Nursing Reports最新文献

(1) Background: Urinary tract infections (UTIs) are caused by the proliferation of pathogenic microorganisms, and they are the second most common hospital-acquired infections, with catheter-associated UTIs (CAUTIs) accounting for about 40% of these nosocomial infections. This review aims to identify the impact of technology on preventing infections in patients with urinary catheters; (2) Methods: The search was conducted in April 2024 through the EBSCOhost platform, with access to the American Search Complete, CINHAL Ultimate, Medline databases, and through the Scopus database; (3) Results: In total were included eight articles in this review. Technology interventions can significantly reduce the incidence of CAUTIs, decrease the duration of catheter use, improve diagnosis, and enhance patient safety; (4) Conclusions: Technological advancements show significant benefits in reducing infection rates and improving patient outcomes, like shorter hospital stays and comfort. Multidisciplinary approaches and educational strategies are essential to maximize these benefits.

Background/Objectives: People with a severe mental illness die much earlier than the rest of the population from a preventable physical illness. Annual health checks are a way of assessing the person to then offer the appropriate interventions. Integrated Care Northampton, England used the long-term plan baseline funding allocated to them from the government department that commissions primary care services, to implement a local enhanced service. Their aim was to provide a person-centred physical health check that people with severe mental illness feel comfortable, confident, and able to engage with. Methods: Wellbeing Organisation Research Training Hub Northampton were commissioned by Integrated Care Northampton to provide training, support, and evaluate the locally enhanced service. Training was provided by training trainers who then offered one-to-one support to those delivering health checks in practice. Providers of the health checks could also access individual support from Wellbeing Organisation Research Training Hub staff. Patient data were collected via a template that is part of usual practice. Questionnaires were used to evaluate the education of staff, the delivery of health checks, and the impact on people with severe mental illness. Results: Training was well received but most of the trainers did not continue in their role. The project was successful in highlighting the physical health needs of people with severe mental illness and monitoring in primary care increased. Though methods were put in place to evaluate the delivery of health checks and their impact on people with severe mental illness, these were not utilised by the service. Conclusions: This paper emphasises how difficult it is to implement a new service and evaluate it successfully. Future projects should prioritise measuring the quality of the service.

Background: Individualizing care is the essence of nursing, and its benefits have been extensively proven in older people. The changes arisen during the COVID-19 pandemic may have affected it. The aim of this study is to analyze the changes produced in the perceptions about the individualization of care, quality of life, and care environment of elderly people living in long-term care centers before and after the pandemic. Methods: A prospective cross-sectional observational study was carried out. For data collection, the Individualized Care Scale-patient, the EuroQol-5D scale, and a reduced version of the Sheffield Care Environment Assessment Matrix test were used, and a statistical analysis was performed. Results: A total of 177 people participated in the study, with 87 pre-COVID-19 and 90 post-COVID-19, 62.7% of whom were women. The average age was 83.3 years. General activities of the individualized care obtained medians of 4, 2.5, and 3 (out of 5) in clinical situation, personal life situation, and decisional control dimensions, respectively, and no substantial change was observed pre- and post-pandemic. Nevertheless, 10 out of 17 items related with the maintenance of individuality in the last shift were higher rated after COVID-19. They are mainly related to the feelings and needs of care, daily life activities, and the expression of opinions. The median of all items was 3 despite the improvement observed after the pandemic. Residents scored an average of 6.47 points (out of 10) in the life quality self-evaluation and were satisfied with the care environment (94%). Patients with higher life quality and adherence to their environment perceived better care. Conclusions: Although slight improvements were observed in the individualized care after the pandemic, the obtained results revealed that there is still room for improvement. Particularly, it is necessary to develop strategies aimed at motivating the family participation or providing individual spaces in the residences.

Background: Loneliness can occur at any age, but it is more prevalent among older adults due to the associated risk factors. Various interventions exist to improve this situation, but little is known about their long-term effects. Our aims were to determine if these interventions have long-lasting effects and for how long they can be sustained. Additionally, we aimed to analyze if the interventions carried out by volunteers affected the outcomes regarding loneliness and psychological impact.

Methods: A systematic review was performed by searching the literature in the MEDLINE PubMed, SCOPUS, Web of Science, PsycINFO, and Web of Science databases for interventions focused on the lonely population. The inclusion criteria for this review were the assessment of loneliness using a validated tool, and loneliness being the primary or secondary outcome. The CASPe checklist was used to assess the risk of bias in the selected studies, and the PRISMA-ScR recommendations were followed to present and synthesize the results.

Results: Thirty articles were included. The interventions identified were classified into five categories: psychosocial, technological, health promotion, physical exercise, and multicomponent interventions. Loneliness improved in 24 studies during the post-intervention analysis. Social connectivity and depressive symptoms also improved in most interventions. Long-term follow-ups were conducted with positive results in a total of 16 interventions. Depressive symptoms and social connectivity were also improved. Eight of the interventions were carried out by volunteers and showed good results regarding loneliness.

Conclusions: The results obtained in this work suggested that multidisciplinary interventions can reduce loneliness, but more controlled clinical studies are needed.

Background/objectives: Previous studies have shown that primary care (PC) professionals have a low knowledge about the management of patients with type 2 diabetes, despite being one of the most common chronic diseases. The objective of this study is to analyze the impact of an educational program for health professionals on the metabolic control of their patients diagnosed with type 2 diabetes.

Methods: This work follows a quasi-experimental longitudinal design following a double perspective. First, an educational intervention was conducted on primary care health professionals. Previous diabetes knowledge was evaluated on 157 PC health professionals. Those with lower knowledge scores (<3.5 out of 7) were allocated to the intervention group. An 8-week advanced education program was conducted on 77 PC health professionals. Self-efficacy and quality of care were evaluated. Second, a prospective cohort study was conducted to evaluate changes in metabolic parameters in their patients with type 2 diabetes. A total of 4099 patients with type 2 diabetes attending PC services were divided depending on the formation of health professionals. Biochemical and other clinical parameters were determined at baseline and after 12 months; the study was allocated in the Primary Health Centers of Meuhedet North District (Israel), from January 2022 to June 2023. Changes from the baseline were compared using ANOVA. Additionally, a mixed-effect model was conducted to capture variability within primary care staff and between groups of patients.

Results: The education program significantly improved health staff knowledge (p < 0.001) and all dimensions of self-efficacy (p < 0.001 in all cases). These improvements were mirrored in patients' outcomes, since those managed by health professionals attending the advanced practice education showed, after 6 months, better glucose (p < 0.001), HbA1c (p < 0.001), and eGFR (p = 0.006) levels.

Conclusions: The advanced practice education program oriented to PC professionals was able to significantly improve their self-efficacy and perceived quality of care, which induced a significant effect on metabolic markers of patients with type 2 diabetes. Overall, the data reinforce the usefulness of advanced education programs, especially in chronic complex diseases like type 2 diabetes.

Background/objectives: The projected increase from 58 million older adults in 2022 to 82 million by 2050 in the United States highlights the urgency of preparing nursing students to care for this aging population. However, studies reveal negative attitudes among nursing students toward older adults. A three-phased educational intervention that included an artificial intelligence (AI)-driven virtual simulation was implemented to address this. AI-generated simulations promise to expose marginalized groups and strengthen future nurses' knowledge, skills, and attitudes.

Methods: A convergent mixed-method design was used to measure the change in nursing students' attitudes toward older adults, as measured by the UCLA Geriatrics Attitudes Survey and a Guided Reflection survey after participating in an Artificial Intelligence in Education learning event (n = 151).

Results: The results indicate that post-intervention scores (M = 35.07, SD = 5.34) increased from pre-intervention scores (M = 34.50, SD = 4.86). This difference was statistically significant at the 0.10 significance level (t = 1.88, p = 0.06). The qualitative analysis indicated that the attitudes impacted were challenging and overcoming ageism, increased empathy and patience, and enhanced communication skills.

Conclusions: Utilizing artificial intelligence technology during educational events effectively yields measurable learning outcomes. Cultivating positive attitudes toward older adults is essential for competent care in an aging society. This study was prospectively approved by the university's Institutional Review Board (IRB) on 30 July 2021, IRB-FY22-3.

The aim of this study was to investigate aggression-related work accidents in an inpatient psychiatric unit before and after implementing a no-restraint policy in Italy. Results revealed that, over the study period (2007-2022), 113 accidents occurred, mostly related to physical aggression (81.4%), with healthcare assistants and psychiatric nurses being the most affected and more accidents occurring during the morning shift (49.6%). A transitory peak of accidents occurred during the policy transition (χ²₂ = 16.0, p < 0.001; V = 1.000), falling rapidly in the subsequent years. In conclusion, adopting a no-restraint policy is not associated with increased aggression toward staff in psychiatric healthcare in the longer term, although greater support is needed during the transition phase to minimize risks.

Background: Economically disadvantaged patients diagnosed with serious mental illness (SMI) experience post-hospitalizations disparities due to fragmented care transitions.

Purpose: To describe the pre-implementation strategies used to adapt and implement a nurse-led transitional care intervention (Thrive) to meet the needs of economically disadvantaged patients diagnosed with an SMI.

Methods: Two pre-implementation strategies, Evidence Based Quality Improvement (EBQI) meetings and Formative Evaluation (FE) research, were used to adapt intervention components. FE data included semi-structured interviews analyzed using Rapid Qualitative Analysis.

Findings: Adaptations were made to core components of Thrive and strategies to support implementation were identified.

Conclusions: Participatory strategies help to adapt interventions that are person-centered and tailored to the organizational context.

Trial: NCT06203509.

Background/objectives: The prevalence of dementia, a complication of uncontrolled type 2 diabetes (T2DM), is rising among older adults. Effective self-management for dementia prevention is essential, but no validated questionnaires currently exist to evaluate these behaviors.

Methods: The Dementia Preventive Individual and Family Self-Management Process Questionnaire (DP-IFSM-PQ) and the Dementia Preventive Self-Management Behavior Questionnaire (DPSMBQ) were developed based on the Individual and Family Self-Management Theory to evaluate dementia prevention self-management behaviors in older adults with T2DM. Items for the DP-IFSM-PQ (30 items) and DPSMBQ (29 items) were generated through literature review and tested for face validity. A quantitative cross-sectional study evaluated their psychometric properties using exploratory factor analysis (EFA) (n = 311) and confirmatory factor analysis (CFA) (n = 254).

Results: The final DP-IFSM-PQ comprises four factors and 29 items, showing acceptable fit with limited discriminant validity. The DPSMBQ includes seven factors and 27 items, demonstrating good fit and acceptable discriminant validity.

Conclusions: The Thai-language DP-IFSM-PQ and DPSMBQ show reasonable psychometric properties for application in Thai older adults, but revisions of certain items and further studies are recommended to reassess their properties.

Background: Loneliness in older people, especially those living in rural areas, is a phenomenon that has received little attention in research and can have detrimental effects on quality of life. The aim of this study was to evaluate loneliness and the psychosocial factors associated with loneliness in rural Spain, which have been minimally studied. Methods: A cross-sectional study was carried out in a sample of permanently resident older people in the Rincón de Ademuz region (Valencia, Spain), a geographic area with very low population density. Emotional and social loneliness were assessed using the de Jong Gierveld Loneliness Scale. We also assessed whether loneliness is associated with sleep quality, depressive symptoms, and autonomy in basic and instrumental activities of daily living. Results: A total of 108 community-dwelling individuals aged 65 years and older participated in the study out of a total sample of 181. Of them, 30.6% experienced feelings of moderate loneliness, while 2.8% presented severe loneliness. A significant correlation was found between loneliness and age (Rho = 0.28, p = 0.003). Significant differences were also observed between emotional loneliness and gender (p = 0.03) but not between social loneliness and the total score on the de Jong Gierveld Scale. Men experienced more emotional loneliness than women. In the multivariate analyses, significant associations were found between the degree of loneliness and having sons/daughters (p = 0.03; odds ratio [OR] = 0.24; 95% CI 0.06-0.89) and the role of caring for a dependent person (p = 0.002; odds ratio [OR] = 0.05; 95% CI 0.009-0.36) but not living with sons/daughters or the presence of grandchildren. Conclusions: There is a high prevalence of loneliness among older people living in rural areas, which is associated with some social factors. Therefore, nursing care plans should include assessments and interventions to prevent or detect and address loneliness in older people. This study was retrospectively registered in ClinicalTrials on 24 April 2024 with registration number NCT06382181.