Journal of Nursing最新文献

Network meta-analysis (NMA), an increasingly appealing method of statistical analysis, is superior to traditional analysis methods in terms of being able to compare multiple medical treatment methods in one analysis run. In recent years, the prevalence of NMA in the medical literature has increased significantly, while advances in NMA-related statistical methods and software tools continue to improve the effectiveness of this approach. Various commercial and free statistical software packages, some of which employ generative artificial intelligence (GAI) to generate code, have been developed for NMA, leading to numerous innovative developments. In this paper, the use of generative AI for writing R programming language scripts and the netmeta package for performing NMA are introduced. Also, the web-based tool ShinyNMA is introduced. ShinyNMA allows users to conduct NMA using an intuitive "clickable" interface accessible via a standard web browser, with visual charts employed to present results. In the first section, we detail the netmeta package documentation and use ChatGPT (chat generative pre-trained transformer) to write the R scripts necessary to perform NMA with the netmeta package. In the second section, a user interface is developed using the Shiny package to create a ShinyNMA tool. This tool provides a no-code option for users unfamiliar with programming to conduct NMA statistical analysis and plotting. With appropriate prompts, ChatGPT can produce R scripts capable of performing NMA. Using this approach, an NMA analysis tool is developed that meets the research objectives, and potential applications are demonstrated using sample data. Using generative AI and existing statistical packages or no-code tools is expected to make conducting NMA analysis significantly easier for researchers. Moreover, greater access to results generated by NMA analyses will enable decision-makers to review analysis results intuitively in real-time, enhancing the importance of statistical analysis in medical decision-making. Furthermore, enabling non-specialists to conduct clinically meaningful systematic reviews may be expected to sustainably improve analytical capabilities and produce higher-quality evidence.

Healthcare systems must embody equity, diversity, and inclusion (EDI) and, in the event of unfairness, appropriate policies / countermeasures should be enacted. The healthcare system response to the COVID-19 pandemic not only highlighted how socioeconomic disparities affect mortality risk but also posed significant challenges to the successful practice of EDI in healthcare. In light of this, this article was written to provide an overview of EDI, analyze the international efforts to promote it, and suggest strategies for promoting EDI in infectious disease healthcare using COVID-19 as an example. In healthcare settings, equity centers on ensuring patients receive fair treatment regardless of race, gender, age, or socioeconomic status; diversity centers on healthcare providers understanding the uniqueness of patients from different cultural backgrounds and the health barriers they face; and inclusion centers on ensuring patients are treated with respect and given the attention they deserve. During pandemics, social determinants of health (SDOH) greatly impact patient health outcomes and hinder the practice of EDI. Reflecting on the impact of COVID-19, healthcare systems can actively apply EDI in clinical practice to provide to all patients equitable access to healthcare opportunities and outcomes. Practical strategies include establishing EDI committees within healthcare systems, monitoring relevant data, conducting staff training, and continuously addressing the SDOH and needs of marginalized groups to achieve EDI in healthcare.

Due to their underdeveloped physiological maturity, preterm infants often face challenges related to sucking, breathing, and swallowing coordination during initial feeding. This lack of coordination may lead to episodes of apnea and choking, resulting in unstable vital signs. Preterm infants with this issue must gradually learn oral feeding skills appropriate to their developmental stage. Registered nurses play a critical role in assessing the right time to transition from tube to oral feeding and in providing a safe and positive oral feeding experience. In this article, three validated assessment tools for feeding premature infants are introduced, accompanied by clinical research data demonstrating their use in clinical practice. These three tools include: (1) the Neonatal Oral Motor Assessment Scale, which is applied to evaluate oral motor skills using observations of nonnutritive sucking and the sucking state during the two minutes before feeding; (2) the Premature Oral Feeding Readiness Assessment Scale, which is used to assess readiness for oral feeding in preterm infants; and (3) the Early Feeding Skills assessment, which is used to evaluate the oral feeding skills of preterm infants. These tools aid nurses in helping preterm infants achieve independent oral feeding, facilitating earlier discharge and return to home. The clinical implications and effectiveness of these tools are also discussed to provide to nurses the means and confidence necessary to apply them appropriately in clinical settings.

In recent years, the rapid development of artificial intelligence has enhanced the efficiency of medical services, accuracy of disease prediction, and innovation in the healthcare industry. Among the many advances, machine learning has become a focal point of development in various fields. Although its use in nursing research and clinical care has been limited, technological progress promises broader applications of machine learning in these areas in the future. In this paper, the authors discuss the application of machine learning in nursing research and care. First, the types and classifications of machine learning are introduced. Next, common neural machine learning models, including recurrent neural networks, transformers, and natural language processing, are described and analyzed. Subsequently, the principles and steps of machine learning are explored and compared to traditional statistical methods, highlighting the quality-monitoring strategies used by machine learning models and the potential limitations and challenges of using machine learning. Finally, interdisciplinary collaboration is encouraged to share knowledge between information technology and nursing disciplines, analyze the advantages and disadvantages of various analytical models, continuously review the research process, and reflect on methodological limitations. Following this course, can help maximize the potential of artificial-intelligence-based technologies to drive innovation and progress in nursing research.

Background: Concurrent with population ageing, falls have become a significantly more challenging public health issue among older adults. Three years of data collected recently from a nursing home in northern Taiwan reveals an increasing trend in fall density that is primarily associated with aging, physiological decline, chronic diseases, polypharmacy, osteoporosis, and lack of exercise. The percentage of nursing home residents at high risk of falls is currently at 12.6%, and the fall rate has been reported as reaching as high as 30% annually.

Purpose: A fall prevention program was implemented to reduce the fall incidence rate to 18%, with secondary goals of improving fall prevention awareness, behavior, self-efficacy, lower limb muscle strength, balance, and gait by 10% on average, respectively, between pre-test and post-test.

Resolution: From September 30, 2023 to February 29, 2024, a health promotion activity and fall prevention exercise course were implemented using an interdisciplinary team collaboration model over a six-week period, providing individualized exercise for the participants.

Results: The study included 20 older adults with an average age of 88 years. Most (90%; n = 18) had chronic diseases, 25% (n = 5) were on more than nine medications, 70% (n = 14) had reduced bone mass, and 40% (n = 8) were at high risk of falls, with a fall incidence rate of 30% during the immediately preceding year. Post-intervention, the fall incidence rate dropped to 5%, fall prevention awareness, behavior, and self-efficacy increased by 18.3%, and lower limb muscle strength, balance, and gait improved by 11.7%. The post-test results in fall prevention awareness, behavioral changes, self-efficacy, and lower limb strength, balance, and gait were all significantly better than pre-test results, with all results achieving statistical significance.

Conclusions: The project results support the positive effects of the developed intervention effectively on elderly physical fitness and fall risk, providing valuable insights for the implementation of fall prevention strategies in nursing homes.

With fertility rates at an all-time low, children have become even more the 'treasures' of their families. Progress in genetic selection technology has made preimplantation genetic diagnosis an increasingly common practice in clinics. However, the practice of purposively selecting genes for future children remains controversial. In this article, the process of preimplantation genetic diagnosis is introduced and related philosophical and social perspectives are reviewed. Finally, the ethics related to this practice are discussed in the contexts of obligation theory, utility theory, and four ethical principles. The authors hope this article sheds light on the diverse perspectives used to consider and discuss the ethical issues surrounding gene selection and, importantly, helps nurses provide care grounded in ethics and humanity in ethically uncertain circumstances.

Game-based teaching strategies enrich nursing education by enhancing the appeal and practicality of teaching activities. Different from the high-pressure and serious nature of traditional nursing education, interactive and entertaining teaching strategies that employ board games, card games, escape rooms, virtual reality, scratch cards, Kahoot quiz competitions, and other innovative methods better motivate learners to engage actively with learning content and retain nursing knowledge and practices, resulting in better learning outcomes. Game-based teaching strategies not only strengthen learners' mastery of core nursing concepts but also enhance their decision-making and critical-thinking abilities. In this article, practical applications of game-based teaching are introduced, in hopes that, by applying these instructional approaches, educators can alleviate the stress of the learning process and make learning more efficient and enjoyable for students.

To excel in their work, nurses must have specialized tools to support their tasks and professional development. Games, as a crucial pathway to achieving nursing education and clinical training goals, demonstrate significant potential and application value, making them an innovative product. Nursing education games come in various forms, including virtual reality, augmented reality, tabletop, and digital, and may be designed as needed for individual, two-player, or team play (Avşar et al., 2023; Bermejo et al., 2023; Tsai et al., 2024). These games, beyond their entertainment value, have clear educational objectives embedded in their design. Through levels, challenging tasks, and reward mechanisms, they stimulate learning enjoyment and promote nursing development. In this column, experts and scholars in the field of nursing engaged in game development share their experiences and achievements. Integrating games into nursing delivers a wealth of tools and resources for nursing education and clinical practice, offering immersive learning experiences, instant feedback, and individualized learning paths. For nursing students, gamified products offer safe and risk-free learning environments in which they can practice critical tasks and make decisions in simulated medical scenarios, increasing their clinical experience and confidence and enhancing their clinical judgment and decision-making skills (Wu et al., 2023). For patients, many therapeutic games have already been designed that use gameplay to improve health by facilitating user engagement in rehabilitation exercises, promoting healthy eating, and fostering social interactivity (Tsai et al., 2024). For nurses, various games are being used to promote continuous professional growth in an interactive and enjoyable learning environment, improving overall quality of care and job satisfaction (Hsieh et al., 2023). In summary, the application of game products in nursing education and clinical training has introduced new learning and training models that provide multifaceted benefits for nurses, nursing students, and patients. We hope that readers will gain a deeper understanding of related game products after reading this column and use games effectively to enhance nursing quality.

The effectiveness of game-based learning strategies lies in the ability of these strategies to engage learners and enhance their motivation to learn. This is particularly important for today's younger generations, which are known to respond better to visual rather than textual information. Gamified education provides stimulating, realistic, and enjoyable learning experiences, helping students understand complex nursing knowledge and skills. The diversity of game-based learning tools, including based board games, escape room games, digital games, simulation games, mobile serious games, and virtual reality games, not only enhances students' learning effectiveness and skills but also improves their problem-solving abilities, communication skills, and ability to cope with various challenges in clinical care. In general, game-based learning is a strategy with great potential and importance. This strategy not only has profound implications for modern nursing education and clinical practice but also, through its promotion of innovative thinking and diversified applications, can effectively promote the learning motivation of nursing professionals, improve teaching effectiveness, and enhance professional abilities and self-directed learning capabilities. In an era in which medical knowledge is constantly evolving, game-based learning should be promoted and utilized to cultivate nursing professionals' capabilities effectively.