Nursing Research and Practice最新文献

Aim: To test the structural validity and internal consistency of one (A-scale) of the two Professional Nurse Self-Assessment Scale II (ProffNurse SAS II) scales among graduating Nordic nursing students with the goal of assessing their psychometric properties when used separately.

Design: This study employed an explorative factor analyses to validate the ProffNurse SAS II A-scale items (n = 50) (self-assessed clinical competence).

Methods: The data were analyzed using jamovi Version 2.3.21. The suitability of the data for the planned analyses was assessed using established criteria for good model fit prior to conducting statistical tests. Exploratory factor analysis (EFA) was used to examine the underlying structure of one of the two scales, given its application in a new population and the lack of prior confirmation of its factor structure within this specific context. Internal consistency was assessed using Cronbach's alpha.

Data sources: Convenience sampling was used to select the participants among graduating nursing students in five Nordic countries. Data collection was made digitally during 2021-2022. A total of 274 graduating nursing students from five Nordic countries and 12 different universities completed the ProffNurse SAS II A-scale holding 50 items in local languages.

Results: EFA and parallel analysis elicited a five-factor solution accounting for 52.14% of variance in scores. Internal consistency reliability was supported with Cronbach's alpha of 0.960 for the ProffNurse SAS II A-scale. The five factors were named Direct Clinical Practice (1), Ethical and Collaborative Practice (2); Pharmaceutical Practice (3); Digital Coaching and Guidance (4); and Development and Leadership (5). The A-scale with a reduced number of items (from 50 to 44 items) showed proper structural validity and internal consistency for measuring self-assessed clinical competence and needs for further training among graduating nursing students.

Conclusions: The scale supports the study's theoretical framework and competencies of the graduating nursing students.

Implications for the profession and/or patient care: Self-assessment supports evidence-based practice and nursing education, and the ProffNurse SAS II A-scale offers a valid tool for measuring clinical competence among graduating students.

Reporting method: The STROBE checklist for cross-sectional studies was adhered to, as well as the COSMIN reporting guideline.

Patient or public contribution: Graduating nursing students from five Nordic countries contributed to the study by answering the questionnaire.

Objective: This study aims to comprehend the current status of prehospital delay among patients with acute myocardial infarction. It analyzes the correlation between various factors and prehospital delay and explores the influencing factors. Methods: A cross-sectional survey was conducted. From February to June 2023, 260 AMI patients were selected by consecutive sampling from the study hospital in Yanji City, Jilin Province. General Data Questionnaire, Pain level Scale, Family Support Scale, Psychological distress scale, and Chinese version of the perceived impairment of medical decision-making scale were used. SPSS 28.0 and AMOS 28.0 were employed for t-test, chi-square test, Pearson correlation analysis, binary logistic regression analysis, and model construction. Results: The median prehospital delay time was 4.67 h. There were 174 patients with prehospital delay, accounting for 66.92%. The structural equation model indicated that the total effect values of prehospital delay influencing factors from strong to weak were pain level (-0.294), a perceptual disorder of medical decision-making (0.209), psychological distress (0.084), and family support (-0.068). Conclusions: Approximately two-thirds of patients experience a prehospital delay. Risk factors for prehospital delay include being female, lower family monthly income, lower education level, complications, symptom relief after taking medicine, lack of health care awareness, seeing a doctor alone, psychological distress, and perceptual disorder of medical decision-making. Protective factors are the pain level and family support. Patient or Public Contribution: No patient or public contribution. Reporting Method: The authors adhered to the EQUATOR network guidelines STROBE to report observational cross-sectional studies.

Background: Numerous programs were promoted during the COVID-19 pandemic to mitigate stress and provide support. Healthcare workers (HCWs) response to these support measures has not been evaluated. Objective/Aim: The objective of this study was to identify and describe the HCWs well-being and support needs over the course of the pandemic and to inform disaster planning preparations. Methods: In this qualitative descriptive study, five semistructured focus groups with 24 multidisciplinary HCWs were conducted between March and June 2022. Using thematic analysis, team members read each transcript to identify patterns in the phrases and apply codes. Phrases were then compressed, and themes identified. Results: Three phases were identified, each with unique themes. Phase 1) "The Beginning": themes included "hard to know what's right", "looked like a warzone", "we're all in it together", "seeing patients suffer", and "it was kind of nonstop". Phase 2) "Tide Turned": themes included "trying to be strong", "angry when they had to come back", and "wanted it both ways". Phase 3) "Starting to Process": themes included "I couldn't cry then", "started therapy, had to keep living", and "considered leaving". Conclusions: HCWs need support during and after prolonged crises to manage ongoing fears and anxieties. Leader presence during the crisis is valuable. Disaster planning through interdisciplinary shared governance is warranted to identify and develop appropriate and meaningful interventions. Resources and plans for psychological support need to be vetted by staff. Support is required in preparation for the crisis, as well as during and after the crisis.

Background: In recent decades, noise pollution has become a significant concern, especially in sensitive environments such as hospitals. For neonates in neonatal intensive care units (NICUs), noise can have serious implications due to their underdeveloped auditory and physiological systems. Elevated noise levels in NICUs have been linked to disruptions in normal physiological parameters and can negatively impact both neonatal health and staff performance. Aim: To identify and quantify sources of noise in the intensive care unit of a hospital NICU. Methods: An observational study was conducted to assess noise levels in a Mexican NICU. Noise measurements were taken across 22 different scenarios identified as potential noise sources, during all three shifts to capture variations throughout the day. Results: Noise levels ranged from 45 to 70 decibels (dB). The nursing shift change was identified as the scenario with the highest noise level, while the paper dispenser area recorded the lowest. These findings highlight specific times and locations within the NICU where noise reduction interventions should be focused. Conclusions: Targeted noise control strategies, especially during shift changes, could significantly improve the acoustic environment in NICUs, helping to safeguard neonatal well-being and staff performance.

Aim: The aim of this study is to explore the international landscape and hot topics within the field of wound, ostomy, and continence (WOC) nursing over recent years. Methods: Literature on WOC nursing published between 2012 and 2024 was retrieved from the Web of Science database. VOSviewer was employed as the primary tool, complemented by CiteSpace, to conduct a bibliometric analysis. This included examining collaborative networks at the author, institutional, and national levels, alongside keyword visualizations employing clustering, time zone diagram analysis, and emergence analyses. Results: An initial search identified 3474 publications. These were subsequently grouped into eight central clusters, encompassing the work of 6341 authors. Analysis revealed current research hotspots, including the field of pressure injury, ostomy management, wound management, incontinence, skin damage, therapy technology, nursing care, and telehealth. Conclusion: First, scientific research attention in the field of WOC nursing is not high. Second, the uneven development of WOC nursing is mainly reflected in the imbalance in the number of publications between journals and countries. Third, the research focus of WOC nursing is in the wound care sector, among which pressure injuries have always been a research hotspot.

Background: Central venous catheters (CVCs) are crucial for critically ill patients but pose risks of complications and unplanned removal, which can interrupt treatment, prolong hospital stays, and increase mortality. This investigation sought to examine the occurrence and risk factors for unplanned CVC removal among intensive care patients in China. Methods: A multicenter cohort study was conducted across 22 public tertiary hospitals throughout China, from September 4, 2023, to February 29, 2024, enrolling critically ill patients with CVCs. Cox proportional hazards regression models were used to assess the risk factors for unplanned CVC removal. Results: The study comprised a total of 2680 first-time CVC insertion events (one per patient) in critically ill patients. 1151 (42.95%) CVCs were removed; most (n = 832, 31.04%) were elective. A total of 153 CVCs were removed prematurely (5.71%; 95% CI: 4.84-6.68), and infection-related complication was the leading cause (n = 124, 4.63%; 95% CI: 3.85-5.50; 5.26 per 1000 CVC days). Independent risk factors included male gender (HR, 2.04; 95% CI: 1.40-2.99; p < 0.001), neurological disorders (HR, 2.41; 95% CI: 1.50-3.86; p < 0.001), and mechanical ventilation (HR, 1.71; 95% CI: 1.09-2.70; p=0.02), while urgent insertion reduced the risk (HR, 0.52; 95% CI: 0.29-0.92; p=0.02). In subgroup analysis, diagnosis with neurological disorders (HR, 2.31; 95% CI 1.40-3.81, p=0.001), and urgent CVC insertion (HR, 0.41; 95% CI 0.21-0.82, p=0.01) were significantly associated with unplanned CVC removal in males but not in females (p > 0.05). No significant interactions were found between gender and diagnosis, mechanical ventilation, or urgent insertion (all p > 0.05). Conclusions: Unplanned CVC removal occurred in 5.71% of cases, primarily due to infection. Identified risk factors (male gender, neurological disorders, and mechanical ventilation) and protective factors (urgent insertion) highlight targets for preventive strategies in critical care.

Background: Infertility is a reproductive disorder affecting either the male or female reproductive system, characterized by the inability to achieve pregnancy after 12 months or more of regular, unprotected sexual intercourse. It may result from male, female, or idiopathic factors, with certain etiologies being preventable. Management of infertility frequently involves assisted reproductive technologies, including in vitro fertilization (IVF). Objective: This quantitative cross-sectional study aimed to discover the traditional practices used for infertility treatment among females in Albaha City. Materials and Methods: This study was conducted with 251 infertile women between the ages of 50 or beneath who had primary or secondary infertility because of personal reasons or male infertility in the maternity outpatient departments of Albaha City hospitals in Saudi Arabia. The study period lasted from May 30, 2021, until January 2022. The research obtained approval from the Faculty of Nursing ethical committee at King Abdulaziz University Jeddah before participants granted their consent. Results: A total of 251 participants indicated that 51.0% found traditional infertility treatment successful and 45.8% had no previous knowledge about the approach, while 3.2% viewed it negatively. Among the participants, 39.5% revealed that they got pregnant after using traditional treatments, whereas 60.5% said they did not get pregnant. About 29.0% of women who got pregnant achieved it within 6 months and 11.0% of them conceived over 6 months to 1 year. Two-thirds of participants reported no side effects from traditional healing treatment, and half of the respondents planned to repeat their experience. The research conducted on pregnancy and herb consumption demonstrated a lack of statistical importance expressed through the data values (p > 0.05). Conclusion: Many participants believed in using traditional practices and visiting traditional healers instead of attending medical facilities and the care services provided by health professionals due to their actions on physiological systems and low cost. Further investigation is required to support the outcomes of this study.

Background: The transition from hospital to home is a critical period for families of children with cancer, requiring adaptation and new knowledge acquisition to manage treatment at home. Lack of adequate preparation can generate insecurity and negatively impact the quality of home care. Objective: To describe the educational and care demands of family members of children with cancer during the hospital-home transition. By addressing these needs, this study seeks to contribute to health education practices which facilitate a safer and less stressful transition for families. Methods: This is a qualitative and descriptive study developed through semistructured interviews from July to October 2023, with 20 family members of children with cancer undergoing chemotherapy treatment in a public pediatric hospital located in Brazil. The data were processed in Iramuteq software, organized by descending hierarchical classification for lexical analysis and interpreted in light of Afaf Meleis' transitions theory. Findings: Two thematic blocks were structured related to the guidance required by family members and strategies for home care, as well as guidance shared by nurses for the hospital-to-home transition. The educational-care demands included the need for guidance. Conclusion: The study demonstrated the need for nursing actions related to guidance for families on the care to be developed after discharge, with the aim of helping them deal with stressful situations, challenges, and difficulties associated with the hospital-to-home transition process. Nurses should be attentive to the educational-care demands of families, recognizing their particular difficulties and promoting collaborative, welcoming, and healthy learning environments.

Coronary artery bypass grafting is the primary treatment for patients with ischemic heart disease and multivessel disease to improve survival, symptoms, and quality of life. However, patients waiting for coronary artery bypass grafting surgery often struggle with advanced age, frailty, and inactivity, leading to anxiety and uncertainty. Psychological distress, pain, and sedentary behavior can worsen their condition. Prehabilitation, combining exercise, education, and support, aims to improve readiness for surgery, but its success depends on understanding patients' perspectives, while this study explores the experiences of patients awaiting coronary artery bypass grafting surgery to contribute insights into the design of future prehabilitation programs. This qualitative study aimed to explore the phenomenon of waiting to have elective coronary artery bypass grafting surgery based on patients' lived experiences. The study used a hermeneutic-phenomenological approach and conducted purposely selected in-depth interviews with one female and nine men the day before surgery. Analysis of the data revealed themes based on experiences of being abandoned in no man's land, balancing between feeling imprisoned and hoping to escape, preparing to fight, and feeling weak and dependent on social support. The phenomena this study uncovered underscore the complexities inherent to the lived experience of waiting for coronary artery bypass grafting surgery. Understanding and integrating these aspects when planning prehabilitation programs for patients waiting for coronary artery bypass grafting surgery have substantial clinical relevance, particularly for enhancing healthcare practice when developing targeted interventions.

Background: The knowledge management (KM) competence of health and social care managers is essential for organizations to achieve and maintain competitiveness. The study aimed to develop and validate the Managers' Competence in Knowledge Management (MCKM) instrument, which assesses health and social care MCKM. Methods: The study followed four phases: (1) items of the instrument were created based on a conceptual framework; (2) the content validity index was assessed by 11 experts. After that, 11 managers provided feedback on the instrument by participating in the pilot study; (3) the construct validity was examined with exploratory factor analysis (EFA); and (4) internal consistency was established with Cronbach's alpha. The data were collected from 116 Finnish managers during two separate periods in February and August 2022. Results: The overall S-CVI for the MCKM instrument was 0.83. EFA revealed a five-factor model for the MCKM instrument, containing 43 items, which explained 72% of the observed variance. The factors' Cronbach's α coefficient ranged from 0.913 to 0.964. The instrument development and validation process resulted in five factors: planning competence development and cooperation, managing a culture of competence, anticipating and defining competence, developing competence, and assessing competence. Items are scored on a Likert scale of 1-5. Conclusions: The instrument gave valid and reliable results in psychometric testing. It is suitable for self-assessment of competence in KM among health and social care managers. Practice Implications: Examining the KM competence of health and social care managers is vital for addressing unforeseen competence and knowledge challenges.