Nursing Research and Practice最新文献

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.

Aim: This study investigated the practice-based learning experiences of third-year nursing students under the Nursing and Midwifery Council (NMC) Future Nurse Standards (2018). The study identified enablers and barriers to proficiency achievement and explored how these experiences inform their preparation for roles as registered nurses and future practice supervisors.

Background: The study focused on nursing students who began their undergraduate programs in September 2020, the first cohort under the NMC Future Nurse Standards (2018). Conducted during the COVID-19 pandemic, the research explored clinical practice learning experiences across three higher education institutions in England, highlighting the challenges in meeting required proficiencies.

Design: A qualitative approach was used, underpinned by hermeneutic phenomenology. Focus group discussions with 17 final-year nursing students were undertaken.

Methods: Thematic analysis was employed to explore shared experiences of practice-based learning. Ethical approval was obtained, and data saturation ensured robust findings.

Results: Five themes emerged: the physical and emotional impact of practice learning, lack of confidence in the process of assessment due to inconsisteny, being prepared for practice, the impact of the practice supervisor/assessor, and what might help. Students described the process of achieving proficiencies as exhausting and emotionally draining, with assessment inconsistencies and limited supervisor engagement contributing to stress, isolation, and reduced learning opportunities.

Conclusion: While students navigated the pandemic's impact on education, practice supervisors/assessors were seen as pivotal yet overstretched or insufficiently prepared. Findings highlight the need for standardized assessments, improved supervisor training, and tailored preplacement support to enhance practice-based learning and better prepare students for registration and future supervisory responsibilities.

Background: Families of patients transitioning from the intensive care unit (ICU) to home care encounter numerous challenges. Nurses play a pivotal role in supporting these families, and identifying their educational needs is crucial for optimal patient care postdischarge. This study aimed to explore the educational needs of patients' families on the eve of discharge from special care units.

Materials and methods: A qualitative study was conducted using purposive sampling, involving 17 families of patients nearing discharge from ICUs in hospitals in eastern Guilan, Iran. Semistructured and in-depth interviews were conducted until data saturation. Data were analyzed using conventional content analysis, guided by the Graneheim and Lundman (2004) model, with MAXQDA 2007 software.

Results: Data analysis resulted in the identification of 48 initial codes, which were categorized into three main categories named "Care in the shadow of fear and worry" with two subcategories (feeling worried and fear of providing independent patient care), "Perceived need for ongoing education" with two subcategories (concerns regarding complex/technical care procedures and needs for education on daily care and well-being management), and "Family evaluations of training: satisfaction and perceived adequacy" with two subcategories (satisfaction with training and dissatisfaction with the adequacy of training).

Conclusions: This study highlights the significant emotional burden and worries experienced by family members as they prepare for their patient's discharge from the ICU. Healthcare providers must address these concerns and offer ongoing education and support to enhance home care safety and competence.

Background: Social support in diabetes is considered a key element for individuals to self-care adherence. However, there is limited knowledge about social support and its impact on the self-care beverage consumption in adults with type 2 diabetes (T2D). The aim of this study is to analyze the association between social support and self-care related to beverages consumption in Mexican adults with T2D.

Methods: This cross-sectional study included adults aged 20 and older with T2D from community health centers. The Social Support Scale for Self-Care in T2D questionnaire was used, and participants were asked about 15 types of beverages according to recommendations for the Mexican population.

Results: A total of 246 participants with T2D were included. Social support for self-care was associated with increased consumption of unsweetened coffee (r = 0.146, p < 0.01), fruit juice (r = 0.102, p < 0.05), and low-fat milk (r = 0.117, p < 0.05) and a reduction in whole milk consumption (r = -0.108, p < 0.05). Men reported higher consumption of fruit juices and soft drinks, as well as generally higher consumption of beverages from categories 5 (whole milk, fruit juices, sports drinks, beer, wine, and spirits, p < 0.01) and 6 (cola, industrialized fruit juices and teas, sweetened coffee, and tea, p < 0.01), which are less recommended.

Conclusion: Social support was associated with a higher consumption of fruit juice, low-fat milk, and unsweetened coffee and a lower consumption of whole milk. It is important to integrate educational programs to improve self-care regarding beverage consumption in individuals with T2D.

Aim: To investigate the effects of a nursing program to early promote the activity of daily living after passing critical conditions among older adults admitted to the semimedical intensive care unit.

Design: Quasi-experimental research.

Methods: A total of 50 older adults admitted to the semimedical intensive care unit were recruited using a consecutive sampling method. Data were collected from June 28 to October 3, 2024, using the Barthel ADL Index, complication record forms, and muscle strength record forms.

Results: The findings indicated that the experimental group reported higher scores in performing activities of daily living (17.48 ± 1.19 vs. 2.76 ± 0.44) and motor power (4.96 ± 0.20 vs. 3.68 ± 0.48), as well as a lower incidence of complications (12% vs. 64%) than the control group (p < 0.001).

Conclusion: The study demonstrates that the nursing program is effective in facilitating early functional recovery and reducing complications among older adults following critical conditions in the semi-intensive care unit. This program provides a valuable approach to enhancing the quality of care and outcomes for this vulnerable population.

Trial registration: Thai Clinical Trials Registry (TCTR): TCTR20240708010.

Background: Evidence-based nursing leads to improved care quality and patient outcomes; however, challenges with implementation prevent that from being achieved. In hospitals, nurses are well positioned across multiple organizational levels to influence the adoption of evidence-based practices (EBP). A better understanding of the roles of those who are serving as implementers of EBP changes in the hospital is needed.

Purpose: This narrative review sought to answer: In hospitals, who (i.e., what roles) are the implementers of nursing-related EBP changes and what are the attributes of those EBP projects? This review aimed to describe (1) the roles and the organizational level of those implementing EBP changes in the hospital for nurses and (2) the attributes of the projects including, its location, the model used to guide the project, and the evaluation measures.

Methods: An iterative, two-phased literature review was conducted. Categorical data were analyzed to achieve the aims.

Findings: Across 158 articles, numerous roles, mostly nursing roles, spanning multiple organizational levels were described. The majority of articles described teams representing multiple levels (n = 132; 84%), implementers positioned in unit-level roles (n = 37; 23%), and projects occurring at the unit-level (n = 127, 80%), using the Joanna Briggs Institute model (n = 97, 61%) and an evaluation of process measures (n = 77; 49%).

Conclusion: This review identified the implementers of nursing-related practice changes and the attributes of the projects, which provides a rich description of some contextual elements that shape how EBP changes occur in hospitals. This new foundational knowledge can stimulate a systematic approach for improvement and optimization of the implementation process, both in practice and through research. This review highlights the need for tailored and role-specific skills, education, and competencies to equip implementers to lead collaborative and effective teams across hospital systems and maximize the impact of implementation.

Objective: To determine participants' pre- and post-training competence in perinatal bereavement care, along with evaluation of the training.

Methods: A quasi-experimental study with a pre-post design was conducted in two phases. The training on coping with perinatal loss (TCPL) was first delivered entirely online to a cohort of students in 2022(N = 56). To enhance the initial intervention, a second cohort of students in 2023(N = 44) received the TCPL with an added on-site scenario simulation component. Questionnaires of Perinatal Bereavement Care Competence Scale, Self-Competence in Death Work Scale, Jefferson Scale of Empathy, Chinese version of the Stress-Related Growth Scale-Short Form, and the evaluation of scenario simulation were used to evaluate the effectiveness of the training.

Results: Including 52 junior undergraduate midwifery students in 2022 and 44 in 2023 completed the questionnaires. We observed higher post-training scores for perinatal bereavement care competence and stress-related growth, and a high degree of satisfaction in the scenario of simulations.

Conclusions: The results support the feasibility of the training and are consistent with short-term improvements; confirmatory controlled studies are warranted.

Trial registration: Chinese Registry of Clinical Trials: ChiCTR2200066048.

Aims: To explore the perspectives and needs of people with HIV in terms of social support from the three perspectives of healthcare professionals, peer volunteers, and people with HIV.

Background: Progress in ART has pushed HIV treatment to improve the quality of life of infected people, and UNAIDS has promoted the "95" goal, emphasizing good quality of health. Social support is critical to HIV health management and is strongly associated with multiple health outcomes. The current research on social support in HIV field is mostly based on traditional classification and requires deeper exploration of multidimensional influences.

Methods: During the period from January to March 2024, face-to-face, semistructured, in-depth interviews were conducted at Beijing You'an Hospital. The data were analyzed using an inductive thematic analysis.

Results: A total of six people with HIV, three peer volunteers, and seven medical professionals were interviewed. Inductive analysis of the purposive samples revealed that the social support needs of people with HIV encompass five dimensions: informational support, instrumental support, emotional support, affiliational social support, and appraisal social support.

Conclusions: The social support required by people with HIV is multidimensional in nature. In clinical practice, it is essential to pay full attention to the individual characteristics of people with HIV and develop personalized support plans to ensure that people with HIV receive comprehensive social support.

Introduction: Ensuring that home-visiting nurses (HVNs) possess adequate skills for providing appropriate care is crucial in the context of increasing service demand with advanced care needs. However, current quality assurance relies on mentors' subjective assessments during accompanying visits, which are burdensome and rater-dependent. This study aimed to develop and evaluate the inter- and intrarater reliability and concurrent validity of objective video-based assessment (VBA) checklists for HVNs' nursing skills, focusing on peripheral intravenous catheter placement, pressure injury care, defecation care, and skin tear care to reduce the burden of skill assessment at home and ensure valid skill assessments.

Methods: The checklists were developed through a literature review, focus group interviews, and a group meeting using the nominal group technique to ensure content validity. The inter- and intrarater reliabilities and concurrent validity of the checklists were evaluated using videos of nurses providing care to simulated patients. Five nursing researchers with experience in mentoring nurses assessed the videos twice using checklists with a washout period. The inter- and intrarater reliabilities were analyzed using Gwet's AC1 statistics. Concurrent validity was evaluated with sensitivity and specificity of assessment using checklists against raters' subjective assessments, with expertise in nursing skills as the gold standard.

Results: The checklists demonstrated substantial to almost perfect inter- and intrarater reliabilities (AC1: 0.63-1.00) for each item. The overall assessments also showed more than substantial inter- and intrarater reliabilities (AC1: 0.72-1.00). The sensitivity and specificity of the checklists were both above 0.90, indicating high concurrent validity.

Conclusion: The checklists were reliable and valid for objectively assessing HVNs' skills. The VBA suggests feasible and cost-effective methods for quality assurance, potentially improving the quality of home care. Further studies with patients in diverse clinical settings are required to enhance the generalizability of the results.

Background: Thirst is a common symptom of severe discomfort in awake patients with transoral tracheal intubation in the intensive care units (ICUs), which affects their physical and mental health. Due to the presence of transoral tracheal intubation, patients are unable to express their thirst needs in a timely manner through words, and nurses are prone to ignore their thirst symptoms. At present, there is a lack of systematic intervention protocols for managing thirst symptoms in awake patients undergoing transoral tracheal intubation in the ICU. Therefore, there is an urgent need to construct systematic intervention protocols for this group of patients.

Design: A stepwise multimethod study was conducted. The intervention protocol was developed through qualitative research, evidence synthesis, and the Delphi method.

Methods: Guided by symptom management theory, first, qualitative research methods were used to explore patients' thirst experience and nursing needs. Second, evidence-based methods were used to summarize the best evidence for thirst intervention in patients. Based on the results of qualitative research and evidence summary, a preliminary intervention protocol was formed. Finally, the Delphi method was used to consult 21 experts, soliciting their opinions and revising the protocol accordingly to form the final version.

Results: The expert enthusiasm of the two rounds of expert consultation was 95.45% and 100%, respectively, the expert authority coefficient was 0.89, the Kendall harmony coefficient of item importance was 0.442 and 0.581, and the Kendall harmony coefficient of item feasibility was 0.363 and 0.509, respectively (p < 0.001). A final draft, including three aspects of thirst assessment, intervention strategies, and effectiveness evaluation, was developed.

Conclusion: The thirst intervention program for awake patients with transoral tracheal intubation in ICU constructed in this study demonstrates sound scientific validity and can provide effective guidance for addressing patients' thirst symptoms while improving oral moisture and comfort levels.