Nursing Reports最新文献

Background: Individuals with severe mental illness live, on average, up to 30 years less than the general population, with cardiovascular disease being the leading cause of death. Metabolic syndrome (MetS) plays a significant role in this, making it crucial to manage this issue in individuals with psychosis at the onset of the illness. The approach to managing this issue has evolved from a focus on calorie counting to a deeper understanding of hormone function, particularly the role of insulin resistance in MetS. Therefore, incorporating this perspective into mental health nursing consultations with individuals experiencing psychosis is of great interest. Methods: In accordance with the SPIRIT guidelines, an open randomized clinical trial is proposed, involving patients from a first-episode psychosis program. Results: The primary outcome will be significant weight loss (≥5%). Secondary outcomes will include changes in metabolic parameters, psychopathological status, quality of life, and physical activity. Participants will be assigned to two groups: one group will attend a series of six previously manualized nursing consultations, while the other will continue with their usual treatment. Results will be evaluated at six months and one year. Conclusions: This study will determine whether a mental health nursing consultation based on the carbohydrate-insulin model of obesity is effective in reducing weight and the risk of MetS in individuals with early-onset psychosis. This study was retrospectively registered on Clinical Trials-NCT06650943.

Background: In the last decades, there has been a growing demand for outpatient services; understanding the factors influencing patient satisfaction is critical for improving healthcare quality.

Objectives: This study evaluates patient satisfaction with nursing care and examines how satisfaction varies based on socio-demographic factors in ambulatory settings across five healthcare centers in the municipality of Vlora, Albania.

Methods: In this cross-sectional study, a total of 246 patients were surveyed using the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), adapted for outpatient contexts, after assessing its validity and reliability. The mean age of the sample was 63.9 ± 13.1 years old with a range of 21 to 94 years, and 47.2% were aged between 50 and 69 years.

Results: The results indicate that the overall satisfaction level was fair, with a mean PSNCQQ score of 2.55 on a five-point scale. Socio-demographic factors, such as age, gender, education, and socio-economic status, significantly impacted patient satisfaction. Younger patients (aged 20-49), females, and those with a higher education and socio-economic status reported higher satisfaction. Medical history also played a role, with patients attending general check-ups showing greater satisfaction compared to those with chronic conditions. Older patients tend to report a lower level of satisfaction with the care provided compared to younger patients.

Conclusions: Communication and nurse-patient interactions emerged as key areas for improvement, particularly in outpatient settings where care is episodic. These findings suggest that personalized care, improved communication, and greater attention to socio-demographic and medical factors can enhance patient satisfaction in ambulatory care settings.

Background: Anxiety in simulations can be influenced by various factors that either motivate or immobilize students. Understanding simulation anxiety is crucial for educators to design appropriately challenging scenarios without overwhelming students. No instruments have yet been tested to differentiate between debilitating and facilitating anxiety within nursing simulations.

Methods: A quantitative repeated measures design was used to examine students' baseline and pre-simulation anxiety with 90 pre-licensure junior level nursing students. The Achievement Anxiety Test (AAT) was administered to differentiate levels of debilitating and facilitating anxiety.

Results: The revised AAT demonstrated preliminary validity and reliability for measuring debilitating and facilitating anxiety when used in nursing simulation. Linear regression showed only debilitating anxiety significantly predicted pre-simulation state anxiety. Baseline anxiety has a significant impact on students, increasing debilitating anxiety in simulated settings.

Conclusions: To ensure success in practice settings, it is important to address students baseline anxiety to support a successful transition into practice. This study was prospectively determined to be exempt with the University's Institutional Review Board on 6 December 2022 and was not prospectively registered in a formal registry.

Background: Promoting physical activity among people living with dementia is critical to maximise physical, cognitive and social benefits; yet the lack of knowledge, skills and confidence among health professionals, informal care partners and people with dementia deters participation. As the initial phase of a larger feasibility study, co-design was employed to develop a new model of community care, 'Changing the Focus', to facilitate the physical activity participation of older people living with mild dementia.

Methods: Co-design methodology was utilised with nine stakeholders (with experience in referring to or providing physical activity programs and/or contributing to policy and program planning) over three workshops plus individual interviews with four care partners of people with dementia. Insights were gathered on the physical activity for people with mild dementia, referral pathways were explored and 'personas' were developed and refined. Materials and resources to support exercise providers and referrers to work effectively with people with mild dementia were finalised.

Results: Three 'personas' emerged from the co-design sessions, aligned with stages of behaviour change: (1) hesitant to engage; (2) preparing to engage; and (3) actively engaged. Referral pathway discussions identified challenges related to limited resources, limited knowledge, access constraints and individual factors. Opportunities were classified as using champions, streamlining processes, recognising triggers for disengagement, influencing beliefs and attitudes, and means of communication.

Conclusion: This study captured the views of physical activity referrers and providers and informal care partners in an inclusive and iterative manner. The use of co-design ensured a robust approach to facilitating participation in formal and informal physical activity options for people living with mild dementia. This study has provided the necessary framework from which to develop and test training and resources for the next stage of intervention (a feasibility trial) to improve physical activity participation for people with dementia.

Objective: This systematic review aimed to identify the most prevalent conflict management styles and strategies employed by nurses in clinical settings and to examine the factors associated with their selection.

Methods: A comprehensive literature search was conducted following the PRISMA guidelines. Databases searched included PUBMED, CINAHL, Medline, and ProQuest, focusing on articles published between 2014 and 2024. Inclusion criteria were primary data studies involving nurses, published in English. The search strategy utilized Boolean operators to combine keywords related to nursing, conflict management, and healthcare settings. A total of 174 articles were initially identified, with 22 meeting the inclusion criteria after screening. The quality of the included studies was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument Critical Appraisal Checklist. The results were synthesized using content analysis.

Results: The main findings from the 22 articles reviewed indicate that accommodation and collaboration/integration are the most common conflict management styles and strategies among nurses, with compromising also frequently employed. Factors such as age, experience, educational level, and workplace culture significantly influence the choice of conflict management strategies.

Discussion: Nurses employ a variety of conflict management strategies depending on the context, individual preferences, and situational factors. Effective conflict resolution is closely linked to collaboration and communication, with proactive strategies being more effective in preventing conflicts. The findings underscore the need for tailored conflict management training to enhance job satisfaction and work relations in nursing environments. We acknowledge several limitations that may affect the interpretation and generalizability of our findings such as the diversity of the tools and the methodologies used by the included studies.

Background: The Fundamentals of Care framework emphasizes a patient-centered approach that prioritizes the nurse-patient relationship and care environment to meet patients' basic needs, including oral hygiene. Recognized as crucial for preventing systemic health problems, oral care neglect is a global concern. Studies identify missed oral care as a widespread issue, contributing to significant patient safety risks. This study aimed at measuring missed nursing care occurrence in a Northern Italian university hospital, exploring the association between missed oral care with nursing staff characteristics and oral care policies.

Methods: A single-center cross-sectional study was conducted according to the STROBE guidelines. Data collection was performed in May 2022 using the MISSCARE survey, a self-administered questionnaire sent by email to 473 nurses from all inpatient units. The degree of implementation of oral care policies was obtained by accessing the Facility Score Sheet data at the department level. Descriptive statistics, chi-square tests, and Fisher tests were conducted using SAS 9.4 and R software.

Results: Providing oral care was the third-most missed nursing care after rotating patients every two hours and walking them three times daily. The reasons for missed care included resource shortage and high patient turnover. The Facility Score Sheet data showed a low adoption of oral care policies. No significant associations were found between missed oral care and both nurses' characteristics and oral care policy at the department level.

Conclusions: The study confirms highly missed oral care in acute care settings, emphasizing the urgent need for systemic changes via an evidence-based oral care policy and practice implementation. This study was prospectively registered under protocol 293 CE 050/2022 (8 Aril 2022).

Background: Optimum efficiency and responsiveness to callers of mental health helplines can only be achieved if call priority is accurately identified. Currently, call operators making a triage assessment rely heavily on their clinical judgment and experience. Due to the significant morbidity and mortality associated with mental illness, there is an urgent need to identify callers to helplines who have a high level of distress and need to be seen by a clinician who can offer interventions for treatment. This study delves into the potential of using machine learning (ML) to estimate call priority from the properties of the callers' voices rather than evaluating the spoken words.

Method: Phone callers' speech is first isolated using existing APIs, then features or representations are extracted from the raw speech. These are then fed into a series of deep learning neural networks to classify priority level from the audio representation.

Results: Development of a deep learning neural network architecture that instantly determines positive and negative levels in the input speech segments. A total of 459 call records from a mental health helpline were investigated. The final ML model achieved a balanced accuracy of 92% correct identification of both positive and negative instances of call priority.

Conclusions: The priority level provides an estimate of voice quality in terms of positive or negative demeanor that can be simultaneously displayed using a web interface on a computer or smartphone.

Hormone blockers are defined as substances that suppress the release of sex hormones, thus inhibiting the development of secondary sexual characteristics in teenagers. There is currently an increase in young people seeking healthcare services due to a mismatch between their birth-assigned gender and their perceived or self-identified gender. In early childhood, individuals are not usually affected by their physical appearance. Dysphoria may arise during the initial stages of adolescence and if the self-perceived gender does not align with the external appearance. This may have a negative impact on adolescents' mental health. Could the use of hormone blockers have a positive effect on mental health? The primary objective of this review is to assess whether the use of hormone blockers can have positive effects on the mental health of transgender youth. The review also seeks to evaluate the usage of hormone blockers and the diagnosis of gender dysphoria. A literature search of scientific evidence was conducted across various databases-PUBMED, CUIDEN, ELSEVIER, COCHRANE, DIMENSIONS, SCIELO, PSYCINFO, and CINAHL-alongside a review of the latest publications in high-impact scientific journals and the gray literature. The following terms were used: , , , , , , and . A time period was specified, covering the last ten years (2014-2024). The initial search identified a total of 290 references, which were subsequently narrowed down to 5 studies, with 1 additional study retrieved through other methods. The literature findings are clear. They show that the use of hormone blockers in transgender adolescents can be beneficial, as a reduction in mental health issues was observed during and after their use. Mental healthcare in transgender teenagers is of crucial importance to their physical, psychological, social, and academic spheres. It is also very important for their families. Nurses must be aware of this knowledge to improve the care provided to these individuals and their families during the difficult time surrounding decisions about the use of hormone blockers.

Background: Adolescent eating disorders pose a significant public health challenge and strongly affect both physical and emotional well-being. Early diagnosis is important for improving treatment outcomes, though it remains complex due to multiple influencing factors. The family perspective is essential in this process, as it provides valuable insights into changes in adolescents' habits and emotional health.

Methods: A descriptive qualitative study was conducted between January and February 2023. Interviews were conducted with 12 participants using a phenomenological approach to explore the experiences and perspectives of family members of adolescents with eating disorders.

Results: Four thematic blocks comprising several categories were identified: (T1) diagnosis, (T2) family, (T3) resources, and (T4) treatment. The participants emphasized the need for early intervention and a multidisciplinary approach to the treatment of eating disorders. Family therapy was recognized as vital to treatment, and common dissatisfaction with the public health structure underscores the need for greater investment in research and access to specialists. Mental health nurse practitioners play an important role in providing comprehensive care and support, as well as mental health literacy.

Conclusions: A holistic, patient-centered approach, including family involvement and appropriate support systems, is key to improving the outcomes and quality of life of adolescents undergoing treatment for eating disorders. Improving healthcare resources and addressing the challenges faced by families is essential. In addition, mental health literacy is critical, as it enables families to understand the disease better, make informed decisions, and actively participate in the recovery process, thus contributing to improved therapeutic outcomes and quality of life for patients.

Background: Despite the short- and long-term acknowledged benefits of breastfeeding for mothers and their infants, worldwide rates trail behind international goals. Prior research confirms that breastfeeding is a nurse sensitive indicator and that problems with latching the baby and painful breastfeeding rank high among the reasons given for not continuing to breastfeed. The Lactation Assessment Tool (LAT^TM) was previously evaluated in a study conducted in Latvia by nurse midwives. Use of the LAT to assess breastfeeding and suggesting corrective interventions were shown to decrease pain and promote healing in traumatized nipples. The inter-rater reliability for that study was by test/re-test amongst participating researcher midwives. The aim of the current study is to expand the understanding of LAT inter-rater reliability to include novice and expert assessors.

Methods: A convenience sample of twenty participants, including both novices (nine nursing students) and 11 self-identified experts, assessed four videos of breastfeeding dyads using the assessment tool, the LAT. Novice participants received a 2 h training session before final tool assessment. Each video was viewed three times, with a 3 min pause between viewings. All elements of the LAT that could be visually evaluated were included, with each element appearing in at least two of the videos.

Results: Acceptable internal consistency of the LAT tool was found, with Cronbach's alpha measuring 0.799, 0.740, 0.756 and 0.735 for each video, respectively. The reliability of the novice assessors improved over the course of the four videos, from 0.484 and 0.610 to 0.714 and 0.711. All of the experts had Cronbach's alpha numbers that were acceptable, ranging from 0.769 to 1.00.

Conclusions: Results indicate that experts perform much better using the tool than trained novices. However, the subsequent use of the tool resulted in the last two video assessments having an acceptable measure for the trained novice group. The LAT is a reliable tool for trained novices and experts to assess breastfeeding positioning and latch.