OAR@UM Collection:

Exploring the push and pull factors affecting third-country migrant nurses in Malta

Sun, 01 Jan 2023 00:00:00 GMT

Title: Exploring the push and pull factors affecting third-country migrant nurses in Malta Abstract: Background: The Maltese healthcare system is heavily dependent on its foreign nursing workforce. Most of these migrant nurses are third-country nationals (TCN) as they come from countries outside the European Union (EU) such as India, Pakistan, and the Philippines. As of October 2022, there were 1627 TCN nurses actively registered in Malta. The retention of these key workers is essential in delivering an effective and efficient universal healthcare system. An exploration of the push and pull factors affecting TCN migrant nurses in Malta was therefore needed to inform policy which can improve the retention of this key workforce. Methodology: An exploratory qualitative research design with a multi-method approach was employed in the research study. Eight TCN nurses participated in online semi-structured interviews, five of whom also participated in a private, anonymous online asynchronous forum. Transcripts from the in-depth interviews and the online forum were coded and thematically analysed. Findings: Pull factors that may attract and retain TCN nurses in Malta include good quality of life, rich culture, civil and political rights, presence of family, Maltese hospitality, English-speaking country, and availability of opportunities. Conversely, push factors that may influence TCN migrant nurses to leave and move to other countries include issues with quality of life, racism and inequality, difficulty settling in and achieving stability, bureaucracy in visa processing, and less desirable work conditions. Conclusion: The identified push and pull factors were found to be multi-dimensional, context-sensitive, idiosyncratic, dynamic and may overlap each other. TCN nurse migration cannot be attributed solely to economic motives. Personal factors can also play a significant role in their decision-making process, and such factors can influence their migration choices. The research study presented a list of recommendations in relation to research, education, policy, and practice. Description: M.Sc. (Melit.)

Informal caregivers’ experiences of care dependency in patients with advanced cancer treated palliatively

Sun, 01 Jan 2023 00:00:00 GMT

Title: Informal caregivers’ experiences of care dependency in patients with advanced cancer treated palliatively Abstract: Background: Being a carer for a dependent person entails serious responsibilities, often with physical, psychological and emotional consequences. As a terminally ill cancer patient enters the palliative phase, informal caregivers (ICs) need support to cope with the growing care dependency (CD) needs of the patient. Aim: This study aimed to explore informal caregivers’ experiences of CD in patients with advanced cancer treated palliatively. Research design: A qualitative research design with an Interpretative Phenomenological Analysis (IPA) approach. Participants: Purposive sampling of ICs caring for patients with advanced cancer being treated with palliative intent at home but who have had at least one admission to the in-patient palliative unit (IPU) during the last 12 months. Method: Data was collected through recorded semi-structured interviews and transcribed verbatim. Analysis was guided by the IPA approach. Results: Findings resulted in three main themes, namely (1) The experience of being an IC, (2) ICs’ experience of healthcare services, and (3) Taking life one day at a time. Conclusions: The findings reflected the helplessness, and isolation that ICs experience when confronted with the patients’ CD needs. Notwithstanding, most coped well with the emotional turmoil by adopting various survival techniques. ICs successfully exploited several informal support channels as an integral part of their coping strategy. Participants highlighted issues with formal support channels and unveiled the practical challenges in accessing various services required by patients. Hence, the principle recommendations were to introduce a system whereby different services are coordinated under one roof, as well as establish more accessible medical backup which could, in turn, avoid re-admissions to the IPU. Description: M.Sc.(Melit.)

The factors influencing adjustment to nursing home admissions as perceived by caregivers of persons living with dementia

Sun, 01 Jan 2023 00:00:00 GMT

Title: The factors influencing adjustment to nursing home admissions as perceived by caregivers of persons living with dementia Abstract: This dissertation investigates the factors that influence adjustment for persons with dementia when admitted to nursing homes as perceived by their informal caregivers. Background of the Study: When persons with dementia are admitted to nursing homes it can be very difficult for them to adjust, especially with a new environment and routine. By understanding the factors that influence adjustment, their transition can be made easier throughout all the phases - pre, mid, and post transition. This can improve their quality of life at the nursing home, especially during the transition process. Key Research Question: What are the factors influencing adjustment to nursing home admissions as perceived by the caregivers of persons with dementia? Methodology: This dissertation is a narrative qualitative approach. Six semi-structured interviews were conducted during the months of October and November 2022. The TRANSCIT model was used to critically discuss the findings. Key Results: The findings were analysed using a software called MAXQDA which is a tool for qualitative data analysis and data management. The themes generated were: nursing home environment, regular visits, maintaining a routine, nursing home staff and engaging activities. Conclusion and Recommendations: Optimum adjustment requires an organised transition from hospital/home to nursing home which should include a pre-transition phase. A person-centred approach that supports individualised activities can facilitate the transition process. Staff education and training on person centred dementia care especially to acute hospital staff is needed. Moreover, a dementia friendly environment in residential homes is recommended. Description: M.Sc.(Melit.)

Knowledge, attitudes and practice of healthcare professionals towards the prevention of catheter-associated urinary tract infections in a local rehabilitation hospital

Sun, 01 Jan 2023 00:00:00 GMT

Title: Knowledge, attitudes and practice of healthcare professionals towards the prevention of catheter-associated urinary tract infections in a local rehabilitation hospital Abstract: Background: Catheter-associated urinary tract infections (CAUTI) are among the most common healthcare-associated infections globally. Most CAUTI are preventable and it is the responsibility of healthcare professionals (HCP) to adhere to the respective guidelines to ensure that the development of CAUTI is minimal. Previous studies assessed HCP knowledge, attitudes and practice (K-A-P) towards CAUTI prevention. However, no local studies investigated the K-A-P of HCP towards CAUTI prevention. Aim: To assess the K-A-P of HCP towards preventing CAUTI in a local rehabilitation hospital. Design: A cross-sectional survey design was employed. A self-administered online questionnaire was disseminated to doctors and nurses (Balu et al., 2021) and a newly developed questionnaire was disseminated to nursing assistants in a local rehabilitation hospital at one point in time. Methods: All HCP (doctors, nurses and nursing assistants, n=315) working at a local rehabilitation hospital during the study were invited to participate. A total of 215 participants completed the questionnaires, yielding a satisfactory response rate of 68.3%. Results: This study's findings are comparable to those published in the literature. The K-A-P of HCP towards CAUTI prevention were generally moderate to adequate levels. The study identified various significant associations between the three questionnaire subscales (K-A-P) and various participants’ demographic variables. A positive correlation was found between doctors’ and nurses’ knowledge and practice (p = 0.002) towards preventing CAUTI. Nursing assistants K-A-P towards CAUTI prevention were positively correlated (p < 0.001). Conclusion: This study concludes that knowledge-practice gaps exist among HCP locally and that there is room for improvement. This study highlights that HCP attitudes and practice are directly influenced by their level of knowledge towards preventing CAUTI. Hence, educating and training HCP about CAUTI prevention measures is crucial. Description: M.Sc.(Melit.)