Effect of the postoperative pain management model on the psychological status and quality of life of patients in the advanced intensive care unit

OBJECTIVE

it was to explore the influence of the postoperative pain management mode on the psychological state, quality of life (QOL), and nursing satisfaction of late patients in the intensive care unit (ICU) and improve the nursing effect of late patients in the ICU.

METHODS

seventy patients who were admitted to the postoperative ICU for gastric cancer and received treatment in our hospital from March 2021 to May 2022 were selected. The patients were assigned into a research group and a control (Ctrl) group according to a random number table, with 70 cases in each group. The Ctrl group received routine nursing intervention, while research group received nursing intervention based on routine nursing intervention with postoperative pain management mode and received psychological care. Good communication was established with the patients, and the postoperative pain assessment was well conducted. The general information, state-trait anxiety (STAI) score, World Health Organization's Quality of Life Instrument (WHO QOL-BREF) score, and care satisfaction were compared.

RESULTS

the general information differed slightly, such as sex, age, and ward type, between groups, with comparability (P > 0.05). S-AI scores (13.15 ± 1.53 vs. 16.23 ± 1.24) and T-AI scores (14.73 ± 3.12 vs. 18.73 ± 3.16) in research group were inferior to those in Ctrl group (P < 0.05). The scores of patients in research group in the physiological field (78.9 ± 6.1 points vs. 72.3 ± 5.6 points), social relationship field (76.9 ± 4.5 points vs. 71.3 ± 4.8 points), psychological field (78.6 ± 6.2 points vs. 72.4 ± 5.3 points), environmental field (78.6 ± 6.7 points vs. 73.5 ± 6.4 points), and total QOL (79.5 ± 7.4 points vs. 71.6 ± 5.4 points) were higher than those in Ctrl group (P < 0.05). The total satisfaction rate with nursing care in research group (82.85%) was dramatically superior to that in Ctrl group (62.85%) (P < 0.05).

CONCLUSION

the adoption of a postoperative pain management model in postoperative nursing interventions for patients in advanced ICUs can alleviate anxiety and depression, improve patients' QOL and nursing satisfaction, and have clinical promotion value.

Nurturing Success: E-Learning readiness and academic self-efficacy in nursing students

BACKGROUND

As nursing education embraces e-learning as a vital component of its pedagogical approach, understanding the interplay between students' readiness for E-learning and their academic self-efficacy becomes imperative in nurturing successful learning outcomes amidst evolving educational paradigms.

PURPOSE

This study aimed to explore the relationship between e-learning readiness, academic self-efficacy, and the academic achievement of nursing students within the dynamic educational environment.

DESIGN

This study employed a cross-sectional design.

METHODS

A total of 208 nursing students were recruited through convenience sampling at the end of the second semester in 2022. The evaluation included the utilization of Grade Point Average, the Online Learning Readiness Scale, and the Academic Self-Efficacy Scale.

FINDINGS

Previous research has indicated a significant positive correlation between academic achievement and readiness for e-learning, suggesting that higher levels of readiness for e-learning among nursing students lead to improved academic achievement (p ≤ 0.001). Additionally, the findings of the current study revealed a notable positive correlation between academic achievement and academic self-efficacy (p ≤ 0.001).

CONCLUSION

This study provides valuable insights into the critical role of academic self-efficacy and e-learning readiness in enhancing academic achievement among nursing students.

Safety climate in the operating room in the pre-pandemic and pandemic period of COVID-19: A mixed method study

INTRODUCTION

To verify whether the COVID-19 pandemic has had an impact on the safety climate based on the perception of the multiprofessional team in the operating room and to analyze the domains of the safety climate during the pre-pandemic and pandemic period of COVID-19, demonstrating the intersections of quantitative and qualitative approaches.

METHODS

Mixed-method research using a convergent approach strategy, carried out in the operating room of a university hospital, located in Rio de Janeiro, Brazil. The nature of the quantitative phase was cross-sectional, and the nature of the qualitative phase was descriptive. We used the Pillar Integration Process to integrate the data. This research considered the pre-pandemic period was defined as before March 2020 and for the pandemic period, the 2nd and 3rd global waves. Research was approved by the institution's board management and ethics committee.

RESULTS

145 health professionals participated in the quantitative approach, and 20 in the qualitative approach. The impact of the COVID-19 pandemic was highlighted in the domains 'Perceived stress' (p-value = 0.017); 'Working conditions' (p-value = 0.040). Six categories emerged from the qualitative analysis, namely: Stress and professional performance due to COVID-19; Patient safety protocols in the operating room; Responsibility for patient safety, lack of effective communication and performance feedback; Biosafety of the professional staff in the operating room; Security culture maturity; Fair culture, organizational learning, and reporting mistakes. As a result of the data integration, 6 pillars were identified: Perception of communication in the operating room; Evolution of safety culture; Overview of protocol management and implementation; Fair organizational culture; Perception of stress due to COVID-19; Perception of professional performance due to COVID-19.

CONCLUSIONS

The impact that COVID-19 had on the safety climate in the operating room is evident. It underlines the need to implement strategies that support the solidification of attitudes aimed at patient safety, even in emergencies.

Comparison of Complication Rates Between Midline Catheters and Peripherally Inserted Central Catheters: A Systematic Review and Meta-analysis of Randomized Controlled Trials

BACKGROUND

Midline catheters (MCs) and peripherally inserted central catheters (PICCs) are essential for reliable vascular access in patients. Despite their prevalent use, comparative risk assessments of these catheters, particularly from randomized controlled trials (RCTs), remain scarce. This meta-analysis primarily focuses on RCTs to evaluate and compare the incidence of complications associated with MCs and PICCs.

METHODS

We conducted a comprehensive search of databases including the Cochrane Library, PubMed, Embase, Web of Science, ScienceDirect, Scopus, and ProQuest, up to April 2024. The primary outcomes analyzed were total complications and catheter-related bloodstream infections (CRBSIs), while secondary outcomes included catheter dwell time and thrombosis incidence. Meta-analyses were performed using a random-effects model.

RESULTS

From 831 initially identified articles, 5 trials involving 608 patients met the inclusion criteria. MCs exhibited a significantly higher rate of total complications compared to PICCs (relative risk = 1.95, 95% confidence interval = 1.23-3.08, p = 0.005, I2= 0%). MCs also had shorter dwell times and a higher incidence of premature removal. However, no significant differences were observed in the rates of CRBSIs or thrombosis between MCs and PICCs.

CONCLUSIONS

PICCs are associated with fewer total complications and longer dwell times compared to MCs, which tend to be more often removed prematurely. Thrombosis rates were similar between the two catheter types, underscoring the need for careful catheter selection based on specific patient conditions and treatment duration. Further research, particularly additional randomized controlled trials, is necessary to confirm these findings and guide optimal catheter selection in clinical practice.

Telemedicine and Teamwork Among Health Care Professionals: State of the Science

Background: As telemedicine becomes further rooted in standard patient care delivery, it is critical to understand how it may affect teamwork among health care providers. Understanding the state of the science between telemedicine and teamwork is an important first step. Obejctive: The purpose of this state-of-the-science review was to synthesize the published research on teamwork within the context of telemedicine. Methods: Data abstraction and analysis were structured following the Virtual Team Performance and the "Big Five" of Teamwork theoretical frameworks. The concepts within these models were used to organize data extraction. This state of the science used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: A total of 14 studies met the inclusion criteria after final review. The most common variables were communication, tasks, leadership, team orientation, and team cohesion. Despite variable commonalities across the included articles, there was a discrepancy between improved and reduced teamwork outcomes with telemedicine. Conclusions: Multiple teamwork variables are influential across health care teams using telemedicine technologies-those that include communication, task facilitation, leadership, team orientation, and cohesion appear to have the greatest impact. However, it is not an individual teamwork variable, type of technology, or care environment alone that influences positive or negative outcomes among health care teams using telemedicine. Instead, it is a combination of factors and mechanisms that facilitate or hinder teamwork outcomes. A comprehensive model that describes the interaction of these common variables in teamwork among blended virtual and in-person health care teams is needed.

Evidence-based practice knowledge, attitude, practice and barriers as predictors of stay intent among Jordanian registered nurses: a cross-sectional study

AIM

This study aimed to identify factors influencing stay intent among Jordanian registered nurses, with a specific focus on the role of evidence-based practice (EBP) knowledge, attitudes, practices and barriers.

METHODS

A descriptive cross-sectional study of 311 nurses from 5 hospitals was conducted from January 2022 to June 2022. Participants completed data about stay intent and knowledge, attitude, practice and barriers of EBP. Data were analysed using SPSS program V.24.

FINDINGS

EBP attitudes, practices, knowledge and barriers significantly predicted stay intent, controlling for participants and workplace characteristics. Private hospitals (t=-4.681, Β=-0.287, p<0.001), having a library in the healthcare institution (t=-2.018, Β=-0.118, p<0.001) and adopter barriers (t=-1.940, Β=-0.105, p=0.05) were significantly associated with stay intent.

CONCLUSION

Our findings show that EBP influences Jordanian nurses' intent to stay. It highlights the importance of addressing EBP barriers, especially in private hospitals as well as library access issues, in enhancing nurse retention and healthcare outcomes in Jordan.

Development of advanced practice nursing core competencies in Saudi Arabia: A modified Delphi study

BACKGROUND

Advanced practice nursing requires a diverse set of competencies that define what advanced practice nurses need to know and be able to do to deliver safe, effective, and high-quality healthcare. Given the lack of evidence regarding core competencies and the evolution of advanced practice nursing roles in Saudi Arabia, it is becoming increasingly important to develop core competencies to standardize educational and clinical training programs.

OBJECTIVE

To define the core competencies of advanced practice nursing in Saudi Arabia.

DESIGN

Utilizing a modified Delphi design and snowball sampling technique, data were collected between April and July 2023 using an online questionnaire consisting of 28 core competencies that was developed based on an in-depth literature review and a critical analysis of advanced practice nursing core competencies published by leading professional organizations. Two rounds of Delphi surveys were conducted.

SETTINGS

The study was set in clinical and academic settings in Saudi Arabia.

PARTICIPANTS

Nursing experts with graduate degrees as advanced practice nurses.

RESULTS

In Round 1, 34 advanced practice nursing experts reached full consensus on 24 of the 28 core competencies, and four core competencies reached partial consensus. Based on suggestions and feedback from the experts, the investigators revised ten core competencies to reflect the improvement suggestions and created three new core competencies. A total of 26 core competencies were used in Round 2, which achieved a full consensus among the 34 advanced practice nursing experts, under the following six core competency domains: knowledge of advanced practice nursing, person-centered care, professional improvement, professionalism, communication and interprofessional partnership, and leadership and system-based practice.

CONCLUSIONS

Given the need for a standardized competency framework, the 26 core competencies proposed in our study have the potential to guide education and training in academic programs and facilitate the implementation of advanced practice nursing in clinical settings.

Gender role attitudes and fertility intentions: the mediating role of parental sacrifice and the moderating role of subjective well-being

Gender role attitudes have been shown to play a critical role in individuals' fertility intentions. However, the underlying mechanism is unclear. The present study examined whether parental sacrifice mediates the relationship between gender role attitudes and fertility intentions, and whether subjective well-being plays a moderating role. A sample of 446 Chinese adults aged 18 to 45 (Mage = 32.78, SDage = 5.63, 60.93% female) completed the Gender Role Attitude Scale, Parental Sacrifice Scale, Index of Well-Being, and Fertility Attitude Scale. Multiple regression analyses showed that traditional gender role attitudes positively predicted fertility intentions, while egalitarian gender role attitudes negatively predicted fertility intentions. Moreover, parental sacrifice was found to partially mediate the relationship between gender role attitudes and fertility intentions. Additionally, subjective well-being was identified as a moderator of the mediating effect of parental sacrifice. Specifically, for individuals with low subjective well-being, parental sacrifice played a partially mediating role. However, for individuals with high subjective well-being, the mediating effect of parental sacrifice was not significant, and gender role attitudes directly influenced fertility intentions. This study adds to our understanding of the connection between gender role attitudes and fertility intentions of adults, providing important information for policymakers and professionals aiming to promote fertility intentions.

Migration intentions among nursing students in a low-middle-income country

BACKGROUND

Migration among skilled labour has been noted as one of the major issues in recent times, especially among health workers. Data from the United Nations show that almost two thirds of people migrating are labor migrants and international migrants constitute 3.5% of the global migration population. Out of the millions of people who migrate across the globe, health workers, especially nurses form a greater portion of these numbers. This study explored nursing students' intention to migrate to other countries after completing their programs.

METHOD

A descriptive cross-sectional design approach was adopted using self-administered questionnaire that contain aspects of open-ended questions. A sample size of 226 nursing students were recruited using convenient sampling technique.

RESULTS

The results overall, revealed that 226 nursing students participated in the study. Out of this, most of the respondents 42.5% were aged between 25 and 30 years with majority 53.1% being males. Also, 35% of the participants were married with more than half 59.7% of the respondents being Christians. The results further revealed that most of the participants 64.2% had intention of migrating to other countries. Among those who intended to migrate, 11.7% identified lack of jobs, 39.3% identified low salaries in Ghana while 50.3% identified bad working conditions. The rest 2.8% attributed their intentions to migrate to educational opportunities. Common places of destination included Canada, USA, UK and Australia.

CONCLUSION

The outcome of this study points to the urgent need for low-income countries such as Ghana to urgently put in measures to curb the menace of brain drain among nurses. Improvement in working condition of nurses must be prioritized to motivate their stay.

Associations Between Sociodemographic Characteristics, eHealth Literacy, and Health-Promoting Lifestyle Among University Students in Taipei: Cross-Sectional Validation Study of the Chinese Version of the eHealth Literacy Scale

BACKGROUND

The popularization of the internet and rapid development of mobile devices have led to an increased inclination and opportunities to obtain health-related information online. The eHealth Literacy Scale (eHEALS), widely used for measuring eHealth literacy, assesses an individual's ability to search, understand, appraise, and use eHealth information. However, the Chinese version of the eHEALS multiple-factor model remains to be validated, and the correlation between eHEALS and the health-promoting lifestyle profile (HPLP) among university students is rarely explored in Taiwan.

OBJECTIVE

This study aimed to examine the fit, validity, and reliability of the Chinese eHEALS multiple-factor model and to clarify the predictive effects of eHEALS on the HPLP among university students.

METHODS

University students in Taipei, the capital of Taiwan, were recruited, and 406 valid questionnaires including sociodemographic characteristics, eHEALS, and HPLP responses were collected. Confirmatory factor analysis was performed to validate the Chinese eHEALS. Independent sample t test, 1-way ANOVA, and multiple linear regression analyses were conducted to examine the relationship between sociodemographic variables and the HPLP. Pearson product-moment correlation and binary logistic regression analyses were performed to ascertain the predictive effects of eHEALS on the HPLP.

RESULTS

The Chinese eHEALS exhibited an optimal fit when delineated into the search, usage, and evaluation 3-factor model (comparative fit index=0.991, Tucker-Lewis index=0.984, root mean square error of approximation=0.062), and its validity and reliability were confirmed. The mean eHEALS score of university students was 3.17/4.00 (SD 0.48) points, and the score for the evaluation subscale was the lowest (mean 3.08, SD 0.56 points). Furthermore, there were significant sex, institution orientation, daily reading time, daily screen time, primary information channel, and perceived health status differences in the HPLP: male participants (t404=2.346, P=.02), participants attending general university (t404=2.564, P=.01), those reading ≥1 hour daily (F2,403=17.618, P<.001), those spending <3 hours on mobile devices or computers daily (F2,403=7.148, P<.001), those acquiring information from others (t404=3.892, P<.001), and those with a good perceived health status (F2,403=24.366, P<.001) had a significantly higher score. After adjusting for sociodemographic variables, the eHEALS score remained an independent predictor of the HPLP. Compared to students with relatively high eHEALS scores, those with relatively low eHEALS scores had a 3.37 times risk of a negative HPLP (adjusted odds ratio [OR]=3.37, 95% CI 1.49-7.61), which could explain 14.7%-24.4% of the variance (Cox-Snell R2=0.147, Nagelkerke R2=0.244, P=.004).

CONCLUSIONS

There is room for improvement in eHealth literacy among university students in Taipei. eHEALS may be used to screen students who require HPLP improvement, thereby providing appropriate eHealth literacy training programs, particularly those targeting evaluation literacy. Additionally, the 3-factor model of the Chinese eHEALS used in this study results in more definite scale content, thus increasing the practicality and applicability of this scale in health-promoting studies.

Gait Assessment Using Smartphone Applications in Older Adults: A Scoping Review

Spatiotemporal parameters such as gait velocity and stride length are simple indicators of functional status and can be used to predict major adverse outcomes in older adults. A smartphone can be used for gait analysis by providing spatiotemporal parameters useful for improving the diagnosis and rehabilitation processes in frail people. The aim of this study was to review articles published in the last 20 years (from 2004 to 2024) concerning the application of smartphones to assess the spatiotemporal parameters of gait in older adults. This systematic review was performed in line with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), and original articles were identified by searching seven electronic databases: SciVerse (ScienceDirect), Excerpta Medica Database (EMBASE), Medline, Scopus, PubMed, Web of Science and the Cochrane Library. Studies were rigorously screened using the inclusion criteria of smartphones and mobile apps, older adults and spatiotemporal gait parameters, and results were narratively synthesized. Seventy-three articles were initially identified while searching the scientific literature regarding this topic. Eleven articles were selected and included in this review. Analysis of these studies covered information about gait assessment using mobile apps recorded in 723 older adults and 164 control cases. Analysis of data related to the application of smartphones to assess spatiotemporal parameters of gait in older adults showed moderate-to-excellent test-retest reliability and validity (ICCs around 0.9) of gait speed, the most common parameter reported. Additionally, gait speeds recorded with mobile apps showed excellent agreement when compared to gold standard systems. Smartphones and mobile apps are useful, non-invasive, low-cost and objective tools that are being extensively used to perform gait analysis in older adults. Smartphones and mobile apps can reliably identify spatiotemporal parameters related to adverse outcomes, such as a slow gait speed, as predictors and outcomes in clinical practice and research involving older adults.

Coming home in the context of very early supported discharge after stroke - An interview study of patients' experiences

OBJECTIVES

To explore patients' experiences of coming home and managing everyday life within the context of very early supported discharge after stroke (VESD).

STUDY DESIGN

An explorative qualitative study using semi structured interviews.

METHOD

This study was nested within a randomised controlled trial,; Gothenburg Very Early Supported Discharge (GOTVED), comparing a home rehabilitation intervention given by a coordinated team (VESD) with conventional care. Eleven participants with a median age 70.0 years (range 63-95) of which nine scoring 0-4 on the NIHSS indicating no symptoms or minor stroke were interviewed on average 12 days after discharge. Data was analysed using thematic analysis.

RESULTS

The diversity of patients' experiences was reflected in the overarching main theme Very Early Supported Discharge after stroke - a multifaceted experience, built upon five themes: "Conditions surrounding the discharge", "Concerns about the condition", "Confronting a new everyday life", "Experiences of the intervention" and the "Role of next of kin".

CONCLUSIONS

The respondents were largely satisfied with the very early supported discharge which might be expected, given that it was well planned regarding timing, individualisation and content. The patients need to be aware of the purpose of the VESD intervention. Due to the unpredictability of the stroke and its consequences, interventions need to be flexible. Goal setting is important but must be comprehensible. The role and burden of next of kin should be addressed and negotiated, and the ending of the intervention must be planned, with seamless transition to further rehabilitation and social support including the issue of participation in everyday life.

Patient participation-18 months of patient and staff perspectives in kidney care: A mixed methods study addressing the effects of facilitating staff person-centredness

RATIONALE

Patient participation should encapsulate the individual's resources and needs, though such standards remain rationed for people living with a long-term health concern like kidney failure.

AIMS

To illustrate what patient participation signified to patients and staff in kidney care, and whether an agreed or disagreed conceptualisation occurred over time, evaluating the influence of two study-specific interventions to facilitate more person-centred participation.

METHOD

By convergent mixed methods design across 9 units in Sweden, we repeated the following data collection at 3 time points over 18 months: semistructured interviews with patients and staff (n = 72), and structured reviews for accounts of participation in patient records (n = 240). Data were subjected to content analysis and descriptive statistics, respectively. The outcomes were appraised for changes over time besides the interventions to enhance attention to patients' participation: a clinical tool and guidance distributed to management, and additional local support, respectively.

RESULTS

Both patients and staff described patient participation as a comprehension of the disease and its management in everyday life. Yet, patients accentuated participation as one's experiences being recognised, and mutual knowledge exchange. Instead, staff emphasised the patients managing their treatment. The health records primarily represented what staff do to support their notion of patient participation. No influence of the interventions was noted, but what signified patient participation was maintained over time.

CONCLUSION

Both patients and staff stress the importance of patient participation, although they focus on different elements. Further person-centred conduct warrants a shared conceptualisation and strategies addressing and scaffolding patients' preferences and means.

Implementation of Intrahospital Transfer Strategy During COVID-19 and Identify Success Factors Based on DEMATEL Technique

BACKGROUND AND OBJECTIVES

The COVID-19 pandemic caused a significant strain on world health care systems. The lack of trained and experienced staff was a complicated issue during the pandemic. To overcome insufficient staffing problems, the intrahospital transfer (IHT) strategy was implemented at Milad Hospital in Tehran during COVID-19. We evaluated the effectiveness of the IHT strategy in order to determine whether the strategy should be continued post-COVID.

METHODS

Six supervisors with experience in COVID-19 wards and the IHT strategy were consulted to identify the advantages of continuing the IHT strategy and to evaluate the success and continuation of IHT factors. Then, the decision-making trial and evaluation laboratory (DEMATEL) method was used to establish a network of influence relationships among IHT strategy factors' success.

RESULTS

The result showed that all criteria except increasing patient satisfaction (C1) and reducing waste of time (C8) are cause-and-effect criteria that affected other criteria.

CONCLUSION

The research findings have implications for improving the day-to-day experience of staff navigating transfers of patients between wards and paraclinic units. This study also highlights the theoretical value of the cross-disciplinary integration of medical decision issues and multiple-attribute decision-making methodologies.

Effectiveness of team-based care interventions in improving blood pressure outcomes among adults with hypertension in Africa: a systematic review and meta-analysis

OBJECTIVE

We evaluated the effectiveness of team-based care interventions in improving blood pressure (BP) outcomes among adults with hypertension in Africa.

DESIGN

Systematic review and meta-analysis.

DATA SOURCE

PubMed, CINAHL, EMBASE, Cochrane Library, HINARI and African Index Medicus databases were searched from inception to March 2023.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We included randomised controlled trials (RCTs) and pre-post study designs published in English language focusing on (1) Adults diagnosed with hypertension, (2) Team-based care hypertension interventions led by non-physician healthcare providers (HCPs) and (3) Studies conducted in Africa.

DATA EXTRACTION AND SYNTHESIS

We extracted study characteristics, the nature of team-based care interventions, team members involved and other reported secondary outcomes. Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs and the National Heart, Lung, and Blood Institute assessment tool for pre-post studies. Findings were summarised and presented narratively including data from pre-post studies. Meta-analysis was conducted using a random effects model for only RCT studies. Overall certainty of evidence was determined using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool for only the primary outcome (systolic BP).

RESULTS

Of the 3375 records screened, 33 studies (16 RCTs and 17 pre-post studies) were included and 11 RCTs were in the meta-analysis. The overall mean effect of team-based care interventions on systolic BP reduction was -3.91 mm Hg (95% CI -5.68 to -2.15, I² = 0.0%). Systolic BP reduction in team-based care interventions involving community health workers was -4.43 mm Hg (95% CI -5.69 to -3.17, I² = 0.00%) and nurses -3.75 mm Hg (95% CI -10.62 to 3.12, I² = 42.0%). Based on the GRADE assessment, we judged the overall certainty of evidence low for systolic BP reduction suggesting that team-based care intervention may result in a small reduction in systolic BP.

CONCLUSION

Evidence from this review supports the implementation of team-based care interventions across the continuum of care to improve awareness, prevention, diagnosis, treatment and control of hypertension in Africa. PROSPERO registration number CRD42023398900.

Predictors of burnout among midwives working at public hospitals in northwest Ethiopia, 2022: A multi-centred study

PROBLEM

Midwives are susceptible to burnout due to the physically and emotionally demanding nature of their job. Burnout is an occupational phenomenon with far-reaching consequences.

AIM

This study aimed to assess the magnitude of burnout and predictors among midwives working at public hospitals in northwest Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted from February 7 to April 30, 2022. A simple random sampling method was employed to include 640 study participants. Data were collected using a self-administered questionnaire, entered into Epi-data 4.6 software, and exported to SPSS version 25 for analysis. A multivariable linear regression analysis model was fitted to identify factors contributing to midwives' burnout.

FINDINGS

The overall prevalence of midwives' burnout was 55.3 % (95 % CI = 51.7-58.9). The prevalence of personal, work-related, and client-related burnout was 58.3 %, 60.3 %, and 55.5 %, respectively. Factors that were significantly associated with burnout includes workplace violence (β = 5.02, CI: 2.90, 7.13), not receiving training (β = 4.32 CI: 1.81, 6.80), being exposed to blood and body fluids or needle stick injuries (β = 5.13 CI: 3.12, 7.13), low superior support (β = 5.13 CI: 1.94, 5.30), working in tertiary hospitals (β = 12.77 CI: 9.48, 16.06), and job rotation of six months or less (β = 16.75, CI: 13.12, 20.39).

CONCLUSION

This study found that the prevalence of burnout among midwives was significantly high. Addressing burnout requires implementing effective burnout prevention measures including enhancing management support, offering professional training, creating a conducive working environment, and adhering to standard precautions.

Psychiatric-Mental Health Nurse Educators' Perceptions of Teaching Dissociative Disorders: A Reflexive Thematic Analysis

BACKGROUND AND PURPOSE

Although the prevalence of dissociative disorders (DDs) is up to 10 percent of the general population, psychiatric-mental health (PMH) registered nurses lack education on how to care for individuals diagnosed with these disorders.

METHOD

Sixty-two PMH nurse educators completed an anonymous online survey about their perceptions of teaching DDs to nursing students. Braun and Clarke's six-phase framework was used to conduct an inductive, reflexive thematic analysis of the data.

RESULTS

Three primary themes were identified: lack of resources, differing opinions on the value of teaching DDs, and stigma.

CONCLUSION

Though roughly 75 percent of participants reported that they teach DDs to their nursing students, they endorsed concerning misperceptions about the diagnoses. By failing to properly educate future PMH RNs about DDs, individuals with DDs are at risk of receiving inadequate and inappropriate nursing care and experiencing poor outcomes.

Relationship between critical thinking ability and medication safety competence among clinical nurses: A multicenter cross-sectional study

AIMS AND OBJECTIVES

This study investigated the relationship between clinical nurses' critical thinking ability and medication safety competence, as well as the factors related to medication safety competence.

BACKGROUND

Nurses can have an active role in promoting medication safety. However, the main factors associating with nurses' competence in medication safety are uncertain.

DESIGN

This was a descriptive, multicenter cross-sectional survey study.

METHODS

A total of 1196 nurses from four different tertiary hospital in China were included in this study. A demographic information questionnaire, the Critical Thinking Diagnostic for nurses, and the Medication Safety Competence Scale for nurses were used to survey. Descriptive statistics, comparisons, correlation and regression analysis of the collected data were performed using SPSS 26.00 software. The study was reported using STROBE checklist.

RESULTS

Included nurses obtained satisfactory scores on the critical thinking and medication safety scales and subscales. There was a strong statistically significant positive correlation between critical thinking ability and medication safety competence. Multiple linear regression analysis indicated that personal critical thinking scores and working years were positively associated with nurses' medication safety scores, accounting for 62.50% of the variance.

CONCLUSION

Clinical nurses' critical thinking ability is positively associated with medication safety competence.

RELEVANCE TO CLINICAL PRACTICE

As critical thinking ability positively predicts nurses' medication safety competence, hospitals and nursing administrators should consider continuing nursing education and training to improve critical thinking skills, thereby promoting medication safety competence among clinical nurses.

Effects of educational methods using extended reality on pre-registration nursing students' knowledge, skill, confidence, and satisfaction: A systematic review and meta-analysis

AIMS

This study examined whether educational methods utilizing extended reality (XR) improve pre-registration nursing students' knowledge, skills, confidence, and satisfaction compared with traditional methods.

DESIGN

We conducted a systematic review and meta-analysis of the effectiveness of XR in nursing education based on the Cochrane methodology.

DATA SOURCES

Randomized controlled trials (RCTs) were searched in MEDLINE, CINAHL, ERIC, Web of Science, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi from inception of each database to March 21, 2024.

REVIEW METHODS

Two authors independently screened study titles and abstracts to identify potentially relevant studies. Subsequently, two reviewers independently assessed the eligibility of the studies based on full-text reviews and extracted the data. They calculated the pooled effect estimates associated with pre-registration nursing students' knowledge and skills, confidence, and satisfaction using a random-effects meta-analytic model.

RESULTS

Among the 1615 records identified, 128 studies were identified. Following full-text evaluation, 38 studies were included in the systematic review. The meta-analysis included 34 studies. XR had significant positive effects on knowledge (N = 1926, standard mean difference [SMD] = 0.55, 95 % confidence interval [CI]: 0.34 to 0.77), skills (N = 904, SMD = 1.00, 95 % CI: 0.46 to 1.54), and satisfaction (N = 574, SMD = 1.19, 95 % CI: 0.09 to 2.30). In particular, immersive virtual reality (VR) had significant positive effects on knowledge (N = 707, SMD = 0.60, 95%CI: 0.36 to 0.83), skills (N = 302, SMD = 1.60, 95%CI: 0.70 to 2.50), and satisfaction (N = 406; SMD = 1.63, 95%CI: 0.04 to 3.22).

CONCLUSIONS

XR may be a viable teaching strategy for improving knowledge, skills, and satisfaction acquisition. In particular, immersive VR improves knowledge, skills, and satisfaction. XR could not be a direct replacement for traditional methods but can complement pre-registration nursing students' traditional education methods.

Challenges and coping strategies when caring for terminally ill persons with cancer: perspectives of family caregivers

INTRODUCTION

Terminal illness is an irreversible illness that, without life-sustaining procedures, usually results in death or permanent disability from which recovery is unlikely. When involved, family caregivers are believed to improve health outcomes, such as reduced hospitalization, and establishing a patient's initial access to professional treatment services. However, caring for a patient with a terminal illness is viewed as one of the most difficult aspects of providing care. This study aimed to identify the challenges, and coping strategies developed by family caregivers to cope with the care of the terminally ill person.

METHODS

An exploratory descriptive qualitative approach was used. Twenty (20) family caregivers voluntarily participated in the study from the Korle-Bu Teaching Hospital. Semi-structured interviews were conducted with the participants. The transcribed interviews were then analysed using thematic analysis.

RESULTS

From the analysis, three main themes emerged: challenges, coping strategies, and social support. These themes encompassed sixteen subthemes including financial burden, bad health conditions, faith and prayer, and support from health professionals. From the study, both male and female family caregivers narrated that providing care for sick relatives undergoing terminal disease is characterized as a daily duty demanding one's time and fraught with emotional strain. In addition, even though it was a difficult job, family members who provided care for ailing relatives never gave up, citing responsibility, the importance of family, and religious beliefs as the primary motivations for doing so.

CONCLUSION

The difficulties and demands of family caregiving roles for terminally ill relatives are complex and multifactorial. The findings call for multidisciplinary professional attention for family caregivers and policies that will support their lives holistically.

Digital Health Education and Training for Undergraduate and Graduate Nursing Students: Scoping Review

BACKGROUND

As technology will continue to play a pivotal role in modern-day health care and given the potential impact on the nursing profession, it is vitally important to examine the types and features of digital health education in nursing so that graduates are better equipped with the necessary knowledge and skills needed to provide safe and quality nursing care and to keep abreast of the rapidly evolving technological revolution.

OBJECTIVE

In this scoping review, we aimed to examine and report on available evidence about digital health education and training interventions for nursing students at the undergraduate and graduate levels.

METHODS

This scoping review was conducted using the Joanna Briggs Institute methodological framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A comprehensive search strategy was developed and applied to identified bibliographic databases including MEDLINE (Ovid; 1946 to present), Embase (Ovid; 1974 to present), CINAHL (EBSCOhost; 1936 to present), ERIC (EBSCOhost; 1966 to present), Education Research Complete (EBSCOhost; inception to present), and Scopus (1976 to present). The initial search was conducted on March 3, 2022, and updated searches were completed on January 11, 2023, and October 31, 2023. For gray literature sources, the websites of select professional organizations were searched to identify relevant digital health educational programs or courses available to support the health workforce development. Two reviewers screened and undertook the data extraction process. The review included studies focused on the digital health education of students at the undergraduate or graduate levels or both in a nursing program. Studies that discussed instructional strategies, delivery processes, pedagogical theory and frameworks, and evaluation strategies for digital health education; applied quantitative, qualitative, and mixed methods; and were descriptive or discussion papers, with the exception of review studies, were included. Opinion pieces, editorials, and conference proceedings were excluded.

RESULTS

A total of 100 records were included in this review. Of these, 94 records were identified from database searches, and 6 sources were identified from the gray literature. Despite improvements, there are significant gaps and limitations in the scope of digital health education at the undergraduate and graduate levels, consequently posing challenges for nursing students to develop competencies needed in modern-day nursing practice.

CONCLUSIONS

There is an urgent need to expand the understanding of digital health in the context of nursing education and practice and to better articulate its scope in nursing curricula and enforce its application across professional nursing practice roles at all levels and career trajectories. Further research is also needed to examine the impact of digital health education on improving patient outcomes, the quality of nursing care, and professional nursing role advancement.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.11124/JBIES-22-00266.

Maternal health service utilization in the Jimma Zone, Ethiopia: results from a baseline study for mobile phone messaging interventions

BACKGROUND

Over the last 20 years, global healthcare has placed a major focus on improving the survival rates of mothers and children, recognizing the potential to prevent a significant number of deaths resulting from pregnancy and childbirth. Nevertheless, there remains an ongoing obstacle to the insufficient utilization of critical obstetric services to achieve optimal health outcomes for pregnant women. This study aimed to assess the magnitude and determinants of maternal healthcare use in the Jimma Zone, Ethiopia.

METHODS

Data were obtained from a household survey as part of the baseline assessment of a cluster randomized controlled trial. The study participants comprised 588 women in early pregnancy, specifically those with a gestational age of less than 20 weeks. Logistic regression analysis was employed to identify factors associated with the use of maternal health services. Adjusted odds ratios (AORs) were used to assess the strength of the associations, with significance level set at a p-value ≤ 0.05.

RESULTS

The overall prevalence of maternal health service utilization was 87.9% (CI: 85.1, 90.4) for antenatal care, 74.7% (CI: 73.2, 79.9) for health facility delivery, and 60.4% (CI: 56.4, 64.3) for postnatal care. Multivariable logistic analysis revealed that maternal health service use was significantly influenced by access to health facilities (AOR: 6.6; 95% CI: 2.39, 18.16), financial hardship (AOR: 3; 95% CI: 1.97, 4.61), perceived respectful care (AOR: 2.3; 95% CI: 1.07, 5.11), perceived privacy of service provisions (AOR: 2.4; 95% CI: 1.47, 4.06), and attitudes toward maternal service use (AOR: 2.2; 95% CI: 1.48, 3.24).

CONCLUSIONS

The study revealed slightly higher rates of antenatal care, facility delivery, and postpartum care utilization. However, there was a low proportion of early antenatal care initiation, and high rates of antenatal care dropout. Mobile phone-based messaging intervention may enhance maternal health service use by addressing factors such as lack of access, economic challenges, disrespectful care, no privacy of procedures, and unfavorable attitudes.

Exploring the disaster experiences and psychosocial support needs of children affected by the Kahramanmaras earthquake in Turkey through drawing narratives

BACKGROUND

On February 6, 2023, a catastrophic earthquake struck the Kahramanmaras region in Turkey. Among the most vulnerable demographic groups in the wake of such disasters are children. To provide effective psychosocial support to these young individuals, it is crucial to gain a comprehensive understanding of their specific needs resulting from the earthquake experience.

OBJECTIVES

This study aimed to determine the disaster experiences and psychosocial support needs of children between the ages of 7 and 12 who were affected by the Kahramanmaraş earthquake in Turkey with drawings.

METHODS

This research used a descriptive qualitative design, employing purposive and snowball sampling approaches to select 32 children aged 7-12 for the study. Thematic analysis approach was used to analyze the data, revealing six distinct themes as expressed through the drawings of school-aged children. The reporting in this study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ).

RESULTS

These six themes are associating precipitation with earthquakes, security and relocation, emotional chaos, expressing the earthquake symbolically, death and physical damage and longing for normalcy.

CONCLUSIONS

This study highlights the importance of acknowledging and attending to children's requirements through psychosocial interventions tailored to their age.

IMPLICATION TO PRACTICE

It underscores the complex nature of the psychosocial needs of children impacted by earthquakes and promotes collaborative efforts among healthcare professionals and nurses to provide more effective support to these children during challenging circumstances.

Twitter Discussions on #digitaldementia: Content and Sentiment Analysis

BACKGROUND

Digital dementia is a term that describes a possible decline in cognitive abilities, especially memory, attributed to the excessive use of digital technology such as smartphones, computers, and tablets. This concept has gained popularity in public discourse and media lately. With the increasing use of social media platforms such as Twitter (subsequently rebranded as X), discussions about digital dementia have become more widespread, which offer a rich source of information to understand public perceptions, concerns, and sentiments regarding this phenomenon.

OBJECTIVE

The aim of this research was to delve into a comprehensive content and sentiment analysis of Twitter discussions regarding digital dementia using the hashtag #digitaldementia.

METHODS

Retrospectively, publicly available English-language tweets with hashtag combinations related to the topic of digital dementia were extracted from Twitter. The tweets were collected over a period of 15 years, from January 1, 2008, to December 31, 2022. Content analysis was used to identify major themes within the tweets, and sentiment analysis was conducted to understand the positive and negative emotions associated with these themes in order to gain a better understanding of the issues surrounding digital dementia. A one-way ANOVA was performed to gather detailed statistical insights regarding the selected tweets from influencers within each theme.

RESULTS

This study was conducted on 26,290 tweets over 15 years by 5123 Twitter users, mostly female users in the United States. The influencers had followers ranging from 20,000 to 1,195,000 and an average of 214,878 subscribers. The study identified four themes regarding digital dementia after analyzing tweet content: (1) cognitive decline, (2) digital dependency, (3) technology overload, and (4) coping strategies. Categorized according to Glaser and Strauss's classifications, most tweets (14,492/26,290, 55.12%) fell under the categories of wretched (purely negative) or bad (mostly negative). However, only a small proportion of tweets (3122/26,290, 11.86%) were classified as great (purely positive) or swell sentiment (mostly positive). The ANOVA results showed significant differences in mean sentiment scores among the themes (F3,3581=29.03; P<.001). The mean sentiment score was -0.1072 (SD 0.4276).

CONCLUSIONS

Various negative tweets have raised concerns about the link between excessive use of digital devices and cognitive decline, often known as digital dementia. Of particular concern is the rapid increase in digital device use. However, some positive tweets have suggested coping strategies. Engaging in digital detox activities, such as increasing physical exercise and participating in yoga and meditation, could potentially help prevent cognitive decline.

Learning interventions and training methods in health emergencies: A scoping review

BACKGROUND

Keeping the health workforce and the public informed about the latest evolving health information during a health emergency is critical to preventing, detecting and responding to infectious disease outbreaks or other health emergencies. Having a well-informed, ready, willing, and skilled workforce and an informed public can help save lives, reduce diseases and suffering, and minimize socio-economic loss in affected communities and countries. Providing "just in time" support and opportunities for learning in health emergencies is much needed for capacity building. In this paper, 'learning intervention' refers to the provision of ad-hoc, focused, or personalized training sessions with the goal of preparing the health workers for emergencies or filling specific knowledge or skill gaps. We refer to 'training methods' as instructional design strategies used to teach someone the necessary knowledge and skills to perform a task.

METHODS

We conducted a scoping review to map and better understand what learning interventions and training methods have been used in different types of health emergencies and by whom. Studies were identified using six databases (Pubmed/Medline, Embase, Hinari, WorldCat, CABI and Web of Science) and by consulting with experts. Characteristics of studies were mapped and displayed and major topic areas were identified.

RESULTS

Of the 319 records that were included, contexts most frequently covered were COVID-19, disasters in general, Ebola and wars. Four prominent topic areas were identified: 1) Knowledge acquisition, 2) Emergency plans, 3) Impact of the learning intervention, and 4) Training methods. Much of the evidence was based on observational methods with few trials, which likely reflects the unique context of each health emergency. Evolution of methods was apparent, particularly in virtual learning. Learning during health emergencies appeared to improve knowledge, general management of the situation, quality of life of both trainers and affected population, satisfaction and clinical outcomes.

CONCLUSION

This is the first scoping review to map the evidence, which serves as a first step in developing urgently needed global guidance to further improve the quality and reach of learning interventions and training methods in this context.

Exploring Burnout among Nursing Students in Bangalore: A t-Distributed Stochastic Neighbor Embedding Analysis and Hierarchical Clustering in Cross-Sectional Data

This study explores burnout among nursing students in Bangalore, India, focusing on Exhaustion and Disengagement scores. A cross-sectional design was applied using the Oldenburg Burnout Inventory modified for nursing students, collecting data using a survey that was conducted between October and December 2023. The sample consisted of 237 female nursing students from the Bachelor of Science in Nursing program at Bangalore College of Nursing, South India. The study integrated the t-distributed Stochastic Neighbor Embedding (t-SNE) procedure for data simplification into three t-SNE components, used in a hierarchical clustering analysis, which identified distinct student profiles: "High-Intensity Study Group" and "Altruistic Aspirants". While burnout scores were generally high, students with high study hours ("High-Intensity Study Group") reported greater Exhaustion, with a mean score of 26.78 (SD = 5.26), compared to those in the "Altruistic Aspirants" group, who reported a mean score of 25.00 (SD = 4.48), demonstrating significant differences (p-value = 0.005). Conversely, those motivated by altruism ("Altruistic Aspirants") showed higher Disengagement, with a mean score of 19.78 (SD = 5.08), in contrast to "High-Intensity Study Group", which reported a lower mean of 17.84 (SD = 4.74) (p-value = 0.002). This segmentation suggests that burnout manifests differently depending on the students' academic load and intrinsic motivations. This study underscores the need for targeted interventions that address specific factors characterizing the clusters and provide information for designing future research and interventions. This study was not registered.

In vitro comparison of zinc-based, chlorhexidine, and essential oil mouth rinses

BACKGROUND

Chlorhexidine (CHX)-based mouth rinses are frequently prescribed following periodontal surgeries. A more recently available brand of zinc-based mouth rinses advertises one of its mouth rinses as a substitute for chlorhexidine. The purpose of this study was to evaluate, in vitro, the effects of this brand of zinc-based mouth rinses on cell survival, cell motility, and gene expression of human gingival fibroblasts (HGFs).

METHODS

HGFs were exposed to essential oil (EO), CHX, and three types of one brand of zinc-based mouth rinses designed to treat breath malodor (ZnA), dry mouth (ZnB), and gingivitis (ZnC). Each mouth rinse was tested over a range of concentrations for its effects on HGF survival and motility. Gene expression of cytokines, interleukins, and growth factors were evaluated via reverse transcriptase-polymerase chain reaction (RT-PCR), as a means to assess potential influences on inflammation and wound healing.

RESULTS

Cell survival was significantly decreased for CHX and ZnC at 10% dilutions (p < 0.05). For all time points, cells exposed to ZnC displayed the greatest reduction in cell motility (p < 0.05). The various mouth rinses examined differentially altered the expression of growth factor transcripts. ZnC particularly enhanced the expression of BMP-2 and FGF-2.

CONCLUSION

ZnC was more cytotoxic and inhibited cell motility to a greater extent than any of the other mouth rinses. Therefore, using ZnC as an alternative to CHX could potentially have negative effects on wound healing after periodontal surgery. However, further investigation is required to confirm the clinical relevance of these in vitro findings.

PLAIN LANGUAGE SUMMARY

One type of zinc-based mouth rinse designed to replace chlorhexidine (often prescribed after oral surgeries) demonstrated the greatest oral cell death and reduction in cell movement when compared to other zinc-based mouth rinses. These zinc-based mouth rinses also reduced the amounts of proteins involved in regulating inflammation, potentially reducing the destruction of bone holding the teeth in place. They also changed the amounts of several molecules involved in tissue healing. It is unknown if this will speed or slow the healing of the soft tissues of the mouth.

Midwives' and registered nurses' role and scope of practice in acute early pregnancy care settings in Australia: A qualitative descriptive study

PROBLEM

There is little documented evidence regarding the practice of midwives providing care for women with acute concerns in early pregnancy (< 20 weeks) in Australia.

BACKGROUND

Women can experience unexpected complications at any gestation of pregnancy and may seek acute care in an emergency or gynaecology service, usually staffed by registered nurses (RNs). They may not receive care from specialised pregnancy clinicians, including midwives. The role and scope of practice of midwives working in acute early pregnancy settings in Australia has not been previously reported. This study provides an opportunity to document practice in an area of pregnancy care not often visible within maternity services in Australia.

RESEARCH AIM

To describe midwives' and RNs perceptions, perspectives and experiences of role and scope of practice in acute early pregnancy care provision in Australia.

METHODS

A qualitative descriptive approach was adopted. Midwives and RNs with acute early pregnancy knowledge and experience were recruited. Semi-structured interviews were conducted, and data analysed using inductive thematic analysis.

FINDINGS

Fifteen participants were interviewed. Three themes were constructed from interview data: Personal and Professional Influences; Being There for Women; The Impact of Setting.

DISCUSSION

Findings reinforce the lack of clarity around how midwives' scope is enabled in traditional acute early pregnancy care. Setting of care has influenced practice and seen a barrier for midwives who don't hold nursing registration from fulfilling professional scope. Results provide novel benchmarking evidence regarding a largely hidden area of midwifery, signposting areas for reform within education, policy and health service sectors.

Geriatric trauma triage: optimizing systems for older adults-a publication of the American Association for the Surgery of Trauma Geriatric Trauma Committee

Background

Geriatric trauma patients are an increasing population of the United States (US), sustaining a high incidence of falls, and suffer greater morbidity and mortality to their younger counterparts. Significant variation and challenges exist to optimize outcomes for this cohort, while being mindful of available resources. This manuscript provides concise summary of locoregional and national practices, including relevant updates in the triage of geriatric trauma in an effort to synthesize the results and provide guidance for further investigation.

Methods

We conducted a review of geriatric triage in the United States (US) at multiple stages in the care of the older patient, evaluating existing literature and guidelines. Opportunities for improvement or standardization were identified.

Results

Opportunities for improved geriatric trauma triage exist in the pre-hospital setting, in the trauma bay, and continue after admission. They may include physiologic criteria, biochemical markers, radiologic criteria and even age. Recent Trauma Quality Improvement Program (TQIP) Best Practices Guidelines for Geriatric Trauma Management published in 2024 support these findings.

Conclusion

Trauma systems must adjust to provide optimal care for older adults. Further investigation is required to provide pertinent guidance.

The utilization of renal dialysis: a comprehensive study in Saudi Arabia

BACKGROUND

Understanding the trend of utilization of renal dialysis in Saudi Arabia (SA) is fundamental as it provides a general overview of renal care. The practice of renal dialysis assists in identifying challenges, opportunities, and potential areas for improvement in the provision of the services.

OBJECTIVES

This research investigated the utilization of renal dialysis services in SA by exploring the number of renal dialysis centers, hemodialysis machines (HD), and peritoneodialysis patients.

METHODS

The dataset for this study was derived from a collaboration between the General Authority of Statistics (GaStat) and the Ministry of Health (MoH), focusing on indicators for renal dialysis centers and patients across health sectors in 2021. Analysis was conducted using MS Excel 365 and IBM SPSS Version 29, incorporating multiple regression techniques. The health sector was treated as the dependent variable. At the same time, the number of hemodialysis (HD) machines and the counts of HD and peritoneal dialysis patients were considered independent variables.

RESULTS

Around 275 renal dialysis centers, over 8000 HD machines, 20,440 HD patients, and 1,861 peritoneal patients were tallied from two resources. The findings revealed a negative relationship between the health sector and several renal dialysis centers and peritoneodialysis patients, as demonstrated by p < 0.05 in multiple regression analysis.

CONCLUSION

The number of renal dialysis centers influences the availability of HD machines, affecting the number of HD and peritoneodialysis patients. Most national patients preferred MoH over other semi-governmental and private sectors, and vice versa for non-Saudis.

Effect of a Web-Based Integrative Support Intervention to Improve Family Caregiver Positive Caregiving Experience and Quality of Life: A Randomized Controlled Trial

BACKGROUND

Cancer caregivers experience significant stress due to their multifaceted role. Current support methods are limited by unidimensional assessments.

OBJECTIVE

The aim of this study was to evaluate a Web-based support system aimed at reducing caregiver stress and anxiety, and improving resilience, vigilance, and quality of life, using both subjective and objective measures.

METHODS

A randomized controlled trial with a single-center, 2-arm parallel design and longitudinal assessment was conducted in Taiwan. Caregivers of patients recently diagnosed with cancer were randomly allocated to either a standard care group or an intervention group that received enhanced nurse-led support. Metrics including psychological resilience, caregiver burden, anxiety, quality of life, stress levels, and vigilance were systematically evaluated on a monthly basis over a period of 5 months, starting from the initial baseline measurement.

RESULTS

Following the intervention, participants in the intervention group exhibited statistically significant reductions in caregiver burden and anxiety, alongside a notable improvement in resilience. Objective evaluations revealed a significant reduction in stress levels within this group. However, there were no discernible differences in vigilance and quality of life metrics between the intervention and control groups.

CONCLUSION

The Web-based program effectively reduced caregiver stress and burden, as indicated by multiple metrics.

IMPLICATIONS FOR PRACTICE

This accessible and efficient Web-based support is beneficial for cancer caregivers facing diverse challenges.

Subgroups of ICU patients identified by self-reported symptoms - A prospective multicenter study

BACKGROUND

Intensive care unit (ICU) patients experience several symptoms, yet patterns of symptoms and their relationship with demographic and clinical characteristics have not previously been investigated.

OBJECTIVES

To identify and compare subgroups (i.e. latent symptom classes) of intensive ICU patients based on prevalence of co-occurring symptoms over seven days.

RESEARCH METHODOLOGY

Prospective cohort study of adult ICU patients' self-reports of five symptoms during seven days in ICU. Latent class analysis was applied to identify subgroups of ICU patients.

SETTING

Multicenter study with patients from six mixed ICUs in Norway.

MAIN OUTCOME MEASURES

Patient Symptom Survey was used to assess five symptoms (i.e., thirst, pain, anxiousness, tiredness, shortness of breath).

RESULTS

Among 353 included patients, median age was 63 years and 60.3 % were male. Subgroups of patients were identified in a Low class (n = 126, 35.7 %), Middle Class (n = 177, 50.1 %) and High Class (n = 50, 14.2 %) based on reporting of the prevalence of five symptoms. Patients in the Low class had a low prevalence of all symptoms. Middle Class patients had a high prevalence of thirst and tiredness and a low prevalence of pain, anxiousness and shortness of breath. The High class patients had a high prevalence of all symptoms. Symptom prevalence remained stable in the Low and Middle class over time and increased over time in the High class. There were significant differences among symptom classes in use of mechanical ventilation (p = 0.012), analgesics (p < 0.001), alpha-2 agonists (p = 0.004) and fluid restriction (p = 0.006). Patients in the High class received more of these ICU-treatments.

CONCLUSIONS

Findings suggest that subgroups of ICU patients with distinct symptom experiences can be identified. The High prevalence class patients had consistently high levels of all symptoms across seven ICU days and received more ICU-related interventions.

IMPLICATION FOR CLINICAL PRACTICE

Some ICU patients experience a consistently high prevalence of co-occurring symptoms. Clinicians should be aware of treatment factors that could be linked to a high burden of symptoms.

The Lived Experience of Cardiac Arrest Survivors: A Scoping Review

BACKGROUND

Survival rates after cardiac arrest have steadily increased over the past few decades because of the adoption of cardiopulmonary resuscitation, public access to automated external defibrillators, and an increase in public education on how to perform cardiopulmonary resuscitation. The lived experiences of post-cardiac arrest survival have been underexplored. The themes that resulted from the analysis in this scoping review can inform clinical practice and propose strategies to improve the patients' quality of life.

OBJECTIVE

The objective of this scoping review was to map out qualitative literature that explores the lived experience of individuals who have survived cardiac arrest.

METHOD

In this scoping review, the authors examined peer-reviewed qualitative studies identified in the PubMed, CINAHL, and MEDLINE databases. Arksey and O'Malley's methodological framework for conducting a scoping study was followed.

RESULTS

The search yielded 174 articles, with 16 meeting inclusion criteria for this scoping review. Initially, 14 articles were selected, and 2 additional articles were identified through references. Themes extracted from these 16 articles include the need for support and information, emotional challenges, and acceptance of a new reality.

CONCLUSION

Cardiac arrest survivors often experience loss of control, vulnerability, and insecurity. These emotional changes can be significant and may include physical challenges, cognitive impairments, and psychological distress, which can cause individuals to reevaluate their perspectives on life and accept a new reality, potentially leading to changes in their future outlook.

Home-based care models for patients with terminal illnesses in low and middle-income countries: A systematic review of randomized and quasi-experimental studies

BACKGROUND

With the increasing lifespan of people and the transition from communicable to non-communicable diseases across the globe, there is an increasing number of people with terminal illnesses requiring home-based care in Low- and Middle-Income Countries (LMICs).

AIM

This systematic review evaluated home-based care models for patients with terminal illnesses in LMICs. The primary outcomes measured are quality of life (QoL), adherence to treatment, fatigue, bimanual and related activities.

METHODS

This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. Four databases; Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE (Ovid), Cochrane Library and Scopus, were systematically searched for potentially relevant studies. Screening of records (titles/abstracts from and full-texts) was done and a total of seven studies (four Randomized Control Trials [RCTs] and three quasi-experimental studies) were included in this review.

RESULTS

Even though the included studies reported significant increase in the QoL of the studied patients, the studies have quality concerns.

CONCLUSION

Noting the general paucity of existing studies coupled with quality concerns across geographies in LMICs. More studies on home-based care for patients with terminal illness are needed with improved qualities and spread in these regions.

Impact of Nurse Manager's Attributes on Multi-Cultural Nursing Teams: A Scoping Review

BACKGROUND

As global migration increases, nurse managers' effectiveness in multi-cultural nursing work environments is crucial due to the rising cultural diversity within healthcare teams. Despite the increasing international recruitment of qualified nurses to address the worldwide nursing shortage, no studies have synthesised the impact of nurse managers' attributes on nurses in multi-cultural nursing teams. Therefore, it was conducted a literature review aimed to synthesise the available literature on how nurse managers' personality traits, competencies, behaviours, and leadership styles influence nurse outcomes in multi-cultural nursing teams.

METHODS

Scoping review conducted according to the Joanna Briggs Institute guidelines to map the relationship or influence of nurse managers' personality traits, competencies, behaviours, and leadership styles on the outcomes of nurses in multi-cultural settings across various clinical environments. Searches were conducted across electronic databases such as CINAHL and MEDLINE, along with grey literature.

RESULTS

This review included 39 studies, highlighting 29 personality traits, 9 competencies, 115 behaviours, and 5 leadership styles that impact nurses' outcomes. Key findings emphasise the importance of nurse managers being supportive, culturally competent, and effective communicators, with transformational leadership style being particularly beneficial.

CONCLUSIONS

These findings provide insights for planning and developing training programmes to equip current and future nurse managers with skills to effectively lead in multi-cultural care settings.

"We do others' Jobs": a qualitative study of non-nursing task challenges and proposed solutions

INTRODUCTION

Non-nursing tasks (NNTs) have become a prevalent issue among healthcare professionals, affecting nurses globally. This study delves into the experiences of Jordanian nurses regarding NNTs, aiming to uncover challenges and propose solutions within the Jordanian healthcare context.

OBJECTIVE

Explore the impact of NNTs on Jordanian nurses' roles, workload, and satisfaction. Additionally, the study aims to identify various types of NNTs performed by nurses, understand their impact, and propose solutions to mitigate challenges associated with these tasks.

METHODS

A qualitative-exploratory research design was employed for this study. Semi-structured interviews were conducted with Jordanian nurses using a purposeful sampling approach to ensure a diverse representation of experiences and perspectives. Thematic analysis was used to identify recurring themes and patterns related to NNTs, their challenges, and potential solutions. Ethical guidelines were strictly followed to maintain participant confidentiality and ensure the integrity of the data collected.

RESULTS

Analysis of the interviews revealed four major themes: challenges of NNTs, types of NNTs, impact of NNTs, and proposed solutions. Nurses faced significant difficulties due to task ambiguity, role confusion, and increased workload from NNTs, which included administrative duties, clerical work, and tasks typically performed by other healthcare professionals. These NNTs negatively impacted nurses' effectiveness, productivity, and job satisfaction by diverting time and energy from primary nursing responsibilities, causing professional strain. To address these issues, participants suggested clearer job descriptions, stricter task assignment protocols, and systemic changes to tackle the root causes of NNTs.

CONCLUSION

This study sheds light on the pervasive challenges posed by NNTs among Jordanian nurses and emphasizes the importance of addressing these issues to enhance nursing care quality and nurse well-being. By proposing actionable solutions tailored to the Jordanian context, this research contributes to the global discourse on NNTs and underscores the need for organizational support and advocacy to optimize nurses' roles and improve patient care outcomes.

Non-pharmacological interventions to reduce procedural needle pain in children (6-12 years): A systematic review

PROBLEM

Children of different age groups frequently undergo painful procedures involving needles, which can be a source of significant discomfort. Regrettably, this aspect of care often receives insufficient attention from healthcare professionals. The existing literature proposes several methodologies for managing procedural pain, with nonpharmacological techniques being particularly promising. These techniques should be adapted to the patient's age, but literature predominantly emphasizes their use with infants. Thus, it is necessary to evaluate their effectiveness in diverse age groups. Consequently, the purpose of this systematic review is to identify non-pharmacological interventions used to prevent needle-related procedural pain in children (age group 6-12 years).

ELIGIBILITY CRITERIA

Primary studies in English language on non-pharmacological interventions in children aged 6-12 years undergoing needle-related procedures found on PubMed, CINAHL and Embase.

SAMPLE

A total of 18 studies were included.

RESULTS

The results indicate the potential application of various non-pharmacological techniques, with distraction methods standing out. These techniques include activities like utilizing cards, watching cartoons, employing virtual reality and playing video games.

CONCLUSIONS

Children's procedural pain represents a significant challenge in treatment plans. Literature offers several approaches, including nonpharmacologic methods, to control this problem. Prioritizing procedural pain management is critical both at clinical and organizational levels to improve the quality of pediatric care.

IMPLICATIONS

These findings offer different options to support clinical practice, holding the potential to enhance the quality of patient care.

The risk of solid organ tumors in patients with chronic kidney disease: A narrative review of literature

Chronic kidney disease (CKD) has been correlated with certain pathological conditions such as cardiovascular diseases and other renal-related dysfunctions. Some other reports suggested an association between CKD and the development of certain solid cancers. Therefore, we aimed to generate this narrative review to present the available literature on the risk of solid cancer development in CKD patient populations. We explored the associations between CKD, organ transplantation, and the development of specific solid organ tumors such as kidney, thyroid, lung, breast, bladder, gastric, and prostate cancers. In conclusion, the previous reports showed an increase in the risk of certain solid cancers such as kidney, lung, bladder, and possibly breast cancer in CKD patients and transplant recipients. On the other hand, thyroid, gastric, and prostate cancers showed unclear association with CKD. Despite the suggested impact of smoking and immunosuppression on the development of cancers in CKD patients, more studies are needed to elucidate the mechanism and the risk factors that might be related to the development of cancer in CKD patients.

The Effects of Hospital-Based School Lessons on Children's Emotions, Distress and Pain

Lessons conducted in hospitals ensure school continuity for hospitalized children unable to attend regular school. Hospital-based school (HS) provides a tailored experience that ensures normality for children through education. The objective of this study is to evaluate the effects of the proposed lessons in reducing negative emotions, distress, and pain in children, as well as fostering positive affects. The study was conducted with 32 hospitalized children, aged 8-12 years, in the Onco-Hematology and Pediatric Unit of Meyer Children's Hospital IRCCS (Florence, Italy). Positive and negative emotions were measured using the Positive and Negative Affect Scale for Children; distress was measured using the Physiological Hyperarousal for Children; pain was measured using the Visual Analogue Scale for children. Variables were assessed before (T0) and after (T1) lessons, for three times; for each variable, collected data were averaged at both T0 and T1. Statistical analyses showed a significant increase in positive emotions in hospitalized children and a significant decrease in negative emotions, distress, and pain; nevertheless, only for pain the significant correlation between its scores before and after the HS lessons indicated that the detected change occurred for all participants in much the same way. These preliminary results suggest that HS lessons can promote hospitalized children's well-being, at least as far as pain reduction is concerned.

Exploring the nurse-patient relationship in caring for the health priorities of older adults: qualitative study

BACKGROUND

Person-centered care (PCC) is critical in addressing the diverse health priorities of older adults. Nurses play a pivotal role in implementing PCC, yet the nuances of the nurse-patient relationship in outpatient settings remain underexplored. This study aimed to gain insights into nurses' experiences, challenges, and strategies in caring for older adults through the lens of PCC.

METHODS

A qualitative descriptive design was employed, involving semi-structured interviews with 12 registered nurses from outpatient clinics serving older adults. Thematic analysis was conducted following the principles of trustworthiness and credibility.

RESULTS

Five main themes emerged: (1)Understanding and Implementing Person-Centered Care (PCC) (2) Experiences in Older Adult Care, highlighting the significance of trust-building, adapting care approaches, interdisciplinary collaboration, and emotional rewards; (3) Challenges in Care Delivery, including resource constraints, navigating family dynamics, keeping up with medical advances, and emotional strain; (4) Impact on Care Quality, encompassing consistency in care, patient satisfaction, professional development, and ethical considerations; and (5) Coping Strategies, such as peer support, work-life balance, reflective practice, and resilience building.

CONCLUSIONS

The study underscores the complexities and rewards of the nurse-patient relationship in caring for older adults in outpatient settings. Nurses face formidable challenges but employ various coping strategies to maintain high-quality, person-centered care. Findings have implications for nursing practice, education, policy, and future research, emphasizing the need for supportive environments, continuous professional development, and recognition of the critical role nurses play in addressing the health priorities of the aging population.

Threat or prospect? Exploring the impact of digital entrepreneurs' artificial intelligence perception and intention to adopt blockchain technology on the achievement of SDGs

This paper explores how digital entrepreneurs' intention toward blockchain technology adoption, perception of reduced costs, and knowledge of Artificial Intelligence impact achieving UN's Sustainable Development Goals (SDGs), drawing attention from various sectors. Present study applies explanatory sequential mixed method for data collection. Moreover, to work with the dual face patterned data, PLS-SEM is used to perform quantitative analysis of the data collected from 389 digital entrepreneurs who are chosen through purposive sampling and then content analysis is performed for the qualitative data according to the explanatory sequential mixed method's rule of thumb. The study's quantitative phase shows that factors such as perceived ease of use and usefulness of Industry 4.0 technologies, knowledge of artificial intelligence (KAI), and perception of reduced cost positively influence digital entrepreneurs' intention to adopt blockchain technology (BCT). Notably, KAI has the strongest impact. In the qualitative phase, it's found that digital entrepreneurs' KAI and willingness to adopt BCT strongly align with achieving several UN Sustainable Development Goals (SDGs), suggesting BCT adoption's potential for sustainable outcomes. The outcomes of this study set a new benchmark in the domain of SDGs achievement with careful integration to Industry 4.0, AI and BCT. This study results undoubtedly instigate the digital entrepreneurs to adopt BCT in doing their start-up and convince the policymakers to set regulatory landscape with convenient environment for the utilization of BCT which then ultimately accelerates the achievement of SDGs.

The persian version of the fear-avoidance beliefs questionnaire among iranian post-surgery patients: a translation and psychometrics

INTRODUCTION

Fear-avoidance beliefs (FAB) play a crucial role in the treatment outcomes of post-surgery patients. These beliefs can lead to activity avoidance, increased pain, and decreased quality of life. Therefore, accurately measuring these beliefs in Iranian patients is of significant importance. The Fear-Avoidance Belief Questionnaire (FABQ) is a patient-reported questionnaire that evaluates individuals' FAB. Since the validity and reliability of the Persian version of FABQ (FABQ-P) have not been assessed based on the Iranian population and sociocultural contexts, the current study has been implemented to determine the reliability and validity of the FABQ-P among Iranian post-operative patients by translation and psychometric properties.

METHODS

This methodological study conducted in 2023, a sample of 400 patients who had undergone surgery were selected using a convenience sampling method. The scale used in the study was translated and its psychometric properties were evaluated through network analysis and assessments of construct validity (including exploratory and confirmatory factor analysis), convergent validity, and discriminant validity. Additionally, the study assessed the internal consistency of the scale.

RESULTS

The MLEFA results with Promax and Kaiser Normalization rotation yielded two factors explaining 57.91% of the variance, encompassing 13 items. Also, the model was approved by CFA. Convergent and discriminant validity have been confirmed through the following criteria: Average Variance Extracted (AVE) exceeding 0.5, Composite Reliability (CR) surpassing 0.7, and Heterotrait-Monotrait Ratio of Correlations (HTMT) equating to 0.597. As for reliability, Cronbach's alpha, composite reliability (CR), and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency.

CONCLUSION

As demonstrated by the results, the FABQ-P has a satisfactory level of reliability along with authentic validity according to the sociocultural contexts of Iranian post-operative patients.

The impacts of a healthy lifestyle on the physical and mental health status of female stroke survivors in Australia

INTRODUCTION

This longitudinal study aimed to explore the impacts of adopting a healthy lifestyle on self-reported physical and mental health outcomes among Australian females who are living with stroke.

METHODS

The study utilized data retrieved from the Australian Longitudinal Study on Women's Health's 1946-51 cohort (from survey 5 conducted in 2007 to survey 9 conducted in 2019), focusing on 531 female stroke survivors. The dependent variables for this study were self-reported physical and mental health status, whereas the independent variables were lifestyle behaviors, including physical activity, smoking, alcohol consumption, and supplement use. Generalized Estimating Equation models were employed to assess the longitudinal associations between a dependent variable and the independent and confounding variables.

RESULTS

The average age of the participants was 58.1 (SD = 1.4) years in survey 5 and 70.5 years in survey 9. The longitudinal analyses revealed that stroke survivors who engaged in moderate/high levels of physical activity had significantly better physical and mental health status than their inactive or sedentary counterparts. Besides, current smokers had significantly poorer physical and mental health status than nonsmokers. In addition, risky/high-risk alcohol consumers had significantly poorer mental health status compared to no/low-risk alcohol consumers.

CONCLUSIONS

Our findings suggest that post-stroke individuals can improve their physical and mental health by maintaining a healthy lifestyle. Specifically, targeted and appropriate programs and strategies are needed to promote physical activity and reduce smoking and alcohol consumption in female stroke survivors in order to optimize their overall health and quality of life.

Enhancing psychological well-being in college students: the mediating role of perceived social support and resilience in coping styles

BACKGROUND

The prevalence of depression among college students is higher than that of the general population. Although a growing body of research suggests that depression in college students and their potential risk factors, few studies have focused on the correlation between depression and risk factors. This study aims to explore the mediating role of perceived social support and resilience in the relationship between trait coping styles and depression among college students.

METHODS

A total of 1262 college students completed questionnaires including the Trait Coping Styles Questionnaire (TCSQ), the Patient Health Questionnaire-9 (PHQ-9), the Perceived Social Support Scale (PSSS), and the Resilience Scale-14 (RS-14). Common method bias tests and spearman were conducted, then regressions and bootstrap tests were used to examine the mediating effects.

RESULTS

In college students, there was a negative correlation between perceived control PC and depression, with a significant direct predictive effect on depression (β = -0.067, P < 0.01); in contrast, negative control NC showed the opposite relationship (β = 0.057, P < 0.01). PC significantly positively predicted perceived social support (β = 0.575, P < 0.01) and psychological resilience (β = 1.363, P < 0.01); conversely, NC exerted a significant negative impact. Perceived social support could positively predict psychological resilience (β = 0.303, P < 0.01), and both factors had a significant negative predictive effect on depression. Additionally, Perceived social support and resilience played a significant mediating role in the relationship between trait coping styles and depression among college students, with three mediating paths: PC/NC → perceived social support → depression among college students (-0.049/0.033), PC/NC→ resilience → depression among college students (-0.122/-0.021), and PC/NC → perceived social support → resilience → depression among college students (-0.016/0.026).

CONCLUSION

The results indicate that trait coping styles among college students not only directly predict lower depression but also indirectly influence them through perceived social support and resilience. This suggests that guiding students to confront and solve problems can alleviate their depression.

Mindful self-care among oncology nurses in China: a latent profile analysis

BACKGROUND

Oncology nurses are considered the group with the highest risk for moral distress, compassion fatigue and burnout. Mindful self-care may help oncology nurses improve their well-being and solve psychological problems. However, the investigation and in-depth analysis of mindful self-care among oncology nurses in China is lacking.

OBJECTIVES

To identify heterogeneity groups of oncology nurses on mindful self-care ability and examine the sociodemographic correlation to these profiles.

DESIGN

Cross-sectional descriptive study.

PARTICIPANTS

The study was carried out among oncology nurses in two affiliated comprehensive hospitals and one affiliated oncology hospital. A total of 839 oncology nurses were enrolled in this survey.

METHODS

From January to May 2023, a cross-sectional study was carried out among oncology nurses using convenient sampling. The subjects were given the brief Mindful Self-Care Scale (B-MSCS) and the General Demographic Information Questionnaire. Latent profile analysis using the Mplus 7.4 program was used to separate oncology nurses' mindful self-care into a variety of subgroups. The SPSS 25.0 statistical program was used to analyze the data. One-way ANOVA and the chi-square test were performed to compare the score of B-MSCS in each class and the difference in sociodemographic characteristics among the subgroups. Multinomial logistic regression was used to examine the influence of the sociodemographic variables on each class.

RESULTS

The total score of the B-MSCS was 76.40 ± 13.19. The support structure dimension had the highest score, with an average mean value of 3.60, and physical care had the lowest score at 2.57. The findings of the latent profile analysis showed that respondents were divided into three classes, moderate mindful self-care(51.2%), low-low mindful relaxation(14.8%), and high-high mindfulness self-awareness(34.0%). Across scale scores and dimensions, three groups demonstrated statistically significant differences (p < 0.05). Univariate analysis revealed significant differences between the three profiles in terms of professional title, position, concern about self-care, interest in mindfulness, and experience with meditation (p < 0.05). Profile membership was predicted by 3 factors, namely, self-care status, interest in mindfulness, and experience with meditation.

CONCLUSION

The mindful self-care among oncology nurses can be categorized into three latent profiles: moderate mindful self-care, low-low mindful relaxation, and high-high mindfulness self-awareness. Multinomial logistic regression results indicated that whether oncology nurses concern about self-care, interest in mindfulness and have experience with meditation influenced different latent profiles. Nursing manager should develop targeted intervention based on the typological characteristics of the oncology nurses to improve their mindful self-care ability and mental health.

Spirituality, Religiosity, Caring Behavior, Spiritual Care, and Personalized Care Among Student Nurses: A Descriptive Correlational Study in the Philippines

This study sought to determine the student nurses' spirituality, religiosity, caring behavior, spiritual care, and personalized care. Further, it sought to determine the relationship between spirituality, religiosity, and caring behavior in student nurses' spiritual care and personalized care. The study used a descriptive correlational design using convenience sampling to collect data from 1248 student nurses in the Philippines from December 2023 to February 2024. We collected data using the Spirituality and Spiritual Care Scale rating scale and the Caring Behaviors Inventory. The study revealed that the mean scores of the students in their "spirituality" and "religiosity" were 4.08 (SD = 0.98) and 2.99 (SD = 1.26), respectively. Student nurses had sufficient confidence and skills in spiritual care, caring behavior, and personalized care. The students' age had a weak and negative association with the students' spirituality and religiosity. Students from University A had higher levels of spirituality and religiosity than students from University B, University C, and University D. Students in the 4th year level were more religious than 3rd year students. Students who had their last clinical exposure in the Admission and emergency room reported poorer caring behaviors than those who had previous clinical exposure in the Medical-surgical ward, Obstetrics and gynecology, Intensive Care Units, and Community. There is no significant relationship between a student nurse's spiritual care and caring behavior. This trend is similar to caring behavior and personalized care. The students' age predicts their personalized care.

Role of the health literacy assessment in healthcare: Content validation of "Health Literacy Behaviour" nursing outcome

PURPOSE

To validate the content of the "Health Literacy Behaviour" nursing outcome (NO).

METHODS

A content validation study was conducted during 2022. Each indicator was included in the NO, and its response levels were operationally defined. The initial version of each indicator and its response levels were refined and validated through the Delphi method. A panel of health literacy (HL) and nursing taxonomies experts evaluated the content through two content validity indicators. The content validity of the NO and each index was determined by calculating the content validity index (CVI). A qualitative analysis of the recommendations provided by the experts was carried out to improve the understanding of the indicators and their levels.

FINDINGS

A total of 108 experts participated in this study. Mostly females with more than 10 years of professional experience. The results demonstrated a high CVI of the indicators and the NO "Health Literacy Behaviour." All indicators achieved excellent (CVI ≥ 0.80) relevance and clarity. The CVI universal average method (CVI-p) of the NO achieved an excellent result of 0.90.

CONCLUSIONS

The indicators included in the NO "Health Literacy Behaviour" have content validity.

IMPLICATIONS FOR NURSING PRACTICE

These findings provide evidence-based indicators to measure the patient's actions to obtain, process, and understand information about health and disease, interact with the health system, and make informed health decisions. The validation of this NO would identify populations with low HL, allowing the health of this community to be promoted. Health literacy should be a priority objective of health management and policies.

'In our culture, we come when you die': Qualitative descriptive analysis of end-of-life perspectives in a reservation-based community

AIM

To explore (1) perspectives and attitudes of Native Americans regarding transitions from serious illness to death, and (2) awareness about hospice and palliative care service models in a Great Plains reservation-based community.

DESIGN

Qualitative descriptive study.

METHODS

Community members and clinicians were invited to participate in a semi-structured focus group or interview by Tribal Advisory Board members. Analysis involved three phases: (1) qualitative descriptive analysis of preliminary themes using the Addressing Palliative Care Disparities conceptual model; (2) a cultural review of the data; and (3) reflexive thematic analysis to synthesize findings.

RESULTS

Twenty-six participants engaged in two focus groups (n = 5-6 participants in each) and interviews (n = 15). Four themes were derived from their stories: (1) family connectedness is always priority; (2) end-of-life support is a community-wide effort; (3) everyone must grieve in their own way to heal; and (4) support needs from outside the community.

CONCLUSION

Findings highlight cultural considerations spanning the life course. Clinicians, researchers and traditional wisdom keepers and practitioners, particularly those working in rural and/or reservation-based settings, must provide culturally safe care. This must include acknowledging and prioritizing the needs and preferences of Native American patients and the impact on their families and communities.

IMPACT AND IMPLICATIONS FOR THE PROFESSION

Leveraging community assets, such as family and social networks, is key for supporting Native American patients with serious illnesses. Additionally, facilitating greater family and caregiver involvement along a patient's care trajectory may be a pathway for easing health care workers' caseloads in reservation-based areas, where resources are limited.

REPORTING METHOD

The Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline was used.

PATIENT/PUBLIC CONTRIBUTION

The study was ideated based on community insight. Tribal Advisory Board members oversaw all aspects including recruitment, data acquisition, interpretation of findings and tribal data dissemination.

Incidence and risk factors of neonatal peripherally inserted central catheter-related thrombosis: A systematic review and meta-analysis

BACKGROUND

Catheter-related thrombosis is a common complication of the peripherally inserted central catheter (PICC) in neonates, leading to unintended tube removal and significantly affecting neonatal health and safety. Despite widespread reporting on the estimated occurrence and factors contributing to neonatal PICC-related thrombosis, these findings have not been synthesized.

OBJECTIVES

The purpose of this study was to determine the incidence and risk factors of neonatal PICC-related thrombosis.

DESIGN

Systematic literature review and meta-analysis.

METHODS

Two independent researchers systematically explored multiple databases-such as PubMed, Medline, Embase and the Cochrane Library-from their inception until October 2023. Our study aggregates and scrutinizes studies specifically addressing the incidence and risk factors of neonatal PICC-related thrombosis. Employing the RevMan 5.3 software, a meta-analysis was executed to determine the incidence of both thrombosis and odds ratios (OR), accompanied by their respective 95% confidence intervals (CI) for the risk factors.

RESULTS

A total of 327 articles were screened, and data from 24 studies were used in synthesis. Neonatal PICC-related thrombosis incidence varied from 0.23% to 17.91%. The pooled incidence was 2% (95% CI: 1%-2%; I2 = 94%; p < .0001). The study identified 12 risk factors, including insertion sites in the lower extremities (OR = 0.22; 95% CI: 0.09-0.56; p = .001), gestational age <28 weeks, abdominal pathology, fresh frozen plasma by day 5 > 50 mL/kg, PICC tip location (proximal placement), two lumens, three lumens, prolonged hospital stay, infection, mothers' use of anticoagulants, patients with cardiac insufficiency and being twin-to-twin transfusion syndrome donor.

CONCLUSIONS

The analysis indicates an overall pooled incidence of neonatal PICC-related thrombosis of 2%. Twelve factors were identified as risks associated with neonatal PICC-related thrombosis. Understanding the risk factors can provide evidence-based recommendations for improving awareness, control and treatment and better nursing management.

RELEVANCE TO CLINICAL PRACTICE

This systematic review and meta-analysis illuminates the incidence and risk factors linked to neonatal PICC-related thrombosis, delivering essential insights pivotal for clinical decision-making and enhancing patient care within neonatal health care settings.

A structural equation model of the impacts of nurses' psychological safety and psychological contract breach

AIM

To investigate the effects of psychological contract breach and psychological safety on health and well-being outcomes among nurses.

DESIGN

A cross-sectional study.

METHODS

Data were gathered from members of the Finnish social and healthcare workers' trade union (n = 4575) in February 2023. This study focused on data from 3260 nurses. Structural equation modelling was employed to firstly explain burnout and work engagement and subsequently health and well-being outcomes in relation to perceived psychological contract breach and psychological safety.

RESULTS

Younger male nurses, those with lower-level university degrees, and nurses employed in public hospitals reported experiencing more psychological contract breaches. Conversely, older nurses and those working in private organizations perceived a higher level of psychological safety. Psychological contract breaches were associated with increased burnout and reduced work engagement, while psychological safety contributed to lower burnout and higher work engagement. Moreover, burnout was linked to health problems and diminished mental well-being, whereas increased work engagement led to fewer health problems and improved mental well-being. The final model demonstrated excellent fit.

CONCLUSION

Breaches in the psychological contract, followed by distrust, and anger significantly burden nurses, detrimentally affecting their well-being at work. Psychologically safe working environments, consequently, improve nurses' well-being at work and should be promoted within work teams.

IMPLICATIONS FOR THE PROFESSION

Nursing managers could receive training to understand the consequences of, and practices for supporting, a beneficial psychological work climate.

IMPACT

The study examined psychological burden and resource factors at work, finding that psychological contract breaches increased burden and led to negative well-being outcomes. In contrast, psychological safety emerged as a positive resource for health and well-being. These results offer benefits for nurses, managers and organizations.

REPORTING METHOD

The study was reported following the Strengthening of the reporting of observational studies in epidemiology guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.