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Nurse-sensitive outcomes in district nursing care: A Delphi study

Objectives To determine nurse-sensitive outcomes in district nursing care for community-living older people. Nurse-sensitive outcomes are defined as patient outcomes that are relevant based on nurses’ scope and domain of practice and that are influenced by nursing inputs and interventions. Design A Delphi study following the RAND/UCLA Appropriateness Method with two rounds of data collection. Setting District nursing care in the community care setting in the Netherlands. Participants Experts with current or recent clinical experience as district nurses as well as expertise in research, teaching, practice, or policy in the area of district nursing. Main outcome measures Experts assessed potential nurse-sensitive outcomes for their sensitivity to nursing care by scoring the relevance of each outcome and the ability of the outcome to be influenced by nursing care (influenceability). The relevance and influenceability of each outcome were scored on a nine-point Likert scale. A group median of 7 to 9 indicated that the outcome was assessed as relevant and/or influenceable. To measure agreement among experts, the disagreement index was used, with a score of <1 indicating agreement. Results In Delphi round two, 11 experts assessed 46 outcomes. In total, 26 outcomes (56.5%) were assessed as nurse-sensitive. The nurse-sensitive outcomes with the highest median scores for both relevance and influenceability were the patient’s autonomy, the patient’s ability to make decisions regarding the provision of care, the patient’s satisfaction with delivered district nursing care, the quality of dying and death, and the compliance of the patient with needed care. Conclusions This study determined 26 nurse-sensitive outcomes for district nursing care for community-living older people based on the collective opinion of experts in district nursing care. This insight could guide the development of quality indicators for district nursing care. Further research is needed to operationalise the outcomes and to determine which outcomes are relevant for specific subgroups.

Professional youth work as a preventive service: towards an integrated conceptual framework

Knowledge of how professional youth work might prevent individual and social problems in socially vulnerable youngsters is poorly developed. This article presents a conceptual framework that clarifies the implicit methodical process used by professional youth workers and focuses on what stakeholders regard as the potential of professional youth work as a preventive service. A qualitative research synthesis approach was used to combine the findings of six practice-based studies conducted in six European countries. This synthesis revealed that professional youth workers employ a multi-methodic approach in their prevention efforts, strengthening the social skills and self-mastery of youngsters, reinforcing their social network, enhancing their civic participation and helping them find additional social or health services. Twelve methodic principles were identified as contributing to achieving these prevention efforts, shedding light on the process taking place between youngsters and youth workers. This conceptual framework provides essential information for future evaluation research.

Effects of music interventions on stress-related outcomes

Music interventions are used for stress reduction in a variety of settings because of the positive effects of music listening on both physiological arousal (e.g., heart rate, blood pressure, and hormonal levels) and psychological stress experiences (e.g., restlessness, anxiety, and nervousness). To summarize the growing body of empirical research, two multilevel meta-analyses of 104 RCTs, containing 327 effect sizes and 9,617 participants, were performed to assess the strength of the effects of music interventions on both physiological and psychological stress-related outcomes, and to test the potential moderators of the intervention effects. Results showed that music interventions had an overall significant effect on stress reduction in both physiological (d = .380) and psychological (d = .545) outcomes. Further, moderator analyses showed that the type of outcome assessment moderated the effects of music interventions on stress-related outcomes. Larger effects were found on heart rate (d = .456), compared to blood pressure (d = .343) and hormone levels (d = .349). Implications for stress-reducing music interventions are discussed.

Online Communities for Child-Attracted Persons as Informal Mental Health Care: Exploring Self-Reported Wellbeing Outcomes

Online support communities are gaining attention among child-attracted persons (CAPs). Though research has largely focused on the negative consequences these environments create for potential offending, they may also provide a beneficial alternative to more formal treatment settings. To assess the utility for clinical and therapeutic purposes, this analysis focused on subcultural dynamics to examine self-reported wellbeing outcomes of participation in a Dutch forum for CAPs. A total of 15 semi-structured interviews were conducted with moderators, members and mental health professionals involved in the community. Thematic analyses demonstrated that by means of informal social control, bonds of trust and social relational education, the network aims to regulate the behavior and enhance the wellbeing of its marginalized participants. Key outcomes include a decreased sense of loneliness and better coping with stigma, to the point that participants experience less suicidal thoughts. Association with prosocial peers also helps to set moral boundaries regarding behavior towards children, although we cannot fully rule out potential adverse influences. Online support networks offer a stepping stone to professional care that fits individual needs of CAPs, while also providing an informal environment that overcomes limitations of physical therapy and that extents principles of existing prevention and desistance approaches. Gepubliceerd door uitgever Sage: Bekkers, L. M. J., Leukfeldt, E. R., & Holt, T. J. (2024). Online Communities for Child-Attracted Persons as Informal Mental Health Care: Exploring Self-Reported Wellbeing Outcomes. Sexual Abuse, 36(2), 158-184. https://doi.org/10.1177/10790632231154882

Care transformation defined by conditions, mechanisms, and outcomes: a systematic literature review

Methodical principles and prevention-focused outcomes in professional youth work: A longitudinal analysis

Previous research has suggested that professional youth work settings empower socially vulnerable youngsters, strengthening their personal development and social participation. It is expected that youth work can prevent personal and social problems of youngsters, which may have longer term positive social returns. How the underlying methodical way of acting of youth workers contributes to prevention-focused outcomes remains unclear. This article presents a four-wave longitudinal cohort study (16 months) that investigated longitudinal associations between 12 individual methodical principles that youth workers apply in interactions with youngsters and four prevention-focused outcomes: prosocial skills, self-mastery, social network and civic participation. The sample consisted of 1,597 Dutch youngsters with a mean age of 16.5 years (SD = 3.60). Findings: Linear mixed models analysis found that all individual methodical principles were longitudinally associated with one or more outcome. The strongest associations were observed with regard to prosocial skills and civic participation. Depending on the outcome measure, methodical principles seem to be more effective for boys, for youngsters who participate for 3 years or longer in youth work settings and for youngsters between 10 and 19 years old. With regard to the effect of methodical principles on improving self-mastery, 9 of the 12 principles appeared to play no positive role in increasing self-mastery of youngsters. Applications: This study provides youth workers with a better understanding of which methodical principles are positively associated with prevention-focused outcomes as well as reinforcing the evidence-based practice of professional youth work.