An active surveillance system was used to identify all residents with hemophilia in six U.S. states (Colorado, Georgia, Louisiana, Massachusetts, New York, and Oklahoma). A hemophilia case was defined as a person with physician-diagnosed hemophilia A or B and/or a measured baseline factor VIII or IX activity (FA) of 30% or less. Case-finding methods included patient reports from physicians, clinical laboratories, hospitals, and hemophilia treatment centers. Once identified, trained data abstractors collected clinical and outcome data retrospectively from medical records. Among cases identified in 1993-1995, 2,743 were residents of the six states in 1994, of whom 2,156 (79%) had hemophilia A. Of those with available FA measurements, 1,140 (43%) had severe (FA < 1%), 684 (26%) had moderate (FA 1%-5%), and 848 (31%) had mild (FA 6%-30%) disease. The mean and median age was 25.4 and 23 years, respectively. The age-adjusted prevalence of hemophilia in all six states in 1994 was 13.4 cases/100,000 males (10.5 for hemophilia A and 2.9 for B). The prevalence by race/ethnicity was 13.2 cases/100,000 among white, 11.0 among African American, and 11.5 among Hispanic males. Application of age-specific prevalence rates from the six surveillance states to the U.S. population resulted in an estimated national population of 13,320 cases of hemophilia A and 3,640 cases of hemophilia B. For the 10-year period 1982-1991, the average incidence of hemophilia A and B in the hemophilia surveillance system (HSS) states was estimated to be 1 in 5,032 live male births.
It is vital that resilience-enhancing initiatives, such as peer mentoring and tailored work options to increase autonomy, are implemented at earlier career phases.
Compassion fatigue is known to impact the well‐being of nurses and patient safety outcomes. Currently, there is limited academic understanding of the role of demographic factors in contributing to compassion fatigue in critical care nurses. The aim of this study was to examine the relationship between nurse demographic characteristics and the development of compassion fatigue, as indicated by level of burnout and compassion satisfaction in critical care nurses in Saudi Arabia. The cross‐sectional study design included administering three surveys to critical care nurses (n = 321) in four Saudi public hospitals to examine the nurse demographic variables in relation to compassion fatigue, the compassion fatigue coping strategies of nurses, and nurse resilience. The results show both demographic and workplace structural elements, such as length of work shift, education level, and nationality, were all significant factors in resilience to compassion fatigue among Saudi critical care nurses, whereas factors of age and sex were not significant. This study concludes that the demographic characteristics of critical care nurses enable the identification of levels of compassion fatigue and compassion satisfaction, and their resilience to the effects of compassion fatigue.
Stories convey values and emotions, and can reveal the differences and similarities between people's experiences. Elucidating personal stories involves sharing which can help form bonds and supportive networks. With reflection, these can help to develop resilience. While the literature recognises the potential cathartic and therapeutic benefits associated with storytelling in research, links between the development of personal resilience and storytelling for research purposes have not been drawn. This paper argues that storytelling aids the development of personal resilience and provides opportunities to celebrate the hardiness of research participants who contribute to knowledge by recounting their stories of difficulty and adversity.
Health-care and public sector institutions are high-risk settings for workplace bullying. Despite growing acknowledgement of the scale and consequence of this pervasive problem, there has been little critical examination of the institutional power dynamics that enable bullying. In the aftermath of large-scale failures in care standards in public sector healthcare institutions, which were characterised by managerial bullying, attention to the nexus between bullying, power and institutional failures is warranted. In this study, employing Foucault's framework of power, we illuminate bullying as a feature of structures of power and knowledge in public sector institutions. Our analysis draws upon the experiences of a large sample (n = 3345) of workers in Australian public sector agencies - the type with which most nurses in the public setting will be familiar. In foregrounding these power dynamics, we provide further insight into how cultures that are antithetical to institutional missions can arise and seek to broaden the debate on the dynamics of care failures within public sector institutions. Understanding the practices of power in public sector institutions, particularly in the context of ongoing reform, has important implications for nursing.
Individuals who are bereaved by suicide and other traumatic natured deaths are thought to be at greater risk of psychological complications, than people bereaved by other means. While it is recognized that interventions can influence the bereavement process, there remains limited communications about both helpful responses and those that may adversely influence the grieving process for the suicide bereaved. This paper presents findings from a narrative study, which sought the experiences of family members after the loss of a loved one as a result of suicide. The study findings demonstrated that responses by agencies are often insensitive and not aligned with the needs of those bereaved. We argue that training is paramount for all services to increase awareness of the needs of people bereaved by suicide and available support services. Changes to organizational policies in relation to finance support would greatly support the bereaved during their time of grief and heightened distress.
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