British Journal of Community Nursing最新文献

Background: Problem-based learning is a meaningful teaching strategy that contextualises theoretical components into clinical knowledge, with the potential to encourage nurses to think critically and solve problems through integration of theory and practice. Problem-based learning may support community nurses to use their own initiative to develop skills relevant to managing complex real-world situations when providing care in patients' homes.

Aims: This article explores the impact of problem-based learning on the critical thinking skills of community nurses.

Methods: This systematic review used an integrative synthesis approach, combining narrative and thematic analysis to interpret findings across heterogeneous quantitative studies examining the impact of problem-based learning on nurses' critical thinking. Key words were established using a Population, Exposure, Outcome framework. Boolean operators, phrase searching, truncations and wildcards were used for the literature search. Three different databases were used on the EBSCOhost platform, including Academic Search Complete, CINAHL Complete and Medline. Thematic analysis was used to establish themes across the studies and to form an overall impression of the results.

Results: The review identified key areas of development reported after exposure to problem-based learning, including knowledge, attitude, perception, self-efficacy, problem solving, clinical reasoning, evaluation skills, performance and competency, motivation and self-directed learning. Some studies also suggested potential benefits for safe and effective nursing care.

Conclusions: Problem-based learning strategies may have a positive learning effect that supports the development of nurses' critical thinking and clinical decision making. As the included studies were conducted with student nurses in academic settings and findings were mixed, a rigorous review incorporating mixed-method studies in both practice and academic environments, and including qualified community and district nurses, is needed to confirm or refute these findings.

Implications for practice: As problem-based learning may have a positive impact on nurses' critical thinking, there is scope to explore its use as an interactive teaching strategy in practice education, with further research needed to determine its impact on safe and effective nursing care.

Background: Post-mastectomy lymphoedema can lead to limitation in daily activities and have a negative impact on quality of life.

Aim: This study explored the effect of yoga exercise on upper limb lymphoedema volume and quality of life in post-mastectomy patients.

Methods: A total of 112 post-mastectomy patients were recruited for this randomised controlled trial using a purposive sampling method, of whom 96 participants completed the study. Participants were randomly assigned to intervention and control groups. After initial assessments using the volumetric-tank technique and the Lymphedema Life Impact Scale, the intervention group received yoga exercises. Data were analysed using Statistical Package for the Social Sciences software with independent t-test, paired t-test and covariance test.

Results: After the intervention, significant differences were found in upper limb lymphoedema volume and mean scores of the Lymphoedema Life Impact Scale and its physical and functional domains (P<0.05).

Implications for practice: Clinicians and nurses can incorporate blended (in-person and online) yoga programmes into self-management and rehabilitation plans to enhance accessibility and adherence. These findings support allocating resources toward low-cost, adaptable yoga interventions within breast cancer survivorship care pathways.

Conclusions: Yoga was found to be a safe and effective complementary approach for reducing upper limb lymphoedema in early stages and improving wellbeing in post-mastectomy patients without comorbidities. Further research is needed to evaluate its efficacy in other populations, or in advanced stages of lymphoedema.

Introduction: The older population is growing worldwide, which places a significant burden on caregivers. As a result, caregivers of frail older adults are at increased risk of developing depressive symptoms.

Aims: This cross-sectional study explored the role of sociodemographic variables in caregiver burden and depressive symptoms among the caregivers of older adults with frailty syndrome.

Methods: A total of 240 caregivers of older adults with frailty syndrome were assessed using the Zarit Burden Interview-22, and depressive symptoms were assessed using the Centre for Epidemiological Studies Depression scale. The study used stratified convenience sampling to select participants. The data were analysed using Jamovi software 2.6.6.

Results: The mean age of caregivers was 51.5±13.9 years and the majority of caregivers were female (53.3%). Most of the caregivers (220; 91.6%) experienced moderate to severe burden, and mild depressive symptoms were observed in 95 caregivers (39.5%). In the mean percentage of Zarit Burden Interview-22, the highest mean was noted in the personal role strain domain (52.3±6.53). For depressive symptoms, the highest mean score was observed in the depressed affect domain (18.9± 2.12). The highest mean was noted in the personal strain domain (36.6±6.77). A significant relationship was found between frailty syndrome and depressive symptoms (P<0.001). The sociodemographic variables did not yield evidence of relationship with frailty syndrome.

Conclusions: The findings of this study highlight various aspects of caregiver burden and depressive symptoms among caregivers of older adults with frailty syndrome, providing an in-depth understanding of their experiences.

Implications for practice: Routine screening for caregiver burden and depressive symptoms can improve caregiver wellbeing and enhance care for older adults with frailty syndrome.

Malnutrition is a significant and often under-recognised health issue among the ageing population in the UK. As people age, physiological, social and economic factors increase their vulnerability to inadequate nutrition, which in turn impacts their overall health, independence and quality of life. This article explores the multifactorial causes of malnutrition in older adults, reviews screening and assessment tools used in the UK, and discusses evidence-based strategies for prevention and intervention across the NHS and social care settings. Drawing on recent research, the author highlights how clinicians and policymakers must act collaboratively to reduce the burden of malnutrition. By prioritising nutritional care in older adults, the UK can enhance longevity, reduce NHS costs and improve the dignity and wellbeing of older people.

The author discusses the symbolism of Valentine's Day and how it may intensify emotional distress for individuals living with life-limiting or terminal illness, their partners and those experiencing bereavement. The article highlights the importance of recognising the emotional significance of culturally significant events and their potential to reactivate grief responses.

This article discusses the importance of initiating conversations on death and dying, and how community nurses can develop these skills. Having timely end-of-life conversations can have a huge impact on care needs. The authors explore the reasons behind the hesitation to talk about death and dying, and the associated challenges faced by district and community nurses.

Background: Delivering health education and information to people and communities to increase their knowledge is an essential part of shared healthcare decision making. However, not all written materials are easily understood and thus multimedia interventions may be an effective alternative.

Aims: This systematic review aimed to identify quantitative evidence related to the effectiveness of multimedia education tools versus standard of care or written educational materials on adult patients' knowledge and understanding of health information.

Methods: The authors conducted a systematic review following JBI methodological guidance. The Medline, Embase and Emcare databases were searched in February 2024. Some 15 publications were identified for inclusion, 10 with animations and five with videos of people.

Results: The results were synthesised into three topics: (i) the effectiveness of multimedia interventions; (ii) the components of the multimedia interventions; and (iii) health literacy and language. Overall, data from 73.3% (n=11) of the studies indicated that a multimedia approach to information delivery could lead to an increase in knowledge and understanding.

Conclusions: Multimedia interventions can be an effective tool for delivering health information, but special attention is required to health literacy, language barriers and the needs of populations from low- or middle-income countries, particularly where the ability to speak or write English may be limited.

Implications for practice: Community nurses can develop and use multimedia education tools during home visits, group health education sessions, or supporting self-care activities for people with long-term conditions for improved patient outcomes.