SAGE Open Nursing最新文献

[This corrects the article DOI: 10.1177/23779608251349951.].

Introduction: Post-stroke fatigue (PSF) is a known sequel after ischemic stroke (IS), which affects quality of life (QoL), however its incidence and contributing factors remain controversial or not enough established, especially in younger population in working age.

Objectives: To assess PSF in patients in working age (18-65 years) at 3 months after IS and evaluate its possible association to other factors.

Methods: Consecutive patients with IS in working age enrolled in the prospective FRAILTY (Factors Affecting the Quality of Life After Ischemic Stroke in Young Adults; ClinicalTrials.gov: NCT04839887) were analyzed. PSF was assessed using Fatigue Severity Scale (FSS) and Neuro_QoL_Fatigue scale, post-stroke depression (PSD) and anxiety (PSA) using Hospital Anxiety and Depression Scale at 3 months after IS. QoL was evaluate using Stroke Impact Scale (SIS), version 3.0. Logistic regression analysis (LRA) was performed to identify possible predictors of PSF.

Results: In total, 150 (54.0% males, mean age 51.2 ± 8.9 years) were analyzed and 132 (88%) had excellent clinical outcome after 3 months. PSF, based on the FSS, was present in 55.3% of patients and severe PSF in 41.3% of them. LRA showed the significant association between SIS domains memory, emotions, communication, mobility and participation and the presence of severe PSF (FSS score > 5). PSD and PSA were found as other predictors of severe PSF. No association was found between PSF and age, sex, and clinical outcome.

Conclusions: Despite overall excellent clinical outcome, severe PSF occurred in 41.3% of patients in working age after 3 months post-stroke. PSF affected strongly QoL and may have close relationship to psychosocial factors and cognition. Routine screening for PSF should be incorporated into post-stroke follow up, especially for working-age patients.

Introduction: Patients in intensive care units (ICUs) have poor oral health due to several factors, such as mechanical ventilation and reduced consciousness, which can lead to serious complications.

Objective: This study aimed to investigate the impact of a multimedia evidence-based oral care training program on the oral hygiene of ICU patients.

Methods: This randomized controlled trial involved 60 nurses and 56 patients in two general ICUs, allocated into control and intervention groups using cluster randomization. Nurses in the intervention ICU received multimedia educational content based on an evidence-based oral care algorithm, along with face-to-face training for one month. They then provided the intervention to patients. During the next 3 months, the oral hygiene scores of newly admitted patients were evaluated using the Beck Oral Assessment Scale (BOAS) three times: upon admission to the ICU, 24 h, and 48 h after admission. The control group continued with usual oral care as before. Data were analyzed using SPSS-26 software. The Chi-square test, Fisher's Exact test, Independent T-test, Mann-Whitney U test, and repeated measures analysis of variance (ANOVA) were used.

Results: There were no significant differences between the patients' and nurses' groups regarding baseline characteristics. Also, BOAS scores of patients upon admission did not significantly differ between groups (P = .863). In the intervention group, patients' BOAS scores significantly decreased (improved) from 12.11 ± 1.03 to 7.93 ± 1.61 (24 h after admission) and then to 6.11 ± 1.26 (48 h after admission) (P < .001). However, BOAS scores in the control group did not improve significantly within 24 or 48 h after admission.

Conclusion: This study indicates that multimedia training of an evidence-based, comprehensive oral care algorithm improves the oral hygiene of ICU patients, especially those requiring higher levels of care.

Background: Continual learning is fundamental for developing critical thinking and problem-solving skills. Although learning activities are well established in education, the connection between objectives, activities, and learning outcomes is often underemphasized. This article proposes a conceptual model that clarifies how learning processes can be better aligned through a hierarchy of objectives, using nursing education as an illustrative context.

Methods: A conceptual analysis was conducted, drawing on established theories, including Kolb's Experiential Learning Theory, the Sociocultural Learning Perspective, and the NLN Jeffries Simulation Theory, to synthesize five core components: hierarchy of objectives, participant, learning activity, learning cycle, and multiple learning activities.

Results: The model presents a structured approach to continual learning by clarifying how each component interacts to foster competence development. The model is presented from a general perspective while also specifically providing examples for the healthcare context. Simulation is used to exemplify how learning activities can support long-term learning goals.

Conclusions: Understanding the importance of each level of the model and how these levels interact, can assist organizations in pursuing excellence. Accordingly, knowing and defining learning outputs and outcomes is the basis for attain the overarching goals. Facilitating learners to conceptualize reflections into active experimentation requires multiple learning activities, towards a spiral of continual learning.

Background: Geriatric care involves providing comprehensive support and healthcare services to older adults aged 65 years and above. Nurses serve as a cornerstone in the delivery of effective geriatric care. However, existing primary studies in Ethiopia present inconsistent and fragmented findings, and there is no comprehensive nationwide data on this topic.

Objective: This systematic review and meta-analysis was conducted to assess the pooled prevalence of knowledge about geriatric care and its associated factors among nurses in Ethiopia.

Methods: Relevant studies were systematically searched in PubMed, Web of Science, ScienceDirect, African Journals Online, and Google Scholar up to April 2025. Data were extracted using Microsoft Excel and analyzed with STATA version 17. Publication bias was assessed using funnel plots and Egger's test. Heterogeneity across studies was evaluated using the I² statistic, and pooled estimates were calculated. Subgroup analyses by region were conducted, and pooled odds ratios were determined for factors associated with nurses' knowledge of geriatric care.

Result: The pooled prevalence of good knowledge towards geriatric care among nurses in Ethiopia was 41.0% (95% confidence interval (CI): 33.48-48.53). Living with older adults (odds ratio (OR)= 2.19; 95% CI: 1.47-2.91; I² = 87.22%, p < 0.001), receiving training on geriatric care (OR = 3.18; 95% CI: 1.65-5.19; I² = 98.73%), having relevant work experience (OR = 2.43; 95% CI: 1.36-3.50; I² = 90.11%, p < 0.001), and attaining a higher educational status (OR = 2.59; 95% CI: 1.76-5.51; I² = 90.11%, p < 0.001) were significantly associated with knowledge of geriatric care among nurses.

Conclusion: The pooled prevalence of nurses' knowledge of geriatric care in Ethiopia was low. Targeted interventions focusing on educational advancement, structured training, work experience, and exposure to older adults are essential to improve knowledge and strengthen geriatric care delivery.

Introduction: Patients who have experienced a stroke are at risk of developing aspiration pneumonia. The risk of aspiration pneumonia is often attributed to dysphagia, which is a condition observed in stroke patients due to the weakening of the muscles involved in swallowing. Nursing care related to oral hygiene, feeding, positioning, and mobilization can reduce the risk of aspiration pneumonia in poststroke patients. This study aims to explore nurses' experiences with prevention practices for aspiration pneumonia in poststroke patients.

Methods: This study employed a qualitative, exploratory, descriptive design. Twelve registered nurses were recruited from the stroke unit of a Teaching Hospital in Accra, Ghana. Data were collected through in-depth, face-to-face, semi-structured interviews, using an interview guide. The data were transcribed and analyzed using thematic analysis.

Results: The findings revealed two main themes and five subthemes about nurse practice to prevent aspiration pneumonia in poststroke patients. They included prevention practices, describing what participants thought were prevention practices for aspiration pneumonia. The second theme, attitudes towards prevention practices, generated the participants' beliefs and attitudes as they related them to carrying out various prevention practices. Highlights of the findings included the participants' detailed descriptions of the preventative measures they utilized and their positive attitudes towards the various patient-centered prevention practices they detailed. These encompassed a dynamic process of care, attentiveness to signs and symptoms of aspiration in poststroke patients, and perceptions of the negative aspects of prevention practices.

Conclusions: Nursing practice should place strong emphasis on the critical role nurses play in preventing respiratory complications, particularly aspiration pneumonia, in poststroke patients. In addition, further research into the burden of pneumonia among stroke survivors and the effectiveness of nurse-led preventive interventions is essential for enhancing the quality of poststroke care.

Introduction: Catheter-associated urinary tract infections (CAUTIs) remain a major healthcare-associated concern despite being largely preventable. They contribute to prolonged hospital stays, increased antimicrobial resistance, and higher healthcare costs.

Objective: This study evaluated the effectiveness of a structured CAUTI prevention bundle combined with a nursing empowerment program in a tertiary care hospital in Makkah, Saudi Arabia. The objective was to update evidence-based practices, improve compliance with urinary catheter insertion and maintenance protocols, and enable nurses to independently discontinue catheters without a documented clinical indication.

Methods: Conducted between October 2023 and May 2024, the prospective single-arm intervention included 247 adult patients requiring indwelling urinary catheters across medical, surgical, and neurosurgical wards. CAUTI rates were measured according to CDC/NHSN (Centers for Disease Control and Prevention/National Healthcare Safety Network) criteria, and bundle compliance was monitored using standardized audits.

Results: The intervention led to a 73% reduction in CAUTI incidence, from 5.4 to 1.41 per 1,000 catheter-days. Nursing compliance improved markedly, rising from 56% to 93%, while catheter utilization remained stable. Additionally, the average catheter days per patient decreased by 41%.

Conclusion: These findings highlight the critical impact of structured protocols and nursing empowerment on reducing infection rates and enhancing clinical efficiency. The results support broader implementation of similar strategies in alignment with Saudi Vision 2030's healthcare improvement goals.

Introduction: Peer learning is an educational strategy used in clinical training for nursing students that has proven to be beneficial for both students and supervisors.

Objective: This study aimed to describe the perceptions and experiences of first-line managers, clinical supervisors, and educators in nursing with peer learning (PL) as a supervision model. It also aimed to describe the implementation process, focusing on key factors and obstacles to successful implementation in healthcare systems facing pressure from registered nurse (RN) shortages.

Method: This qualitative descriptive interview study involved individual and focus group interviews with 20 participants from three groups: first-line managers, clinical supervisors, and educators in nursing. Interviews were analyzed using deductive content analysis, guided by the i-PARIHS framework.

Results: While PL improved supervision quality, adaptability, and recruitment opportunities, it required active engagement from staff and students, and ongoing collaboration with the university. Experienced challenges were students with varying competence levels and inadequate continuity due to the shortage of RNs. Participants found the introductory activities and scheduled meetings valuable but faced challenges related to time allocation and a lack of RNs to act as clinical supervisors.

Conclusion: Despite PL's benefits, the RN shortage hinders its implementation, necessitating the development of flexible models that can be implemented despite the shortage.

Introduction: Permanent ostomy surgery has been shown to improve patient survival rates; however, it also results in changes to body image, bowel habits, and lifestyle. These changes can significantly affect both the physical and mental well-being of patients, ultimately impacting their overall quality of life (QOL).

Objective: This study examines the effectiveness of the Information-Knowledge-Attitude-Practice (IKAP) nursing model in patients with permanent stomas, with a particular focus on its impact on self-efficacy and QOL. The goal is to enhance the self-care abilities of patients and their families, thereby promoting a swift return to normal social activities.

Methods: A retrospective study design was used to select patients who underwent permanent ostomies in the Department of General Surgery at the hospital, between January 2015 and December 2022. Both the IKAP group (IKAP nursing model) and the control group included 94 patients. IKAP group included: (1) establishing an intervention group; (2) developing a public relations strategy and a tailored education program; (3) applying health education; and (4) implementing behavioral intervention. The two groups with various nursing modalities were assessed using the Basic Demographic Data Questionnaire, the Self-Efficacy Scale for Stoma Patients, the Quality-of-Life Scale for Stoma Patients, and data on stoma complications. SPSS software (version 20.0) was used for general description and single-factor analysis of data for comparison between groups.

Results: Three months postoperatively, the IKAP group performed better than the control group in terms of self-efficacy (92.09 $\pm$ 10.12 vs 66.17 $\pm$ 12.83, t = 8.219, P = 0.000). There was significant difference in the ostomy complication rate between the two groups (6 [6.38%] vs 17 [18.09%], c ² = 3.946, P = 0.041). In terms of QOL, the IKAP group scored better in the functional dimension and symptom dimension.

Conclusion: The IKAP model can effectively improve self-efficacy and QOL, reduce complications, and enhance participation in social activities and family life for patients with permanent enterostomy.

[This corrects the article DOI: 10.1177/17483026241256093.].