Janane Hanna - Academia.edu (original) (raw)
Papers by Janane Hanna
European Journal of Cardiovascular Nursing, Jul 1, 2022
Funding Acknowledgements Type of funding sources: None. Background Discussing disease trajectorie... more Funding Acknowledgements Type of funding sources: None. Background Discussing disease trajectories with patients living with chronic illnesses is recommended in guidelines worldwide and Heart Failure [HF] is no different. Discussions are centered around day-to-day disease management and less on illness trajectory including prognosis, symptoms, treatment options, preferences, and advanced care planning. Lack of open communication is common leading to prolonged suffering and unnecessary admissions [1] and can be improved when patients are able to initiate discussions, ask questions that are of concern to them, and engage in healthcare decision making [2,3]. A range of approaches have been employed to promote patient participation and empowerment. One such approach is the use of Question Prompt Lists [QPL]. Studies show that QPLs are linked to more questions asked, increased satisfaction, and reduced unmet information needs [3,4]. Despite this, they are less commonly used in non-oncology contexts and not available in Lebanon. Health system differences and cultural factors may influence content and impact of QPLs and as such cross-cultural adaptation is essential [5]. As the need for disclosure can vary among cultures, examining QPLs through an anthropological lens is imperative. Purpose To develop a culturally sensitive QPL designed to improve communication about HF illness trajectory. Methods A review of literature on HF QPLs was done. To address cultural and country specific needs, studies on HF from Lebanon and the Middle East were reviewed. This comprised the initial draft of a QPL that included context specific challenges and concerns. A Delphi survey inviting an interdisciplinary team of healthcare providers caring for HF patients was used to seek expert consensus regarding the draft. Sixteen experts rated each question for relevance, using a Likert scale from 0 to 4, clarity, and need to rephrase and suggested additional questions. Ratings were analyzed to determine the level of consensus. Questions that received less than 80% favorable answers [Very Relevant/Relevant and/or more than 20% indicated lack of clarity or the need to rephrase] were discussed in the second round of Delphi. Experts met and reviewed the comments provided on some questions and questions that were rated unfavorably, suggested for deletion, as well as those added by the panelists. Clarity of questions and suggestions for wording improvements was ensured. Results During the second round of Delphi, 12 questions were rephrased, one was dropped, and one was added. A final QPL of 42 questions and 6 categories was reached. Conclusion This is the first step of more research work that will aim at developing Arabic QPLs in the Middle East. The immediate next step would be repeating the Survey with patients, caregivers, and HF providers. Data will be analyzed using central tendency and levels of dispersion to assess consensus. The final QPLs will be translated to Arabic, culturally validated, and pilot tested in Lebanon.
Pain management nursing : official journal of the American Society of Pain Management Nurses, 2021
BACKGROUND Although nurse's knowledge and attitudes regarding pain management has been suffic... more BACKGROUND Although nurse's knowledge and attitudes regarding pain management has been sufficiently studied worldwide, the impact of an educational intervention program in improving such attitudes and knowledge has not been likewise researched, especially in Middle Eastern countries. AIMS To examine nurses' knowledge and attitudes regarding pain at a university hospital in Lebanon before and after the introduction of a pain management educational program. And to assess the relationship between the characteristic of nurses and their pain knowledge. METHODS Design; A nonrandomized pretest posttest study design was used. Setting; A university hospital in Lebanon. Participants; Included 183 nurses using the Nurses' Knowledge and Attitudes Survey Regarding Pain questionnaire. The pain educational intervention was based on the principles of Ajzen's theory of planned behavior. RESULTS A significant difference between the pre and post test scores was noted (p = .016). Questi...
Pain Management Nursing, 2018
decrease overdose, opioid-related deaths and crime. METHODS Various techniques used in LEAN metho... more decrease overdose, opioid-related deaths and crime. METHODS Various techniques used in LEAN methodology component of Six Sigma. RESULTS (1) Created a multi-disciplinary/multi-agency task force and work groups that include, among others: hospital representatives (administration, medicine, nursing, pharmacy, LEAN staff), law enforcement, public health (local and state), first responders, the college and university, treatment centers, mental and behavioral health, local and state government, community activists, the NC Harm Reduction Coalition, people in recovery, family members of those who have died. (2) Developed subgroups to increase coordination and improve communication across disciplines; investigated LEAD and other interventions; educated providers on multimodal analgesia and other options for pain control; multifaceted community education and outreach; increased drop boxes; promoted and initiated a clean needle exchange program; and encouraged and increased naloxone use among law enforcement. CONCLUSIONS This is truly a work in progress. Updates and additional progress will be reported.
Progress in Palliative Care, 2021
Lebanese Medical Journal, 2013
Palliative care is in the early stages of development in Lebanon. The National Committee for Pain... more Palliative care is in the early stages of development in Lebanon. The National Committee for Pain Control and Palliative Care (NCPCPC) was established under the Ministry of Public Health to work towards the development of palliative care. This paper summarizes the recommendations of the Subcommittee on Practice of the NCPCPC regarding hospital standards and provider competencies in palliative care. The authors propose actions that should be taken to implement these recommendations to help move palliative care forward in the country.
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2012
Purpose We designed a randomized double-blind placebo-controlled trial to assess the role of a si... more Purpose We designed a randomized double-blind placebo-controlled trial to assess the role of a single prophylactic dose of vitamin C (2 g) po in reducing the consumption of opioids postoperatively in patients undergoing laparoscopic cholecystectomy. Methods Eighty adult patients were allocated to receive 2 g vitamin C po or placebo approximately one hour prior to induction of anesthesia. Following laparoscopic cholecystectomy, patients received morphine patient-controlled analgesia for 24 hr. The following data were assessed postoperatively in the postanesthesia care unit at two, four, six, 12, and 24 hr: morphine consumption, verbal numerical rating scale scores for incisional pain and nausea/
European Journal of Cardiovascular Nursing, Jul 1, 2022
Funding Acknowledgements Type of funding sources: None. Background Discussing disease trajectorie... more Funding Acknowledgements Type of funding sources: None. Background Discussing disease trajectories with patients living with chronic illnesses is recommended in guidelines worldwide and Heart Failure [HF] is no different. Discussions are centered around day-to-day disease management and less on illness trajectory including prognosis, symptoms, treatment options, preferences, and advanced care planning. Lack of open communication is common leading to prolonged suffering and unnecessary admissions [1] and can be improved when patients are able to initiate discussions, ask questions that are of concern to them, and engage in healthcare decision making [2,3]. A range of approaches have been employed to promote patient participation and empowerment. One such approach is the use of Question Prompt Lists [QPL]. Studies show that QPLs are linked to more questions asked, increased satisfaction, and reduced unmet information needs [3,4]. Despite this, they are less commonly used in non-oncology contexts and not available in Lebanon. Health system differences and cultural factors may influence content and impact of QPLs and as such cross-cultural adaptation is essential [5]. As the need for disclosure can vary among cultures, examining QPLs through an anthropological lens is imperative. Purpose To develop a culturally sensitive QPL designed to improve communication about HF illness trajectory. Methods A review of literature on HF QPLs was done. To address cultural and country specific needs, studies on HF from Lebanon and the Middle East were reviewed. This comprised the initial draft of a QPL that included context specific challenges and concerns. A Delphi survey inviting an interdisciplinary team of healthcare providers caring for HF patients was used to seek expert consensus regarding the draft. Sixteen experts rated each question for relevance, using a Likert scale from 0 to 4, clarity, and need to rephrase and suggested additional questions. Ratings were analyzed to determine the level of consensus. Questions that received less than 80% favorable answers [Very Relevant/Relevant and/or more than 20% indicated lack of clarity or the need to rephrase] were discussed in the second round of Delphi. Experts met and reviewed the comments provided on some questions and questions that were rated unfavorably, suggested for deletion, as well as those added by the panelists. Clarity of questions and suggestions for wording improvements was ensured. Results During the second round of Delphi, 12 questions were rephrased, one was dropped, and one was added. A final QPL of 42 questions and 6 categories was reached. Conclusion This is the first step of more research work that will aim at developing Arabic QPLs in the Middle East. The immediate next step would be repeating the Survey with patients, caregivers, and HF providers. Data will be analyzed using central tendency and levels of dispersion to assess consensus. The final QPLs will be translated to Arabic, culturally validated, and pilot tested in Lebanon.
Pain management nursing : official journal of the American Society of Pain Management Nurses, 2021
BACKGROUND Although nurse's knowledge and attitudes regarding pain management has been suffic... more BACKGROUND Although nurse's knowledge and attitudes regarding pain management has been sufficiently studied worldwide, the impact of an educational intervention program in improving such attitudes and knowledge has not been likewise researched, especially in Middle Eastern countries. AIMS To examine nurses' knowledge and attitudes regarding pain at a university hospital in Lebanon before and after the introduction of a pain management educational program. And to assess the relationship between the characteristic of nurses and their pain knowledge. METHODS Design; A nonrandomized pretest posttest study design was used. Setting; A university hospital in Lebanon. Participants; Included 183 nurses using the Nurses' Knowledge and Attitudes Survey Regarding Pain questionnaire. The pain educational intervention was based on the principles of Ajzen's theory of planned behavior. RESULTS A significant difference between the pre and post test scores was noted (p = .016). Questi...
Pain Management Nursing, 2018
decrease overdose, opioid-related deaths and crime. METHODS Various techniques used in LEAN metho... more decrease overdose, opioid-related deaths and crime. METHODS Various techniques used in LEAN methodology component of Six Sigma. RESULTS (1) Created a multi-disciplinary/multi-agency task force and work groups that include, among others: hospital representatives (administration, medicine, nursing, pharmacy, LEAN staff), law enforcement, public health (local and state), first responders, the college and university, treatment centers, mental and behavioral health, local and state government, community activists, the NC Harm Reduction Coalition, people in recovery, family members of those who have died. (2) Developed subgroups to increase coordination and improve communication across disciplines; investigated LEAD and other interventions; educated providers on multimodal analgesia and other options for pain control; multifaceted community education and outreach; increased drop boxes; promoted and initiated a clean needle exchange program; and encouraged and increased naloxone use among law enforcement. CONCLUSIONS This is truly a work in progress. Updates and additional progress will be reported.
Progress in Palliative Care, 2021
Lebanese Medical Journal, 2013
Palliative care is in the early stages of development in Lebanon. The National Committee for Pain... more Palliative care is in the early stages of development in Lebanon. The National Committee for Pain Control and Palliative Care (NCPCPC) was established under the Ministry of Public Health to work towards the development of palliative care. This paper summarizes the recommendations of the Subcommittee on Practice of the NCPCPC regarding hospital standards and provider competencies in palliative care. The authors propose actions that should be taken to implement these recommendations to help move palliative care forward in the country.
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2012
Purpose We designed a randomized double-blind placebo-controlled trial to assess the role of a si... more Purpose We designed a randomized double-blind placebo-controlled trial to assess the role of a single prophylactic dose of vitamin C (2 g) po in reducing the consumption of opioids postoperatively in patients undergoing laparoscopic cholecystectomy. Methods Eighty adult patients were allocated to receive 2 g vitamin C po or placebo approximately one hour prior to induction of anesthesia. Following laparoscopic cholecystectomy, patients received morphine patient-controlled analgesia for 24 hr. The following data were assessed postoperatively in the postanesthesia care unit at two, four, six, 12, and 24 hr: morphine consumption, verbal numerical rating scale scores for incisional pain and nausea/