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Biomedical subjects

R Halfens

Publications and source records attributed to R Halfens.

At least 19 recordsLinked to original sources
PubMed1999

Quality of life in older patients with systolic and diastolic heart failure.

AIMS: To get insight into the quality of life of a clinical practice sample of patients with heart failure that are admitted to the hospital. Secondly to determine differences between patients with systolic and diastolic dysfunction and finally to describe factors relating to quality of life. METHODS: Three dimensions of quality of life (functional capabilities, symptoms and psychosocial adjustment to illness) were assessed during interviews of 186 patients with chronic heart failure. In addition, data on demographic, clinical and self-care characteristics were collected and patients completed a 6-min walk. RESULTS: On average patients walked 172 m in 6 min and reported functioning in daily life at a mean level of 4.5 MET. Patients experienced four different symptoms of heart failure. Most of them described dyspnea, fatigue, sleep disturbance and ankle oedema. Problems with psychosocial adaptation occurred mostly in social and vocational domains. Overall well-being of patients was rated as 6.4 on a 10-point scale. In regard to quality of life, the only differences between patients with systolic and diastolic heart failure was the occurrence of ankle oedema and health-care orientation. The variance in components of quality of life were partly explained by demographics and clinical characteristics. All three dimensions of quality of life were related to ability for self-care. CONCLUSION: Patients with heart failure seen in clinical practice are often not comparable to patients described in major clinical trials or patients that are admitted for transplant evaluation. Their functional capabilities are more compromised, but they may have fewer problems with psychosocial adjustment. Patients with normal systolic dysfunction also report a low quality of life. It could be important to enhance self-care abilities of patients to improve psychosocial adaptation to illness.

Aged↗
PubMed1999

Effects of education and support on self-care and resource utilization in patients with heart failure.

AIMS: To test the effect of education and support by a nurse on self-care and resource utilization in patients with heart failure. METHODS: A total of 179 patients (mean age 73, 58% male, NYHA III-IV) hospitalized with heart failure were evaluated prospectively. Patients were randomized to the study intervention or to 'care as usual'. The supportive educative intervention consisted of intensive, systematic and planned education by a study nurse about the consequences of heart failure in daily life, using a standard nursing care plan developed by the researchers for older patients with heart failure. Education and support took place during the hospital stay and at a home visit within a week of discharge. Data were collected on self-care abilities, self-care behaviour, readmissions, visits to the emergency heart centre and use of other health care resources. RESULTS: Education and support from a nurse in a hospital setting and at home significantly increases self-care behaviour in patients with heart failure. Patients from both the intervention and the control group increased their self-care behaviour within 1 month of discharge, but the increase in the intervention group was significantly more after 1 month. Although self-care behaviour in both groups decreased during the following 8 months, the increase from baseline remained statistically significant in the intervention group, but not in the control group. No significant effects on resource utilization were found. CONCLUSIONS: Intensive, systematic, tailored and planned education and support by a nurse results in an increase in patients' self-care behaviour. No significant effects were found on use of health care resources. Additional organisational changes, such as longer follow-up and the availability of a heart failure specialist would probably enhance the effects of education and support.

Aged↗
PubMed1998

Developing a supportive-educative program for patients with advanced heart failure within Orem's general theory of nursing.

Recovery from heart failure and coping with the effects of this serious condition has a major impact on the self-care demand of patients with heart failure. To prevent potential self-care deficits, education and support are important issues in nursing care. The purpose of this article is to describe the development of a supportive-educative program that is designed to enhance self-care abilities of patients with heart failure. To structure nursing care for these patients and their families in a consistent systematized way, Orem's general theory of nursing is used as a frame of reference.

Activities of Daily Living↗
PubMed1997

Burnout and the work environment of nurses in psychiatric long-stay care settings.

The aim of this study was to investigate the relationship between burnout and a number of work-related factors among nurses working in psychiatric long-stay care settings. Another aim was to investigate the differences between these associations at individual and at group level. Differences were found in the correlations, as well as in the regression analyses, at individual and group level. The correlations between burnout and the independent variables were more often significant at individual level and the explained variances of the regression analyses were much higher at ward than at individual level. Results showed that work environments associated with low levels of burnout were those in which workers had good support and feedback, job clarity, autonomy and low levels of complexity in their work, who had managers with a social leadership style and who had realistic expectations about their patients' potential for rehabilitation. Furthermore, it was found that it was not the individual work experience of the nurse that was important in determining burnout, but the mean work experience of the nursing staff.

Adult↗
PubMed1997

'Maintaining the balance'--nursing care of patients with chronic heart failure.

Nurses in different settings are involved in caring for patients with heart failure. In the clinic, hospital, nursing home or patients' home, the nurse has a role in detecting, identifying and treating heart failure. In order to provide optimal care, literature on possible and effective interventions should be available to nurses. This study gives an overview of nursing care for patients with heart failure as described in practice, literature and standard nursing care plans. Based on interviews of 45 nurses, a review of all pertinent literature published between 1983 and 1993 and a review of standard nursing care plans used in the Netherlands to care for patients with heart failure, four composite themes emerged; namely, basic nursing care, assessment and observation, symptom-relieving interventions, and patient education. Caring for patients with heart failure is very complex and is often aimed at keeping a very delicate balance between, e.g. rest and activity, fluid intake and elimination, and therapeutic cost and benefit. Treatment strategies for optimizing care for these patients are described.

Heart Failure↗
PubMed1997

[Education and guidance of a patient with chronic heart failure. A case study].

The number of patients with heart failure is growing. To optimize care for these patients in hospital and at home, a supportive-educative intervention is developed. The intervention is guided by a standard nursing care plan which is developed from literature, existing standard nursing care plans, and interviews with nurses. A case study is used to explain and illustrate the intervention and to review the importance of the standard nursing care plan.

Aged↗
PubMed1995

The tasks of psychiatric nurses in long-term residential settings in The Netherlands.

The tasks of the psychiatric nurse, working in long-term psychiatric settings, are described and analysed in this study. A questionnaire was completed by 361 nurses in five different psychiatric hospitals in the Netherlands. Nurses appear to concentrate upon personal care tasks in and around their ward. This does not fit adequately the changes in psychiatric practice. By means of an externally oriented hospital policy, cooperation with other care agencies and a realization of a more patient-orientated and rehabilitation model of care, the nurse is better prepared for helping patients make their move to the community.

Adult↗
PubMed1994

Likert or Rasch? Nothing is more applicable than good theory.

In nursing research many concepts are measured by questionnaires. Respondents are asked to respond to a set of related statements or questions. In unidimensional scaling these statements or questions are indicants of the same concept. Scaling means to assign numbers to respondents, according to their position on the continuum underlying the concept. It is very common to use the summative Likert scaling procedure. The sumscore of the responses to the items is the estimator of the position of the patient on the continuum. The rationale behind this procedure is classical test theory. The main assumption in this theory is that all items are parallel instruments. The Rasch model offers an alternative scaling procedure. With Rasch both respondents and items are scaled on the same continuum. Whereas in Likert scaling all items have the same weight in the summating procedure, in the Rasch model items are differentiated from each other by 'difficulty'. The model holds that the probability of a positive response to an item is dependent on the difference between the difficulty of the item and the value of the person on the latent trait. The rationale behind this procedure is item response theory. In this paper both scaling procedures and their rationales are discussed.

Bias↗
PubMed1994

Effect of the use of sleep medication in Dutch hospitals on the use of sleep medication at home.

Insomnia is an important nursing problem in hospitals. Although the use of sleep medication is often criticized, it is one of the commonest interventions with regard to sleep problems. In this study, the effect of the administration of sleep medication in Dutch hospitals on the use of sleep medication at home is investigated. Only patients were included who had never used sleep medication before admittance in hospital. Results show that patients who used sleep medication for at least 5 days in hospital (n = 233) used sleep medication more often at home after discharge than patients who did not use sleep medication in hospital (n = 55). Furthermore, the study showed that those patients who used at least 5 days' sleep medication, especially those patients who used sleep medication more often in hospital, also used sleep medication more often at home. This is in line with the addictive effects of sleep medication. From these results it can be concluded that the administration of sleep medication is not without danger. Therefore, it is recommended to search for alternative interventions, especially for patients who are in hospital for a longer period.

Adult↗
PubMed1994

Aggression in psychiatry: a qualitative study focusing on the characterization and perception of patient aggression by nurses working on psychiatric wards.

The present study focuses on the characterization and perception of patient aggression by nurses working in a psychiatric hospital in The Netherlands. Data have been collected by interviewing nurses working on open and closed wards. The results have been compared and related to the existing literature on aggression. An expert panel has collaborated in the assessment of part of the research findings. Nurses perceive and describe aggression in different ways. Since the descriptions of aggression varied considerably, it was not possible to formulate a general definition of aggression on the basis of the results of the study. Despite the fact that on the whole the general public have a negative view of aggression, the descriptions nurses gave were not always negative. Most of the nurses acknowledged positive as well as negative aspects of aggressive behaviour by patients. Interventions in cases of aggressive behaviour depend on different factors, e.g. the individual nurse's perception of the situation, the (mostly unwritten) rules, and the type of ward (open or closed). The same interventions are often used both to prevent aggression and to stop it. The difference lies in the moment of execution. Most interventions are aimed at stopping aggressive behaviour by acting in a non-restrictive way, e.g. by talking to the patient, touching the patient and giving unexpected responses. Nurses express the belief that aggression is mainly caused by a combination of patient-related, situational and interactional factors. This is not in accordance with the opinion of the North American Nursing Diagnosis Association, who relate aggressive behaviour mainly to patient characteristics.

Aggression↗
PubMed1994

[Level of competence. Relationship to the complexity of nursing care].

The aim of the study was to investigate the correlation between complexity of nursing care and the level of competence of the nurse. In the study the actual level of competence and the desired level of competence has been distinguished. In total, 105 patients participated in the study. Complexity of care correlates with desired level of competence, but hardly with the actual level of competence. The correlation between complexity and level of competence is higher for new patients than for patients who were receiving care already.

Clinical Competence↗