6th World Nursing and Nursing Care Congress

Biography:

Abstract:

Dr. Elisabeth Kübler-Ross (EKR) was among the most important psychiatrists of the twentieth century. Current media reports on her legacy are often misrepresentative of her many contributions to a wide field within the medical world. Speaker, Ken Ross discusses the historical context of his mother’s inspirations and guiding principles that lead her to the field of end-of-life (EOL). Elisabeth Kübler-Ross' seminal 1969 work, On Death and Dying, opened the door to understanding individuals' emotional experiences with serious illness and dying. This year marks the 50th anniversary of this seminal book. A review of the how the grief theory has come to dominate the medical worlds perspective of grief theory in this last half century. Further, the Five Stages of Grief™ has now been adopted to explain not only loss related to death but all sorts of loss including: divorce, job changes, and all major life changes. This recent adaption of the stage theory is known as well as the “Kübler-Ross Change Curve”™. Audience members will expect to gain a better understanding of Kübler-Ross’ techniques and approaches to the dying. Discussions will include: hospice, palliative care, bioethics, and others. Many individuals working in EOL have a distorted conception of the Five Stages of Grief ™. Ross will explain EKR’s corrected and more comprehensive description of the stages of grief including more than ten stages she reported fifty years ago. Last, the speaker will discuss what it was like to take care of this famous caretaker for the last nine years of her life. The Elisabeth Kübler-Ross Foundation currently continues the work of this groundbreaking pioneer in Europe, Asia, and Latin America. A short description of the Foundations effects around the world will be described.

Biography:

Abstract:

Dr. Elisabeth Kübler-Ross (EKR) was among the most important psychiatrists of the twentieth century. Current media reports on her legacy are often misrepresentative of her many contributions to a wide field within the medical world. Speaker, Ken Ross discusses the historical context of his mother’s inspirations and guiding principles that lead her to the field of end-of-life (EOL). Elisabeth Kübler-Ross' seminal 1969 work, On Death and Dying, opened the door to understanding individuals' emotional experiences with serious illness and dying. This year marks the 50th anniversary of this seminal book. A review of the how the grief theory has come to dominate the medical worlds perspective of grief theory in this last half century. Further, the Five Stages of Grief™ has now been adopted to explain not only loss related to death but all sorts of loss including: divorce, job changes, and all major life changes. This recent adaption of the stage theory is known as well as the “Kübler-Ross Change Curve”™. Audience members will expect to gain a better understanding of Kübler-Ross’ techniques and approaches to the dying. Discussions will include: hospice, palliative care, bioethics, and others. Many individuals working in EOL have a distorted conception of the Five Stages of Grief ™. Ross will explain EKR’s corrected and more comprehensive description of the stages of grief including more than ten stages she reported fifty years ago. Last, the speaker will discuss what it was like to take care of this famous caretaker for the last nine years of her life. The Elisabeth Kübler-Ross Foundation currently continues the work of this groundbreaking pioneer in Europe, Asia, and Latin America. A short description of the Foundations effects around the world will be described.

Biography:

Abstract:

Dr. Elisabeth Kübler-Ross (EKR) was among the most important psychiatrists of the twentieth century. Current media reports on her legacy are often misrepresentative of her many contributions to a wide field within the medical world. Speaker, Ken Ross discusses the historical context of his mother’s inspirations and guiding principles that lead her to the field of end-of-life (EOL). Elisabeth Kübler-Ross' seminal 1969 work, On Death and Dying, opened the door to understanding individuals' emotional experiences with serious illness and dying. This year marks the 50th anniversary of this seminal book. A review of the how the grief theory has come to dominate the medical worlds perspective of grief theory in this last half century. Further, the Five Stages of Grief™ has now been adopted to explain not only loss related to death but all sorts of loss including: divorce, job changes, and all major life changes. This recent adaption of the stage theory is known as well as the “Kübler-Ross Change Curve”™. Audience members will expect to gain a better understanding of Kübler-Ross’ techniques and approaches to the dying. Discussions will include: hospice, palliative care, bioethics, and others. Many individuals working in EOL have a distorted conception of the Five Stages of Grief ™. Ross will explain EKR’s corrected and more comprehensive description of the stages of grief including more than ten stages she reported fifty years ago. Last, the speaker will discuss what it was like to take care of this famous caretaker for the last nine years of her life. The Elisabeth Kübler-Ross Foundation currently continues the work of this groundbreaking pioneer in Europe, Asia, and Latin America. A short description of the Foundations effects around the world will be described.

Biography:

Lorrie Blitch has an impressive and diverse career in nursing and as a business owner. She is owner of Magellan Christian Academies for the past 18 years in Phoenix, Arizona and Jacksonville, Florida. Her schools have won numerous awards including Declaration of Magellan Day by the Mayor of Jacksonville, Florida in 2010. Ms. Blitch was awarded the prestigious title of Top Women in Business in Jacksonville, Florida by Jacksonville Magazine and recognized in Arbus Magazine as a Female Entrepreneur." She is a published author of children's books achieving number one on Amazon. Her experience in nursing is impressive that encompasses critical care, trauma, cardiovascular intensive care, toxicology, administration and management, nursing professor, medical-legal nursing and field hospital nursing. She is a nurse educator for the Banner Health System in Phoenix, Arizona responsible for the education of multiple service lines. Ms. Blitch frequently lectures internationally on nursing topics. She served her country honorably as a Naval Officer for 20 years. Ms. Blitch holds a bachelor's degree in nursing and a master's degree in nursing education and is pursuing a doctorate degree in nurse anesthesia. She sits on the Board of Directors for the Banyon School, New Delhi, India. She lectures on the dangers of academia's "Indoctrination Establishments and the importance of returning to traditional academic learning. 

Abstract:

The proper management of documentation in the hospital setting is a paramount duty of healthcare providers, as it greatly affects patient outcome. Nurses, who are in direct care of patient documentation, play a pivotal role in the proper assessment and recording of health data. However, it has come to the attention of healthcare authorities that patient records often have many gaps or deficiencies in information. Many medical records contain inaccurate information, are poorly detailed, or have missing information. This is especially common in patients diagnosed with cancer and elderly patients. For this reason, it is being stressed by researchers that nurses need to strengthen their documentation skills. There are a variety of ways in which to improve nursing assessments, such as training, workplace culture, and proper preparation, which will ultimately result in the improvement of patient well-being. 

Nursing assessments are an important part of proper diagnoses. The creation of progress notes help nurses evaluate patient intervention strategies (Myklebust, Bjørkly, & Råheim, 2018). The relationship between nurses and patients are an important part of patient care, where the nursing process of correct documentation is an influential part of health services. Documentation that is high quality allows for more consistent and structured communication between healthcare providers and patients, and help support their safety (Instefjord, Aasekjær, Espehaug, & Graverholt, 2014). Lack of consistency in this care, such as inaccurate data and misdiagnosis, can result in a longer hospital stay, poor patient satisfaction, hazardous events, re-admissions, and also delays in treatment (Instefjord et al., 2014). Worst of all, the wrong treatment could be provided for a patient which could threaten their life.

Nurses who utilized documented information expressed dissatisfaction with other’s form of record keeping. They believed that it is important to record information to provide patients with a form of protection, and that the system of documentation contains too many duplicates, inaccuracies, and missing data (Charalambous & Goldberg, 2016). The main specialties which seem to have reflected many of these errors are in nursing homes, post-operative care, pain management, wound care and orthopedic care (Instefjord et al., 2014). The fields that seemed to suffer most were the geriatric and cancer disciplines. 

Geriatric patient medical records often have the most incomplete, inaccurate, or repetitive data. These elderly patients tend to have complex healthcare requirements, which demands more in-depth geriatric assessments (Charalambous & Goldberg, 2016). This documentation is necessary for decision-making and treatment plans between a multi-disciplinary team to tackle the wide range of health problems that plague an elderly individual. However, nurses felt that the quality of documentation for this population is poor. 

The documentation for patients with terminal cancer also suffers from the same inconsistencies. In a study on patients that had received palliative chemotherapy for advanced pancreatic or lung cancer, it was found that only 4% of these patients had a documented care plan concerning the event of an acute deterioration (Harle, Karim, Raskin, Hopman, & Booth, 2017). These patients in particular had a life expectancy of less than one year. Quality improvement for nursing assessment is crucial for these patients, whether or not they have advanced cancer. It reveals a lack of concern of these patients’ well-being. Similar studies revealed issues in other cancer studies, such as only 6.2% of patients having documentation of cardiopulmonary resuscitation concerning long-term advanced healthcare. 

Methods of improvement include changes in attitude and the record keeping system. The improvement of workflow helped motivate nurses in their data collection initiatives, where one study revealed a 70% increase in documentation of patient data (Harle et al., 2017). Another study revealed that an important connection existed between intention and nursing documentation behavior (Dewi, 2018). These correlations also existed between intention and attitude, as well as intention and perceived behavioral control. The creation of a system of cycles of review, an expert panel of reviewers, and reflection on inputted information can help improve nursing documentation (Stewart, Doody, Bailey, & Moran, 2017). Accessible practice guidelines for enhanced documentation processes can help create better information systems. 

Conclusion

Documentation of patient data often contains inconsistencies such as inaccurate or missing information. The most effected fields that reveal these issues are geriatric patients and advanced cancer patients. As a result, these patients suffered the most neglect. Ways to overcome this issue are to perform audits of nursing documents, as well as implement new attitudes and workflow systems which can help motivate nurses to allow the reformed intention of creating better assessments. 

Biography:

Dr. Corjena Cheung received her doctoral and post-doctoral trainings at the University of Minnesota School of Nursing, USA.  Dr. Cheung is currently a professor at Hong Kong Adventist College and a Fellow of the Gerontological Society of America. A nurse educator and researcher, Dr. Cheung is passionate about improving the health and well-being of older adults. She has conducted a number of randomized controlled trials and qualitative studies on the use of complementary and integrative therapies for managing symptoms, promoting physical activity, preventing disability, and improving quality of life in community dwelling older adults with chronic health conditions specifically knee osteoarthritis and Parkinson’s disease.  Through her scholarly activities, Dr. Cheung has built a strong foundation for research and scholarship in her area of interest.  Dr. Cheung has published over 25 articles and presented research findings in both regional and international professional conferences. Email: corjena@hkac.edu  

Abstract:

Statement of the Problem: Exercise such as aerobic/strength exercises (ASE) and Hatha yoga are recommended for optimal management of knee osteoarthritis (OA).  While there is information on their short-term benefits, little is known about long-term adherence and factors that affect it. 

Methodology & Theoretical Orientation: This qualitative study assessed barriers and motivators to long-term adherence of an 8-week yoga versus ASE program for knee OA. Twenty-eight older adults (mean age: 71 years) participated in five semi-structured focus group interviews 12 months post-intervention. Transcript-based qualitative content analysis approach was used.

Findings: Although the adherence rate during the 8-week intervention programs was ≥50%, adherence to the prescribed level of yoga or ASE regimen (30 minutes/day, 5 days/week) during the 1-year follow-up was poor and episodic. The majority of participants incorporated only selected poses/ASE learned in class into their own exercise habit. Participants in the yoga group reported experiencing mind-body benefits which motivated them to practice: reduced knee pain and swelling, improved muscle tone, increased flexibility, better stress coping, and more relaxation. Additional motivators include having a routine and family support. Caretaker responsibility, lack of structure, unsure of accuracy of poses, time constraints, and health issues prevented participants from practicing yoga independently.  Pain avoidance, improving muscle strengths, weight loss, and stress reduction were the key motivators of ASE.  Participants in the ASE group reported competing interests on time from family and life events, injuries and health issues, and depressed moods were the main exercise barriers. Practical and attitudinal strategies for adherence were making an activity list to ability and preference, and self-monitoring.

Conclusion & Significance: Most participants attempted to remain active and incorporated some elements of the intervention into their regular exercise regimens; however, none adhered to the full program or recommended levels. Information on exercise barriers and strategies for long-term adherence can inform future OA exercise intervention studies.

Biography:

Prof. Dr Andrea Maier-Nöth holds a professorship at the university in Sigmaringen, Germany and is a guest-professor at the University of Bern, Switzerland.

She is a teaching and research professor in nutrition, sensory and consumer research questions along the whole product life cycle.

In this role, she also is responsible for driving the strategy development and application of the new Inno-Camp Concept, that focus on testing and driving new innovation areas and product ideas to launch.

Prof. Dr Andrea Maier-Nöth is also the managing director of the Eat-Health-Pleasure GmbH and works as a scientific advisor and lecturer in the area of health psychology and nutritional sciences. In this role she guides industries, public institutions and universities on strategies and nutritional concepts to promote healthy eating from pregnancy up to adulthood.

Prof. Maier-Nöth is known as the author of several scientific publications, journals and books, a member of national and international professional societies and is committed as a speaker and lecturer at congresses for the subjects of health, prevention and nutrition.

Abstract:

The early development of taste and food pleasure plays a crucial role for children determining food and behavioural choices in adult age. Eating a variety of foods especially vegetables is essential to achieve adequate coverage of macro- and micronutrients. However, children’s vegetable consumption falls below current recommendations, highlighting the need to identify strategies that can successfully promote better acceptance of vegetables.

Except for our innate liking of sweet foods, we learn sensory pleasure from food through our early eating experiences. Infants have a fine palate and more taste buds than adults when they are born. They have about 10,000 taste buds all around their tongues including at the roof of their mouths and the back and sides of the mouth. The flavours of what a mother eats while pregnant can reach the infant and help set up flavour preferences later on. From birth, infants can taste and smell foods, an experience that can take place through human milk as the food eaten by the mother influences the flavour of her milk, and thereby the child’s preference. 

Thus, preferences for specific flavours develops early, through milk-related flavour exposure, or even during pregnancy, allowing for an easier acceptance to new flavours and textures. Breastfeeding favors the acquisition of a taste for a variety of foods. At weaning, food preferences develop due to repeated exposure to a variety of foods especially vegetables and fruits. The persistence of these early influences seems to be long-lasting. Factors favouring the development of food acceptance at the beginning of complementary feeding include, in particular, the role of early variety, repeated exposure, timing of introduction the foods, and the sensory properties (texture, taste and flavours). 

During the 3^rd year of life, most children enter a neophobic phase, during which previously liked foods are no longer accepted and the introduction of new foods becomes difficult. However, habits of eating a variety of vegetables and foods acquired before the neophobic phase trace further on into childhood and early adulthood. 

Recently, experimental studies have reported promising interventions that increase acceptance of vegetables and new foods. The first, offering infants a high variety of vegetables at weaning, increased acceptance of new foods, including vegetables. The frequency of changes in vegetables was more effective than the number of solids and vegetables fed. The combination of breastfeeding and a wide variety of foods will product the greatest new food intake, persisting at later stages. The second, offering an initially disliked vegetable at 8 subsequent meals markedly increased acceptance for that vegetable. These effects have been shown to persist into childhood. This underlines the importance of promoting access to a variety of healthy foods (such as vegetables and fruits) in early childhood. 

In conclusions, early experiences with vegetable variety during weaning can impact food choice and preference into childhood, and parents should actively encourage their children to try new vegetables and foods. Parents should offer an initially disliked food about 8 times to promote the acceptance of healthy foods. The effects are long-lasting and provide the foundation for science-based nutrition recommendations to help parents promote healthy eating habits to their children.

Biography:

Dr. Ruthsatz’ expertise & passion is to build and strengthen relations between regulators, policymakers, healthcare professionals, patient organizations world-wide to change people’s lives through nutrition. He held lead regulatory positions in healthcare industries (Nestlé Health Science, L’Oréal-innéov, Abbott, Roche), providing him with a wide blend of hands-on experiences in nutrition, drugs, devices, biotech, botanicals and cosmetics, rounded out by quality, safety, vigilance, health economics & reimbursement. He was a NIH R&D Visiting Fellow (cancer virology; microbiology) & served as a reviewing pharmacologist at the US-FDA (CDER, HIV/AIDS division).

Dr. Ruthsatz maintains a long-standing recognition on governing, scientific & editorial boards (VP ISDI; ERNA; MIRRI; European Botanical Forum’s past president; RAPS faculty, editorial, awards, EU, CH) & lead working groups with global and regional medical nutrition and dietary/food supplements associations. He has published extensively & been a frequent speaker worldwide to governments and associations in Europe, the Americas & Asia (China, India, ASEAN), covering a wide array of healthcare & safety related topics on the food-drug borderline (i.e. disease-related malnutrition, targeted nutrition, the microbiome, global convergence, multi-stakeholder engagement & policymaking.

He upholds Board Certifications in Pharmacy, Toxicology (DABT), Regulatory Affairs (RAC) & received the rare distinction as a Fellow by the Regulatory Affairs Professionals Society (RAPS).

Abstract:

New scientific insights and technological opportunities coming at an unprecedented pace promise new perspectives and potential solutions to currently unmet needs considering demographic changes, increase in non-communicable diseases (NCDs) and exploding healthcare costs. Novel nutrition therapeutic findings, dietary/food/health supplements, the microbiome, and ‘omics’ diagnostics will transform health and disease management, how we approach disease prevention, personalize nutrition, counter the negative impact of disease related malnutrition, and even define a patient.

Our regulatory frameworks have historically aimed for and demonstrated consumer and patient protection. Disruptive findings in diagnostics and innovative nutritional approaches make the once separate silos of food (health) and drug (disease) systems move closer together, and hence provide ample opportunity for product developers, multi-stakeholder, public-private partnership engagement to address divergent expertise, interests, with improved quality of healthcare and patient-centered outcomes, and cover the magnitude and complexity of issues. Examples are the EU Commission endorsed Optimal Nutrition Care for All (ONCA) multi-stakeholder campaign across multiple member states, or the OECD Microbiome, Diet and Health initiative, as a promising way for an open dialogue to promote a science and technology based, yet flexible and appropriate regulatory and policy guidance framework in the food-medicine continuum.

By sharing the voice of regulators, policymakers, payers, developers, medical associations, healthcare professionals, as well as consumers and patients, multi-stakeholder platforms have the great potential to align on big objectives to better serve the needs of society. Current thinking and frameworks need to adapt rapidly, in particular addressing legal limitations on the use of disease prevention claims for nutrition, dietary disease management, personalized nutrition, as well as to create favorable development conditions for the human microbiome to provide innovative solutions in consumer and healthcare.