SAGE Open Nursing最新文献

Introduction: Home blood pressure monitoring is often considered less reliable than conventional blood pressure monitoring due to different factors.

Aim: To investigate variations in home blood pressure monitoring and associated factors, differences in measured blood pressure under varying conditions such as postural changes from sitting to standing, among adults with hypertension.

Methods: A systematic review of studies was conducted on adults (≥18 years) with hypertension. Peer-reviewed studies published between 1992 and 2025 were searched in the Web of Science, PubMed, MEDLINE, and CINAHL databases in August 2023 and September 2025. The review included studies on home blood pressure monitoring, the associated factors, and reported in systolic and/or diastolic values. The main outcome was variations in home blood pressure monitoring categorized as small (<5 mmHg), moderate (5-15 mmHg), or large (>15 mmHg). Associated factors were also identified and the findings were analyzed using narrative synthesis.

Results: A total of 2,843 peer-reviewed articles were identified across four databases, of which 33 met the inclusion criteria. Generally, variations in home blood pressure monitoring ranged from -21.8 to +9.5 mmHg for systolic blood pressure and from -5.0 to +5.5 mmHg for diastolic blood pressure, where the + and - signs indicate the direction of changes. Fifteen factors associated with variations in home blood pressure monitoring were identified and broadly categorized into patient, device, procedural, protocol, and observer factors with related subcategories.

Conclusions: There were variations in home blood pressure monitoring and were associated with the factors, ranging from large decreases to large increases in both systolic and diastolic blood pressures, among adults with hypertension. Therefore, when measuring and interpreting blood pressure at home, it is essential to consider the factors associated with the variations. Furthermore, this study serves as a baseline for future research. This review is registered in PROSPERO.

Introduction: Coronary artery disease is the leading cause of death, and one of the major health burdens worldwide. The prevalence of coronary artery disease in Ethiopia is increasing steadily irrespective of age and gender. Some of the risk factors are preventable and modifiable.

Objective: The aim was to examine the levels of knowledge, attitude, and practice of cardiac patients toward preventive measures of coronary artery disease.

Methods: An institution based cross sectional study was conducted in Tikur Anbessa Specialized Hospital between March and April 2022. A total of 402 patients were randomly selected. Interviewer guided standardized questioners were used to gather information from participants. Descriptive statistics was utilized to describe participant's characteristics and logistics regression analysis was employed to examine the relationship between independent and outcome variables. Level of significance was determined at p < .05 and 95% CI.

Result: A total of 320 participants with response rate of 83.3% were included. The mean age was 46.74 ± 14.15SD. Most (67.2%) of the respondents demonstrated good knowledge with mean knowledge score of 58 ± 15.96 SD. More than half of the respondents (54.4%) had good attitude, with mean attitude score of 60.4 ± 25.33SD. Half (50%) of respondents mean showed good practice with mean practice score of 55.13 ± 17.365. Upon logistic regression, variables namely, sex (AOR = 0.578, 95%CI: 0.332-0.879), and presence of comorbidity (AOR = 2.818, 95%CI: 1.029-7.713), were significantly associated with knowledge. Similarly, occupation (AOR = 0.66, 95%CI: 0.330-0.968), marital status (AOR = 0.545, 95%CI: 0.333-0.893), and sex (AOR = 0.506, 95%CI: 0.313-0.819), were significantly associated with practice of coronary artery disease prevention.

Conclusion: The study found that 67.2% of cardiac patients had good knowledge, 54.3% had a positive attitude, but only 50% practiced effective coronary artery disease prevention. Male gender, single marital status, unemployment, and presence of comorbidities were significantly associated with lower knowledge and poor preventive practices.

[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.