Validation of the instrument “Complexity of Nursing Care”—A mixed‐methods study

Huber, Evelyn; Kleinknecht-Dolf, Michael; Kugler, Christiane; Müller, Marianne; Spirig, Rebecca

doi:10.1002/nop2.383

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…Reflective variables refer to the effects of a latent variable, whereas formative variables refer to the causes of a latent variable (Huber, Kleinknecht‐Dolf, Kugler, Müller, & Spirig, 2020). For instance, when nurses’ burnout is assumed as a latent variable, nurses’ mental health and workload could be the reflective and formative variable, respectively.…”

Section: Methodsmentioning

confidence: 99%

Resilience in Multicultural Families of Children With Disabilities in Korea: A Path Analysis Using National Data

Heo

Lee

2021

J of Nursing Scholarship

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Purpose The number of multicultural families has increased globally, and Korea has also witnessed a surge. Along with the various challenges experienced by these families, a child with a disability can pose additional challenges. In‐depth knowledge about resilience factors among multicultural families of children with disabilities is important. The aim of this study was to examine relationships between family demands, family appraisals, family problem solving and coping, family resources, and family adaptation in multicultural families of children with disabilities in Korea as perceived by married immigrants. Design This study was based on a secondary analysis of national survey data in 2015 and 2018 in Korea. Methods A total of 256 multicultural families who have children with disabilities participated. Family demands were identified by examining marital conflict, cultural differences, marital status, and public assistance recipient households. Family appraisal was assessed by how the family perceived the married immigrant’s culture. Family problem solving and coping were examined by how actively a married immigrant participated in social activities. Family resources were assessed by examining Korean language competency and the health status of immigrants. Family adaptation was identified by how immigrants perceived their life satisfaction. Path analysis was used to assess the factors. Findings Family demands had a direct impact on family resources and family adaptation. Family appraisal had a direct impact on family adaptation. Family resources mediated the effect of family demands on family adaptation. Conclusions This study demonstrated that although a multicultural family of a child with a disability struggles with family demands, if the family receives positive resources from family members, they can adapt well. Current findings can be used to develop interventions that can foster greater resilience among families. Clinical Relevance This study provides evidence that nurses can target modifiable family aspects, including immigrants’ health and family perceptions of immigrants’ cultures identified in this study to enhance the immigrant and family adaptation.

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Section: Methodsmentioning

confidence: 99%

Resilience in Multicultural Families of Children With Disabilities in Korea: A Path Analysis Using National Data

Heo

Lee

2021

J of Nursing Scholarship

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“…Multimorbidity adds another layer to complexity because of the need for various treatments and coordination of multiple care services. As well as multimorbidity, socioeconomic position, social support options, psychological stress, inadequate nutritional intake, reduce physical activity all have an impact on the family's ability to assist and the variety of services needed to support the older person [26,27]. These factors influence health outcomes and require comprehensive assessment and monitoring [28].…”

Section: Factors Contributing To Complexitymentioning

confidence: 99%

Improving Detection of Client Complexity in the Community (Impact): A Study Protocol of a Pragmatic Randomized Controlled Trial

Boak

Blackberry

Rasekaba

2021

MPs

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Background: Community-dwelling older clients are becoming increasingly complex. Detecting this complexity in clinical practice is limited, with greater reliance on community nurses’ clinical judgment and skills. The lack of a consistent approach to complexity impacts the level of care and support for older clients to remain in their homes for longer. Objective: To examine the effectiveness of the Patient Complexity Instrument (PCI) in addition to nurses’ clinical judgment to enhance detection of complexity, and subsequent older clients’ resource allocation compared to usual nursing assessment. Design: A pragmatic randomized controlled trial will be conducted within a community nursing service in regional Victoria, Australia. Clients 65 years and over referred to the service who are eligible for Commonwealth Home Support Programme (CHSP) funding will be randomized into Control group: usual nursing assessment or Intervention group: usual nursing assessment plus the PCI. Nurse participants are Registered Nurses currently employed in the community nursing service. Results: This study will explore whether introducing the PCI in a community nursing service enhances detection of complexity and client care resource allocation compared to nurses’ clinical judgment based on usual nursing assessment. Conclusion: This protocol outlines the study to enhance the detection of complexity by nurses delivering care for community-dwelling older people in the regional Australian context. The findings will inform the use of a standardized tool to detect complexity among community-dwelling older Australians.

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“…Due to the duration of the overall research programme, we updated the literature with a second theoretical phase in 2018 and finished with a final analytical phase. A study protocol and further results have been published (5,25,(39)(40)(41)(42)(43).…”

Section: Designmentioning

confidence: 99%

“…Each case study included the following data: (i) analysis of the patient's electronic documentation; (ii) one assessment taken by the RN responsible for this patient and one by the clinical nurse specialist (CNS) of this ward, using our newly developed instrument 'Complexity of Nursing Care'; (iii) a single interview with the RN and the CNS on their deliberations on how they rated the situation and its demands on nursing care while completing the instrument. The interviews were recorded and transcribed verbatim (39)(40)(41).…”

Section: Fieldwork Phasementioning

confidence: 99%

Patient‐related complexity of nursing care in acute care hospitals – an updated concept

Huber

Kleinknecht-Dolf

Kugler

et al. 2020

Scandinavian Caring Sciences

Self Cite

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Patient-related complexity of nursing care in acute care hospitalsan updated concept Rational: The interest in complexity of nursing care has grown in science and practice in recent years because of changed patient profiles and higher average levels of patient acuity in acute care hospitals. Aim: The aim of this study was to redefine the concept of patient-related 'complexity of nursing care' in acute care hospitals. Design: The hybrid model for concept development was chosen. Methods: In a first theoretical phase, we performed a narrative literature review regarding defining elements of patient-related 'complexity of nursing care' and developed a working definition. In the fieldwork phase, we investigated collective case studies representing 12 nursing care situations. The theoretical phase was updated before all findings were synthesised, and in the final analytical phase, the preliminary working definition was refined. Ethics: An ethical committee judged the study as unproblematic (waiver no. 82/14 from 5 December 2014). Results: The concept was redefined confirming previous understandings of patient-related 'complexity of nursing care' as a dynamic, relational concept characterised by the instability, variability and uncertainty that exist. The extent of complexity was determined by multifaceted patient problems and resources as well as extensive knowledge, experience, attention and caring skills of registered nurses interacting with each other. Limitations: The study did not include organisation-related complexity of nursing care. Conclusions: The redefinition of the concept may support a common understanding of patient-related demands on nursing care among practitioners, managers and politicians which is important regarding patient safety and health nursing staff.

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Validation of the instrument “Complexity of Nursing Care”—A mixed‐methods study

Cited by 5 publications

References 34 publications

Resilience in Multicultural Families of Children With Disabilities in Korea: A Path Analysis Using National Data

Resilience in Multicultural Families of Children With Disabilities in Korea: A Path Analysis Using National Data

Improving Detection of Client Complexity in the Community (Impact): A Study Protocol of a Pragmatic Randomized Controlled Trial

Patient‐related complexity of nursing care in acute care hospitals – an updated concept

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