Effect of combined care nursing on patient satisfaction, staff satisfaction, and quality of care /

This research evaluates the effect of combined care nursing on three outcomes: i) patient satisfaction; ii) staff satisfaction; and iii) quality of care. Oakville-Trafalgar Memorial Hospital was in the early planning stages of changing to combined care nursing from the traditional method of providing separate postpartum and nursery care to mothers and babies. The opportunity existed to evaluate formally the change to combined care. There were three hypotheses to be investigated. Data were collected from four sources: patient surveys, staff surveys, informal interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. The surveys were administered on three different occasions to patients and staff. Other sources of data included informal interviews with patients and staff who responded to the surveys, and chart audits.The study findings revealed that the majority of respondents had increased levels of satisfaction and perceptions of increased quality of care following implementation of combined care. These findings, related to combined care and the role of change in its implementation and evaluation, indicate that there are no right or easy answers about how to make new ideas become reality in a smooth, pleasant way.

Examining the influence of family support on diabetes education behavioural outcomes

The purpose of this study was to examine the influence of family support on diabetes education behavioural outcomes, specifically in relation to diet, exercise, and blood glucose monitoring in adult individuals with Type 2 diabetes. Fifty-three individuals attending diabetes education for the first time were followed approximately 1 month. The findings for the influence of family support were mixed. Family attending diabetes class with participants had a positive influence with respect to diet. This is consistent with Carl Rogers (1969) who espouses setting a positive climate for learning and that learning new attitudes or information comes when external barriers are at a minimum. However family attending class with participants had no influence with respect to exercise or blood glucose monitoring. The family support action of encouraging with respect to diet overall did not influence healthy eating behaviours except for decreased skipped meals and scheduled snacks. In fact, in the areas of family willing to make healthy choices along with participant, the less the family was involved in encouraging, the better the participant did. Exercise on the other hand was influenced positively by family encouragement. This is consistent with Bandura's theory that enhancement of self-confidence and self-efficacy can lead to desired behaviour changes. Family encouragement however did not appear to influence blood glucose monitoring behaviours. This study has implications for practice in that diabetes education programs can encourage family to attend classes or get involved in encouraging the person with diabetes, so that it may help to increase healthy eating behaviours and exercise. As time is necessary to implement changes in behaviour, future research can look at the influence of family support over a 6-month, I-year, or greater period.

Exploring the impact of outgroup membership discoveries on individual outcomes and intergroup relations

Group memberships represent important components of identity, with people holding membership in various groups and categories. The groups that one belongs to are known as ingroups, and the groups that one does not belong to are known as outgroups. Movement between groups can occur, such that an individual becomes a member of a former outgroup. In some cases, this movement between groups can represent a sudden discovery for the self and/or others, especially when one becomes a member of an ambiguous, concealable, or otherwise not readily visible group. The effects of this type of movement, however, are poorly documented. The purpose of this dissertation is to investigate these outgroup membership discoveries, examining the individual intrapsychic, interpersonal, and potential intergroup effects of both self- and other-outgroup membership discoveries. Specifically, discoveries of homosexuality were examined in three studies. In Study 1, hypothetical reactions to self- and other-homosexuality discovery were assessed; in Study 2, the effects of discovering self-homosexuality (vs. self-heterosexuality) were experimentally examined; and in Study 3, the effects of discovering another’s homosexuality earlier relative to later in a developing friendship were experimentally examined. Study 1 revealed that, upon a discovery of self-homosexuality, participants expected negative emotions and a more negative change in feelings toward the self. Upon a discovery of a friend’s homosexuality, participants expected a more negative change in feelings toward the friend, but more a positive change in feelings toward homosexuals. For both hypothetical self- and friend- homosexuality discoveries, more negative expected emotions predicted more negative expected change in feelings toward the target individual (the self or friend), which in turn predicted more negative expected change in feelings toward homosexuals as a group. Further, for self-homosexuality discovery, the association between negative expected emotions and negative expected change in feelings toward the self was stronger among those higher in authoritarianism. Study 2 revealed that, upon discovering one’s own homosexuality (vs. heterosexuality), heterosexual participants experienced more negative emotions, more fear of discrimination, and more negative self-evaluations. The effect of the homosexuality discovery manipulation on negative self-evaluations was mediated by fear of discrimination. Further, those higher in authoritarianism or pre-test prejudice toward homosexuals demonstrated more negative emotions following the manipulation. Study 3 revealed that upon discovering an interaction partner’s homosexuality earlier (vs. later) participants reported a more positive contact experience, a closer bond with the partner, and more positive attitudes toward the partner. Earlier (vs. later) discovery predicted more positive contact experience, which in turn predicted a closer bond with the partner. Closer bond with the partner subsequently predicted more positive evaluations of the partner. Interestingly, the association between bond with partner and more positive attitudes toward the partner was stronger among those higher in authoritarianism or pre-test prejudice toward homosexuals. Overall, results suggest that self-homosexuality discovery results in negative outcomes, whereas discovering another’s homosexuality can result in positive outcomes, especially when homosexuality is discovered earlier (vs. later). Implications of these findings for both actual outgroup membership discoveries and social psychological research are discussed.

The association between maternity insurance, residence status and selected perinatal outcomes among Chinese women

Objective: To investigate the impact of maternity insurance and maternal residence on birth outcomes in a Chinese population. Methods: Secondary data was analyzed from a perinatal cohort study conducted in the Beichen District of the city of Tianjin, China. A total of 2364 pregnant women participated in this study at approximately 12-week gestation upon registration for receiving prenatal care services. After accounting for missing information for relevant variables, a total of 2309 women with single birth were included in this analysis. Results: A total of 1190 (51.5%) women reported having maternity insurance, and 629 (27.2%) were rural residents. The abnormal birth outcomes were small for gestational age (SGA, n=217 (9.4%)), large for gestational age (LGA, n=248 (10.7%)), birth defect (n=48 (2.1%)) including congenital heart defect (n=32 (1.4%)). In urban areas, having maternal insurance increased the odds of SGA infants (1.32, 95%CI (0.85, 2.04), NS), but decreased the odds of LGA infants (0.92, 95%CI (0.62, 1.36), NS); also decreased the odds of birth defect (0.93, 95%CI (0.37, 2.33), NS), and congenital heart defect (0.65, 95%CI (0.21, 1.99), NS) after adjustment for covariates. In contrast to urban areas, having maternal insurance in rural areas reduced the odds of SGA infants (0.60, 95%CI (0.13, 2.73), NS); but increased the odds of LGA infants (2.16, 95%CI (0.92, 5.04), NS), birth defects (2.48, 95% CI (0.70, 8.80), NS), and congenital heart defect (2.18, 95%CI (0.48, 10.00), NS) after adjustment for the same covariates. Similar results were obtained from Bootstrap methods except that the odds ratio of LGA infants in rural areas for maternal insurance was significant (95%CI (1.13, 4.37)); urban residence was significantly related with lower odds of birth defect (95%CI (0.23, 0.89)) and congenital heart defect (95%CI (0.19, 0.91)). Conclusions: whether having maternal insurance did have an impact on perinatal outcomes, but the impact of maternal insurance on the perinatal outcomes showed differently between women with urban residence and women with rural residence status. However, it is not clear what are the reason causing the observed differences. Thus, more studies are needed.