Nursing Research and Practice最新文献

Aims: Intimate partner violence (IPV) is a significant yet underreported public health issue in Thailand. This study culturally adapted and piloted the World Health Organization (WHO) IPV training curriculum for Thai healthcare providers, evaluating its feasibility and preliminary effects on attitudes, subjective norms, perceived behavioral control, and screening behavior, guided by the theory of planned behavior (TPB).

Design: Quasiexperimental, single-group pilot study.

Methods: A structured adaptation process (ADDIE model) localized the WHO curriculum to Thai cultural and healthcare contexts. Twenty-two providers completed a 5-day blended program (12-h online theory, 18-h practice with mentored sessions). Outcomes were measured at baseline, immediately post-training, and 1-month follow-up using validated TPB-based instruments. Analyses employed Wilcoxon signed-rank tests, McNemar's tests, and logistic regression.

Results: Attitudes improved significantly (mean difference = 0.34; p = 0.005), and IPV screening behavior increased from 22.7% pretraining to 72.7% at 1 month (p < 0.001), with no decline between post-training and follow-up. Changes in subjective norms (p = 0.070) and perceived behavioral control (p = 0.416) were not statistically significant. Prior screening experience predicted screening at follow-up (OR = 8.08; 95% CI: 1.53-42.78). Participants identified persistent barriers, including workload, time constraints, and family presence during consultations.

Conclusion: The culturally adapted WHO IPV curriculum was feasible and acceptable and showed promising effects on attitudes and screening behavior among Thai providers. However, sustaining changes in subjective norms and perceived control requires post-training organizational reinforcement.

Introduction: The burden of supporting patients undergoing lung transplantation often falls on family members, who become primary caregivers. This role significantly impacts their lives, leading to changes in family roles, physical and emotional exhaustion, and substantial psychological strain. This study explores the experiences, needs, and expectations of family members throughout the lung transplantation process.

Materials and methods: A qualitative study with a descriptive phenomenological approach was conducted between 2018 and 2022 at Vall d'Hebron University Hospital. In-depth interviews were performed with 31 adult relatives of lung transplantation patients. Data were analyzed using Colaizzi's method, identifying central themes and subthemes to better understand participants' experiences.

Results: Interviewees report having experienced changes in their family and social roles, attending the needs of others more than their own. Although exhausted on many occasions, they are surprised by how they can muster their energy at critical moments. Anxiety and fear are present throughout the process. The future generates uncertainty. The support of their relatives and health staff is crucial for them, but they believe that social and financial support should be increased.

Conclusion: Family caregivers of lung transplant recipients face significant challenges, including role changes, psychological distress, and emotional ambivalence, which align with the transitional experiences described in Meleis' theory of transitions. Effective support systems, including reliable information, robust social networks, and financial assistance, are crucial for helping caregivers adapt to these demands. Targeted psychological interventions and tailored nursing strategies can mitigate stress, improve caregiver well-being, and enhance the overall success of the transplantation process. This study highlights the importance of integrating caregiver-centered approaches into healthcare practices to address the multidimensional needs of this vulnerable population.

Aim: To explore and describe the experiences of Swedish diabetes specialist nurses in supporting emerging adults with type 1 diabetes mellitus after the transfer from paediatric to adult care.

Background: The transfer from paediatric to adult care for emerging adults living with type 1 diabetes mellitus is a critical period that can impact their well-being and long-term health outcomes. Diabetes specialist nurses play a crucial role in supporting these individuals during the transitions in emerging adulthood. However, their experiences and challenges in providing optimal support have not been extensively studied.

Method: We used a qualitative descriptive design. Ten diabetes nurse specialists from six different Swedish hospitals participated in recorded individual interviews by video link or face-to-face using a semistructured interview guide. Data collection spanned from May to December 2023, and the data were analysed with qualitative content analysis. Informed consent was obtained.

Results: The main theme of the results was ambition to optimise individual support but with hands tied by structural barriers with three additional themes concentrating on the individual and the relationship, emphasising long-term objectives in self-management support, and struggling with obstacles to providing accessible care. The results indicate that while diabetes specialist nurses focus on building strong relationships and emphasise long-term goals in self-management support, they encounter significant obstacles when providing accessible care after the transfer to adult care.

Conclusion: Diabetes specialist nurses highlighted a need for education and training that extends beyond simply managing the medical condition, considering various life transitions and psychosocial challenges. The findings indicate that future standards for supportive interventions should prioritise existential and psychosocial factors. There is a lack of systematic national consensus on collaboration, as the diabetes specialist nurses reported differing experiences regarding transfers and continuity of care.

This paper considers the assessment of the benefits and needs of the position of crisis manager in homes for the elderly (nursing homes or NH) in the countries of the Visegrad Four (V4). It is essential to reinforce safety management at these facilities in view of the increasing vulnerability of the elderly resulting from demographic changes and the increased risk of disasters caused by both natural and anthropogenic factors. The paper analyses the situation at NH in Central European countries, where the establishment of the role of the manager for emergency situations is not currently mandated, although such a position contributes significantly towards protecting the lives and health of the elderly. The methodology of the paper includes an analysis of the existing crisis management frameworks at NH and an assessment of benefits of such a role on the basis of the data obtained and comparative studies. The aim is to offer an insight into the need for the position of crisis manager in connection with increasing the safety and resilience of homes for the elderly against various types of threats and, thereby, improving their ability to respond. The results of the mapping study are universal and serve as a basis for the revision of and possible changes to national guidelines relating to crisis management at NH in both the V4 states and elsewhere.

Background: This study aimed to examine the effectiveness of an intervention based on the Extended Parallel Process Model (EPPM) in improving treatment adherence and self-care among elderly individuals with type 2 diabetes.

Methods: This randomized clinical trial was conducted among 70 elderly individuals with type 2 diabetes attending the Deziani Diabetes Clinic in Gorgan, Iran, during 2022. Participants were aged 60 years or older and capable of participating in the study. They were randomly assigned to either an intervention or a control group. The intervention was delivered over 5 weeks, and a posttest was conducted 4 weeks after the final session.

Results: The Mann-Whitney U test revealed a statistically significant difference in treatment adherence between the intervention and control groups (U = -5.78, p = 0.01). The intervention group showed higher treatment adherence (mean = 102.91 SD = 6.67) than the control group (mean = 88.51, SD = 10.63), with a confidence interval of 11.18, a p-value of 0.001, and an effect size of η = 0.61 (p < 0.01), indicating that approximately 61% of the posttest variance was attributable to the intervention. There was a significant difference between total self-care scores after the intervention (t = 6.66, p = 0.01, CI: 8.31, 15.4). These findings suggest that the EPPM-based intervention effectively improved treatment adherence among elderly individuals with type 2 diabetes.

Conclusion: The EPPM-based educational intervention significantly improved treatment adherence and self-care among elderly patients with type 2 diabetes. These results support the integration of the EPPM framework into diabetes education and management programs.

Aims: Medical nutrition therapy, which incorporates dietary tracking, is routinely used in the management of gestational diabetes mellitus (GDM). However, paper-based tracking approaches are associated with several challenges. Based on user feedback, the M♡THer app, an existing digital platform for GDM management, was enhanced with a digital diet diary feature. This study aimed to evaluate the uptake, usage, usability and acceptability of the diet diary feature.

Methods: The diary was codesigned and trialled in three hospital services. Data collection occurred over 6 months. User engagement metrics, surveys and interviews with healthcare providers (HCPs) and app users were analysed using thematic analysis and triangulation.

Results: Of the 305 M♡THer app users, 95 used the diet diary with uptake varying from 13% to 53%. Users logged their diet for an average of 33.5 days. The diary improved patient-provider communication, reducing consultation time and supporting dietary literacy. Barriers to uptake and optimal engagement included the timing of the diary introduction and usability issues.

Conclusion: This study contributes to the growing evidence on digitally supported GDM care, highlighting the feasibility of applying a digital diet diary for individuals with GDM and their HCPs. The approach positively enhanced diet tracking and consultation efficiency. Future iterations should prioritise early introduction, a condensed user interface and comprehensive food library.

Trial registration: Therapeutic Goods Administration (TGA): CT-2020-CTN-01167-1-v8.

The Universal Mental Health Literacy Scale for Adolescents (UMHL-A) is a new 17-item tool designed to assess adolescents' mental health attitudes and knowledge. This scale can also be adapted for adults and is known as the UMHL. This study evaluated the dimensionality of the UMHL among Colombian adult high school students. A validation study involved 378 students aged 18-70 years (M = 20.06 and SD = 4.67), with 51.32% of the participants being female. The authors performed confirmatory factor analyses (CFAs) to compute loadings and goodness-of-fit statistics. Moreover, Kuder and Richardson's Formula 20 was calculated for dichotomous items, and Cronbach's alpha was calculated for Likert items to assess the internal consistency of each dimension. The CFA presented two subscales for the UMHL: attitudes and knowledge. Within the attitudes subscale, two dimensions were observed: help-seeking and stigma/discrimination; this solution showed adequate goodness-of-fit indicators (X ²  = 16.93, df = 14, p = 0.26, normalized X ²  = 1.21, root mean square error of approximation (RMSEA) = 0.07 (90% confidence interval [90% CI]: 0.00-0.16), Comparative Fit Index (CFI) = 0.98, Tucker-Lewis Index (TLI) = 0.96, and normalized mean square residual (SRMR) = 0.05), while the knowledge subscale comprised a single dimension, similarly with acceptable goodness-of-fit coefficients (X ²  = 26.08, df = 22, p = 0.25, normalized X ²  = 1.19, RMSEA = 0.06 (90% CI: 0.00-0.14), CFI = 0.96, TLI = 0.94, and SRMR = 0.09). The internal consistency of help-seeking dimension was appropriate (Cronbach's alpha of 0.70), of stigma/discrimination dimension exhibited was low (Cronbach's alpha of 0.45) and of knowledge dimension was acceptable (Kuder-Richardson's Formula 20 of 0.68). In summary, the UMHL shows acceptable dimensionality; however, the stigma/discrimination aspect requires further examination. Additional studies are warranted.

Background: Patient satisfaction is a measure of the effectiveness of care, particularly in patients with coronary artery disease (CAD). It has been demonstrated that one of the factors affecting a patient's quality of life is their satisfaction with the nursing care they receive. Inadequate nursing care can have negative effects on patients' satisfaction and, if appropriate action is not taken, may deter patients from visiting hospitals. This study aimed to assess the level of satisfaction with nursing care and its associated factors among patients with CAD.

Methods: A cross-sectional hospital-based study was conducted at the Jakaya Kikwete Cardiac Institute (JKCI) in Dar es Salaam, Tanzania. A total of 150 respondents were recruited using a simple random sampling technique. Data were collected using a standardised questionnaire. Univariate and multivariate logistic regression analyses were performed to assess the association of sociodemographics, level of patient satisfaction and factors associated with patient satisfaction with nursing care. A p value of < 0.05 was considered statistically significant.

Results: The mean age of respondents was 58.78 ± 15.16 years, with the majority, 81 (54%), being males. Most 106 (70.7%) respondents were married, and 103 (68.7%) were peasants. Most respondents, 127 (85%), were satisfied with nursing care. Patients with higher education and treatment category with VIP services had significantly reduced chances of satisfaction with nursing care (adOR 0.478, 95% CI: 0.094-0.632, p = 0.012) and adOR 0.234 of 95% CI: 0.074-0.432, p = 0.002, respectively. Other factors were not statistically associated with satisfaction with nursing care.

Conclusion: The majority of patients were satisfied with the nursing care. Treatment categories by VIP, insurance and higher education were associated with satisfaction with nursing care. Further research is needed to qualitatively assess the aspects of nursing care that lead to the satisfaction among patients with CAD.

Introduction: Effectiveness of basic emergency care by bystanders is the cornerstone of ensuring maritime safety. This study aimed to assess the effectiveness of the BMEC-TC program in enhancing both knowledge and practical skills related to maritime emergency care among layperson participants.

Methods: A mixed-methods design, integrating both quantitative and qualitative approaches to evaluate the program's impact, was employed from March to October 2021. Pre- and post-training assessments of knowledge and practical skills were utilized to measure learning outcomes. In addition, qualitative data were collected through group discussions to explore participants' perceptions and experiences regarding the training program.

Results: After participating in the BMEC-TC program, both healthcare providers and laypersons demonstrated statistically significant improvements in knowledge scores (p < 0.001). Post-test mean ranks were considerably higher than pretest ranks for both groups, indicating enhanced understanding. Skill scores after training were notably high for healthcare providers (M = 90.81, SD = 2.81) and laypersons (88.80, SD = 3.92), reflecting strong competency development. Practical assessments further confirmed substantial gains in clinical performance. Participants also reported high levels of engagement and widely acknowledged the training's relevance and applicability to daily maritime emergencies. The findings highlighted four key elements: 1E: Empathy and Knowledge Exchange in Healthcare Training, 2E: Encouraging Knowledge Sharing and Active Learning through Real-Life Experiences, 3E: Effective Communication for Practical Skills, and 4E: Ensuring Comprehensive Understanding to Prevent Misapplication.

Conclusion: The BMEC-TC program effectively improved knowledge and skills in maritime emergency care education within local communities. This study highlights the importance of an integrated training approach that combines cognitive learning with practical application.

Background: Advances in health care seem incapable of eliminating fear of death among elderly patients (Eps) ill with chronic cardiovascular diseases (CVD). Lack of research on the topic shows the uniqueness and novelty of this study. The following research questions were raised: "How do nurses assist elderly patients ill with chronic CVD who experience fear of death? What kind of emotions do nurses experience and how do they deal with this while working with elderly patients ill with chronic CVD who experience fear of death?"

Aim: The study aimed to highlight how nurses help patients, and self-help, in managing personal emotions while working with elderly patients ill with chronic CVD and experiencing fear of death.

Setting: The research setting in this study was five hospitals from the five biggest cities of Lithuania.

Methods: In the research study, a qualitative research design was applied. Fifteen individual semi-structured interviews were conducted with nurses. For data analysis, latent qualitative content analysis was used.

Results: Findings showed that nurses assist elderly patients ill with chronic CVD and their families by helping overcome their fear of death by using empathetic and respectful communication, and cooperating with other specialists for managing and supporting patients' needs. Nurses help themselves by managing their emotions through maintaining professional distance and demonstrating professionalism and confidentiality.

Conclusions: Nurses assist elderly patients ill with chronic CVD who experience fear of death to manage their emotions by communicating respectfully and empathetically, creating dignified relationships, establishing a comfortable emotional and social environment, providing specific information, recommending therapy for emotional well-being, organizing special professional assistance, and encouraging family involvement. Nurses help themselves while managing their own emotions by reflecting in- and after-acting at work, detaching emotions from work, and finding time for personal interests.