International Journal of Nursing Practice最新文献

Background

Preoperative anxiety and postoperative complications significantly impact recovery among orthopaedic surgery patients. Nursing interventions, including education, psychological support and physical care, have shown potential in improving surgical outcomes. This review evaluated the effectiveness of nursing interventions in reducing anxiety, pain and postoperative complications among patients undergoing orthopaedic surgeries.

Methods

A comprehensive search was conducted across PubMed, CINAHL, EMBASE, Cochrane Library and Scopus, resulting in the inclusion of 59 studies. Outcomes assessed were preoperative anxiety (eight studies), postoperative anxiety (nine studies), pain (16 studies), surgical site infections (36 studies), poor incision healing (three studies) and deep vein thrombosis (two studies). Standardized mean differences (SMD) and odds ratios (OR) were pooled using random-effects models. Heterogeneity was assessed using I² and tau², and sensitivity analyses were performed.

Results

Nursing interventions showed no significant effect on preoperative anxiety (SMD −0.301; p = 0.082), postoperative anxiety (SMD −0.408; p = 0.137) or postoperative pain (SMD −0.203; p = 0.325). However, significant reductions were observed for surgical site infections (OR 1.122; p < 0.001), poor incision healing (OR 0.381; p = 0.012) and DVT (OR 0.132; p = 0.020). Heterogeneity was high for anxiety and pain outcomes but minimal for infections and healing. Sensitivity analyses confirmed the robustness of results.

Conclusion

Nursing interventions significantly reduce surgical site infections, poor incision healing and DVT, underscoring their role in perioperative care. However, their impact on anxiety and pain remains inconclusive, warranting further research. Standardized intervention protocols and targeted studies are needed to optimize nursing care in orthopaedic surgery.

Aim

This study aimed to evaluate the effectiveness of nurse-led self-management interventions on self-management behaviours and self-efficacy in individuals with type 2 diabetes mellitus.

Design

Systematic review and meta-analysis.

Data Sources

Sinomed, Wang Fang, The VIP Database, CNKI, PubMed, Embase, Web of Science, CENTRAL, CINAHL and Medline. The search period was from the establishment of the databases to 20 March 2024.

Methods

Electronic databases were searched to identify studies on the effects of nurse-led interventions on self-management behaviours and self-efficacy in people living with type 2 diabetes mellitus. Two researchers independently screened, extracted and analysed the literature using RevMan 5.4.1.

Results

A total of 21 articles were reviewed. The meta-analysis revealed that nurse-led interventions significantly improved self-management behaviours and self-efficacy in persons with type 2 diabetes mellitus. Subgroup analyses revealed that the intelligent intervention (remote interventions using an app, WeChat or other online measures) had the most substantial effect on the self-management behaviours in this population. Additionally, a 3-month intervention duration was found to be optimal for enhancing self-management behaviours in persons with type 2 diabetes. The self-management education intervention had the most significant impact on improving self-efficacy in people diagnosed with type 2 diabetes, with a 3-month duration also proving optimal for enhancing self-efficacy in people diagnosed with type 2 diabetes.

Conclusion

Nurse-led self-management interventions positively affect individuals with type 2 diabetes mellitus.

Aim

This study aimed to determine the effects of a virtual reality game or autogenic relaxation on pruritus, anxiety and dermatological quality of life in patients undergoing haemodialysis.

Background

Pruritus is a prevalent and disturbing symptom in patients with chronic kidney disease that causes a scratching behaviour with a vicious itch-scratch cycle.

Design

This is a randomized controlled study.

Methods

The study was conducted with 47 participants at two haemodialysis centres between December 2021 and February 2022. The participants in the intervention group were informed about virtual reality games (n: 15) or autogenic relaxation (n: 16). Data collection was performed face-to-face with the 5-D Itch Scale, State and Trait Anxiety Inventory and Dermatology Quality of Life Index in the first and third haemodialysis sessions in the first week and in the last sessions of the fifth and seventh weeks.

Results

Scores of both intervention groups for the 5-D Itch Scale and State–Trait Anxiety scores decreased significantly in the fifth and seventh weeks, and Dermatology Quality of Life Index scores decreased significantly in the fifth week compared to the control group.

Conclusion

Both virtual reality games and autogenic relaxation interventions, undertaken 1 day before haemodialysis sessions, reduce pruritus and anxiety symptoms and increase dermatologic quality of life.

Trial Registration

This study was registered in the Clinical Trials protocol registry system (ClinicalTrials.gov identifier: NCT04289038).

Aim

This meta-analysis examines the effectiveness of nursing interventions on various outcomes, including mortality, postoperative complications, quality of life (QoL), anxiety, depression and pain in HCC patients undergoing surgery.

Background

Hepatocellular carcinoma (HCC) is a prevalent liver malignancy often requiring surgical intervention. Postoperative outcomes in HCC patients are heavily influenced by perioperative management, with nursing interventions playing a critical role in improving recovery, minimizing complications and enhancing QoL.

Design

Systematic review and meta-analysis.

Review Methods

This review was conducted following PRISMA guidelines, evaluating studies on nursing interventions in surgical HCC patients. Databases were searched for studies reporting clinical and psychological outcomes, with eligible studies pooled using random-effects models. Heterogeneity, sensitivity analyses and publication bias assessments were performed to ensure robustness.

Result

Twenty-seven studies were analysed. Nursing interventions significantly reduced postoperative complications (OR 0.23; 95% CI: 0.17–0.31) and shortened hospital stay (WMD −5.92 days; 95% CI: −7.76 to −4.08). Additionally, significant improvements were observed in QoL (SMD 2.00; 95% CI: 0.74–3.27), anxiety (SMD −3.42; 95% CI: −5.95 to −0.89) and depression (SMD −3.70; 95% CI: −6.52 to −0.88). Pain levels were significantly reduced (WMD −2.02; 95% CI: −3.03 to −1.02), while nursing satisfaction was enhanced (OR 4.80; 95% CI: 2.42–9.51). Mortality did not show significant differences between groups.

Conclusion

Nursing interventions significantly enhance postoperative outcomes in HCC patients by reducing complications, improving QoL and alleviating psychological distress. These findings support integrating comprehensive nursing protocols into postoperative HCC care, emphasizing both physical and mental health.

Purpose

This study aimed to determine the effect of progressive muscle relaxation on disease activity, anxiety, sleep quality and quality of life in patients with ulcerative colitis.

Method

This randomised, assessor-blinded, three-arm study was conducted in a university hospital in western Turkey between February and December 2022. Sixty patients were randomly assigned to three groups of 20: a progressive muscle relaxation group, a relaxing music group and a standard care group. The intervention groups received their respective therapies for 8 weeks, while the standard care group received routine treatment. Data were collected using instruments measuring disease activity, anxiety, sleep quality and quality of life. Repeated-measures ANOVA was used for comparisons.

Findings

There were improvements in the quality of life, anxiety and sleep quality in the progressive muscle relaxation group compared to the relaxing music and standard care groups. Although disease activity was evaluated, no statistically significant differences were observed between the groups.

Conclusion

Progressive muscle relaxation, an affordable and easily applicable method, was found to be an effective nursing intervention for improving psychological and functional outcomes in patients with ulcerative colitis.

Background

Trauma-informed care is recommended in healthcare settings. However, the understanding of its effects on nurses' well-being, including secondary trauma, burnout and posttraumatic growth, remains lacking.

Objective

This study aimed to investigate the hypothesis that trauma-informed care is associated with nurses' negative outcomes, including secondary traumatic stress and burnout, and positive outcomes, including posttraumatic growth.

Design

This is a cross-sectional study.

Methods

This study randomly recruited 291 nurses from two tertiary hospitals in Saudi Arabia. The online survey was sent to nurses in different clinical settings. Structural equation modelling analysis and confirmatory factor analysis were conducted to evaluate the hypothesised model.

Results

The study revealed that trauma-informed care exhibited a significant negative association with secondary trauma (β = −0.351, p < 0.0001) and burnout (β = −0.535, p < 0.0001) and a positive association with posttraumatic growth (β = 0.281, p < 0.0001). Further, trauma-informed care is indirectly associated with posttraumatic growth through the mediation of burnout (β = 0.265, p < 0.0001) and secondary traumatic stress (β = −0.103, p = 0.003).

Conclusions

The study provides evidence that trauma-informed care is significantly associated with nurses' outcomes, including reducing secondary trauma and burnout and promoting posttraumatic growth. Therefore, implementing trauma-informed care training and integrating its principles into daily nursing practice may have a positive effect on nurses.

Background

Flipped learning and escape room (gamification) are among the innovative teaching strategies frequently used in interactive education methods today, focusing on problem-solving learning. These methods are important in promoting achievement by taking responsibility for learning.

Objectives

The study aimed to evaluate the effect of flipped learning and the escape room method on nursing students' knowledge and skill learning about infection control.

Materials and Methods

The study was a randomized controlled trial with open-label pretest-posttest. The research was conducted with 76 students in the experimental and control groups. In the study, while the experimental group students were taught using the flipped learning method, which is an effective way of learning outside the classroom, their learning was reinforced with gamification using the escape room method. These teaching methods also encouraged students to take responsibility for their own learning. Data were collected by administering the ‘Characteristics Form for the Student Group’, the ‘Knowledge Test on Infection Control Measures’ and the ‘Self-Directed Learning Skills Scale’.

Results

The post-test and follow-up test knowledge scores of the experimental group are statistically significantly higher than those of the control group (p < 0.001), and the difference has a high effect (d = 4.15). When the total score and all sub-dimensions of the Self-Directed Learning Skills Scale were analysed, a significant increase was found between the pretest and posttest scores of the experimental group compared with the control group (p = 0.003; p = 0.023; p = 0.023; p = 0.001; p = 0.049; p = 0.033; p < 0.05).

Conclusion

The study showed that flipped learning and escape room methods significantly improved nursing students' knowledge and skills related to infection control. Students' self-learning ability, taking responsibility and teamwork skills were strengthened.

Trial Registration: ClinicalTrials.gov identifier: NCT06670469.

Background

The nursing contribution to patient safety is often linked to their proximity to patients and ability to intervene when quality of care is compromised. However, the quality of nursing care provided also directly contributes to patient outcomes and is associated with increased rates of healthcare-associated infections.

Aim

This study aimed to measure and compare nurses' perceptions of the frequency of and reasons for missed IPC practices in their workplaces and to examine nurses' perceptions of their ability to conduct IPC activities and their hospital capacity to support them.

Methods

This study used a cross-sectional online survey of nurses in acute general hospitals (n = 113) using the Missed Nursing Care Infection Prevention and Control (MNCIPC) instrument (March 21–May 26, 2022). Study reportage was informed by the STROBE guidelines.

Results

Care activities relating to hand hygiene and minimisation of hospital-acquired infections were identified as the most frequently missed infection prevention and control practices. Factors that hindered best practice occurred at systemic (staffing/resources) and environmental (patient room overcrowding/bathroom sharing) levels.

Conclusion

Best practice infection prevention and control care is hampered by factors outside of individual nurse control. Unit-specific infection prevention and control training, including support staff, is recommended to help prevent hospital-acquired infections.

Aims

The aim of this study was to evaluate the cross-cultural adaptation and examine the psychometric properties of the Indonesian version of the 35-item Nurse Professional Competence Scale Short Version (NPC Scale SV).

Method

This descriptive cross-sectional study involved translation, cross-cultural adaptation and evaluation of psychometric properties. Data were collected from 352 registered nurses (RNs) working in various healthcare settings across Indonesia. The NPC Scale SV was translated into Bahasa Indonesia. Preliminary psychometric testing was conducted with content validation using an expert panel and pilot testing. Psychometric testing included confirmatory factor analysis (CFA), construct reliability, and finally the Model Fit.

Results

The 35-item Bahasa Indonesia version (NPC Scale SV-INA) demonstrated six domains evident from the CFA. This was confirmed with fit indices: CMIN/df 1.346; GFI 0.914; NFI 0.967; TLI 0.989; CFI 0.991; and RMSEA 0.031. Factor loadings in each domain were more than 0.5 and showed good construct reliability (> 0.7).

Conclusion

The NPC Scale SV-INA has been tested among RNs across Indonesia and evaluated from a cultural perspective.

Aim

The objective of this study was to determine the effectiveness of various interventions—including educational programmes, counselling, mobile applications, peer support and home visits—on improving breastfeeding self-efficacy, breastfeeding success and infant-feeding attitudes in pregnant and postpartum women.

Method

The literature review for this systematic review was conducted between September and October 2024 by searching four electronic databases. Studies related to ‘in vivo’ were identified using MeSH-based keywords. Only Randomized Controlled Trials (RCTs) published within the last decade were eligible for inclusion in the review.

Result

The analysis was conducted with 3677 women and a total of 26 studies. Subgroup analysis showed no significant difference in breastfeeding self-efficacy before the intervention (MD: −0.53, 95% CI: −1.43 to 0.38, p = 0.25), while a significant increase was observed after the intervention (MD: 53.53, 95% CI: 29.34 to 77.72, p < 0.0001). Breastfeeding success also improved significantly postintervention (MD: 1.22, 95% CI: 0.52 to 1.92, p = 0.0007). No significant change was found in infant-feeding attitudes (SMD: 0.01, 95% CI: −0.18 to 0.16, p = 0.47). Postnatal interventions were significantly more effective than antenatal ones in increasing breastfeeding self-efficacy (MD: 53.53, 95% CI: 29.34 to 77.72, p < 0.0001).

Conclusion

Subgroup analyses demonstrated that interventions significantly increased breastfeeding self-efficacy and success, particularly when delivered in the postnatal period. Antenatal interventions were not found to be effective. These findings highlight the importance of the timing of maternal support, suggesting that postnatal interventions are more beneficial in improving breastfeeding-related outcomes.