On average, a professional rugby union player is more likely than not to sustain a concussion after 25 matches
- Rafferty, James, Ranson, Craig, Oatley, Giles, Mostafa, Mohamed, Mathema, Prabhat, Crick, Tom, Moore, Isabel
- Authors: Rafferty, James , Ranson, Craig , Oatley, Giles , Mostafa, Mohamed , Mathema, Prabhat , Crick, Tom , Moore, Isabel
- Date: 2019
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 53, no. 15 (2019), p. 969-973
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- Description: To investigate concussion injury rates, the likelihood of sustaining concussion relative to the number of rugby union matches and the risk of subsequent injury following concussion. A four-season (2012/2013-2015/2016) prospective cohort study of injuries in professional level (club and international) rugby union. Incidence (injuries/1000 player-match-hours), severity (days lost per injury) and number of professional matches conferring a large risk of concussion were determined. The risk of injury following concussion was assessed using a survival model. Concussion incidence increased from 7.9 (95% CI 5.1 to 11.7) to 21.5 injuries/1000 player-match-hours (95% CI 16.4 to 27.6) over the four seasons for combined club and international rugby union. Concussion severity was unchanged over time (median: 9 days). Players were at a greater risk of sustaining a concussion than not after an exposure of 25 matches (95% CI 19 to 32). Injury risk (any injury) was 38% greater (HR 1.38 95% CI 1.21 to 1.56) following concussion than after a non-concussive injury. Injuries to the head and neck (HR 1.34 95% CI 1.06 to 1.70), upper limb (HR 1.59 95% CI 1.19 to 2.12), pelvic region (HR 2.07 95% CI 1.18 to 3.65) and the lower limb (HR 1.60 95% CI 1.21 to 2.10) were more likely following concussion than after a non-concussive injury. Concussion incidence increased, while severity remained unchanged, during the 4 years of this study. Playing more than 25 matches in the 2015/2016 season meant that sustaining concussion was more likely than not sustaining concussion. The 38% greater injury risk after concussive injury (compared with non-concussive injury) suggests return to play protocols warrant investigation.
- Authors: Rafferty, James , Ranson, Craig , Oatley, Giles , Mostafa, Mohamed , Mathema, Prabhat , Crick, Tom , Moore, Isabel
- Date: 2019
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 53, no. 15 (2019), p. 969-973
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- Description: To investigate concussion injury rates, the likelihood of sustaining concussion relative to the number of rugby union matches and the risk of subsequent injury following concussion. A four-season (2012/2013-2015/2016) prospective cohort study of injuries in professional level (club and international) rugby union. Incidence (injuries/1000 player-match-hours), severity (days lost per injury) and number of professional matches conferring a large risk of concussion were determined. The risk of injury following concussion was assessed using a survival model. Concussion incidence increased from 7.9 (95% CI 5.1 to 11.7) to 21.5 injuries/1000 player-match-hours (95% CI 16.4 to 27.6) over the four seasons for combined club and international rugby union. Concussion severity was unchanged over time (median: 9 days). Players were at a greater risk of sustaining a concussion than not after an exposure of 25 matches (95% CI 19 to 32). Injury risk (any injury) was 38% greater (HR 1.38 95% CI 1.21 to 1.56) following concussion than after a non-concussive injury. Injuries to the head and neck (HR 1.34 95% CI 1.06 to 1.70), upper limb (HR 1.59 95% CI 1.19 to 2.12), pelvic region (HR 2.07 95% CI 1.18 to 3.65) and the lower limb (HR 1.60 95% CI 1.21 to 2.10) were more likely following concussion than after a non-concussive injury. Concussion incidence increased, while severity remained unchanged, during the 4 years of this study. Playing more than 25 matches in the 2015/2016 season meant that sustaining concussion was more likely than not sustaining concussion. The 38% greater injury risk after concussive injury (compared with non-concussive injury) suggests return to play protocols warrant investigation.
Data Praxis : Teacher educators using data to inform and enhance pre-service teacher mathematics
- Peter, Sellings, Robyn, Brandenburg
- Authors: Peter, Sellings , Robyn, Brandenburg
- Date: 2018
- Type: Text , Journal article
- Relation: Mathematics teacher education & development Vol. 20, no. 3 (2018), p. 61-79
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- Description: This paper explores how data can shape and enhance mathematics learning and teaching in an initial teacher education Learning and Teaching Mathematics Course for First Bachelor of Education Students in a Regional University. The implementation of a 'data praxis' approach to research, required the development of a custom-designed suite of data gathering tools and approaches to inform our mathematics teaching and enhance pre-service teacher mathematical learning, underpinned the conduct of the study. Praxis required the teacher educators to constantly and systematically interact with the data sets and refine the pedagogical approaches to mathematics teaching and learning. The results of this research highlight the gains that students made and the challenges for teacher educators who choose a data based approach. [Author abstract]
- Authors: Peter, Sellings , Robyn, Brandenburg
- Date: 2018
- Type: Text , Journal article
- Relation: Mathematics teacher education & development Vol. 20, no. 3 (2018), p. 61-79
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- Description: This paper explores how data can shape and enhance mathematics learning and teaching in an initial teacher education Learning and Teaching Mathematics Course for First Bachelor of Education Students in a Regional University. The implementation of a 'data praxis' approach to research, required the development of a custom-designed suite of data gathering tools and approaches to inform our mathematics teaching and enhance pre-service teacher mathematical learning, underpinned the conduct of the study. Praxis required the teacher educators to constantly and systematically interact with the data sets and refine the pedagogical approaches to mathematics teaching and learning. The results of this research highlight the gains that students made and the challenges for teacher educators who choose a data based approach. [Author abstract]
Burnout, stress and resilience of an Australian regional hospital during COVID-19: a longitudinal study
- Armstrong, Samantha, Porter, Joanne, Larkins, Jo-Ann, Mesagno, Christopher
- Authors: Armstrong, Samantha , Porter, Joanne , Larkins, Jo-Ann , Mesagno, Christopher
- Date: 2022
- Type: Text , Journal article
- Relation: BMC health services research Vol. 22, no. 1 (2022), p. 1-1115
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- Description: Abstract Coronavirus disease 2019 (COVID-19) has placed huge strain on hospital staff around the world. The aim of the current longitudinal study was to investigate the resilience, stress and burnout of hospital staff located at a large, regional hospital in Victoria, Australia during the COVID-19 pandemic over time via cross-sectional surveys. The surveys were disseminated six times from August 2020 to March 2021, with the first three data collection points distributed during a state-wide lockdown. A total of 558 responses from various professional roles within the hospital over the survey period were included in the sample. Analysis of variance indicated significant main effects for the psychological variables across time, age, and workload. Hospital staff reported an increase in burnout levels throughout the eight-months. Significant negative relationships were observed between resilience and burnout, and between resilience and stress. A backward regression highlighted the contribution of resilience, stress, age, and nursing roles on burnout. Hierarchical regression analysis indicated that resilience contributed to the stress-burnout relationship. This study strengthens the evidence between resilience and burnout among healthcare workers and hospital staff and highlights the need for psychological wellbeing programs to be implemented for hospital staff impacted by a prolonged worldwide pandemic.
- Authors: Armstrong, Samantha , Porter, Joanne , Larkins, Jo-Ann , Mesagno, Christopher
- Date: 2022
- Type: Text , Journal article
- Relation: BMC health services research Vol. 22, no. 1 (2022), p. 1-1115
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- Description: Abstract Coronavirus disease 2019 (COVID-19) has placed huge strain on hospital staff around the world. The aim of the current longitudinal study was to investigate the resilience, stress and burnout of hospital staff located at a large, regional hospital in Victoria, Australia during the COVID-19 pandemic over time via cross-sectional surveys. The surveys were disseminated six times from August 2020 to March 2021, with the first three data collection points distributed during a state-wide lockdown. A total of 558 responses from various professional roles within the hospital over the survey period were included in the sample. Analysis of variance indicated significant main effects for the psychological variables across time, age, and workload. Hospital staff reported an increase in burnout levels throughout the eight-months. Significant negative relationships were observed between resilience and burnout, and between resilience and stress. A backward regression highlighted the contribution of resilience, stress, age, and nursing roles on burnout. Hierarchical regression analysis indicated that resilience contributed to the stress-burnout relationship. This study strengthens the evidence between resilience and burnout among healthcare workers and hospital staff and highlights the need for psychological wellbeing programs to be implemented for hospital staff impacted by a prolonged worldwide pandemic.
Significance level of a query for enterprise data
- Thi Ngoc Dinh, Loan, Karmakar, Gour, Kamruzzaman, Joarder, Stranieri, Andrew, Das, Rajkumar
- Authors: Thi Ngoc Dinh, Loan , Karmakar, Gour , Kamruzzaman, Joarder , Stranieri, Andrew , Das, Rajkumar
- Date: 2017
- Type: Text , Conference proceedings
- Relation: 30th International Business Information Management Association Conference - Vision 2020: Sustainable Economic development, Innovation Management, and Global Growth, IBIMA 2017; Madrid, Spain; 8th-9th November 2017 Vol. 2017-January, p. 4494-4504
- Full Text: false
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- Description: To operate enterprise activities, a large number of queries need to be processed every day through an enterprise system. Consequently, such a system frequently faces hugely overloaded information and incurs high delay in producing query responses for big data. This is because, traditional queries are normally treated with equal importance. With the advent of big data and its use in enterprise systems and the growth of process complexity, the traditional approach of query processing is no more suitable as it does not consider semantic information and captures all data irrespective of their relevance to a business organization, which eventually increases the computational time in both big data collection and analysis. The significance level of a query can make a trade-off between query response delay and the extent of data collection and analysis. This motivates us to concentrate on determining the significance level of a query considering its importance to an enterprise system. To our knowledge, no such approach is available in the literature. To bridge this research gap, this paper, for the first time, proposes an approach to determine the significance level of a query to prioritize them with the relevance to a business organization. As business processes play key roles in any enterprise system and all business processes are not equally important, this is done by determining the semantic similarity between a query and the processes of a business organization and the importance of a business process to that organization. With a case study on an enterprise system of a retail company, the results produced by our proposed approach have shown that significance level is higher for more important queries compared to the less important ones.
Barriers to effective management of primary postpartum haemorrhage following in-hospital births in northwest Ethiopia: healthcare providers’ views using a qualitative approach
- Bewket, Tiruneh, Ensieh, Fooladi, Plummer, Virginia, McLelland, Gayle
- Authors: Bewket, Tiruneh , Ensieh, Fooladi , Plummer, Virginia , McLelland, Gayle
- Date: 2022
- Type: Text , Journal article
- Relation: BMC pregnancy and childbirth Vol. 22, no. 1 (2022), p. 1-755
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- Description: Abstract Background Data showed that postpartum haemorrhage contributed to over 40% of in-hospital deaths of Ethiopian women. However, little is known about the barriers to effective management of primary postpartum haemorrhage. This study aims to explore the views and experiences of maternity healthcare professionals about the barriers to managing primary postpartum haemorrhage following in-hospital births in northwest Ethiopia using the ‘Three Delays’ model as a conceptual framework. Methods A qualitative descriptive study was employed at two tertiary referral hospitals between December 2018 and May 2019. Forty-one maternal healthcare providers, including midwives, midwifery unit managers, and obstetricians, participated in this study. Individual face-to-face interviews, focus group discussions, and self-administered open-ended questionnaires were used to collect data. A framework analysis approach was used for the qualitative data analysis. Themes were identified based on the Three Delays model of ‘delay the decision to seek care’, ‘delay arrival at a health facility’, and ‘delay the provision of appropriate and quality care’. Results Participants reported several modifiable issues when managing primary postpartum haemorrhage, and all were linked to a delay in receiving appropriate and quality care due to limited resources. Five sub-themes were identified: ‘workforce’, ‘communication issues between healthcare providers’, ‘systemic issues’, ‘education, training, and resourcing issues’, and ‘lack of identification and referral’. Conclusion Maternal healthcare providers in these hospitals require training in managing a birthing emergency. In addition, the birth units need adequate supplies and continuous essential services.
- Authors: Bewket, Tiruneh , Ensieh, Fooladi , Plummer, Virginia , McLelland, Gayle
- Date: 2022
- Type: Text , Journal article
- Relation: BMC pregnancy and childbirth Vol. 22, no. 1 (2022), p. 1-755
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- Description: Abstract Background Data showed that postpartum haemorrhage contributed to over 40% of in-hospital deaths of Ethiopian women. However, little is known about the barriers to effective management of primary postpartum haemorrhage. This study aims to explore the views and experiences of maternity healthcare professionals about the barriers to managing primary postpartum haemorrhage following in-hospital births in northwest Ethiopia using the ‘Three Delays’ model as a conceptual framework. Methods A qualitative descriptive study was employed at two tertiary referral hospitals between December 2018 and May 2019. Forty-one maternal healthcare providers, including midwives, midwifery unit managers, and obstetricians, participated in this study. Individual face-to-face interviews, focus group discussions, and self-administered open-ended questionnaires were used to collect data. A framework analysis approach was used for the qualitative data analysis. Themes were identified based on the Three Delays model of ‘delay the decision to seek care’, ‘delay arrival at a health facility’, and ‘delay the provision of appropriate and quality care’. Results Participants reported several modifiable issues when managing primary postpartum haemorrhage, and all were linked to a delay in receiving appropriate and quality care due to limited resources. Five sub-themes were identified: ‘workforce’, ‘communication issues between healthcare providers’, ‘systemic issues’, ‘education, training, and resourcing issues’, and ‘lack of identification and referral’. Conclusion Maternal healthcare providers in these hospitals require training in managing a birthing emergency. In addition, the birth units need adequate supplies and continuous essential services.
Insider research, validity issues, and the OHS professional: one person's journey
- Authors: Teusner, Annabel
- Date: 2016
- Type: Text , Journal article
- Relation: International journal of social research methodology Vol. 19, no. 1 (2016), p. 85-96
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- Description: Validity in the context of qualitative research may take on many different definitions depending on the philosophical perspective. When a researcher conducts research within their place of employment, this will also influence the approach and interpretation. Insider research has been under scrutiny for the very fact that the insider is an actor within the setting. This paper explores my journey, conducting insider research and working as an occupational health and safety practitioner, by presenting an example of the methods used, including reflectivity and reflexivity, to address validity issues which may arise prior, during and post data collection.
Psychological impact of COVID-19 on healthcare workers : cross-sectional analyses from 14 countries
- Ghozy, Sherief, Cross, Wendy, Islam, Shariful, Al-Mawali, Adhra Hilal, Alqurashi, Alaa, Hamza, Amr, Joseph, Bindu, Banik, Biswajit, Elsori, Deena, Sultana, Farhana, Yasmin, Farhana, Mahmud, Ilias, Lam, Louisa, Hammoud, Majeda, Salehin, Masudus, Keblawi, Mohammed Ali, Eltewacy, Nael Kamel, Al Laham, Nahed, El-Khazragy, Nashwa, Oli, Natalia, Tungpunkom, Patraporn, Almustanyir, Sami, Chair, Sek, Alif, Sheikh, Al-Madhoun, Sondos, Chien, Wai Tong, Rahman, Muhammad Aziz
- Authors: Ghozy, Sherief , Cross, Wendy , Islam, Shariful , Al-Mawali, Adhra Hilal , Alqurashi, Alaa , Hamza, Amr , Joseph, Bindu , Banik, Biswajit , Elsori, Deena , Sultana, Farhana , Yasmin, Farhana , Mahmud, Ilias , Lam, Louisa , Hammoud, Majeda , Salehin, Masudus , Keblawi, Mohammed Ali , Eltewacy, Nael Kamel , Al Laham, Nahed , El-Khazragy, Nashwa , Oli, Natalia , Tungpunkom, Patraporn , Almustanyir, Sami , Chair, Sek , Alif, Sheikh , Al-Madhoun, Sondos , Chien, Wai Tong , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: Glob. Ment. Health Vol. 9, no. (2022), p. 328-338
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- Description: Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs. A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively. A total of 2447 HCWs participated 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20% the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63% the lowest rate was reported in Libya (28%) and the highest in Syria (76%). COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered.
- Authors: Ghozy, Sherief , Cross, Wendy , Islam, Shariful , Al-Mawali, Adhra Hilal , Alqurashi, Alaa , Hamza, Amr , Joseph, Bindu , Banik, Biswajit , Elsori, Deena , Sultana, Farhana , Yasmin, Farhana , Mahmud, Ilias , Lam, Louisa , Hammoud, Majeda , Salehin, Masudus , Keblawi, Mohammed Ali , Eltewacy, Nael Kamel , Al Laham, Nahed , El-Khazragy, Nashwa , Oli, Natalia , Tungpunkom, Patraporn , Almustanyir, Sami , Chair, Sek , Alif, Sheikh , Al-Madhoun, Sondos , Chien, Wai Tong , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: Glob. Ment. Health Vol. 9, no. (2022), p. 328-338
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- Reviewed:
- Description: Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs. A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively. A total of 2447 HCWs participated 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20% the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63% the lowest rate was reported in Libya (28%) and the highest in Syria (76%). COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered.
P2DCA: A Privacy-preserving-based data collection and analysis framework for IoMT applications
- Usman, Muhammad, Jan, Mian, He, Xiangjian, Chen, Jinjun
- Authors: Usman, Muhammad , Jan, Mian , He, Xiangjian , Chen, Jinjun
- Date: 2019
- Type: Text , Journal article
- Relation: IEEE journal on selected areas in communications Vol. 37, no. 6 (2019), p. 1222-1230
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- Description: The concept of Internet of Multimedia Things (IoMT) is becoming popular nowadays and can be used in various smart city applications, e.g., traffic management, healthcare, and surveillance. In the IoMT, the devices, e.g., Multimedia Sensor Nodes (MSNs), are capable of generating both multimedia and non-multimedia data. The generated data are forwarded to a cloud server via a Base Station (BS). However, it is possible that the Internet connection between the BS and the cloud server may be temporarily down. The limited computational resources restrict the MSNs from holding the captured data for a longer time. In this situation, mobile sinks can be utilized to collect data from MSNs and upload to the cloud server. However, this data collection may create privacy issues, such as revealing identities and location information of MSNs. Therefore, there is a need to preserve the privacy of MSNs during mobile data collection. In this paper, we propose an efficient privacy-preserving-based data collection and analysis (P2DCA) framework for IoMT applications. The proposed framework partitions an underlying wireless multimedia sensor network into multiple clusters. Each cluster is represented by a Cluster Head (CH). The CHs are responsible to protect the privacy of member MSNs through data and location coordinates aggregation. Later, the aggregated multimedia data are analyzed on the cloud server using a counter-propagation artificial neural network to extract meaningful information through segmentation. Experimental results show that the proposed framework outperforms the existing privacy-preserving schemes, and can be used to collect multimedia data in various IoMT applications.
Nurses, physicians and patients' knowledge and attitudes about nurse prescribing
- Haririan, Hamidreza, Seresht, Deniz Manie, Hassankhani, Hadi, Porter, Joanne, Wytenbroek, Lydia
- Authors: Haririan, Hamidreza , Seresht, Deniz Manie , Hassankhani, Hadi , Porter, Joanne , Wytenbroek, Lydia
- Date: 2022
- Type: Text , Journal article
- Relation: BMC Nursing Vol. 21, no. 1 (2022), p. 112-112
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- Description: One of the roles that nurses have acquired in recent years is the role of prescribing. This study aimed to investigate the knowledge and attitudes of critical care nurses, physicians and patients about nurse prescribing. A descriptive cross-sectional study with the participation of 152 nurses, 53 physicians and 75 patients was carried out. Participants were selected by stratified random sampling from the critical care units of six hospitals in Tabriz, Iran. Demographics and participants' knowledge and attitudes about nurse prescribing questionnaires were used to collect data. The collected data were analyzed using SPSS-22 software. The mean scores of total knowledge about nurse prescribing in nurses, patients and physicians' were 15.41 ± 1.85,16.45 ± 2.31, 14.74 ± 1.7 respectively (from a range of 10 -20), and the mean score of knowledge by physicians was significantly higher than others (P = 0.000) and they had more knowledge about nurse prescribing. The mean scores of the attitudes towards nurse prescribing in nurses, physicians and patients were 40.62 ± 3.68, 37.98 ± 5.92 and 39.38 ± 4.39 respectively (from a range of 10 -50). However, the total mean score of attitudes among nurses was significantly higher than others (P = 0.000) and nurses had more positive attitudes toward prescribing. The results showed that the participants have a good understanding and attitudes toward nurse prescribing. Nurse prescribing as a new duty and authority can be considered in providing more effective care by specialist nurses. The results of this study can also be used in the future planning of health policy for nurses to have the right to prescribe and ultimately improve the quality of patient care.
- Authors: Haririan, Hamidreza , Seresht, Deniz Manie , Hassankhani, Hadi , Porter, Joanne , Wytenbroek, Lydia
- Date: 2022
- Type: Text , Journal article
- Relation: BMC Nursing Vol. 21, no. 1 (2022), p. 112-112
- Full Text:
- Reviewed:
- Description: One of the roles that nurses have acquired in recent years is the role of prescribing. This study aimed to investigate the knowledge and attitudes of critical care nurses, physicians and patients about nurse prescribing. A descriptive cross-sectional study with the participation of 152 nurses, 53 physicians and 75 patients was carried out. Participants were selected by stratified random sampling from the critical care units of six hospitals in Tabriz, Iran. Demographics and participants' knowledge and attitudes about nurse prescribing questionnaires were used to collect data. The collected data were analyzed using SPSS-22 software. The mean scores of total knowledge about nurse prescribing in nurses, patients and physicians' were 15.41 ± 1.85,16.45 ± 2.31, 14.74 ± 1.7 respectively (from a range of 10 -20), and the mean score of knowledge by physicians was significantly higher than others (P = 0.000) and they had more knowledge about nurse prescribing. The mean scores of the attitudes towards nurse prescribing in nurses, physicians and patients were 40.62 ± 3.68, 37.98 ± 5.92 and 39.38 ± 4.39 respectively (from a range of 10 -50). However, the total mean score of attitudes among nurses was significantly higher than others (P = 0.000) and nurses had more positive attitudes toward prescribing. The results showed that the participants have a good understanding and attitudes toward nurse prescribing. Nurse prescribing as a new duty and authority can be considered in providing more effective care by specialist nurses. The results of this study can also be used in the future planning of health policy for nurses to have the right to prescribe and ultimately improve the quality of patient care.
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