evidence with clinical expertise and patient values and needs in the delivery of quality, cost-effective care.A PICO format can be used by nurses to better articulate their clinical questions and search for answers to those questions. Evidence Based Essay PaperThe IOWA model can be used to help nurses understand how to find answers to their clinical questions and to search for answers to those questions.Clinical practice guidelines are systematically developed statements or recommendations that link research and practice and serve as a guide for practitioners. They create a bridge between practice and research.Hospitals who are pursuing Magnet status (or who have achieved it) are incorporating evidence-based practice into nursing care. MUST USE THE IOWA model.Evidence Based PaperMust use four total resources.Evidence Based Paper journal2013.pdfsample_ebpp_finding_the_evidence_paper_1_.pdfon_campus_n3321_assignmenJournal of Caring Sciences, 2013, 2(4), 321-327 ِdoi:10.5681/jcs.2013.038 http:// journals.tbzmed.ac.ir/ JCS What are important for patient centered care? A quantitative study based on perception of patients’ with cancer Roghayeh Azimzadeh1, Leila Valizadeh2, Vahid Zamanzadeh3*, Azad Rahmani3 1 Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran. 3 Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran 2 ARTICLE INFO Article Type: Review Article Article History: Received: 22 May. 2013 Accepted: 20 Agu. 2013 ePublished: 30 Nov. 2013 Keywords: Care Cancer care Patients Perception Nursing care ABSTRACT Introduction: Today in all aspects of health care, there is a considerable emphasis on the provision of patient centered care. Various researches in cancer wards have demonstrated that from view of patients, there were some similarities and differences in importance of care in different cultural area. Evidence Based Essay Paper. This study aimed to assess what are important for patient centered care in cancer wards. Methods: This is a descriptive study conducted with participation of 200 patients with cancer from a cancer center in Tabriz. Convenience sampling was used. The data were collected using Care-Questionnaire, developed by Larson. The Caring behaviors were ordered in 6 dimensions: “Being accessible”, “Explains and facilitates”, “Comforts”, “Anticipates”, “Trusting relationship”, “Monitors and follows through” and ordered on a 5-point Likert-type scale. Evidence Based Essay Paper. The data were analyzed using SPSS ver. 13.0. Results: The results showed that patients with cancer evaluated most of nurses caring behaviors with higher scores (moderate to high) and assigned the “Monitors and follows through” and “Being accessible” as patients’ higher priorities vs the “Comforts” 4.06 (0.50) and “Trusting Relationships” as lower priorities. Conclusion: The findings of the present study, indicate that the “Monitors and follows through” and “Being accessible” caring behaviors have more importance by patients with cancer, so these conduces nurses to notice and perform these behaviors in their nursing care. By so doing, moving to the main goal of patient centered care can be provided. Introduction It is now widely recognized for all health care professionals that patient centered care is important1, and so there is a considerable emphasis on the provision of patient centered care in all aspects of health care.2 Patient centered care was defined as care that “respectful of and responsive to individual patients’ preferences, needs and values, and ensures that patients’ values guide all clinical designs”.3 If so, this is significant for researchers to determine patients’ needs or perception of nurses caring behaviors in different clinical settings. In this context, one of the main nursing efforts is to identify a particular and valuable range of patients’ needs and problems.4 This requires that the patients’ interpretations of nursing care be examined.5 Indeed, patient centered care needs that nurses ask patients about their perception of the importance or prioritizing of various nursing care behaviors.6 Nurses can’t be certain that their behavior is consistent with caring needs of their patients.Evidence Based Paper. Evidence Based Essay PaperEvidence Based Essay Paper. 7 Also, nurses cannot assume that patients perceive caring efforts as they are intended. To avoid these problems and to perform patient centered care, it is imperative that nurses validate with the patients that their caring needs are being met.8,9 Also, all attentions must be paid to the aspects of * Corresponding Author: Vahid Zamanzadeh (PhD), E- mail: Zamanzadeh@tbzmed.ac.ir. This study was extracted from the MSc thesis of Rogayeh Azimzadeh, MSC in Nursing. (Project number: 244) Copyright © 2013 by Tabriz University of Medical Sciences Roghayeh Azimzadeh et al. nursing care that patients perceive as important to feeling well cared for.10 In this regard, Larson for the first time in cancer wards identified a certain series of nurses’ caring behaviors which conveyed a sense of caring to the patients.5 Also, various studies in this field, have been done that indicated from view of patients with cancer, there were some similarities and differences in prioritization of care. In some studies, the caring behaviors of “Explains and facilitates” or “Trusting relationship”5,11,12, “Physical and emotional comforts”9 were in lower priorities and in some others, the caring behaviors, “Anticipates” or “Explains and facilitates”6,9, “Monitors and follows through” or “Being accessible”5,11,12 were in higher priorities. The existence of such differences is not unexpected though; because although caring is a universal phenomenon, but caring processes and patterns are very different among cultures. In fact, care is meant by culture background.13 Some research in cancer wards have indicated that the majority of patients’ needs are not met.14 In fact, nurses do not perform patient centered care or do not consider the concerns of each cancer patient individually. 15 As a result, nurses in cancer wards are faced with challenges in some points of their nursing care.Evidence Based Essay Paper. 16 Thus, the care of patients with cancer is an unique, professional and challenging issue which requires research in the field of cancer care. 17 On the other hand, cancer is still a major health problem18 that according to today’s figures, one in three people will be diagnosed with cancer at some point in their lives, and one in four of the population will die from the disease.19 Additionally, it must be acknowledged that the nature of cancer in recent years has changed dramatically, including shorter in-patients’ stays, an increasing older cancer population and significant improvements in treatments, outcomes and effectiveness. Despite the recent changes to service delivery, little attention in terms of the quality of health 322 | Journal of Caring Sciences, December 2013; 2 (4), 321-327 services has yet been focused on patients with cancer.20 In light of these factors, in all aspects of health care, there is currently a considerable emphasis on the provision of patientcentered care.Evidence Based Essay Paper. 2 Therefore, It is necessary for nurses to understand patients’ perception of caring. Furthermore, individualized holistic nursing emphasizes respect for the views and wishes of patients21, nurses need to ensure that they are providing care according to what the patients want and not what the nurses want.22 Nevertheless, there aren’t adequate studies on patients’ perception in regard to nursing care needs in cancer wards of our care systems. As such, it is important to study about the perception of patients with cancer toward the importance of nursing care behaviors. Finally, by specially identifying the most important caring behaviors or performing patient centered care, nurses would be able to care better for patients with cancer and indeed, our knowledge of the caring nature of cancer will be added. Evidence Based PaperThe purpose of this study was to examine the perception of patients with cancer toward the importance of nursing care behaviors. Materials and methods This is a descriptive study. Evidence Based Essay Paper. The target population for this study was patients with cancer from a comprehensive cancer center in Tabriz, Iran where these patients are treated. In this center, we selected the patients by using convenience sampling. All potential participants were individually asked to cooperate during the study (between May and August, 2009).Evidence Based Paper.Evidence Based Essay Paper.   The inclusion criteria consisted of a cancer diagnosis known to the patient, age ≥ 15 years, ability to answer questions (physically or mentally) and to understand and speak Azeri or Persian and having at least one time prior hospitalization. Of a total of 652 patients, in during the study, 210 persons were selected by these criteria; however 10 persons did not want to participate mainly because of symptoms and Copyright © 2013 by Tabriz University of Medical Sciences Patient’s perception about importance of nurse caring behaviors tiredness. Therefore the final sample included 200 patients. In this study, we use the Care-Questionnaire that was developed by Larson to measure the perceived importance of nurse caring behaviors among patients with cancer. This Care-Q is the most frequently used instrument for assessing caring in the world and therefore the most appropriate instrument for international comparison.23 This questionnaire consisted of caring behaviors that were categorized into 6 dimensions. Scores to each item assigned in a Likert- type rating scale, grading from the least important=1 to the most important=5. The questionnaire was translated to Persian and the psychometric properties of the CareQ related to validity and reliability were assessed. Results showed internal consistency reliabilities Cronbach’s α (alpha) of 0.93 for the total items and from 0.61 to 0.80 for the 6 dimensions participating 40 patients with cancer. Content validity was evaluated by expert panel (2 oncologists, 4 nurses and 6 nurse educators) and some minor alternations were made based on their suggestions. For cultural reasons, only three items were added to the original version and four items that convey different concepts were separated into two items. As a result, the Care-Q consists of 57 caring behaviors that were ordered in the following 6 dimensions: “Being accessible” (6 items), “Explains and facilitates” (9 items), “Comforts” (11 items), “Anticipates” (5 items), “Trusting relationship” (18 items), “Monitors and follows through” (8 items). Thus, the final instrument pack (containing the consent form, directions for doing the scoring, a demographic data sheet and main questionnaire of caring) were reviewed with the study participants to score the items of caring behaviors according to the following question “In order to make you feel cared for, how important is it that the nurses…?” Finally, The data were analyzed using SPSS ver. 13.0 and each questionnaire item was first coded for a statistical analysis from 1 for Copyright © 2013 by Tabriz University of Medical Sciences the least important to 5 for the most important and then mean scores and standard deviations were calculated to find the most important nurse caring behaviors. Evidence Based Paper.Evidence Based Essay PaperORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERSThe overall mean for each individual was calculated for each dimension to determine the order distribution of them. It should be mentioned that before beginning the study, approval was obtained from the Ethical Committee of Tabriz University of Medical Sciences. The research assistant met with each participant explained the purpose of the study and the instrument packet materials. Evidence Based Essay Paper. Moreover, written and oral informed consent to participate in the study were obtained from each participant who agreed to complete the instrument. It emphasized that participation was voluntary and subjects were assured of confidentiality. Results Demographic Characteristics The participants ranged in age from 15 to 85 (a mean age of 44.7, SD=17.7) years. Among the patients with cancer, the majority were married and their educational level was moderate to low. The original diagnosis of cancer mostly consisted of hematological and digestive systems and numbers of prior hospitalizations in this center were lower than 5-time, for majority of the patients. The detailed demographic characteristic of the patients with cancer are presented in Table 1. Importance of Nurse Caring Behaviors As shown in Table 2, patients with cancer rated the Care-Q dimensions with mean scores ranging from 3.95 to 4.32 and in general. The scores showed that patients gave high mean values to a large number of dimensions. This indicates that patients with cancer assigned various nurse caring behaviors to be of a very high importance. Also, the results of the importance of caring behaviors were calculated based on their confidence intervals which showed patients with cancer prioritized “Monitors and Journal of Caring Sciences, December 2013; 2 (4), 221-327| 323 Roghayeh Azimzadeh et al. follows through”, “Being accessible”as the most important and “Comforts”, “Trusting relationship” as the least important dimensions (Table 2 and Chart 1). Table 1.Demographic Characteristic of Patients with Cancer (N=200) N (%) Characteristic Sex Male Female 97 (48.5) 103 (51.5) Marital status Single Married Other 41(20.5) 156 (78.0) 3 (1.5) Educational level Uneducated Primary education Secondary education Tertiary education 59 (29.5) 78 (39.0) 46 (23.0) 17 (8.5) Numbers of priori hospitalizations Lower than 5-time Between 6 to 10-time Upper than 11-time 156 (78.0) 31 (15.5) 13 (6.5) Original diagnosis of cancer disease Hematological system Digestive system Lymphatic system Urogenital system Respiratory system Musculoskeletal system Other systems system 63 (31.5) 54 (27.0) 27 (13.5) 14 (7.0) 12 (6.0) 12 (6.0) 18 ( 9.0) Table 2: The Mean Values of Perception among Patients with Cancer toward the Importance of Nursing Care Behaviors (in order of importance) The Care-Q Behaviors Monitors and follows through (8 items) Being accessible (6 items) Anticipates (5 items) Explains and facilitates (9 items) Comforts (11 items) Trusting relationship (18 items) Mean ( SD*) 4.33 (0.41) 4.32 (0.44) 4.19 (0.57) 4.17 (0.49) 4.06 (0.50) 3.95 (0.45) Patients (n=200) order 1 2 3 4 5 6 *. Highest possible mean=5, lowest possible mean=1 324 | Journal of Caring Sciences, December 2013; 2 (4), 321-327 Copyright © 2013 by Tabriz University of Medical Sciences Patient’s perception about importance of nurse caring behaviors 4.4 4.3 4.2 95%Confidence Interval 4.1 4.0 3.9 3.8 “Being accessible” “Explains and “Comforts” “Anticipates” “Trusting facilitates” relationship” “Monitors and follows through” Chart 1. The 95% Confidence Interval of Perception of Patients with Cancer toward the Importance of Nursing Care Behaviors Discussion The present study indicated that patients with cancer assigned “Monitors and follows through” and “Being accessible” as the high priorities. Indeed, in order to provide patient centered care or to make patients feel cared for, patients with cancer expected their nurses to consider these high priorities as important in their caring behaviors. Evidence Based PaperIn this study, the high prioritizing of “Monitors and Follows through” is in accordance with previous studies results. 5,11,12 A possible explanation of this result is that nurses in the present wards monitor highly advanced treatments for cancer diagnosis and therefore may be considered this Care-Q dimension more important.9 With monitoring and follow-up of patients, clinical nurses show their professional ability and competent and hereby guarantee to provide all their nursing care.24 As mentioned in the results, “Being accessible” had been chosen as the second priority of caring dimension by the patients with cancer. In this filed, several studies in cancer wards showed that due to the importance of “Being accessible”, patients identified it as higher levels of importance in Copyright © 2013 by Tabriz University of Medical Sciences caring behaviors5,11,12 which were in accordance with the findings of the present study. Nevertheless, some studies in cancer treatment wards were also done in which patients with cancer considered lower priority for this dimension6,9 which were not in accordance with the present study. According to Henderson et al., when nurses immediately and quickly are available for patients to provide care, potentially, it would cause patients to believe nurses truly take care of them.25 The other findings of this study indicated that patients with cancer considered “Physical and emotional comforts” and “Trusting relationship” as the low priorities. When we compared these with previous studies, the low prioritizing of “Trusting relationship”5,6,9,11,12 and “Physical and emotional comforts”9 were in accordance with our study results. Of course, There are also few studies6, 11 that indicate “Physical and emotional comforts” are still highly valued and respected by patients with cancer. It is likely that with shortage of nursing staffs in combination with increased workload and high number of patients, our nurses can only focus on main tasks and leave the tasks they Journal of Caring Sciences, December 2013; 2 (4), 221-327| 325 Roghayeh Azimzadeh et al. are not reprimanded for failing to do so26 and thus patients’ perception may be affected by these issues and think that they should not expect their nurses to do these tasks. Another possible explanation is related to the study patients’ cultural field that makes to expect from their families more emotional care and just expect from their nurses to provide appropriate physical care. On the other hand, the findings are accordance with Leininger’s statement that caring processes, expressions, patterns and behaviors can culturally be identified differently, so that eventually lead nurses’ decision-making and performances. Indeed, to provide therapeutic nursing care, the nurse should have knowledge of caring values, beliefs and practices of the patients.Evidence Based Paper. Evidence Based Paper. Evidence Based Essay PaperPatients have the right to be “cared for” in a way that indicates respect for their cultural diversity.27 Therefore, each nurse should consider individual characteristics, interests, needs, socio-cultural and physiological characteristics of each patient.28 It should be acknowledged that in the present study, patients evaluated most caring behaviors with higher scores (mean scores of dimensions were over 3.5 or in moderate to high level). In fact, this indicates that patients with cancer had enormous expectations from provided care and wanted from their nurses to do those best. The findings of this research require to be considered in light of few limitations. In this study, most patients with cancer mentioned that the many numbers of the questionnaire items (n=57) needed lengthy time for completion, as such this was accomplished with some patients in two or three different periods. The majority of the respondents tended to nominate the top two values of the 5-point Likert scale for most scale items. This makes it difficult to make a true distinction between the relative importance of the items and the dimensions. Conclusion This study aimed to assess what are important for patient centered care in cancer 326 | Journal of Caring Sciences, December 2013; 2 (4), 321-327 wards by measuring patients’ perception toward the importance of caring behaviors. The findings of the present study, indicated that the “Monitors and follows through” and “Being accessible” caring behaviors were more importance by patients with cancer, so these conduces nurses to notice and perform these in their nursing care. By so doing, moving to. the main goal of patient centered care can be provided. Indeed, the results provide some concrete information on what caring behaviors the patients with cancer would like to experience in their nursing care. Of course, to understand truly about nursing care, there is a need for further investigations, and so it is recommended that further qualitative research be carried out. Also more work is required into examining the pragmatics of using a quantitative instrument with cancer respondents. Methods such as Likert-scales may confuse some patients, so we need to develop other user friendly options. Furthermore, this study measured patients’ expectations toward the impotence of caring behaviors rather than nurses’ real practice in providing care. Therefore, for evaluation of the real status of care, similar studies are recommended to be done and so findin …Evidence Based Paper Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10 Order NowjQuery(document).ready(function($) { $.post(‘https://nursingpaperessays.com/wp-admin/admin-ajax.php’, {action: ‘wpt_view_count’, id: ‘9257’});});jQuery(document).ready(function($) { $.post(‘https://nursingpaperessays.com/wp-admin/admin-ajax.php’, {action: ‘mts_view_count’, id: ‘9257’});});

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