International Journal of Nursing Studies Advances最新文献

英文中文

Cold sensitivity among female clinical nurses in Japan: A nationwide study 日本临床女护士对寒冷的敏感性：一项全国性研究

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-05-11 DOI: 10.1016/j.ijnsa.2024.100208

Miyuki Suzuki , Toshie Tsuchida , Aki Ibe

Objectives

This study aimed to clarify the nature of cold sensitivity in female nurses working in hospitals in Japan.

Design

A cross-sectional post survey research design.

Settings

The questionnaire targeted nurses working in 14 hospitals across ten prefectures throughout Japan.

Participants

1,138 female nurses

Methods

The survey captured participants’ characteristics, work environment, health, and lifestyle. The factors investigated were perceived cold sensitivity, cold sensitivity according to the Hiesho Sensation Scale, and cold sensitivity during nursing care. The Diagnostic Inventory of Health and Life Habits (DIHAL.2) assessed health and lifestyle habits.

Results

Of the respondents, 44.3 % were aware of daily cold sensitivity and 21.4 % had a cold sensitivity disorder. The majority of respondents (63.1 %) felt cold in their hands when providing nursing care, and 28.1 % felt discomfort due to the coldness of their hands. Individuals diagnosed with cold sensitivity disorders exhibited poorer overall health compared to those without such disorders. However, there was no statistically significant difference in the overall health status between individuals who reported perceiving cold sensitivity and those who did not. The group with perceived cold sensitivity had significantly lower scores on exercise behavior, meal regularity, rest, sleep regularity, and sleep sufficiency. The proportion of female nurses working in Japanese hospitals who experienced cold sensitivity was similar to that of Japanese women with the same sensitivity. Most female nurses experienced cold in their hands while providing care. Nearly 30 % of the respondents experienced discomfort owing to cold hands.

Conclusions

The study underscores the widespread issue of cold sensitivity among female nurses in Japanese hospitals, emphasizing the critical need for targeted interventions to improve their comfort and optimize care provision.

设计采用横断面后调查研究设计。调查对象为日本全国 10 个都道府县的 14 家医院的护士。调查因素包括感知到的冷敏感度、根据 Hiesho 感觉量表得出的冷敏感度以及护理过程中的冷敏感度。健康和生活习惯诊断量表（DIHAL.2）对健康和生活习惯进行了评估。大多数受访者（63.1%）在提供护理服务时感到手冷，28.1%的受访者因手冷而感到不适。与没有冷敏感症的人相比，确诊患有冷敏感症的人总体健康状况较差。然而，报告对寒冷敏感的人与没有报告对寒冷敏感的人在总体健康状况上没有明显的统计学差异。有寒冷敏感感的人群在运动行为、进餐规律、休息、睡眠规律和睡眠充足性方面的得分明显较低。在日本医院工作的女护士中，对寒冷敏感的比例与具有相同敏感度的日本女性相似。大多数女护士在提供护理时都会感到手冷。近 30% 的受访者因手冷而感到不适。结论该研究强调了日本医院女护士中普遍存在的对寒冷敏感的问题，强调亟需采取有针对性的干预措施来改善她们的舒适度并优化护理服务。

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引用次数: 0

Nursing students' personality (Temperament and Character), burnout symptoms, and health and well-being 护理专业学生的个性（气质和性格）、职业倦怠症状以及健康和幸福感

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-05-06 DOI: 10.1016/j.ijnsa.2024.100206

Danilo Garcia , Maryam Kazemitabar , Elina Björk , Thiago Medeiros da Costa Daniele , Marko Mihailovic , Kevin M. Cloninger , Mirna Albuquerque Frota , C.Robert Cloninger

Background

About 9 million nurses will be needed by 2030. To face these unprecedented times, governments/institutions focus on educating as many nursing students as possible. This strategy is clouded by burnout and lack of both health and well-being among students and by the fact that personality is one of the major determinants of these health outcomes. Nevertheless, recent findings show that personality is a complex adaptive system (i,e., nonlinear) and that combinations of people's temperament and character traits (i.e., joint personality networks) might provide further information to understand its development, academic burnout, and lack of health and well-being.

Aims

Our aims were to investigate the linear relationship between nursing students’ personality, burnout, health, and well-being; investigate the linear mediational effects of personality and burnout on health and well-being; and investigate differences in these health outcomes between/within students with distinct joint personality networks (i.e., nonlinear relationships).

Method

Swedish nursing students (189 women, 29 men) responded to the Temperament and Character Inventory, The Maslach Burnout Inventory-General Survey for Students, and the Public Health Surveillance Well-Being Scale. We conducted correlation analyses and Structural Equation Modeling and, for the nonlinear relationships, Latent Profile Analysis and Latent Class Analysis for clustering and then Analyses of Variance for differences in health outcomes between/within students with distinct personality networks. This study was not pre-registered.

Results

High levels of health and well-being and low burnout symptoms (low Emotional Exhaustion, low Cynicism, and high Academic Efficacy) were associated with low Harm Avoidance and high Self-Directedness. Some personality traits were associated with specific health outcomes (e.g., high Self-Transcendence-high Emotional Exhaustion and high Persistence-high Academic Efficacy) and their effects on health and well-being were mediated by specific burnout symptoms. Cynicism and Emotional Exhaustion predicted low levels of health and well-being, Academic Efficacy predicted high levels, and Cynicism lead both directly and indirectly to low levels of health and well-being through Emotional Exhaustion. We found two joint personality networks: students with an Organized/Reliable combination who reported being less emotionally exhausted by their studies, less cynical towards education, higher self-efficacy regarding their academic work/skills, and better health and well-being compared to nursing students with an Emotional/Unreliable combination.

Conclusions

The coherence of temperament-character, rather than single traits, seems to determine students’ health outcomes. Thus, nursing education might need to focus on helping students to develop professional

背景到 2030 年将需要约 900 万名护士。面对这一史无前例的时代，政府/机构将重点放在尽可能多地培养护理专业学生上。学生的职业倦怠、缺乏健康和幸福感，以及人格是这些健康结果的主要决定因素之一的事实，给这一战略蒙上了阴影。然而，最近的研究结果表明，人格是一个复杂的适应系统（即非线性），人们的气质和性格特征的组合（即联合人格网络）可能会提供更多信息、我们的目的是调查护理专业学生的人格、职业倦怠、健康和幸福感之间的线性关系；调查人格和职业倦怠对健康和幸福感的线性中介效应；调查具有不同联合人格网络的学生之间/内部在这些健康结果上的差异（即非线性关系）、方法瑞典护理专业学生（189 名女生，29 名男生）对气质与性格问卷、马斯拉赫学生职业倦怠调查问卷和公共卫生监测幸福感量表进行了问卷调查。我们进行了相关性分析和结构方程建模，对于非线性关系，我们进行了潜在轮廓分析和潜在类分析以进行聚类，然后进行了方差分析以了解具有不同性格网络的学生之间/内部在健康结果方面的差异。结果高水平的健康和幸福感以及低倦怠症状（低情绪耗竭、低玩世不恭和高学术效率）与低伤害规避和高自我导向相关。一些人格特质与特定的健康结果相关（如高自我超越-高情感枯竭和高坚持-高学术效率），它们对健康和幸福的影响通过特定的职业倦怠症状来调节。玩世不恭和情感枯竭预示着低水平的健康和幸福感，学术效率预示着高水平的健康和幸福感，而玩世不恭则通过情感枯竭直接或间接地导致低水平的健康和幸福感。我们发现了两个共同的人格网络：与情绪化/不可靠组合的护理专业学生相比，有组织/可靠组合的学生在学习中的情绪耗竭较少，对教育的愤世嫉俗较少，对学业工作/技能的自我效能感较高，健康和幸福感较好。因此，护理教育可能需要通过支持自我意识，重点帮助学生发展专业技能和与健康相关的能力（如自我接纳和精神接纳）。

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引用次数: 0

Pregnancy loss among Muslim women: A narrative review 穆斯林妇女的妊娠损失：叙述性综述

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-05-03 DOI: 10.1016/j.ijnsa.2024.100205

Khadijat K. Adeleye , Oluwabunmi Ogungbe , Muhammad Chutiyami , Favorite Iradukunda

Background

Diversity in spirituality, religion, and cultural norms among women leads to varying attitudes, grieving processes, and coping mechanisms after a pregnancy loss. Despite this, there is a limited understanding of grief, coping mechanisms, and mental health outcomes following pregnancy loss among Muslim women.

Objectives

This study aims to examine the impact of religion, spirituality, and faith communities on the psychological health of Muslim women during pregnancy loss.

Method

We systematically searched six databases with the key concepts, ‘pregnancy loss’ and ‘Muslim women,’ in PubMed, CINAHL, Embase, Web of Science, APA PsycINFO, and Academic Search. The search strategy was developed in line with the PCOT framework: Population – Muslim Women with "pregnancy loss," "miscarriage," "stillbirth, Context - "religion," faith, "spirituality," "faith communities," Outcome – “religious practices,” perception, coping mechanism, "psychological health."Studies were screened, their quality appraised, and narratively sized in line with the review aim. The review protocol was registered at Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/52QTA.

Result

Findings from the reviewed articles addressed the following themes: (a) Overwhelming Grief and Loss, (b) social isolation and stigmatization, (c) impact on mental health, and (d) trust in divine destiny. Islamic beliefs were strongly featured in how Muslim women processed pregnancy loss. Concepts such as tawakkul and yaqeen (trusting and certainty) were used to interpret pregnancy loss, with many women acknowledging that their Islamic faith eased the sorrow of pregnancy loss, facilitated acceptance, and strengthened their Islamic belief system.

Conclusion

This review revealed that there is limited information on Muslim women's experience of pregnancy loss. Professionals helping Muslim women dealing with the grief of pregnancy loss need to be aware that spirituality and faith communities play a major role in shaping their coping mechanisms. Future studies on the development of culturally congruent bereavement care models and supportive interventions for Muslim women facing pregnancy loss.

背景妇女在精神信仰、宗教和文化规范方面的多样性导致她们在妊娠丧子后的态度、悲伤过程和应对机制各不相同。尽管如此，人们对穆斯林妇女妊娠丧子后的悲伤、应对机制和心理健康结果的了解仍然有限。本研究旨在探讨宗教、灵性和信仰团体对穆斯林妇女妊娠丧子期间心理健康的影响。搜索策略是根据 PCOT 框架制定的：对研究进行筛选、质量评估，并根据综述目的对研究进行叙述性评价。综述协议已在开放科学框架（Open Science Framework，OSF）上注册：https://doi.org/10.17605/OSF.IO/52QTA.ResultFindings，综述文章涉及以下主题：(a) 不堪重负的悲伤和失落，(b) 社会隔离和污名化，(c) 对心理健康的影响，(d) 对神圣命运的信任。在穆斯林妇女如何处理妊娠损失的问题上，伊斯兰教信仰是一个突出的特点。tawakkul和yaqeen（信任和确定性）等概念被用来解释妊娠损失，许多妇女承认，她们的伊斯兰信仰减轻了妊娠损失带来的悲伤，促进了对妊娠损失的接受，并加强了她们的伊斯兰信仰体系。帮助穆斯林妇女处理妊娠损失悲痛的专业人员需要意识到，灵性和信仰团体在形成她们的应对机制方面发挥着重要作用。未来的研究将针对面临妊娠损失的穆斯林妇女，开发与文化相一致的丧亲护理模式和支持性干预措施。

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引用次数: 0

A nursing perspective on the antecedents and consequences of incivility in higher education: A scoping review 从护理角度看高等教育中不文明行为的前因后果：范围审查

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-05-01 DOI: 10.1016/j.ijnsa.2024.100204

Tatiana Penconek , Leslie Hayduk , Diane Kunyk , Greta G. Cummings

Background

Understanding antecedents and consequences of incivility across higher education is necessary to create and implement strategies that prevent and slow uncivil behaviors.

Purpose

To identify the nature, extent, and range of research related to antecedents and consequences of incivility in higher education.

Objectives

1) To identify disciplines and programs sampled in higher education incivility research, and 2) to compare antecedents and consequences examined in nursing education research with other disciplines and programs in higher education.

Design

A scoping review of the literature.

Data sources

Eight electronic databases searched in January 2023 including MEDLINE Ovid, CINAHL, ERIC, PsycINFO, Scopus, ProQuest Education Database, Education Research Complete, and ProQuest Dissertations and Theses Global.

Review methods

We included primary research articles examining antecedents or consequences of incivility in higher education. Two reviewers independently screened and determined inclusion of each study. Data extraction was completed. We employed a numerical descriptive summary to analyze the range of data and content analysis to categorize the antecedents and consequences of incivility in higher education.

Results

Database searches yielded 6678 unique articles. One hundred and nineteen studies published between 2003 and 2023 met the inclusion criteria, of which, 65 reported research in nursing education, and 54 in other programs and disciplines. A total of 91 antecedents and 50 consequences of incivility in higher education were reported. Stress (n = 12 nursing, n = 4 other programs), faculty incivility (n = 9 nursing, n = 5 other programs), and student incivility (n = 4 nursing, n = 5 other programs) were reported as antecedents of incivility in higher education. Physiological and psychological negative outcomes (n = 25 nursing, n = 12 other programs), stress (n = 6 nursing, n = 6 other programs), and faculty job satisfaction (n = 3 nursing, n = 2 other programs) were reported as consequences of incivility in higher education

Conclusions

Supporting development of teaching practices and role modeling of civility by faculty is a crucial element to slowing the frequency of uncivil interactions between faculty and students. Specific strategies that target stress, such as, cognitive behavioral therapy, coping skills, and social support could mitigate incivility in higher education. Future research needs to examine the strength of the negative effects of incivility on physiological and psychological outcomes through advanced statistical methods, as well as the cumulative effects of uncivil behavior on these outcomes over time for both students a

背景了解高等教育中不文明行为的前因后果对于制定和实施预防和减缓不文明行为的策略非常必要。目的确定与高等教育中不文明行为的前因后果相关的研究的性质、程度和范围。数据来源2023年1月检索的八个电子数据库，包括MEDLINE Ovid、CINAHL、ERIC、PsycINFO、Scopus、ProQuest Education Database、Education Research Complete和ProQuest Dissertations and Theses Global。两名审稿人独立筛选并确定是否纳入每项研究。完成数据提取。我们采用了数字描述性总结来分析数据的范围，并采用了内容分析来对高等教育中不文明行为的前因后果进行分类。2003年至2023年间发表的119篇研究符合纳入标准，其中65篇报告了护理教育方面的研究，54篇报告了其他课程和学科方面的研究。共报告了高等教育中不文明行为的 91 个前因和 50 个后果。压力（n = 12 个护理专业，n = 4 个其他专业）、教师不文明行为（n = 9 个护理专业，n = 5 个其他专业）和学生不文明行为（n = 4 个护理专业，n = 5 个其他专业）被报告为高等教育中不文明行为的前因。据报告，高等教育中不文明行为的后果包括生理和心理方面的负面影响（护理专业 25 人，其他专业 12 人）、压力（护理专业 6 人，其他专业 6 人）以及教师的工作满意度（护理专业 3 人，其他专业 2 人）。针对压力的具体策略，如认知行为疗法、应对技巧和社会支持，可以减轻高等教育中的不文明现象。未来的研究需要通过先进的统计方法来检验不文明行为对生理和心理结果的负面影响的强度，以及不文明行为对这些结果的累积影响。应用先进的统计方法还可以帮助我们了解不文明行为的来源以及其前因后果之间因果关系的准确性。

{"title":"A nursing perspective on the antecedents and consequences of incivility in higher education: A scoping review","authors":"Tatiana Penconek , Leslie Hayduk , Diane Kunyk , Greta G. Cummings","doi":"10.1016/j.ijnsa.2024.100204","DOIUrl":"10.1016/j.ijnsa.2024.100204","url":null,"abstract":"<div><h3>Background</h3><p>Understanding antecedents and consequences of incivility across higher education is necessary to create and implement strategies that prevent and slow uncivil behaviors.</p></div><div><h3>Purpose</h3><p>To identify the nature, extent, and range of research related to antecedents and consequences of incivility in higher education.</p></div><div><h3>Objectives</h3><p>1) To identify disciplines and programs sampled in higher education incivility research, and 2) to compare antecedents and consequences examined in nursing education research with other disciplines and programs in higher education.</p></div><div><h3>Design</h3><p>A scoping review of the literature.</p></div><div><h3>Data sources</h3><p>Eight electronic databases searched in January 2023 including MEDLINE Ovid, CINAHL, ERIC, PsycINFO, Scopus, ProQuest Education Database, Education Research Complete, and ProQuest Dissertations and Theses Global.</p></div><div><h3>Review methods</h3><p>We included primary research articles examining antecedents or consequences of incivility in higher education. Two reviewers independently screened and determined inclusion of each study. Data extraction was completed. We employed a numerical descriptive summary to analyze the range of data and content analysis to categorize the antecedents and consequences of incivility in higher education.</p></div><div><h3>Results</h3><p>Database searches yielded 6678 unique articles. One hundred and nineteen studies published between 2003 and 2023 met the inclusion criteria, of which, 65 reported research in nursing education, and 54 in other programs and disciplines. A total of 91 antecedents and 50 consequences of incivility in higher education were reported. Stress (<em>n</em> = 12 nursing, <em>n</em> = 4 other programs), faculty incivility (<em>n</em> = 9 nursing, <em>n</em> = 5 other programs), and student incivility (<em>n</em> = 4 nursing, <em>n</em> = 5 other programs) were reported as antecedents of incivility in higher education. Physiological and psychological negative outcomes (<em>n</em> = 25 nursing, <em>n</em> = 12 other programs), stress (<em>n</em> = 6 nursing, <em>n</em> = 6 other programs), and faculty job satisfaction (<em>n</em> = 3 nursing, <em>n</em> = 2 other programs) were reported as consequences of incivility in higher education</p></div><div><h3>Conclusions</h3><p>Supporting development of teaching practices and role modeling of civility by faculty is a crucial element to slowing the frequency of uncivil interactions between faculty and students. Specific strategies that target stress, such as, cognitive behavioral therapy, coping skills, and social support could mitigate incivility in higher education. Future research needs to examine the strength of the negative effects of incivility on physiological and psychological outcomes through advanced statistical methods, as well as the cumulative effects of uncivil behavior on these outcomes over time for both students a","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000316/pdfft?md5=04128f72a6531dc4e25486b8d912c150&pid=1-s2.0-S2666142X24000316-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141040179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Black African international nurses' experiences of pastoral support: A scoping review 非洲国际护士在牧灵支持方面的经验：范围审查

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-05-01 DOI: 10.1016/j.ijnsa.2024.100202

Chinenye Ifeoma Ubah , Sally Goldspink , Samson Maekele Tsegay

Purpose

Overseas nurses are not new to the United Kingdom (UK), and neither is the concept of pastoral care. The immense contributions of international nurses are so obvious that it would be commonly assumed that there will be a strong literature base on pastoral care for these nurses. However, the opposite is very much the case. Pastoral support is crucial to the successful adaptation and integration of nurses who are recruited outside the United Kingdom to work within the NHS. To offer comprehensive fit-for-purpose support, the perspective of the nurses is important.

Objective

This scoping review aims to identify what is known about pastoral support for internationally educated nurses in the UK.

Methods

A scoping review method was used to review literature on pastoral support.

Results

Existing literature provided evidence on current practices, the challenges, and outcome criteria for successful pastoral support. It also provided evidence on how early pastoral support can fortify the nurses or deskill them. Finally, it revealed significant disparities in the support received by overseas nurses.

Conclusion

While the nurses’ experience of the previous adaptation programme has been explored, evidence on the current pastoral care practices is mostly found in policy guidelines, trainers’ reports, and opinion pieces. Since the inception of the NMC test of competence in 2014, the voice of the recipients of pastoral care is yet to be heard. This scoping review suggests that there is a difference in understanding of pastoral care practices. Therefore, the perspectives of specific groups such as Black African nurses should be explored on this issue.

目的海外护士对英国来说并不陌生，牧养护理的概念也不陌生。国际护士的巨大贡献是显而易见的，因此人们普遍认为，有关这些护士的牧养护理的文献基础十分雄厚。然而，事实恰恰相反。牧养支持对于从英国以外招聘到英国国家医疗服务系统工作的护士成功适应和融入英国国家医疗服务系统至关重要。结果现有文献提供了有关当前实践、挑战和成功的牧养支持结果标准的证据。它还提供了证据，说明早期的教牧支持如何能够加强护士的能力或使其丧失能力。最后，研究还揭示了海外护士在获得支持方面存在的显著差异。结论虽然已经对护士在之前的适应计划中的经验进行了探讨，但有关当前牧养支持实践的证据大多出现在政策指南、培训师报告和评论文章中。自 2014 年开始实施 NMC 能力测试以来，人们尚未听到接受牧养关怀者的声音。本次范围界定审查表明，人们对牧灵关怀实践的理解存在差异。因此，应探讨黑非洲护士等特定群体对这一问题的看法。

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引用次数: 0

Transforming the discharge conversation through support and structure: A scoping review 通过支持和结构转变出院谈话：范围界定审查

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-04-30 DOI: 10.1016/j.ijnsa.2024.100203

Marie C. Haverfield , Gisselle De Leon , Angelica Johnson , Victoria L. Jackson , Geetali Basu , Jane Dodge

Background

System level demands and interpersonal barriers can disrupt nurse delivery of high-quality information at discharge, which can contribute to a lack of caregiver preparedness to manage care of the patient and ultimately affect patient health.

Objective

To synthesize evidence on effective nurse communication with informal caregivers during hospital discharge of adult patients with cognitive decline or Alzheimer's disease and related dementia.

Design

A scoping review of inpatient nurse communication with informal caregivers.

Methods

Collected research (published between 2011 and 2023) from three databases (MEDLINE, PsycINFO, and CINAHL), along with a separate search for gray literature (N = 18), to extract and synthesize recommended communication practices evidenced to improve the nurse care experience and support caregiver activation and preparedness.

Results

Extraction synthesis of strategies resulted in two themes with corresponding sub-themes: Support (Information exchange, Space and time to determine preparedness, and Positive reinforcement of caregiver efforts) and Structure (Setting shared expectations, Informational resources, and Standardization).

Conclusions

We offer practical recommendations for both interpersonal and policy level facilitation of nurse delivery of high-quality information at discharge to caregivers of patients with serious illness.

背景系统层面的需求和人际交往障碍会干扰护士在患者出院时提供高质量的信息，从而导致护理人员缺乏管理患者护理的准备，最终影响患者的健康.目的综合认知功能下降或阿尔茨海默病及相关痴呆症成年患者出院时护士与非正式护理人员进行有效沟通的证据。方法从三个数据库（MEDLINE、PsycINFO 和 CINAHL）中收集研究成果（2011 年至 2023 年间发表），并对灰色文献（N = 18）进行单独检索，提取并综合推荐的沟通方法，以改善护士的护理体验，支持护理人员的积极性和准备性：结论我们从人际交往和政策层面提出了切实可行的建议，以促进护士在重症患者出院时向护理人员提供高质量的信息。

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引用次数: 0

Patients’ perioperative experiences of an opioid-free versus opioid-based care pathway for laparoscopic bariatric surgery: A qualitative study 腹腔镜减肥手术无阿片护理路径与阿片护理路径的患者围手术期体验：定性研究

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-04-20 DOI: 10.1016/j.ijnsa.2024.100201

Alexander Olausson , Eva Angelini , Birgit Heckemann , Paulin Andréll , Pether Jildenstål , Sven-Egron Thörn , Axel Wolf

Background

Despite recent evidence supporting the adoption of opioid-free anaesthetic and analgesic alternatives in the perioperative context, opioid-based regimens remain standard of care. There is limited knowledge about the patients’ perioperative experiences of bariatric surgery, with no study yet investigating their experiences within an opioid-free care pathway.

Objective

We aimed to describe similarities and differences in patients’ perioperative experiences of undergoing bariatric surgery with either an opioid-free or opioid-based care pathway.

Design

A qualitative interview study

Setting

A strategic sample of patients enrolled in an ongoing randomized controlled trial investigating the effects of opioid-free anaesthesia for bariatric surgery were recruited. In the randomized controlled trial, participants were randomized to either opioid-based anaesthesia or opioid-free anaesthesia, including transcutaneous electrical nerve stimulation as primary postoperative pain management.

Participants

Twenty patients were interviewed 3 months after surgery: 10 participants in the opioid-free group versus 10 in the opioid-based group.

Methods

Semi-structured interviews were conducted between December 2020 and February 2022 and analysed with qualitative content analysis.

Results

The analysis yielded four categories and 12 subcategories. In Category 1, participants shared diverse emotions before surgery, including anticipation of a healthier life, but also apprehensions and feelings of failure. In Category 2, describing liminality of general anaesthesia, there were similar descriptions of struggling to remember the anaesthesia induction and struggling to surface when recovering from anaesthesia. However, some participants in the opioid-free group shared descriptions of struggling to keep control, describing accentuated memories of the anaesthesia induction. Category 3, managing your pain, showed similar experiences and strategies but different narrations of pain management, with the opioid-free group stating that transcutaneous electrical nerve stimulation works but not when it really hurts, and the opioid-based group describing confidence in but awareness of opioids. Throughout the overall perioperative time period, participants acknowledged Category 4, a patient-professional presence, stating that preparations boost the feeling of confidence before surgery and that they felt confidence in a vulnerable situation although vulnerability challenges communication.

Conclusions

We highlighted the overall similarities in perioperative experiences of patients undergoing bariatric surgery. However, the differences in experiences du

背景尽管最近有证据支持在围手术期采用不含阿片类药物的麻醉和镇痛替代方案，但以阿片类药物为基础的治疗方案仍是标准护理方案。关于患者在减肥手术围手术期的经历，我们所知甚少，目前还没有研究对患者在无阿片护理路径下的经历进行调查。我们旨在描述患者在无阿片或阿片护理路径下接受减肥手术围手术期经历的异同。在随机对照试验中，参与者被随机分配到阿片类药物麻醉或无阿片类药物麻醉，包括经皮神经电刺激作为术后疼痛治疗的主要方法：方法在 2020 年 12 月至 2022 年 2 月期间进行了半结构化访谈，并对访谈内容进行了定性分析。结果分析得出了四个类别和 12 个子类别。在第 1 类中，参与者分享了手术前的各种情绪，包括对更健康生活的期待，但也有担忧和失败感。在描述全身麻醉临界状态的第 2 类中，也有类似的描述，即努力回忆麻醉诱导和在麻醉恢复时努力浮出水面。然而，不使用阿片类药物组的一些参与者也描述了他们努力保持控制的情况，描述了他们对麻醉诱导的深刻记忆。无阿片组的参与者表示经皮神经电刺激很有效，但真正疼痛时就不行了，而使用阿片类药物组的参与者则表示对阿片类药物很有信心，但也意识到了这一点。在整个围手术期，参与者都承认第 4 类情况，即患者与专业人员之间的存在，他们说术前准备工作增强了自信感，他们在脆弱的情况下感受到了自信，尽管脆弱给沟通带来了挑战。然而，无阿片麻醉诱导过程中的体验差异需要在进一步的实施和研究中加以解决，调查减少失控感的策略。我们需要开展更多的研究，以促进无阿片治疗策略在临床实践中的实施，并改善患者的护理体验。

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引用次数: 0

A nurse by any other name? An international comparison of nomenclature and regulation of healthcare assistants 护士的其他名称？医护助理名称和监管的国际比较

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-04-16 DOI: 10.1016/j.ijnsa.2024.100200

Jennifer Jackson, Farida Gadimova, Sandra Epko

Background

Across international healthcare systems, healthcare assistant roles have proliferated, in part to decrease nursing costs and support workplace staffing. There is a lack of consensus about the professional title for healthcare assistants, and whether this group requires professional regulation. The variety of terms for healthcare assistants has resulted in confusion around their scope of practice and role within the healthcare team, which may influence patient care.

Aim

We aimed to identify the terminology used for healthcare assistants across English speaking countries and determine the international status of professional regulation of healthcare assistants.

Method

We conducted a deductive, structured search for healthcare assistant roles that were codified on English-language nursing regulator websites in each jurisdiction in Australia, New Zealand, USA, Canada, Ireland, and the United Kingdom. We assessed what terminology were used for healthcare assistant roles in each area, and whether they were regulated by a professional regulator, such as a college of nursing.

Results

Across 77 jurisdictions, we identified 37 different terms for healthcare assistants. The most frequent term was Certified Nurse Aid with 24 uses, and Certified Nursing Assistant with 13 uses. The majority of healthcare assistants are not professionally regulated. Only 12 jurisdictions have professional regulation programs for healthcare assistants, all in the USA.

Conclusion

There is an urgent need for international consensus about the nomenclature for healthcare assistants, so the healthcare assistant workforce can be supported, and their work evaluated via research studies. Regulators can consider how to engage with healthcare assistants and protect the public, as healthcare assistants provide an increasing proportion of patient care.

背景在整个国际医疗保健系统中，医护助理的职位激增，部分原因是为了降低护理成本和支持工作场所的人员配置。关于医护助理的专业职称以及这一群体是否需要专业监管，目前还缺乏共识。我们的目的是确定英语国家对医护助理使用的术语，并确定医护助理专业监管的国际现状。方法我们对澳大利亚、新西兰、美国、加拿大、爱尔兰和英国各辖区的英语护理监管机构网站上编纂的医护助理角色进行了演绎式、结构化搜索。我们评估了每个地区对医护助理角色使用的术语，以及这些角色是否受护理学院等专业监管机构的监管。结果在 77 个辖区中，我们发现了 37 个不同的医护助理术语。最常见的术语是注册护士助理，有 24 种用法，注册护理助理有 13 种用法。大多数医护助理不受专业监管。只有 12 个辖区对医护助理实施了专业监管计划，这些辖区均位于美国。结论目前迫切需要就医护助理的术语达成国际共识，以便为医护助理队伍提供支持，并通过研究对他们的工作进行评估。监管机构可以考虑如何与医护助理接触并保护公众，因为医护助理提供的病人护理服务所占比例越来越大。

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引用次数: 0

Nursing home residents’ perspectives on oral health: An in-depth interview study 养老院居民对口腔健康的看法：深入访谈研究

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-04-11 DOI: 10.1016/j.ijnsa.2024.100198

Patricia A․ I․ Vandenbulcke , Johanna de Almeida Mello , Valerie Cornette , Marijke Brabants , Emilie Schoebrechts , Jan De Lepeleire , Anja Declercq , Dominique Declerck , Joke Duyck

Background

Oral health is associated with general health and care dependency, but is often neglected in nursing homes. Integration of oral care into general care is necessary, but is hampered by multiple barriers at different levels. This study is part of research into the implementation of the new Oral Health Section for use within the interRAI Long-Term Care Facilities instrument, which is used to assess care needs of nursing home residents. This new Oral Health Section evaluates nine aspects of oral health and results in two Collaborative Action Points.

Objective

To identify residents' perspectives on oral health, oral care, and on the assessment of their oral health using the new Oral Health Section

Design

Qualitative design using in-depth interviews.

Setting(s)

Three nursing homes

Participants

Residents were selected using purposeful sampling in nursing homes participating in research evaluating the use of the new Oral Health Section. The selection was based on their oral status for maximum variation and on their cognitive performance score. Twenty-two residents from three Flemish nursing homes agreed to participate.

Methods

Residents’ oral health was assessed using the new Oral Health Section and dental indices. In-depth interviews were conducted, including the validated short-form Oral Health Impact Profile to evaluate the impact of oral conditions on residents’ well-being. The interviews were coded and analysed by three researchers and mapped into a model to understand participants’ oral health behaviours.

Results

Low Oral Health Impact Profile scores indicated a low impact of oral health issues on participants’ lives. However, despite 77.3 % of the participants reporting satisfaction with their oral health, 86.4 % had poor oral hygiene and 68.2 % required referral to a dentist, suggesting a tendency to overestimate their oral health. Their oral health behaviour was determined by a lack of oral health knowledge (Capability), positive attitudes towards oral health and autonomy (Motivation), upbringing and social support (Opportunity). Participants considered assessments with the new Oral Health Section acceptable.

Conclusions

This study shows how older people perceive their oral health and oral healthcare. Understanding their wishes and needs will not only facilitate their involvement in their oral care, but is also likely to enable the improvement of their oral hygiene and the development of effective oral care strategies for the future. Policy makers and managers of care organisations may use these results to foster integration of oral care guidelines into care protocols within nursing homes, including collaboration with dentists and dental hygienists.

Tweetable abstract

Oral health assessments with the new Oral Health Sectio

背景口腔健康与一般健康和护理依赖有关，但在疗养院中却常常被忽视。将口腔护理纳入一般护理是必要的，但却受到不同层面多重障碍的阻碍。本研究是对 interRAI 长期护理设施工具中新的口腔健康部分的实施情况进行研究的一部分，该工具用于评估疗养院居民的护理需求。这项新的口腔健康部分对口腔健康的九个方面进行了评估，并产生了两个合作行动点。目标确定居民对口腔健康、口腔护理以及使用新的口腔健康部分对其口腔健康进行评估的看法。环境三家疗养院参与者在参与评估新的口腔健康部分使用情况研究的疗养院中，通过有目的的抽样挑选居民。选择的依据是他们的口腔状况，以实现最大程度的差异化，以及他们的认知能力得分。来自三家佛兰德疗养院的 22 名住院者同意参与。方法使用新的口腔健康部分和牙科指数评估住院者的口腔健康。我们还进行了深度访谈，包括经过验证的简表《口腔健康影响档案》，以评估口腔状况对住院者福祉的影响。三位研究人员对访谈进行了编码和分析，并将其映射到一个模型中，以了解参与者的口腔健康行为。结果口腔健康影响档案得分较低，表明口腔健康问题对参与者生活的影响较小。然而，尽管 77.3% 的参与者对自己的口腔健康表示满意，但 86.4% 的参与者口腔卫生状况不佳，68.2% 的参与者需要转诊至牙医，这表明他们倾向于高估自己的口腔健康状况。他们的口腔健康行为是由缺乏口腔健康知识（能力）、对口腔健康的积极态度和自主性（动机）、成长环境和社会支持（机会）决定的。参与者认为新口腔健康科的评估是可以接受的。了解他们的愿望和需求不仅能促进他们参与口腔护理，还能改善他们的口腔卫生并为未来制定有效的口腔护理策略。政策制定者和护理机构的管理者可以利用这些结果，促进将口腔护理指南纳入养老院的护理协议中，包括与牙医和牙科保健师合作。

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引用次数: 0

Application and challenges of using a Constructivist Grounded Theory methodology to address an undertheorized clinical challenge: A discussion paper 使用建构主义基础理论方法解决理论不足的临床难题的应用和挑战：讨论文件

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-04-10 DOI: 10.1016/j.ijnsa.2024.100199

Paul Bobbink , Philip Larkin , Sebastian Probst

Background

The benefits of nurse-led therapeutic patient education regarding wound healing and the prevention of recurrences for individuals living with a venous leg ulcer remain unclear. Obtaining the individuals perspective could offer an in depth understanding of why and how they engage or not, in self-management strategies following nurse-led patient education. Despite strong evidence indicating the need for further investigation into the benefits of therapeutic patient education in this population there is a lack of research into how individuals cope with chronic venous insufficiency or resulting ulceration. With this discussion paper we therefore explore the challenges associated with employing a Constructivist Grounded Theory methodology to gain a deeper insight into the experiences of patients with venous leg ulcers receiving individualized nurse-led patient education programs focused on the self-management of their condition.

Objective

To identify and analyse the specific methodological and practical challenges encountered when applying a Constructivist Grounded Theory methodology to gain a better understanding of how patients with venous leg ulcer experience an individualised nurse-led patient education programme concerning the self-management of their condition.

Design

discussion paper

Results and Discussion

The constructivist approach to Grounded Theory methodology allows for the investigation of understudied phenomena such as nurse-led patient education for individuals living with venous leg ulcers. This methodology values the co-construction of a theory taking into consideration the inherent value of participants’ and researchers’ experiences. However, the specificities of constructivist epistemology challenge certain methodological aspects of Grounded Theory methods, such as how and when to use existing literature, conduct interviews to generate data and engage in the coding and theoretical sampling process for conceptualizing and proposing a theory.

Conclusions

The constructivist paradigm of grounded theory methodolgy resonates with the art and science of nursing through its collaborative ‘real-world’ reflective approach, offering a unique way to explore understudied complex clinical nursing practice.

Registration

This methodological paper is derived from a PhD study embedded in a clinical trial (NCT04019340) were the recruitment started on February 2020, approved by ethical committee of Geneva (CCER: 2019-01964)

Tweetable abstract

Constructivist Grounded Theory Methodologies could support an in depth understanding of the impact of nursing interventions

背景以护士为主导的治疗性患者教育对静脉性腿部溃疡患者伤口愈合和预防复发的益处尚不清楚。从患者的角度出发，可以深入了解他们在接受护士指导的患者教育后，为何以及如何参与或不参与自我管理策略。尽管有强有力的证据表明，有必要进一步调查治疗性患者教育对这一人群的益处，但目前还缺乏对个人如何应对慢性静脉功能不全或由此导致的溃疡的研究。因此，我们在本讨论文件中探讨了采用建构主义基础理论方法深入了解静脉性腿部溃疡患者在接受以自我病情管理为重点的个性化护士指导患者教育项目时所面临的挑战。目标确定并分析在应用建构主义基础理论方法时遇到的具体方法和实际挑战，以更好地了解静脉性腿部溃疡患者是如何体验由护士主导的有关自我管理病情的个性化患者教育项目的。设计讨论论文结果与讨论基础理论方法的建构主义方法允许对研究不足的现象进行调查，如由护士主导的针对静脉性腿部溃疡患者的患者教育。这种方法重视理论的共同建构，同时考虑到参与者和研究人员经验的内在价值。然而，建构主义认识论的特殊性对基础理论方法的某些方法论方面提出了挑战，例如如何以及何时使用现有文献、进行访谈以生成数据，以及参与编码和理论抽样过程以构思和提出理论。结论基础理论方法的建构主义范式通过其合作的 "真实世界 "反思方法与护理艺术和科学产生了共鸣，为探索研究不足的复杂临床护理实践提供了一种独特的方法。本方法论论文来源于一项临床试验（NCT04019340）中的博士研究，该临床试验的招募工作已于2020年2月开始，并已获得日内瓦伦理委员会的批准（CCER：2019-01964）。

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