International Journal of Nursing Practice最新文献

Aim

This study aimed to assess the effects of web-based education on blood glucose control, self-care and quality of life in patients with type 2 diabetes.

Methods

A single-blinded randomized controlled trial was conducted in accordance with the Consolidated Standards of Reporting Trials (CONSORT) checklist at a university hospital in Turkey. The study included 89 patients with type 2 diabetes who were randomly divided into an intervention group (44) and a control group (45). Participants in the intervention group participated in a 3-month web-based education programme.

Results

The findings indicated that there were no significant differences in sociodemographic characteristics and illness features between the intervention and control groups, and both were homogeneous. A statistically significant decrease of 0.71 was observed in the HbA1c (%) level of the intervention group following web-based education. Following web-based education, there was a significant difference in body mass index (kg/m²) and waist circumferences (cm) between the intervention and control groups. The intervention group displayed significantly improved self-care and quality of life over the 3-month period (p < 0.05).

Conclusion

This study suggests that web-based education can enhance the self-care and quality of life of patients with type 2 diabetes.

Aim

This study aimed to analyse cross-cultural differences in the prevalence of low back pain (LBP) and other back pain of general nurses in direct inpatient care in the Czech Republic (CZ) and Great Britain (GB).

Methods

The survey was used using an extended standardized Nordic Musculoskeletal Questionnaire and self-created additional questions. The data were analysed with Stata 15 using a significance level of 0.05.

Results

The data analysis was based on 1043 questionnaires. We identified statistically significant differences in the LBP prevalence between the respondents (CZ 93% and GB 85%) over a period of 12 months. Nurses in both countries stated a higher prevalence of LBP compared to pain in the neck, shoulders or upper back. LBP increases in relation to age, length of work experience, body mass index (BMI) and university education (BSc). Age, length of work experience, BMI and education (nursing college and master's degree) were confirmed as significant risks contributing to the increased prevalence of other back pain as well. Respondents reported a reduction in work performance, leisure activities and the need to change profession in relation to LBP.

Conclusion

The results of the study confirm that LBP is a frequent occupational health issue in the general nurses working in direct inpatient care in both countries.

Background

Role understanding and practice standards become extremely important in countries that are developing and assessing nursing and advanced practice nursing (APN) roles.

Aim

To describe the process and findings of a content validation study conducted on the Advanced Practice Role Delineation (APRD) tool in a Finnish context.

Design

A tool content validation study.

Method

Between September and October 2019, three rounds of surveys (n = 9, n = 8, n = 5) were conducted to assess the content validity of the APRD tool. Furthermore, a thorough literature review was conducted in December 2020 to examine how the tool has been used and validated between January 2000 and December 2020.

Results

A 45-item amendment of the APRD tool was created. The Scale Content Validity Index Average of 0.97 reflects excellent content validity. A literature review of 15 studies revealed that the tool has been used by many researchers, yet there is limited research on its content and construct.

Conclusion

The steps taken in this study were effective and may be replicated in other countries. Further studies are needed to validate the content and structure of the developed 45-item modification of the APRD tool.

Aim

Coronary heart disease (CHD) is a prevalent cardiovascular disease with high mortality rates worldwide. Patients with CHD often experience adverse psychological stress related to the disease's diagnosis, treatment and recovery phases. This stress can hurt sleep quality and overall quality of life. Mindfulness-based interventions (MBIs) have been studied as a psychotherapeutic approach to alleviating the psychological stress associated with CHD. This study aimed to determine the effectives of MBIs for health outcomes in patients with CHD.

Methods

A total of eight English-language databases were searched, and eight relevant studies were included in the analysis. The included studies were assessed for literature quality, and data were extracted and analysed using Review Manager 5.3.

Results

A total of eight studies involving 802 participants were included in the analysis. Compared to control groups, MBIs significantly reduced anxiety, depression, perceived stress, and systolic blood pressure. However, there was no significant effect on diastolic blood pressure, quality of life or body mass index. One study reported that MBIs significantly improved sleep quality in patients with acute myocardial infarction after percutaneous coronary intervention but had no significant effect on body mass index.

Conclusion

MBIs had significant effects on anxiety and depression in patients with CHD, reduced perceived stress and were associated with reductions in systolic blood pressure and improvements in sleep quality. However, they did not significantly affect diastolic blood pressure, quality of life or body mass index.

Aims

This review examined the impact of virtual reality (VR) training on nursing students' clinical skill performance and identified essential features of VR training.

Background

VR provides immersive content, simulating real-life scenarios and preventing errors in clinical settings.

Design

This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.

Data sources

Studies were obtained from Ovid-EMBASE, MEDLINE, CINAHL and PubMed.

Review methods

Studies related to VR training published from 1 January 2000 to 8 May 2024 were included. Comprehensive Meta-Analysis 4.0 software was used for meta-analysis and random effects meta-regression. The overall effect was assessed with Hedges' g and Z-statistics (p < 0.05). Heterogeneity was measured using I-squared (I²) statistics.

Results

Among the 31 476 studies, 11 randomized controlled trial studies were included. Meta-analysis demonstrated a significant improvement in clinical skill performance, with a medium to large effect (g = 0.61) in the VR group (Z = 3.80, p < 0.001). Subgroup analyses highlighted higher nursing skills in the VR training topic. Meta-regression revealed that the VR training topic (β = 1.23, p < 0.001) and method of VR training (β = −0.53, p = 0.05) were significant covariates influencing clinical skill performance.

Conclusion

VR training improves nursing students' clinical skill performance, addressing shortcomings in the clinical practicum.

Aims

This work aims to investigate whether virtual care can improve clinical outcomes for children with asthma, similar to face-to-face specialty care.

Design

The study used a randomized controlled trial design, with participants allocated to either a virtual care group (n = 47) or a control group (n = 50) using simple randomization.

Methods

The study was conducted from March to August 2021, and a sample of 97 children with asthma was recruited. Children in the virtual care group received online training in four modules within the first month and support through virtual meetings and phone or video calls, while the control group received standard care. The primary outcome of the study was the Asthma Control Test and Child Asthma Control Test.

Results

The virtual care group had significantly better outcomes than the control group in terms of C-ACT scores for children aged 7–11 years, fewer days under 80% of the optimum level of peak expiratory flow, lower peak expiratory flow variability, fewer rescue medication uses, and more symptom-free days. The virtual care group also had a lower number of unscheduled hospital visits and a greater improvement in quality of life compared with the control group.

Conclusion

This study demonstrated that virtual care can improve disease management and quality of life for children with asthma.

Aim

To explore what is known about nurses' experiences and perceptions of running nurse-led clinics.

Background

Nurse-led clinics were established to address health care needs. In collaboration with medical practitioners, advanced practice nurses may take a selected group of patients and manage their ongoing healthcare independently. Their experiences in running nurse-led clinics directly impact patient satisfaction and clinical outcomes.

Design

Scoping review of the peer-reviewed literature.

Data Source

Systematic search through CINAHL, Medline, PsycINFO and Web of Science databases from January 2010 to September 2023.

Review Methods

This scoping review is guided by the updated methodological guidance for the conduct of scoping review from Joanna Briggs Institute.

Results

Of 2747 retrieved articles, 15 were included in this review. Synthesis of the findings revealed that nurses believed implementing nurse-led clinics was beneficial to themselves, patients, and healthcare systems. However, they faced challenges in running nurse-led clinics, including insufficient support, teamwork obstacles and lack of role recognition.

Conclusion

Nurses need to be proactive in promoting their clinics and overcoming challenges. Healthcare organizations are responsible for creating a positive culture to support nurse-led services. Future research should focus on ways to increase global awareness of nurse-led clinics.

Aims

This work aimed to analyse retrospective data on hypotension incidence and associated factors among patients requiring continuous renal replacement therapy.

Background

The incidence and risk factors of continuous renal replacement therapy-related hypotension have not been adequately explored.

Design

The study was designed as a retrospective analysis.

Methods

Patients who required continuous renal replacement therapy in the ICU between January 2017 and June 2021 were reviewed. The multivariate logistic regression model was used to determine the associated factors of hypotension.

Results

Hypotension occurred in 242 out of 885 circuits (27.3%) among 140 patients. The logistic regression analysis identified seven factors associated with the occurrence of hypotension during CRRT: serum albumin (OR = 0.969, 95%CI: 0.934–0.999), serum calcium (OR = 0.514, 95%CI: 0.345–0.905), CO₂CP (OR = 0.933, 95%CI: 0.897–0.971), use of vasopressors (OR = 5.731, 95%CI: 4.023–8.165), hypotension before CRRT initiation (OR = 2.779, 95%CI:1.238–6.242), age (OR = 1.016, 95%CI: 1.005–1.027), and fluid removal rate (OR = 1.002, 95%CI: 1.001–1.003).

Conclusions

Hypotension frequently occurs in patients receiving continuous renal replacement therapy, especially in the early stages. Multiple factors can be associated with cardiac output or peripheral resistance changes, including excessive ultrafiltration, vasopressors, serum albumin and serum calcium levels, and carbon dioxide combining power.

Aim

The study aims to develop a protocol for the combined use of swaddling, facilitated tucking, expressed breast milk and sucrose administration methods in the orogastric tube (OGT) insertion procedure and evaluate its effectiveness.

Methods

The randomized controlled trial was conducted in the Neonatal Intensive Care Unit between 15 February 2022 and 15 September 2022, with 175 preterms. Preterms at 32–34 gestational weeks were randomly allocated to five groups: routine care, swaddling + expressed breast milk, swaddling + sucrose, facilitated tucking + expressed breast milk and facilitated tucking + sucrose groups. The data were collected using the Preterm Descriptive Information Form, the Physiological Measurement Form, the COMFORTneo scale and the Premature Infant Pain Profile (PIPP).

Results

The facilitated tucking + expressed breast milk method was found to be more effective than the routine care (p_distress < 0.001; p_pain = 0.031) and swaddling + expressed breast milk (p_distress = 0.004; p_pain = 0.015) methods in reducing the estimated distress and PIPP pain level of preterms during the procedure. Two minutes after the procedure, the facilitated tucking + expressed breast milk method was more effective than the routine care (p < 0.001), swaddling + expressed breast milk (p = 0.011) and swaddling + sucrose (p = 0.002) methods in reducing the comfort level score.

Conclusions

The facilitated tucking + expressed breast milk method is effective in reducing pain and distress and providing comfort during the OGT procedure.

Clinical Trials ID: NCT05180058.