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Nursing leadership: Key element of professional development 护理领导力:专业发展的关键要素
IF 3.8 3区 医学 Q1 NURSING Pub Date : 2024-01-01 DOI: 10.1016/j.ijnss.2023.12.015
Xiaoying Jiang
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引用次数: 0
Identification and information management of cognitive impairment of patients in acute care hospitals: An integrative review 急症医院患者认知障碍的识别和信息管理:综合评述
IF 3.8 3区 医学 Q1 NURSING Pub Date : 2024-01-01 DOI: 10.1016/j.ijnss.2023.11.001
Beibei Xiong , Daniel X. Bailey , Paul Prudon , Elaine M. Pascoe , Leonard C. Gray , Frederick Graham , Amanda Henderson , Melinda Martin-Khan

Objectives

Recognition of the cognitive status of patients is important so that care can be tailored accordingly. The objective of this integrative review was to report on the current practices that acute care hospitals use to identify people with cognitive impairment and how information about cognition is managed within the healthcare record as well as the approaches required and recommended by policies.

Methods

Following Whittemore & Knafl’s five-step method, we systematically searched Medline, CINAHL, and Scopus databases and various grey literature sources. Articles relevant to the programs that have been implemented in acute care hospitals regarding the identification of cognitive impairment and management of cognition information were included. The Mixed Methods Appraisal Tool and AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) Checklist were used to evaluate the quality of the studies. Thematic analysis was used to present and synthesise results. This review was pre-registered on PROSPERO ( CRD42022343577).

Results

Twenty-two primary studies and ten government/industry publications were included in the analysis. Findings included gaps between practice and policy. Although identification of cognitive impairment, transparency of cognition information, and interaction with patients, families, and carers (if appropriate) about this condition were highly valued at a policy level, sometimes in practice, cognitive assessments were informal, patient cognition information was not recorded, and interactions with patients, families, and carers were lacking.

Discussion

By incorporating cognitive assessment, developing an integrated information management system using information technology, establishing relevant laws and regulations, providing education and training, and adopting a national approach, significant improvements can be made in the care provided to individuals with cognitive impairment.

目的识别患者的认知状况非常重要,这样才能为患者提供相应的护理。本综合综述旨在报告急症护理医院目前用于识别认知障碍患者的方法、如何在医疗记录中管理认知信息以及政策要求和建议的方法。方法按照 Whittemore & Knafl 的五步法,我们系统地检索了 Medline、CINAHL 和 Scopus 数据库以及各种灰色文献来源。我们纳入了与急症护理医院实施的认知障碍识别和认知信息管理计划相关的文章。采用混合方法评估工具(Mixed Methods Appraisal Tool)和 AACODS(权威性、准确性、覆盖性、客观性、日期、重要性)核对表对研究质量进行评估。采用主题分析法呈现和综合结果。本综述已在 PROSPERO(CRD42022343577)上进行了预先登记。研究结果包括实践与政策之间的差距。讨论通过纳入认知评估、利用信息技术开发综合信息管理系统、制定相关法律法规、提供教育和培训以及采用全国性方法,可以显著改善为认知障碍患者提供的护理。
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引用次数: 0
Symptoms and symptom clusters in patients with hepatocellular carcinoma and commonly used instruments: An integrated review 肝细胞癌患者的症状和症状群及常用工具:综合评述
IF 3.8 3区 医学 Q1 NURSING Pub Date : 2024-01-01 DOI: 10.1016/j.ijnss.2023.09.009
Thitiporn Pathomjaruwat , Yaowarat Matchim , Jane M. Armer

Objective

This study aimed to synthesize the available knowledge of identifying hepatocellular carcinoma (HCC) symptoms and symptom clusters in patients with HCC and instruments used for these assessments to maximize symptom management.

Methods

Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in five databases (PubMed, ScienceDirect, Scopus, CINAHL, and ThaiJO). The retrieved articles were limited to those which were peer-reviewed, published between 2005 and 2022, and had English abstracts. All of identified studies were screened, extracted, and analyzed independently by two researchers.

Result

Fourteen articles were included in this review. They were grouped into three themes: symptoms, symptom assessment, and symptom clusters of HCC patients. Fatigue, lack of energy, stomach or abdominal pain/distension, loss of appetite, change in taste, sleep disturbance, distress, and sadness are the most prevalent symptoms reported in HCC patients. The different concurrent symptoms are related to the stage and treatment. Five types of symptom assessment instruments were commonly used (symptoms-specific HCC, general cancer symptom, measuring non-symptom constructs, measuring specific symptoms, such as fatigue, sleep disturbance, anxiety, and depression, and symptom assessment with clinical examination). Furthermore, the symptom clusters in HCC patients were classified into five categories: 1) pain-related symptoms, 2) gastrointestinal symptoms, 3) neuropsychological symptom clusters and sensory symptoms, 4) liver dysfunction-related symptom clusters, and 5) others (including sickness symptom clusters, fatigue clusters, location pain symptoms, and asymptomatic or symptomatic).

Conclusion

The findings of this review add to the body of knowledge on symptoms, symptom assessment, and symptom clusters in patients with HCC. Despite a variety of instruments being available, none covers all symptoms experienced by HCC patients. It is recommended that future studies should include larger and more homogenous samples to evaluate assessment instruments more precisely, avoid ambiguity in classifying symptoms into symptom clusters, and increase the effectiveness of symptom management.

本研究旨在综合现有知识,识别 HCC 患者的肝细胞癌(HCC)症状和症状群,以及用于这些评估的工具,以最大限度地改善症状管理。方法采用 Whittemore 和 Knafl 的综合综述法,在五个数据库(PubMed、ScienceDirect、Scopus、CINAHL 和 ThaiJO)中对文献进行系统检索。检索到的文章仅限于经过同行评审、发表于 2005 年至 2022 年之间、有英文摘要的文章。本综述共收录了 14 篇文章。这些文章被分为三个主题:HCC 患者的症状、症状评估和症状群。疲劳、乏力、胃痛或腹痛/腹胀、食欲不振、味觉改变、睡眠障碍、苦恼和悲伤是 HCC 患者最常见的症状。不同的并发症状与阶段和治疗方法有关。常用的症状评估工具有五种(针对特定症状的 HCC、一般癌症症状、测量非症状结构、测量特定症状(如疲劳、睡眠障碍、焦虑和抑郁)以及结合临床检查的症状评估)。此外,HCC 患者的症状群被分为五类:1) 疼痛相关症状;2) 胃肠道症状;3) 神经心理症状群和感觉症状;4) 肝功能异常相关症状群;5) 其他(包括疾病症状群、疲劳症状群、位置疼痛症状、无症状或有症状)。尽管有多种工具可供使用,但没有一种工具能涵盖 HCC 患者的所有症状。建议今后的研究应纳入更大、更同质的样本,以便更精确地评估评估工具,避免在将症状分类为症状群时出现歧义,并提高症状管理的有效性。
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引用次数: 0
The prevalence and factors associated with sarcopenia in Thai older adults: A systematic review and meta-analysis 泰国老年人肌肉疏松症的患病率及相关因素:系统回顾与荟萃分析
IF 3.8 3区 医学 Q1 NURSING Pub Date : 2024-01-01 DOI: 10.1016/j.ijnss.2023.11.002
Phatcharaphon Whaikid, Noppawan Piaseu

Objective

This systematic review and meta-analysis aimed to assess the prevalence and identify factors associated with sarcopenia in older Thais.

Methods

Research studies were searched in online databases, including PubMed, Embase, Scopus, and Thai-Journal Citation Index. The articles included in this review were limited to being published between January 1, 2013 and January 31, 2023 and observational study designs. The research quality was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tool for prevalence studies. A meta-analysis was performed using the JBI SUMARI software. The review protocol has been registered on PROSPERO with the assigned ID CRD42023420514.

Results

A total of 265 research articles were initially identified, out of which 17 articles were included in this study, including a total of 4,668 participants aged 60 years and over, consisting of 1,380 (29.6%) men and 3,288 (70.4%) women. The overall prevalence of sarcopenia in Thai older adults was 20.7% (95% CI 14.4%–27.8%). Subgroup analysis of the sarcopenia prevalence based on the study areas revealed that the prevalence was 33.4% (95% CI 28.7%–38.3%) in hospitalized individuals, 23.2% (95% CI 12.5%–35.9%) in outpatient clinic settings, and 17.3% (95% CI 9.4%–26.8%) in community-living older adults. Advanced age (OR = 4.60, 95% CI 3.07–6.91), being male (OR = 2.30, 95% CI 1.37–3.85), low body mass index (BMI) (OR = 8.95, 95% CI 6.05–13.25), and malnutrition (OR = 2.78, 95% CI 2.09–3.70) are strong predictors of sarcopenia in older adults in Thailand.

Conclusions

This systematic review represents the first assessment of the overall prevalence and factors associated with sarcopenia in Thai older adults, indicating its significant concern within this population. These findings are of importance for public health management aimed at preventing and managing sarcopenia in the country.

目的 本系统综述和荟萃分析旨在评估泰国老年人肌肉疏松症的患病率,并确定与之相关的因素。 方法 在在线数据库(包括 PubMed、Embase、Scopus 和 Thai-Journal Citation Index)中搜索研究。纳入本综述的文章仅限于在 2013 年 1 月 1 日至 2023 年 1 月 31 日期间发表,且采用观察性研究设计。研究质量采用乔安娜-布里格斯研究所(JBI)的流行病学关键评估工具进行评估。使用 JBI SUMARI 软件进行了荟萃分析。本研究共收录了 4,668 名 60 岁及以上的参与者,其中男性 1,380 人(29.6%),女性 3,288 人(70.4%)。泰国老年人肌肉疏松症的总体发病率为 20.7%(95% CI 14.4%-27.8%)。根据研究地区对肌肉疏松症患病率进行的分组分析显示,住院患者的患病率为 33.4%(95% CI 28.7%-38.3%),门诊患者的患病率为 23.2%(95% CI 12.5%-35.9%),而社区生活的老年人的患病率为 17.3%(95% CI 9.4%-26.8%)。高龄(OR = 4.60,95% CI 3.07-6.91)、男性(OR = 2.30,95% CI 1.37-3.85)、低体重指数(BMI)(OR = 8.95,95% CI 6.05-13.25)和营养不良(OR = 2.78,95% CI 2.09-3.70)是预测泰国老年人肌肉疏松症的重要因素。结论 这篇系统性综述首次评估了泰国老年人肌肉疏松症的总体患病率和相关因素,表明了这一问题在泰国老年人群中的严重性。这些发现对泰国预防和管理肌肉疏松症的公共卫生管理具有重要意义。
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引用次数: 0
The effect of intelligent management interventions in intensive care units to reduce false alarms: An integrative review 重症监护病房智能管理干预对减少误报的影响:综述
IF 3.8 3区 医学 Q1 NURSING Pub Date : 2024-01-01 DOI: 10.1016/j.ijnss.2023.12.008
Bingyu Li , Liqing Yue , Huiyu Nie , Ziwei Cao , Xiaoya Chai , Bin Peng , Tiange Zhang , Weihong Huang

Objective

In intensive care units (ICU), frequent false alarms from medical equipment can cause alarm fatigue among nurses, which might lead to delayed or missed responses and increased risk of adverse patient events. This review was conducted to evaluate the effectiveness of intelligent management interventions to reduce false alarms in ICU.

Method

Following the framework of Whitmore and Knafl, the reviewers systematically searched six databases: PubMed, EMBASE, CINAHL, OVID, Cochrane Library, and Scopus, and studies included intelligent management of clinical alarms published in the English or Chinese language from the inception of each database to December 2022 were retrieved. The researchers used the PICOS framework to formulate the search strategy, developed keywords, screened literature, and assessed the studies’ quality using the Joanna Briggs Institute-Meta-Analysis of Statistics, Assessment, and Review Instrument (JBI-MAStARI). The review was preregistered on PROSPERO (CRD42023411552).

Results

Seven studies met the inclusion criteria. The results showed that different interventions for intelligent management of alarms were beneficial in reducing the number of false alarms, the duration of alarms, the response time to important alarms for nurses, and the alarm fatigue levels among nurses. Positive results were found in practice after the application of the novel alarm management approaches.

Conclusion

Intelligent management intervention may be an effective way to reduce false alarms. The application of systems or tools for the intelligent management of clinical alarms is urgent in hospitals. To ensure more effective patient monitoring and less distress for nurses, more alarm management approaches combined with artificial intelligence will be needed in the future to enable accurate identification of critical alarms, ensure nurses are responding accurately to alarms, and make a real difference to alarm-ridden healthcare environments.

目的在重症监护病房(ICU)中,医疗设备频繁发出错误警报可能会引起护士的警报疲劳,从而可能导致延迟或错过反应,增加患者不良事件的风险。本综述旨在评估智能管理干预措施对减少重症监护室误报的有效性。方法按照 Whitmore 和 Knafl 的框架,综述者系统地检索了六个数据库:方法按照 Whitmore 和 Knafl 的框架,审稿人系统地检索了 PubMed、EMBASE、CINAHL、OVID、Cochrane Library 和 Scopus 六个数据库,检索了自各数据库建立至 2022 年 12 月期间以英文或中文发表的包括临床警报智能管理的研究。研究人员使用 PICOS 框架制定检索策略、开发关键词、筛选文献,并使用 Joanna Briggs Institute-Meta-Analysis of Statistics, Assessment, and Review Instrument(JBI-MAStARI)评估研究质量。结果有七项研究符合纳入标准。结果表明,对警报进行智能管理的不同干预措施有利于减少误报次数、警报持续时间、护士对重要警报的响应时间以及护士的警报疲劳程度。结论智能管理干预可能是减少误报的有效方法。医院急需应用系统或工具对临床警报进行智能管理。为了确保更有效地监护病人,减少护士的痛苦,未来需要更多与人工智能相结合的警报管理方法,以准确识别关键警报,确保护士对警报做出准确反应,并真正改善警报频发的医疗环境。
{"title":"The effect of intelligent management interventions in intensive care units to reduce false alarms: An integrative review","authors":"Bingyu Li ,&nbsp;Liqing Yue ,&nbsp;Huiyu Nie ,&nbsp;Ziwei Cao ,&nbsp;Xiaoya Chai ,&nbsp;Bin Peng ,&nbsp;Tiange Zhang ,&nbsp;Weihong Huang","doi":"10.1016/j.ijnss.2023.12.008","DOIUrl":"10.1016/j.ijnss.2023.12.008","url":null,"abstract":"<div><h3>Objective</h3><p>In intensive care units (ICU), frequent false alarms from medical equipment can cause alarm fatigue among nurses, which might lead to delayed or missed responses and increased risk of adverse patient events. This review was conducted to evaluate the effectiveness of intelligent management interventions to reduce false alarms in ICU.</p></div><div><h3>Method</h3><p>Following the framework of Whitmore and Knafl, the reviewers systematically searched six databases: PubMed, EMBASE, CINAHL, OVID, Cochrane Library, and Scopus, and studies included intelligent management of clinical alarms published in the English or Chinese language from the inception of each database to December 2022 were retrieved. The researchers used the PICOS framework to formulate the search strategy, developed keywords, screened literature, and assessed the studies’ quality using the Joanna Briggs Institute-Meta-Analysis of Statistics, Assessment, and Review Instrument (JBI-MAStARI). The review was preregistered on PROSPERO (CRD42023411552).</p></div><div><h3>Results</h3><p>Seven studies met the inclusion criteria. The results showed that different interventions for intelligent management of alarms were beneficial in reducing the number of false alarms, the duration of alarms, the response time to important alarms for nurses, and the alarm fatigue levels among nurses. Positive results were found in practice after the application of the novel alarm management approaches.</p></div><div><h3>Conclusion</h3><p>Intelligent management intervention may be an effective way to reduce false alarms. The application of systems or tools for the intelligent management of clinical alarms is urgent in hospitals. To ensure more effective patient monitoring and less distress for nurses, more alarm management approaches combined with artificial intelligence will be needed in the future to enable accurate identification of critical alarms, ensure nurses are responding accurately to alarms, and make a real difference to alarm-ridden healthcare environments.</p></div>","PeriodicalId":37848,"journal":{"name":"International Journal of Nursing Sciences","volume":"11 1","pages":"Pages 133-142"},"PeriodicalIF":3.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352013223001503/pdfft?md5=b7f8f52b93e47bd9e723231a0d12061a&pid=1-s2.0-S2352013223001503-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139017806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Air quality self-management in asthmatic patients with COPD: An integrative review for developing nursing interventions to prevent exacerbations 慢性阻塞性肺病哮喘患者的空气质量自我管理:为制定预防病情恶化的护理干预措施而进行的综合评述
IF 3.8 3区 医学 Q1 NURSING Pub Date : 2024-01-01 DOI: 10.1016/j.ijnss.2023.12.003
Bruna F. Sebastião , Raquel M. Hortelão , Sara S. Granadas , José M. Faria , Joana R. Pinto , Helga Rafael Henriques

Objectives

Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) patients experience a lower quality of life, frequent exacerbations, and worse pulmonary function. Environmental management is essential in a complex chronic condition, as pollutant exposure can worsen symptoms and increase morbidity and mortality. We aimed to identify evidence that informs nursing interventions in promoting self-management of air quality in asthmatic people with COPD.

Methods

We conducted an integrative review in March of 2023. We searched the databases CINAHL, MEDLINE, Academic Search Complete, Cochrane Database of Systematic Reviews (CDSR), Scopus, Web of Science, Joanna Briggs Institute (JBI) Evidence-Based Practice Database, and Google Scholar. We included articles whose participants were adults with asthma, COPD, or both; the intervention was air quality management and the outcome of any exacerbations. We excluded editorials, letters, commentaries, opinion papers, position papers, study protocols, conference abstracts, and reviews. Data extraction and synthesis were performed, categorizing interventions according to nursing actions. Methodological quality assessment was conducted using the JBI Critical Appraisal Checklist tools. The review protocol was registered at Open Science Framework (https://doi.org/10.17605/OSF.IO/5Y4KW).

Results

We included five articles from different countries. The interventions promoting air quality self-management for individuals with asthma and COPD included vigilance interventions (health professional regular visits, assessment of symptoms), monitoring interventions (measurement of indoor and outdoor trigger factors), and educational interventions (air quality alerts, allergen avoidance). Policy interventions such as smoke-free policies and comprehensive strategies to improve air quality were also identified. These areas of focus represent critical components of nurses’ interventions and can integrate the fundamental patterns of knowing in nursing. Although the studies reveal heterogeneous interventions and the methodological quality is variable, these interventions showed potential for preventing exacerbations, reducing emergency department visits, and minimizing hospitalizations.

Conclusions

The study emphasizes the need for a comprehensive approach involving nurses in multidisciplinary teams to air quality self-management. They can use these results to inform their interventions and ways of knowing, benefiting individuals with asthma and COPD. Further research is needed to expand the evidence base and refine these interventions.

目标哮喘-慢性阻塞性肺病(COPD)重叠(ACO)患者的生活质量较低、病情经常加重、肺功能较差。环境管理对于这种复杂的慢性疾病至关重要,因为接触污染物会加重症状并增加发病率和死亡率。我们旨在找出相关证据,为促进慢性阻塞性肺病哮喘患者自我管理空气质量的护理干预措施提供依据。我们检索了 CINAHL、MEDLINE、Academic Search Complete、Cochrane Database of Systematic Reviews (CDSR)、Scopus、Web of Science、Joanna Briggs Institute (JBI) Evidence-Based Practice Database 和 Google Scholar 等数据库。我们收录的文章的参与者为患有哮喘、慢性阻塞性肺病或两者兼有的成年人;干预措施为空气质量管理,结果为任何病情加重。我们排除了社论、信件、评论、观点文件、立场文件、研究方案、会议摘要和综述。我们对数据进行了提取和综合,并根据护理措施对干预措施进行了分类。采用 JBI 批判性评估清单工具进行方法学质量评估。综述协议已在开放科学框架(https://doi.org/10.17605/OSF.IO/5Y4KW)上注册。结果我们纳入了来自不同国家的五篇文章。促进哮喘和慢性阻塞性肺病患者进行空气质量自我管理的干预措施包括警惕性干预措施(卫生专业人员定期访问、症状评估)、监测干预措施(测量室内外触发因素)和教育干预措施(空气质量警报、过敏原避免)。此外,还确定了政策干预措施,如无烟政策和改善空气质量的综合战略。这些重点领域代表了护士干预措施的关键组成部分,可以整合护理知识的基本模式。尽管这些研究揭示了不同的干预措施,方法质量也参差不齐,但这些干预措施在预防病情恶化、减少急诊就诊和最大限度地减少住院治疗方面显示出了潜力。他们可以利用这些结果来指导他们的干预措施和认知方式,从而使哮喘和慢性阻塞性肺病患者受益。需要进一步开展研究,以扩大证据基础并完善这些干预措施。
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引用次数: 0
Attitudes of the public and medical professionals toward nurse prescribing: A text-mining study based on social medias 公众和医务人员对护士开处方的态度:基于社交媒体的文本挖掘研究
IF 3.8 3区 医学 Q1 NURSING Pub Date : 2024-01-01 DOI: 10.1016/j.ijnss.2023.12.005
Qi Zhou , Yiqing Xu , Lili Yang , Rashid Menhas

Objectives

This study aimed to explore the public and medical professionals’ concerns and attitudes toward nurse prescribing using text-mining method to analyze social media data.

Methods

Python was used to automatically mine data related to the keywords “nurse prescribing” and “prescription” that were posted on four Chinese internet platforms between January 1, 2017, and November 1, 2022. The four Chinese internet platforms included social media sites such as Zhihu and Weibo, as well as medical forums like Aiaiyi Medical Hotspot and Dingxiangyuan Medicine. We conducted personnel, topic, and sentiment analysis techniques using SnowNLP, Bayesian Latent Dirichlet Allocation (LDA), and BosonNLP. Finally, we conducted content analysis using Nvivo 11 based on the results of the topic and sentiment analysis to obtain comprehensive and insightful results.

Results

We acquired 2,823 comments totaling 92,859 words on the four Internet platforms to conduct analysis. The analyze result showed that many public and medical professionals held a negative attitude toward nurse prescribing, and few had a prudent positive attitude. The public is concerned about the impact of nurse prescribing on medical professionals and the competency requirements for nurses. Medical professionals are concerned about the current and future status of nurse prescribing in China and the difficulties in implementing nurse prescribing.

Conclusion

Nurses should gradually gain recognition for their expertise and win the acceptance of the public and medical professionals on their ability of nursing prescribing by striving to enhance their professional capacity and self-authorization capabilities. Nurse administrators and educators need to recognize the advantages of nurse prescribing and address the challenges and issues in its implementation through promoting legislation, education, and heightening public awareness of its benefits.

方法 使用Python自动挖掘2017年1月1日至2022年11月1日期间在中国四个互联网平台上发布的与关键词 "护士开处方 "和 "处方 "相关的数据。这四个中文互联网平台包括知乎、微博等社交媒体网站,以及爱医热点、丁香园医学等医学论坛。我们使用 SnowNLP、贝叶斯潜在 Dirichlet 分配(LDA)和 BosonNLP 进行了人员、主题和情感分析。最后,我们根据主题分析和情感分析的结果,使用 Nvivo 11 进行了内容分析,得出了全面而深刻的结果。分析结果显示,许多公众和医务人员对护士开处方持否定态度,持审慎积极态度的人很少。公众担心护士开处方对医务人员的影响以及对护士能力的要求。结论护士应通过努力提高自身的专业能力和自我授权能力,逐步获得专业知识的认可,赢得公众和医务人员对其护理处方能力的认同。护士管理者和教育者需要认识到护士处方的优势,并通过促进立法、教育和提高公众对其益处的认识来应对其实施过程中的挑战和问题。
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引用次数: 0
Competencies of the nurses in the limitation of therapeutic effort in the intensive care unit: An integrative review 重症监护室护士在限制治疗努力方面的能力:综合评述
IF 3.8 3区 医学 Q1 NURSING Pub Date : 2024-01-01 DOI: 10.1016/j.ijnss.2023.12.011
Elvia R. López-Panza , Vanessa C. Pacheco-Roys , Kelly J. Fernández-Ahumada , Diana C. Díaz-Mass , María Y. Expósito-Concepción , Elizabeth Villarreal-Cantillo , Cesar I. Aviles Gonzalez

Objective

Nurses inevitably encounter patients who require care aimed at limiting therapeutic effort (LTE), even though many of them are not prepared to provide support to individuals with terminal illnesses and their families. One of the contexts in which the LTE is considered is the intensive care unit (ICU). This review is to describe the competencies for the execution of a nursing professional role in the LTE in the ICU.

Method

An integrative review of the literature published between the years 2010 and 2023. The search was carried out in five databases: Medline, Wiley Online Library, SciELO, ScienceDirect, and Web of Science. The Critical Appraisal Skills Programme in Spanish was used as the template for study evaluation. The methodology of the Oxford Center for Evidence-Based Medicine (CEBM) was used to assess the level of evidence and the degree of recommendation.

Result

A total of 25 articles in a wide range of studies were included. The findings suggest that the competencies for LTE in the ICU are direct patient care, family-centered care, and the role of the nurse within the team. However, more high-quality studies are needed to confirm these conclusions. Three categories were identified: (a) competencies as defender agent between the patient, his family, and the interdisciplinary team; (b) competencies for decision-making in limiting the therapeutic effort; and (c) competencies for nursing therapeutic interventions at the end of life.

Conclusion

The competencies of the nursing professionals who work in the adult ICU in the LTE are essential to the patient’s quality of life, dignity of their death, and comprehensive family support for coping with grief.

目的护士不可避免地会遇到需要以限制治疗努力(LTE)为目的的护理的病人,尽管他们中的许多人还没有准备好为身患绝症的病人及其家属提供支持。重症监护室(ICU)是考虑限制治疗努力的环境之一。本综述旨在描述在重症监护室中执行LTE护理专业角色的能力。在五个数据库中进行了检索:Medline、Wiley Online Library、SciELO、ScienceDirect 和 Web of Science。研究评估以西班牙语的 "批判性评估技能计划 "为模板。采用牛津循证医学中心(CEBM)的方法评估证据水平和推荐程度。研究结果表明,重症监护室中LTE的能力包括直接护理病人、以家庭为中心的护理以及护士在团队中的角色。然而,还需要更多高质量的研究来证实这些结论。确定了三个类别:(a) 作为病人、家属和跨学科团队之间的维护者的能力;(b) 限制治疗努力的决策能力;(c) 生命末期护理治疗干预的能力。
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引用次数: 0
Thanks to our reviewers in 2023 感谢 2023 年的审查员
IF 3.8 3区 医学 Q1 NURSING Pub Date : 2024-01-01 DOI: 10.1016/S2352-0132(24)00017-6
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引用次数: 0
Associations among frailty status, hypertension, and fall risk in community-dwelling older adults 社区老年人体弱状况、高血压和跌倒风险之间的关系
IF 3.8 3区 医学 Q1 NURSING Pub Date : 2024-01-01 DOI: 10.1016/j.ijnss.2023.12.010
Liping Teng , Danhui Wang , Zhou Zhou , Jun Sun , Min Zhu , Renrong Wang

Objectives

Frailty and hypertension often coexist in older adults, which may lead to fall risks. This study aimed to examine the relationship between frailty status, hypertension, and fall risk.

Methods

In this cross-sectional study, a total of 401 older adults were conveniently recruited from communities in Wuxi, China, between September 2022 and November 2022. The fall risk self-assessment checklist from the Stopping Elderly Accidents, Deaths & Injuries (STEADI) Toolkit was used to evaluate their fall risks. The FRAIL scale questionnaire was used to assess frailty status. Participants’ demographic information and comorbidities were collected. Multivariate logistic regression, generalized additive model, and smooth curve fitting were used to analyze the association between frailty, hypertension, and fall risk.

Results

Frailty had a strong association with increased prevalence of fall risk among the participants (OR 8.52, 95% CI 3.21–22.57; P < 0.001). Hypertension significantly increased the fall risk among older adults (OR 1.87, 95% CI 1.11–3.13; P = 0.019). The group with hypertension and frailty had the highest prevalence of fall risk (OR 12.24, 95% CI 3.51–42.65). Smooth curve fitting showed a nonlinear association between frailty and fall risk in hypertension status. In the progress of pre-frailty to frailty status, a higher tendency to fall was found among older adults with hypertension.

Conclusions

Frailty status and hypertension independently and jointly influenced the increased prevalence of fall risk. Enhanced frailty and hypertension management may help decrease fall risk among this population.

目的 老年人体弱和高血压常常同时存在,这可能会导致跌倒风险。本研究旨在探讨虚弱状态、高血压和跌倒风险之间的关系。方法在这项横断面研究中,我们于 2022 年 9 月至 2022 年 11 月期间在无锡的社区招募了 401 名老年人。研究采用 "制止老年人意外事故、死亡和伤害(STEADI)工具包 "中的跌倒风险自我评估清单来评估老年人的跌倒风险。FRAIL 量表问卷用于评估虚弱状态。此外,还收集了参与者的人口统计学信息和合并症。采用多变量逻辑回归、广义加性模型和平滑曲线拟合来分析虚弱、高血压和跌倒风险之间的关系。结果虚弱与参与者跌倒风险的增加有很大关系(OR 8.52,95% CI 3.21-22.57;P <0.001)。高血压会明显增加老年人跌倒的风险(OR 1.87,95% CI 1.11-3.13;P = 0.019)。患有高血压和体弱的人群跌倒风险最高(OR 12.24,95% CI 3.51-42.65)。平滑曲线拟合显示,在高血压状态下,虚弱与跌倒风险之间存在非线性关联。结论虚弱状态和高血压共同影响着跌倒风险的增加。加强对虚弱和高血压的管理有助于降低这一人群的跌倒风险。
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引用次数: 0
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International Journal of Nursing Sciences
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