International Journal of Nursing Studies Advances最新文献_第9页

Promoting Well-being: A Scoping Review of Strategies Implemented During the COVID-19 Pandemic to Enhance the Well-being of the Nursing Workforce 促进福祉：对 COVID-19 大流行期间为提高护理人员福利而实施的战略进行的范围审查。

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-01-11 DOI: 10.1016/j.ijnsa.2024.100177

Caroline Browne , Ylona Chun Tie

Background

The nursing workforce faces significant stressors every day that can lead to exhaustion and burnout. The unprecedented challenges that were faced during the Covid-19 pandemic, placed an added burden on nurses who were already under pressure. Nurses were at the frontline of care provision, and nursing leaders had to rapidly implement strategies to support and maintain staff safety, short and long-term well-being.

Objective

A scoping review of strategies nurse leaders and organisations initiated to enhance the well-being of their colleagues during the Covid-19 pandemic was undertaken. Experiences from around the globe have been collated to provide an insight into well-being initiatives that can inform future practice to sustain and retain the nursing workforce.

Design

A scoping review of strategies nurse leaders and organisations initiated to enhance the well-being of their colleagues during the Covid-19 pandemic was undertaken.

Method

A search of key electronic databases identified articles published between January 2020 and February 2023. 21 pieces of original research that met the inclusion criteria were reviewed.

Results

Well-being interventions evaluated in the literature included: dedicated well-being spaces, peer debriefing, psychological support, online resources and education, introduction of well-being strategies and resources, and meditations. There were six broad themes identified that enhanced the success of well-being strategies including: Education and Communication, Tailored or Adaptable Strategies, Support from Leadership, Sharing Experiences and Peer Support, and Feeling appreciated and heard. There were also barriers to accessing well-being interventions that have been identified.

Conclusion

The Covid 19 pandemic highlighted how imperative strong nursing leadership is for supporting nurses at every level. Practical strategies provided psychological support essential for maintaining the health and well-being of the nursing workforce. The strategies identified demonstrate the creativity and adaptability of nursing leadership to look after colleagues to maintain and sustain our nursing workforce.

Tweetable

Strategies implemented during the COVID-19 pandemic can be used to guide ongoing initiatives to enhance wellbeing for the nursing workforce.

背景护理人员每天都面临着巨大的压力，这些压力可能导致精疲力竭和职业倦怠。在 Covid-19 大流行期间，护士们面临着前所未有的挑战，这给本已压力重重的护士们增加了额外的负担。护士处于提供护理服务的第一线，护理领导者必须迅速实施相关策略，以支持和维护员工的安全、短期和长期福祉。目标对护士领导者和组织在 Covid-19 大流行期间为提高同事福祉而采取的策略进行了范围界定审查。对全球各地的经验进行了整理，以深入了解可为未来实践提供参考的福利措施，从而维持和留住护理人员队伍。方法对主要电子数据库进行检索，确定了 2020 年 1 月至 2023 年 2 月期间发表的文章。结果文献中评估的福祉干预措施包括：专门的福祉空间、同伴汇报、心理支持、在线资源和教育、引入福祉策略和资源以及冥想。为提高幸福战略的成功率，确定了六大主题，包括教育与沟通、量身定制或适应性强的策略、领导层的支持、分享经验和同伴支持，以及感受到赞赏和倾听。结论 Covid 19 大流行凸显了强有力的护理领导对支持各级护士的重要性。切实可行的策略为维护护理人员的健康和福祉提供了必要的心理支持。Tweetable在COVID-19大流行期间实施的策略可用于指导正在开展的提高护理人员健康水平的活动。

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引用次数: 0

Clinical research nursing pathways: The development and evaluation of a nursing research internship program using the RE-AIM framework 临床研究护理路径：使用 RE-AIM 框架开发和评估护理研究实习计划。

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-01-09 DOI: 10.1016/j.ijnsa.2024.100176

Natasha A Roberts , Elise Button , Jed Duff , Catherine Paterson , Michael Smith , Nicole Gavin

Background

In 2018 a Nursing Research Internship program was started within a major referral and tertiary teaching centre in Australia.

Aim

We aimed to evaluate the first 12 months of the program using an implementation science framework.

Methods

This was a qualitative study. Following ethical approval n = 20 semi -structured interviews were recorded and transcribed verbatim. Participants included nurses with clinical, research and management roles who had engaged in or supported a Nursing Research Internship program. The Framework Method was conducted to analyse the findings.

Results

Key themes identified included ‘What is the impact of a Nursing Research Internship program?’; ‘Why do a Nursing Research Internship program?’; ‘How do we do a Nursing Research Internship program?’; ‘How do we sustain a Nursing Research Internship program?’. Positive impacts were identified for clinical nurses and their teams, for the hospital and health service, and for patients and families. Identified key components included protected research time, specialist support (including library, statistics, health economist, implementation scientist), regulatory support (ethics and governance procedures) and access to a computer and IT resources. The Nursing Research Internship program required support from nurse clinicians, nurse managers and nurse academics.

Conclusion

A structured Nursing Research Internship program supports clinical nurses to answer research questions identified directly from clinical practice.

背景2018年，澳大利亚一家主要的转诊和三级教学中心启动了一项护理研究实习计划。目的我们旨在使用实施科学框架对该计划的前12个月进行评估。在获得伦理批准后，我们对 20 个半结构化访谈进行了录音和逐字记录。参与者包括曾参与或支持护理研究实习计划的临床、研究和管理护士。结果确定的关键主题包括："护理研究实习计划的影响是什么？"；"为什么要开展护理研究实习计划？"；"我们如何开展护理研究实习计划？"；"我们如何维持护理研究实习计划？确定了对临床护士及其团队、医院和医疗服务以及病人和家属的积极影响。确定的关键要素包括受保护的研究时间、专家支持（包括图书馆、统计、卫生经济学家、实施科学家）、监管支持（伦理和管理程序）以及使用计算机和 IT 资源的机会。护理研究实习计划需要临床护士、护士管理人员和护士学者的支持。

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引用次数: 0

Prioritizing chronic pain self-management amid coexisting chronic illnesses: An exploratory qualitative study 在慢性疾病并存的情况下优先考虑慢性疼痛的自我管理：一项探索性定性研究

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-01-06 DOI: 10.1016/j.ijnsa.2024.100175

Charlotte Moore-Bouchard , Marie-Eve Martel , Elise Develay , José Côté , Madeleine Durand , M Gabrielle Pagé

Background

In Canada, one out of five people lives with chronic pain, a condition frequently co-occurring with other chronic illnesses. As with most chronic illnesses, successful engagement in symptom management is key. In the context of multiple illnesses, self-management involves daily prioritization of symptoms and conditions and decision-making, which can be challenging. Self-management of chronic illnesses can require more complex competence and tasks to address the different implications of each condition.

Objective

Our research objective was to explore types and processes of self-management symptom prioritization among adults living with chronic pain and other chronic illnesses.

Design

This research was carried out as part of a larger study that adopted an explanatory sequential mixed-methods design. This study focused more specifically on the qualitative part of the study.

Setting(s)

Participants recruited for the qualitative component took part in a semi-structured individual interview online or in-person at the center hospitalier de l'Université de Montréal.

Participants

In total, 25 participants were interviewed, including 18 women and 7 men.

Methods

To participate in the qualitative part of the study, participants were selected from the larger study and were eligible if they were 18 years old or older and experiencing pain for more than 3 months and had at least one other chronic illness for which they were receiving treatment or engaged in symptom management. Semi-structured interviews were conducted in-person or virtually and were transcribed verbatim. Reflexive thematic analysis was used to explore patients’ narratives, and an open and iterative approach was adopted to code interviews and generate themes.

Findings

The first theme, focus on symptom prioritization, showed different prioritization processes, including prioritizing a dominant illness, prioritizing multiple illnesses to avoid undesirable consequences, and finally absence of or automatic processes of prioritization. In the second theme, we identified several characteristics of an illness, in this case chronic pain that made it a self-management priority: uncontrollable and disabling nature, omnipresence, unpredictability, unpleasantness, and invisibility to others. In the last theme, we highlighted that some psychosocial factors influenced levels of engagement in self-management and prioritization processes, including social support and the patient-physician relationship.

Conclusions

Chronic pain was the medical condition most often prioritized by participants in their self-management tasks. Because of its characteristics, it was the medical condition that had the most negative impact on day-to-day functioning.

背景在加拿大，每五个人中就有一人患有慢性疼痛，这种疾病经常与其他慢性疾病并发。与大多数慢性病一样，成功参与症状管理是关键。在患有多种疾病的情况下，自我管理需要每天对症状和病情进行优先排序并做出决策，这可能具有挑战性。慢性疾病的自我管理可能需要更复杂的能力和任务，以应对每种疾病的不同影响。目标我们的研究目标是探索患有慢性疼痛和其他慢性疾病的成年人自我管理症状优先顺序的类型和过程。设计本研究是一项大型研究的一部分，采用了解释性顺序混合方法设计。本研究更具体地侧重于研究的定性部分。参与者总共有 25 人接受了访谈，其中包括 18 名女性和 7 名男性。方法参加定性研究的参与者是从大型研究中挑选出来的，只要年龄在18岁或18岁以上，疼痛时间超过3个月，并至少患有一种正在接受治疗或参与症状控制的其他慢性疾病，就有资格参加定性研究。半结构式访谈以面谈或虚拟方式进行，并逐字记录。研究结果第一个主题是对症状优先顺序的关注，显示了不同的优先顺序过程，包括优先考虑一种主要疾病、优先考虑多种疾病以避免不良后果，以及最后没有优先顺序或自动优先顺序过程。在第二个主题中，我们确定了一种疾病（在本例中为慢性疼痛）的几个特征，这些特征使其成为自我管理的优先事项：无法控制和致残的性质、无处不在、不可预测、令人不快以及不为他人所见。在最后一个主题中，我们强调了一些社会心理因素会影响自我管理的参与度和优先级的确定，其中包括社会支持和患者与医生的关系。由于其特点，慢性疼痛是对日常功能产生负面影响最大的疾病。

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引用次数: 0

Saturation in qualitative research: An evolutionary concept analysis 定性研究的饱和度：演变概念分析

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2024-01-05 DOI: 10.1016/j.ijnsa.2024.100174

Sara Rahimi , Marzieh khatooni

Background and Aim

Qualitative research plays an important role in improving nursing knowledge. Understanding the concept of saturation is essential to conducting rigorous qualitative research that contributes to evidence-based practice. The purpose of this study is to clarify the concept of saturation in qualitative research.

Method

Evolutionary concept analysis was performed. A literature search was conducted using a variety of online databases for the years 2005- 2023. In total, 33 articles and books were analyzed using thematic analysis to identify the attributes, antecedents and consequences of saturation. The validity of the data was obtained by examining the analysis process by two independent researchers.

Results

Saturation in qualitative research is a context-dependent, subjective process that requires detailed systematic analysis. Saturation is used in four ways in qualitative research: theoretical saturation, data saturation, code or thematic saturation, and meaning saturation. The antecedents of saturation were classified into two categories: study related factors and researcher related factors. The consequences of saturation were identified as: ensuring credibility and quality in qualitative research and time, energy and budget saving.

Conclusion

This concept analysis serves to enhance the understanding of the concept of saturation, thereby offering valuable resources for qualitative researchers. By gaining a profound comprehension of saturation and its various types, researchers can ensure the validity of their studies while also optimizing time and resource allocation by avoiding redundant data collection. Future investigation warranted to elucidate how factors associated with reaching saturation impact estimations sample size.

背景和目的定性研究在提高护理知识方面发挥着重要作用。了解饱和度的概念对于开展严谨的定性研究、促进循证实践至关重要。本研究旨在澄清定性研究中饱和度的概念。使用各种在线数据库对 2005 年至 2023 年的文献进行了搜索。采用主题分析法对总共 33 篇文章和书籍进行了分析，以确定饱和的属性、前因和后果。结果定性研究中的饱和是一个依赖于背景的主观过程，需要进行详细的系统分析。定性研究中的饱和有四种方式：理论饱和、数据饱和、代码或主题饱和以及意义饱和。饱和的前因分为两类：与研究相关的因素和与研究者相关的因素。饱和的结果被确定为：确保定性研究的可信度和质量，节省时间、精力和预算。通过对饱和及其各种类型的深刻理解，研究人员可以确保其研究的有效性，同时还可以通过避免多余的数据收集来优化时间和资源分配。未来的调查需要阐明与达到饱和相关的因素如何影响样本量的估计。

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引用次数: 0

Psychometric evaluation of the United States-adapted perceived perioperative competence scale-revised: A national survey 美国修订版围手术期能力认知量表的心理计量学评估：全国调查

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2023-12-18 DOI: 10.1016/j.ijnsa.2023.100173

Shannon Maio , James X. Stobinski , Brigid M. Gillespie

Background

Nursing competence is integral to ensuring patient safety, especially in high-risk environments such as the operating room. Instruments which facilitate self-assessment of specialty specific nursing competence allow nurses to gain important insights into their practice to facilitate continuous growth in their professional practice. Currently, there are no psychometrically tested tools to assess perioperative competence applicable to the United States context.

Objective

Test the psychometric properties of the Perceived Perioperative Competence Scale-Revised in the United States context.

Methods

A cross-sectional survey design was used. Perioperative nurses were recruited via four professional associations and the survey was administered online. Construct validity of the six-dimensional Perceived Perioperative Competence Scale-Revised was tested using a multidimensional item response theory model known as the graded response model. Measurement invariance was assessed relative to years of perioperative experience. Internal consistency was estimated using McDonald's Omega and Cronbach's alpha reliability coefficients.

Results

Responses from a total of 1,581 participants were analyzed in the psychometric analysis. The six-dimensional graded response model of the Perceived Perioperative Competence Scale-Revised displayed satisfactory model fit for the sample (Chi-square(df) = 5,699.09(725); root mean square error of approximation = 0.066, 90% confidence interval: 0.064, 0.067; comparative fit index = 0.955; Tucker-Lewis index = 0.952; standardized root mean squared residual = 0.045). Scalar invariance was established when assessing the psychometric equivalence of the scale across years of perioperative experience (<10 years, ≥ 10 years) (Chi-square(df) = 5,785.29(1,573); root mean square error of approximation = 0.058, 90% confidence interval: 0.057, 0.060; comparative fit index = 0.959; Tucker–Lewis index = 0.959). Reliability across the six subscales ranged from alpha = 0.87 - 0.94 and Omega = 0.93 - 0.97.

Conclusions

Results suggest that the Perceived Perioperative Competence Scale-Revised is suitable to use with perioperative nurses practicing in clinical settings in the United States. Measurement invariance testing indicates the scale is measuring the same construct and is being interpreted in a conceptually similar manner across groups based on years of perioperative experience.

背景护理能力是确保患者安全不可或缺的因素，尤其是在手术室等高风险环境中。有助于对专科护理能力进行自我评估的工具可以让护士对自己的实践有重要的了解，从而促进其专业实践的不断发展。目前，还没有经过心理测试的评估围手术期能力的工具适用于美国的情况。通过四个专业协会招募围手术期护士，并在线进行调查。采用多维项目反应理论模型（即分级反应模型）对六维围手术期能力感知量表-修订版的结构效度进行了测试。根据围手术期的年限对测量不变性进行了评估。采用麦克唐纳Ω和克朗巴赫α信度系数对内部一致性进行了估计。结果心理测量分析共分析了 1,581 名参与者的回答。围手术期能力感知量表-修订版的六维分级反应模型在样本中显示出令人满意的模型拟合度（Chi-square(df) = 5,699.09(725)；均方根近似误差 = 0.066，90% 置信区间：0.064, 0.067；比较拟合指数 = 0.955；Tucker-Lewis 指数 = 0.952；标准化均方根残差 = 0.045）。在评估不同围手术期年限（<10 年，≥ 10 年）的量表心理测量等效性时，确定了量表的标度不变性（Chi-square(df) = 5,785.29(1,573); 均方根近似误差 = 0.058, 90% 置信区间：0.057, 0.060; 比较拟合指数 = 0.959; Tucker-Lewis 指数 = 0.959）。结论结果表明，围手术期能力认知量表（修订版）适用于在美国临床环境中工作的围手术期护士。测量不变性测试表明，该量表测量的是相同的结构，并且在不同围手术期经验的组别中以概念相似的方式进行解释。

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引用次数: 0

Patient-reported outcome measures for the assessment of stress in neurological patients: An integrative review 用于评估神经系统患者压力的患者报告结果测量法：综合评述

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2023-12-15 DOI: 10.1016/j.ijnsa.2023.100172

Ilkka Sairanen , Heli Virtanen , Päivi Hämäläinen , Riitta Suhonen

Background

Patient stress is often overlooked in the care of patients with neurological problems. Nursing theorists have previously heralded stress assessment through conceptual clarification, while clinical nurses in the health care system hold an ideal position for implementation of assessment and coordination of support. Integrated with a hospital assessment and support scheme, recognition of stress as a target of systematic assessment can lead to improved clinical outcomes.

Objective

The aim of the study was to describe and compare patient-reported outcome measures suitable for assessment of the stress response as symptoms in neurological patients.

Design

This study is an integrative review and concept development of patient stress based on qualitative and quantitative analysis of available self-reporting instruments.

Methods

Instruments were retreived with a systematic search from PubMed, CINAHL, PsychINFO and Web of Science reference databases on August 2, 2021. Search terms associated with the concept of stress symptoms were used. Instrument inclusion was done with the guidance of authoritative symptom inventories, with partial confirmation by a second author to mitigate bias. In the analysis, the instruments included in the review were quantitatively described and compared. Insights from the instrument composition led to clarification of our concept of stress response to further refine the list of instruments suitable for self-assessment of the stress status. This study was not registered.

Results

Based on the inclusion criteria, 23 patient-reported outcome measures extending over a variety of stress concepts were included. The similarity of items among the instruments implied a symptom cluster delineated by 59 common symptom subclasses that were grouped together in a re-classification of instrument items. A comparative quantitative analysis prompted us to distinguish the concept of stress response from antecedent, consequent, and related concepts as a manifestation of mental, somatic, and behavioral domains. Ten instruments with items covering the three domains, each with unique qualities regarding number of items, measured spread, and letter count were described.

Conclusions

Within an organizational framework, effective allotment among types of support can be founded on the patient's stress status and the stressors. The stress status manifests itself as a set of measurable symptoms. Optimal instruments for use in systematic clinical assessment of neurological patients’ stress status should satisfy the suggested specification of the stress response with a minimal number of items and concise wording. Finding and including the relevant instruments for analysis were the main limitation of the study.

Tweetable abstract

Stress of neurological patients needs to be assessed and add

背景在护理神经系统疾病患者的过程中，患者的压力常常被忽视。护理理论家曾通过澄清概念来预示压力评估，而医疗保健系统中的临床护士则是实施评估和协调支持的理想人选。本研究旨在描述和比较适合评估神经科患者作为症状的应激反应的患者报告结果测量方法。本研究是基于对现有自我报告工具的定性和定量分析，对患者应激反应进行综合回顾和概念发展。使用了与压力症状概念相关的检索词。纳入的工具以权威症状清单为指导，并由第二位作者进行部分确认，以减少偏差。在分析过程中，对纳入综述的工具进行了定量描述和比较。从工具构成中获得的启示使我们澄清了压力反应的概念，从而进一步完善了适用于压力状态自我评估的工具清单。本研究未注册。结果根据纳入标准，共纳入了 23 种患者报告的结果测量方法，涵盖了各种压力概念。这些测量工具的测量项目具有相似性，这意味着在对测量工具的测量项目进行重新分类时，将59个共同的症状子类归为一组。比较定量分析促使我们将应激反应概念与前因、后果和相关概念区分开来，将其视为精神、躯体和行为领域的一种表现形式。结论在一个组织框架内，可以根据患者的应激状态和应激源来有效分配不同类型的支持。压力状态表现为一系列可测量的症状。用于系统性临床评估神经科患者压力状态的最佳工具应满足所建议的压力反应规范，项目数量最少，措辞简洁。寻找并纳入相关工具进行分析是本研究的主要局限性。我们列出了 10 种可用于评估的合适工具。

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引用次数: 0

A bachelor's degree for entering the nursing profession: A scoping review for supporting informed health care policies 获得学士学位才能进入护理行业：支持知情医疗保健政策的范围审查

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2023-12-07 DOI: 10.1016/j.ijnsa.2023.100171

Angela Schnelli , Laura Maria Steiner , Loris Bonetti , Sara Levati , Mario Desmedt

Background

Numerous studies have emphasized the relevance of work environment, staffing, and educational level in nursing as determinants of safe, timely, effective, equitable, and efficient patient-centered care. However, an overview of the evidence focusing on the nursing education level is still lacking.

Objective

To provide an overview of the existing evidence regarding bachelor's degree as an entry level for the nursing profession.

Design

This was a scoping review.

Methods

We conducted a systematic search of CINAHL, Medline via PubMed, Cochrane, and Web of Science Core Collection. Additionally, we conducted a free web search using Google and contacted international nursing associations via email. We summarized the evidence narratively. For reporting guidelines, we used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews.

Results

We included 10 studies, 12 response letters, 24 position papers, three books, and one webpage. The sources of evidence identified agreed that the inclusion of a higher number of nurses with a bachelor's degree would lead to a higher quality of care.

Conclusions

Using a bachelor's degree education as a minimum requirement to enter the nursing profession in the future is essential to generate a respected, competent, and satisfied nursing workforce that can impact the quality and safety of care; and positively influence outcome indicators for patients, nurses, healthcare organizations, and society.

Tweetable abstract

Policy makers and healthcare organizations should set bachelor's degrees as standards for registration and entry to nursing.

背景大量研究强调了护理工作环境、人员配备和教育水平的相关性，它们是安全、及时、有效、公平和高效的以患者为中心的护理的决定因素。目标概述有关学士学位作为护理专业入门水平的现有证据。方法我们对 CINAHL、Medline via PubMed、Cochrane 和 Web of Science Core Collection 进行了系统检索。此外，我们还使用 Google 进行了免费网络搜索，并通过电子邮件与国际护理协会取得了联系。我们对证据进行了叙述性总结。在报告指南方面，我们采用了《系统性综述的首选报告项目》和《范围综述的元分析》。结果我们纳入了 10 项研究、12 封回信、24 篇立场文件、3 本书和 1 个网页。结论将学士学位教育作为未来进入护理行业的最低要求对于培养一支受人尊敬、有能力、满意的护理队伍至关重要，这支队伍可以影响护理质量和安全，并对患者、护士、医疗机构和社会的结果指标产生积极影响。

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引用次数: 0

Enabling nurses’ engagement in the design of healthcare technology – Core competencies and requirements: A qualitative study 让护士参与医疗保健技术设计--核心能力和要求：定性研究

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2023-12-06 DOI: 10.1016/j.ijnsa.2023.100170

Thijs van Houwelingen , Alexandra C.M. Meeuse , Helianthe S.M. Kort

Background

Due to the globally increasing demand for care, innovation is important to maintain quality, safety, effectiveness, patient sensitivity, and outcome orientation. Health care technologies could be a solution to innovate, maintain, or improve the quality of care and simultaneously decrease nurses’ workload. Currently, nurses are rarely involved in the design of health care technologies, mostly due to time constraints with clinical nursing responsibilities and limited exposure to technology and design disciplines. To ensure that health care technologies fit into nurses’ core and routine practice, nurses should be actively involved in the design process.

Objective

The aim of the present study was to explore the main requirements for nurses’ active participation in the design of health care technologies.

Design

An exploratory descriptive qualitative design was used which helps to both understand and describe a phenomenon.

Participants

Twelve nurses from three academic hospitals in the Netherlands participated in this study.

Method

Data were collected from semistructured interviews with hospital nurses experienced in design programs and thematically analysed.

Results

Four themes were identified concerning the main requirements for nurses to participate in the design of health care technologies: (1) nurses’ motivations to participate, (2) the process of technology development, (3) required competence to participate (such as assertiveness, creative thinking, problem solving skills), and (4) facilitating and organizing nurses’ participation.

Conclusion

Nurses experience their involvement in the design process as essential, distinctive, and meaningful but experience few possibilities to combine this work with their current workload, flows, routines, and requirements. To participate in the design of health care technologies nurses need motivation and specific competencies. Organizations should facilitate time for nurses to acquire the required competencies and to be intentionally involved in technology design and development activities.

背景由于全球对护理的需求日益增长，创新对于保持护理质量、安全性、有效性、患者敏感性和结果导向性非常重要。医疗保健技术是创新、保持或提高护理质量的一种解决方案，同时还能减轻护士的工作量。目前，护士很少参与医疗保健技术的设计，这主要是由于临床护理职责的时间限制以及对技术和设计学科的接触有限。本研究旨在探讨护士积极参与医疗保健技术设计的主要要求。研究采用了探索性描述性定性设计，有助于理解和描述一种现象。参与者来自荷兰三家学术医院的 12 名护士参与了本研究。研究方法通过对有设计项目经验的医院护士进行半结构化访谈收集数据，并进行主题分析。结果就护士参与医疗保健技术设计的主要要求确定了四个主题：（1）护士参与的动机，（2）技术开发过程，（3）参与所需的能力（如自信、创造性思维、解决问题的技能），以及（4）促进和组织护士参与。要参与医疗保健技术的设计，护士需要动力和特定的能力。组织应为护士提供时间，使其获得所需的能力，并有意识地参与技术设计和开发活动。

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引用次数: 0

Effectiveness of telehealth on the glycemic control of patients with type 2 diabetes mellitus during the COVID-19 pandemic: A systematic review and meta-analysis of randomised controlled trials COVID-19大流行期间远程医疗对2型糖尿病患者血糖控制的有效性:随机对照试验的系统回顾和荟萃分析

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2023-12-01 DOI: 10.1016/j.ijnsa.2023.100169

Chantira Chiaranai , Saranya Chularee , Surasak Saokaew , Patraporn Bhatarasakoon , Adinat Umnuaypornlert , Natthaya Chaomuang , Nudchaporn Doommai , Porntip Nimkuntod

Background

During the COVID-19 pandemic, telehealth was employed to enhance clinical outcomes for patients with type 2 diabetes mellitus. However, the effectiveness of telehealth remains inconclusive.

Objective

This study aimed to examine the impact of telehealth on the glycemic control of individuals with type 2 diabetes mellitus during the pandemic.

Design

A systematic review and meta-analysis of randomized controlled trials.

Setting

N/A

Participants

A total of 669 studies was sourced from electronic databases, including EMBASE, PubMed, and Scopus. Among these, twelve randomized controlled trials, comprising 1498 participants, were included.

Methods

A comprehensive search was performed in electronic databases. The quality of the included studies was assessed using the Cochrane Risk of Bias tool, and statistical heterogeneity was assessed using I² and Cochran's Q tests. A random-effects model was utilized to combine the outcomes. Grading of Recommendations, Assessment, Development, and Evaluations was used to evaluate the certainty of the evidence.

Results

The meta-analysis showed that participants receiving a telehealth intervention achieved a greater reduction in the glycated haemoglobin (HbA1C) compared to those receiving usual care, with a weighted-mean difference of -0.59 (95 % CI -0.84 to -0.35, p < .001, I² = 74.1 %, high certainty of evidence). Additionally, participants receiving telehealth interventions experienced better secondary outcomes, including a reduction in fasting blood sugar (16.06 %, 95 %CI -29.64 to -2.48, p = .02, high certainty of evidence), a decrease in body mass index (1.5 %, 95 %CI -1.98 to -1.02, p < .001, high certainty of evidence), and a decrease in low-density lipoprotein (7.8 %, 95 %CI -14.69 to -0.88, p = .027, low certainty of evidence).

Conclusions

In our review, we showed telehealth's positive impact on glycaemic control in type 2 diabetes mellitus patients. Healthcare professionals can use telehealth in diabetes care. Caution is needed due to heterogeneity of the results. Further research should explore the long-term impacts of telehealth interventions.

Registration

The study was registered with PROSPERO, CRD42022381879.

在2019冠状病毒病大流行期间，远程医疗被用于改善2型糖尿病患者的临床结果。然而，远程保健的有效性仍然没有定论。目的探讨大流行期间远程医疗对2型糖尿病患者血糖控制的影响。设计随机对照试验的系统评价和荟萃分析。总共669项研究来自电子数据库，包括EMBASE、PubMed和Scopus。其中纳入12项随机对照试验，1498名受试者。方法在电子数据库中进行全面检索。采用Cochrane偏倚风险工具评估纳入研究的质量，采用I²和科克伦Q检验评估统计异质性。随机效应模型用于合并结果。建议、评估、发展和评价的分级用于评估证据的确定性。结果荟萃分析显示，与接受常规护理的参与者相比，接受远程医疗干预的参与者糖化血红蛋白(HbA1C)的降低幅度更大，加权平均差异为-0.59 (95% CI -0.84至-0.35,p <.001, I²= 74.1%，证据确定性高)。此外，接受远程医疗干预的参与者经历了更好的次要结果，包括空腹血糖降低(16.06%，95% CI -29.64至-2.48,p = 0.02，证据的高确定性)，体重指数降低(1.5%，95% CI -1.98至-1.02,p <.001，证据高确定性)，以及低密度脂蛋白的减少(7.8%，95% CI -14.69至-0.88,p = 0.027，证据低确定性)。结论在我们的综述中，我们发现远程医疗对2型糖尿病患者血糖控制的积极影响。医疗保健专业人员可以在糖尿病护理中使用远程医疗。由于结果的异质性，需要谨慎。进一步的研究应探讨远程医疗干预的长期影响。注册:本研究注册号为PROSPERO, CRD42022381879。

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引用次数: 0

Patients’ experiences and perspectives of post-hospital follow-up care to improve physical recovery for intensive care survivors: A systematic review of qualitative research 病人的经验和观点的院后随访护理，以改善身体恢复重症监护幸存者:一个系统的回顾定性研究

Q1 Nursing

International Journal of Nursing Studies Advances

Pub Date : 2023-12-01 DOI: 10.1016/j.ijnsa.2023.100168

Nicola M.A. Rea , Lis Neubeck , Kalliopi Kydonaki , Sheona McHale

Background

Intensive care units deliver care to a heterogeneous group of patients with pre-existing co-morbid disease. Focus has shifted to improving health related quality of life with more patients surviving beyond hospital discharge. Randomised controlled trials evaluating follow-up interventions, to improve physical recovery, have not demonstrated a health-related quality of life benefit. Qualitative research may provide the context to understand the experiences of intensive care survivors during follow-up care addressing physical limitations.

Objective

To synthesise qualitative studies and explore Intensive Care survivors’ experiences and perspectives of physical symptoms in the context of follow-up care.

Setting(s)

A systematic search of electronic databases (MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Web of Science, Applied Social Sciences Index and Abstracts, Ovid Nursing and Ovid Emcare) was conducted to identify peer-reviewed primary qualitative studies. No date parameters were applied. Inclusion/exclusion criteria guided the screening process.

Participants

The data from eligible primary research studies was extracted into NVivo (v12).

Methods

Critical appraisal was completed using the Joanna Briggs Critical Appraisal Tool. Thematic analysis, guided by Braun and Clarke (2022), informed the data synthesis.

Results

From 2457 studies, ten relevant studies were included. Two main themes were identified: 1. Recovery as uncertain; which outlines the uncertainty experienced by intensive care unit survivors during recovery. This theme pertained to system-level factors (role of healthcare professional and information provision) which provides the context for delivering follow-up care. 2. Self-determination of recovery; outlines individual characteristics in determining recovery which is conceptualised by patient-level factors (motivation, support network and perception of health).

Conclusions

For intensive care survivors, the recovery trajectory is uncertain with a gap in information provision during the acute phase following hospital discharge. Patients’ self-determination of recovery is an important consideration to ensure follow-up care addresses the needs of individual patients. The impact of pre-existing co-morbid disease and subgroups of patients deriving benefit from follow-up care remains uncertain.

Registration

PROSPERO Registration no. CRD42022355711

Tweetable abstract

Patients’ experiences of post-hospital follow-up care to improve physical recovery for intensive care survivors: A Systematic Review of Qualitative Research

背景:重症监护室为存在并存疾病的异质患者提供护理。重点已转移到改善与健康相关的生活质量，更多的患者在出院后存活下来。评估随访干预以改善身体恢复的随机对照试验未显示出与健康相关的生活质量益处。定性研究可以提供上下文，以了解重症监护幸存者的经验，在后续护理解决身体限制。背景(5)系统检索电子数据库(MEDLINE、护理与联合健康文献累积索引、Web of Science、应用社会科学索引与摘要、Ovid Nursing和Ovid Emcare)，筛选经同行评议的初步定性研究。没有应用日期参数。纳入/排除标准指导筛选过程。从符合条件的初步研究中提取数据到NVivo (v12)中。方法采用乔安娜·布里格斯批判性评估工具完成批判性评估。以Braun和Clarke(2022)为指导的主题分析为数据综合提供了依据。结果从2457项研究中纳入10项相关研究。确定了两个主要主题:复苏不确定;它概述了重症监护病房幸存者在康复期间所经历的不确定性。该主题涉及系统级因素(医疗保健专业人员的作用和信息提供)，为提供后续护理提供了背景。2. 恢复的自决;概述了决定康复的个体特征，这是由患者层面的因素概念化的(动机、支持网络和健康感知)。结论重症监护幸存者的康复轨迹不确定，出院后急性期的信息提供存在空白。患者对康复的自我决定是一个重要的考虑因素，以确保后续护理解决个别患者的需求。已存在的合并症和从随访护理中获益的患者亚组的影响仍不确定。注册号普洛斯彼罗注册号【摘要】重症监护幸存者院后随访护理改善其身体恢复的患者体验:质性研究的系统回顾

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引用次数: 0

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