International Journal of Nursing Practice最新文献

Aims

The aim of this study was to develop and verify a new emergence agitation risk prediction model based on the electronic medical records of patients undergoing transurethral resection of the prostate.

Background

The incidence of prostate disease in elderly men is high, and the harm caused by emergence agitation in patients after transurethral resection of the prostate is serious. It is necessary to develop a predictive model for emergence agitation in patients undergoing transurethral resection of the prostate.

Design

This was a retrospective cohort study. Patients who underwent transurethral resection of the prostate from January 2016 to December 2020 formed the study population.

Methods

The multivariate logistic backward stepwise method was used to further evaluate the variables with p-values of less than 0.1 in the univariate analysis. A receiver operating characteristic curve was used to analyse the discrimination of models, and the Hosmer–Lemeshow test was used to evaluate calibration.

Results

A total of 956 patients undergoing transurethral resection of the prostate were included in the study. The incidence of emergence agitation in the deduction data set and the verification data set were 24.6% and 23.2%, respectively. Multiple logistic regression analysis showed that age (OR = 1.05, 95% CI, 1.02–1.09), urea (OR = 1.14, 95% CI, 1.05–1.29), postoperative pain (OR = 3.74, 95% CI, 1.99–7.03) and catheter-related bladder discomfort (OR = 2.26, 95% CI, 1.80–2.84) were independent predictors of emergence agitation in patients with transurethral resection of the prostate. The prediction model showed good discrimination in both the derivation dataset and the verification dataset (the area under the curve was 0.737 and 0.804, respectively) and calibration (Hosmer–Lemeshow test p = 0.895 and 0.418, respectively).

Conclusion

This low-cost low-risk clinical prediction model based on electronic medical records is simple and practical, easy to generalize, and contributes to health care providers identifying individuals at high risk of emergence agitation in patients undergoing transurethral resection of the prostate.

Background

Obesity is a risk factor for osteoarthritis and total hip/knee joint replacement and can lead to poorer outcomes following surgical interventions.

Aim

This work aimed to determine the preliminary efficacy of a self-management programme versus usual care in improving health-related quality of life in obese patients with osteoarthritis awaiting joint replacement.

Methods

This was a two-group parallel randomised trial involving patients with obesity and osteoarthritis who were awaiting hip or knee arthroplasty. Patients were randomly allocated to the Flinders Program of self-management support plus usual care or usual care alone groups. Primary outcomes at 10 months were Short-Form Health Survey (SF-36) and Osteoarthritis of Knee/Hip Quality of Life (OAKHQoL).

Results

Ninety-five patients were randomised to either intervention (n = 48) or usual care (n = 47) and analysed in an intent-to-treat analysis. While there was no intervention effect in SF-36, evidence was in favour of intervention for OAKQoL improved social support (d = 0.43, 95% CI: 0.01–0.83) versus usual care (d = −0.01, 95% CI: −0.41 to 0.42) (p = 0.03). Similarly, intervention patients experienced larger improvements for social activity (d = 0.47; 95% CI: 0.05–0.89) versus usual care (d = −0.16; 95% CI: −0.58 to 0.25) (p = 0.005).

Conclusion

The intervention warrants examination in a larger trial to establish effectiveness among patients with obesity and osteoarthritis awaiting arthroplasty.

Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12615000674538

Background

Maintaining normal body temperature during operation is significant for the prognosis of surgical patients. The purpose of this study was to investigate the risk factors of hypothermia during posterior cervical surgery and establish a risk prediction model to facilitate the surgical team to identify high-risk patients before surgery.

Aim

The aim of this study was to establish and validate a predictive model for assessing intraoperative hypothermia risk in patients undergoing posterior cervical surgery under general anaesthesia.

Design

Retrospective cohort study.

Methods

This was a retrospective, two-centre, observational study conducted in the anaesthesia surgery departments of two tertiary Grade A hospitals. Patients who underwent posterior cervical surgery between January 1, 2018 and June 30, 2024 were included in our study. Based on the literature and working experience, the patient factors and surgical factors related to intraoperative hypothermia were selected. The predictive model of intraoperative hypothermia was constructed by pairings comparison, LASSO, logistic regression. The performance of the model was evaluated by correction curve, consistency index (C-index) and decision curve.

Results

The incidence of intraoperative hypothermia in 818 patients in the modelling group was 32.8%. Of the initial 17 potential predictors, three variables were incorporated into the final predictive model: preoperative body temperature, preoperative serum albumin value, and preoperative white blood cell count. The C-index of the prediction model was 0.858 (95% CI: 0.827–0.887), the patient benefit rate was 0.08–0.83, and the C-index of the validation group was 0.824.

Conclusion

This study found that this prediction model can accurately predict the risk of intraoperative hypothermia in patients undergoing posterior cervical surgery and can therefore be used to improve patient safety intraoperatively.

Aim

This study was conducted to evaluate the effect of warm shower on fatigue, comfort and mood in women who had spontaneous vaginal delivery.

Methods

This randomized controlled trial was conducted with 128 women (64 in the intervention group and 64 in the control group by computer randomization) in the postpartum clinic of a public hospital. Between 6- and 12-h postpartum, the women in the intervention group took a shower in a standing position at a water temperature of 37°C–41°C for 10–20 min, and the control group received standard care. Data were collected using the Visual Similarity Scale for Fatigue, Visual Analogue Scale, Postpartum Comfort Questionnaire and Brief Mood Insight Scale.

Results

The intervention group experienced a statistically significant decrease in fatigue, discomfort and negative mood levels compared with the control group after the intervention (p < 0.001). In addition, the intervention group had statistically significantly higher levels of energy, physical, mental and sociocultural comfort, and positive mood levels compared with the control group (p < 0.001).

Conclusion

Taking a warm shower in the postpartum 6th–12th hours was effective in decreasing fatigue, discomfort, and negative mood of women, while increasing comfort levels and positive mood.

Aim

This mixed-method study aimed to examine the relationship between mode of conception and breastfeeding self-efficacy among first-time mothers in Turkey, comparing outcomes between those who conceived spontaneously and those who conceived through assisted reproductive technologies (ART). A secondary objective was to explore the lived experiences of women with low breastfeeding self-efficacy in both groups.

Methods

Using an exploratory sequential mixed-methods design, quantitative data were collected from 100 mothers, 50 with spontaneous pregnancies and 50 with ART-conceived pregnancies, using a validated breastfeeding self-efficacy scale. In the qualitative phase, in-depth interviews were conducted with six mothers who scored low on the scale or reported breastfeeding difficulties. The qualitative component was guided by Dennis' Breastfeeding Self-Efficacy Framework.

Results

Quantitative findings revealed significantly higher breastfeeding self-efficacy scores among mothers with spontaneous pregnancies compared to those who conceived through ART. Qualitative analysis identified key influencing factors such as emotional adjustment to motherhood, perceived social expectations and physical challenges related to breastfeeding. A critical gap in targeted breastfeeding education and postnatal support was noted across both groups.

Conclusions

The findings underscore the need for individualized, culturally sensitive breastfeeding interventions, particularly for mothers who have conceived through ART. Tailored support strategies addressing both psychological and physical aspects of the postpartum experience may enhance breastfeeding outcomes in this growing population.

Objective

The efficacy of postoperative nursing management in patients undergoing prostate surgery remains poorly recognized. To address this, we conducted a meta-analysis to evaluate the effectiveness of this approach.

Methods

From January 2000 to February 2024, seven randomized controlled trials were selected, involving a total of 593 patients from PubMed, EMBASE and the Cochrane Library to evaluate the efficacy of postoperative nursing management in patients undergoing prostate surgery. All data were analysed using the Review Manager 5.4 software. Outcomes assessed included nursing satisfaction, psychological scores, hospital stay, urinary frequency, residual urine volume (RUV), incidence of complications, frequency of urinary incontinence (UI), urinary tract infection (UTI), pain scores and incidence of UI.

Results

Postoperative nursing management for prostate surgery significantly increased patients' nursing satisfaction (OR 6.46, 95% CI 3.53–11.83, p < 0.00001), improved psychological scores (MD −4.88, 95% CI −8.67 to −1.09, p = 0.01) and shortened hospital stay (MD −4.19, 95% CI −6.14 to −2.25, p < 0.0001). Regarding urinary symptoms, urinary frequency (MD −4.28, 95% CI −8.00 to −0.55, p = 0.02) was significantly reduced, although no significant difference was observed in RUV. In addition, postoperative nursing management significantly reduced the incidence of complications (OR 0.36, 95% CI 0.21–0.62, p = 0.0003), primarily reflected in a decrease in the frequency of UI (MD −2.72, 95% CI −4.70 to −0.74, p = 0.007). However, no significant differences were found in terms of UTI, pain scores or the incidence of UI.

Conclusion

Collectively, our findings suggest that targeted and systematic postoperative nursing management is essential for optimizing recovery and should be integrated as a standard component of perioperative care for patients undergoing prostate surgery.

Registration Number

CRD42024617179.

Aims

This article aimed to critically analyse three frequently used evidence-based practice models to determine similarities and differences in their process steps, terminology, tools and implementation models.

Background

Evidence-based practice is an essential competency taught across academic nursing curriculums to prepare nurses for problem solving throughout their career in clinical practice.

Design

A crosswalk analysis was used to compare and contrast the Advancing Research and Clinical Practice Through Close Collaboration (ARCC) Model, the Iowa Model and the Johns Hopkins Evidence-Based Practice (JHEBP) Model.

Results

Findings suggest that although these models contain similar principles, there are differences in terminology and process steps (both alignment and emphasis), leading to a lack of congruence.

Conclusions

Differences in terminology may be confusing to both novice and experienced users of the evidence-based practice process. We suggest that educational and clinical settings adopt a primary evidence-based practice model to use throughout their organization, in addition to purposefully creating awareness of the variety of other models and resources available, including their similarities and differences.