Nursing Research and Practice最新文献

Aim: To gain new insights into the lived experience of poststroke sleep. Design: Qualitative interview study. Methods: The study was based on a phenomenological-hermeneutic approach inspired by the French Philosopher Paul Ricoeur. Fifteen participants were included between 2021 and 2022 and interviewed 3 months after stroke. Interviews were interpreted through naïve reading and structurally analyzed. Credibility was enhanced by investigator triangulation, and field notes were used for reflections during the interpretation process to challenge preconceptions. Results: The participants experienced changes in sleep and described a fear of lying awake at night. They described a lack of energy and a heavy body and mind as well as an overwhelming sleepiness during daytime. Three themes were identified through the analyses: "Floating through the night-a mental state of mind being between awake and asleep," "Left with a heavy and slow feeling-poor sleep leads to a lack of energy," and "Sleeping during daytime may happen like lightning from a clear sky." Conclusions: The participants experienced frequent and substantial changes in sleep which affected their everyday lives in various ways.

Background: The political conflict in the West Bank was escalated on October 7, 2023, further increasing exposure to traumatic events among children and adolescents, with potential implications for their mental health. This study estimates the prevalence and severity of posttraumatic stress disorder (PTSD), its sociodemographic correlates, and functional impacts on affected youth. Methods: This cross-sectional study was conducted from February 5 to March 5, 2024, among 1148 Palestinian children and adolescents aged 8-15 years from the North and Middle West Bank, selected by stratified random sampling. The Child PTSD Symptom Scale was used to assess symptoms of PTSD, while trauma exposure was measured using the War-Trauma Exposure Checklist. SPSS was used for data analysis. Results: Symptoms of PTSD were moderate to very severe in 70.0% of participants. The most prevalent traumatic experiences were witnessing bombings on television (93.4%) and witnessing dismembered bodies on television (92.8%). Intrusion symptoms predominated, with frequent reports of nightmares and intrusive thoughts. Age showed a significant positive correlation with PTSD severity (r = 0.12, p=0.034), indicating more severe symptoms in older children. PTSD significantly impaired academic performance (55.0%), emotional relationships (41.5%), and recreational activities (32.7%). Children experiencing > 5 traumatic events had substantially higher rates of severe PTSD symptoms (73.6% of this group; p=0.003). Conclusions: These findings indicate a severe mental health crisis among conflict-exposed children in the West Bank. Immediate interventions are needed, including trauma-focused cognitive behavioral therapy delivered with substantial modifications for ongoing conflict settings and school-based mental health programs. Respite for children and parents may be an important first step to engaging children and families in therapy. Systemic barriers to mental health care need to be tackled if better outcomes are achieved in this vulnerable population.

Infertility significantly impacts individuals and society, necessitating effective strategies for its management. Among the various factors influencing female fertility, micronutrients play a crucial role in reproductive health by supporting oocyte quality, hormonal balance, and implantation processes. This narrative review examines the importance of optimal preconception micronutrient intake in enhancing female fertility. By analyzing research from various scientific databases, including PubMed, Google Scholar, and ScienceDirect, spanning from 2000 to April 2024, we highlight the impact of key micronutrients such as folate, vitamin D, iron, selenium, and antioxidants on fertility outcomes. Deficiencies in these nutrients have been associated with impaired ovarian function, disrupted menstrual cycles, and increased risk of pregnancy complications. Given the prevalence of micronutrient inadequacies among women of reproductive age, this review underscores the need for evidence-based nutritional interventions and standardized supplementation guidelines. The findings aim to bridge the gap between research and clinical practice, providing healthcare professionals with insights to optimize fertility care through targeted nutritional strategies.

Aim: To explore nurses' and patients' perspectives on characteristics of the 'good nurse' (an ethical ideal, representing perfection in nursing practice) in hospitals. Design: Scoping literature review and narrative synthesis. Methods: The scoping literature review was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Subsequently, a thematic analysis of identified papers was undertaken to uncover the main themes relating to characteristics of the good nurse. Data Sources: Five databases (Medline, Cumulative Index for Nursing and Allied Health Professionals (CINAHL), British Nursing Index, Scopus and PsycINFO) were searched in May 2023. An initial 2968 records were identified, which were refined to 124 articles after screening titles and abstracts, and then further refined through more detailed review to 13 articles meeting the inclusion criteria for the study. Results: Two central themes were identified: character and competence. With respect to the good nurse's character, the virtues which were identified as important include patience, being caring, optimism, trustworthiness, selflessness, respectfulness and confidence. With respect to competence, the studies revealed that the good nurse must demonstrate knowledge and technical skill, act in a professional way, be an expert communicator, be supportive to patients and colleagues and know how to provide holistic care. Conclusions: The results highlight the dual importance of character and competence in defining the good nurse. Nurses and patients both recognised the importance of balancing technical expertise with character traits and effective communication to offer the best possible care.

Introduction: Nursing students often lack engagement and confidence in vaccination procedures, despite their critical public health importance. To address this gap, this study aimed to assess the effect of Kahoot!-based gamification on nursing students' knowledge, satisfaction, interest, and collaboration regarding vaccination. Methods: The students were randomly divided into two groups: case (Kahoot! game) and control (teaching in the traditional way). Eight different games were created based on vaccination topics. During each session, the case group played one of the games developed by Kahoot!. Then, at the end of 8 sessions, the posttest was taken from both controls and cases. Results: Findings from ANCOVA showed that the average knowledge after the internship in the group that used gamification with Kahoot! was significantly (F [1, 69] = 27.208, p ≤ 0.001) increased even after controlling for the effect of baseline knowledge. An independent t-test was performed to compare the average satisfaction of the internship between the two groups of control (mean = 7.5, SD = 1.34) and intervention (mean = 8.7, SD = 1.04), which showed to be significant (t (70) = 4.23, p ≤ 0.001). In addition, our results showed that the overall average interest in Kahoot!'s classes was 34.1 (SD = 2.03), ranging from 29 to 38. The average score for level of interaction at Kahoot!'s classes was 33.47 (SD = 2.36), ranging from 26 to 37. Conclusions: In general, our findings showed that nursing students' knowledge and satisfaction significantly increased after the end of 8 weeks of Kahoot! gamification. Moreover, we found that the level of interest and collaboration among students after gamification with Kahoot! was significantly higher than the average score of 2.5.

Aim: This study examined the dyadic relationships among parenting stress, family resilience, and coping styles within Chinese intergenerational co-parenting households. Design: A cross-sectional study was conducted in China from December 2022 to September 2023. The STROBE checklist was used to report the current study. Methods: A total of 312 parent-grandparent dyads caring for children under three years old participated. Both parents and grandparents completed the Parenting Stress Scale, Grandparenting Parenting Stress Scale, Family Hardiness Index, and Simplified Coping Style Questionnaire. Dyadic associations were analyzed using the Actor-Partner Interdependence Mediation Model (APIMeM) to examine whether parenting stress was associated with family resilience and coping styles among parents and grandparents. Results: Family resilience was found to partially mediate the relationship between parenting stress and positive coping styles in both parents (β = -0.054, p < 0.001) and grandparents (β = -0.067, p < 0.001). Additionally, family resilience mediated partner effects, suggesting interdependence between parents' (β = -0.311, p < 0.001) and grandparents' stress and coping mechanisms (β = -0.231, p < 0.001). Conclusions: This study enhances understanding of the interdependent relationships between parenting stress, family resilience, and coping strategies in Chinese intergenerational co-parenting households.

Aim: Mothers of children with intellectual disabilities are particularly vulnerable to mental distress due to demanding and exhausting caregiving. However, in the Arab world, they are seldom screened for depression because of limited diagnostic resources. Addressing the urgent need for brief and reliable screening tools, this study evaluated the psychometric properties of the Arabic version of the Patient Health Questionnaire-2 (PHQ-2) among 85 Saudi mothers. Design: A cross-sectional study. Methods: The construct, convergent, and divergent validity of the PHQ-2 was examined through a latent variable model (LVM), while its cutoff score was examined through receiver-operating characteristic (ROC) curve analysis. Results: The unidimensional PHQ-2 (item loadings > 0.7) was positively predicted by stress and negatively predicted by high mood and happiness, supporting its convergent and divergent validity. The PHQ-2 effectively predicted low mood, poor sleep quality, nightmares, high stress, low general physical health, and willingness to join a psychological support program (area under the curve [AUC] range = 0.72-0.84, p values < 0.001). The best balance between sensitivity and specificity was achieved at the PHQ-2 threshold ≥ 2.5, while the cutoff ≥ 3.5 demonstrated a higher positive predictive value (PPV) for all outcomes (range = 30.0-78.8 vs. 23.0-70.8). Conclusions: The PHQ-2 is a brief, valid tool, which at cutoffs ≥ 2.5 and ≥ 3.5 can reliably detect clinically significant depression and related psychological and physical adverse effects. Mothers scoring ≥ 3.5 may require a clinician-based examination for depression, and they may benefit from specific mental health literacy interventions. However, the results should be interpreted with caution given convenience sampling, a small sample size, and elevated distress levels in the current population. These limitations highlight the need to replicate the study with larger, randomly selected samples from more diverse populations. Implications for Practice: Nurses can efficiently screen for depression and its mental/physical sequelae, as well as monitor response to treatment using only two items. The study provided two well-interpreted cutoffs of the PHQ-2, with real-world implications for mental health screening in under-resourced settings. Reporting Method: The study adhered to STROBE guidelines. Patient or Public Contribution: No patient or public contribution.

Background: The adoption of 12-h shifts in response to workforce shortages has raised questions about their impact on nurses' well-being and patient care quality. While international studies offer mixed findings, little is known about these effects in the Omani context. Aim: To compare the effects of 8-h and 12-h shifts on nurse fatigue, quality of life, satisfaction, turnover intention, and perceived patient care in a tertiary hospital in Oman. Methods: A comparative cross-sectional study was conducted with 100 nurses from Sultan Qaboos University Hospital using self-administered surveys. Descriptive statistics, t-tests, and chi-square tests were performed to compare outcomes across shift types. A multiple regression analysis was also conducted to assess predictors of quality of life, controlling for shift type, age, gender, marital status, satisfaction, fatigue, and unit assignment. Results: Nurses working 12-h shifts reported significantly higher levels of fatigue (p < 0.001; Cohen's d = 0.82) but also reported higher quality of life (p < 0.001; d = 0.91) and greater satisfaction with their shift length (p=0.001; d = 0.72). No significant differences were found in turnover intention. Patient falls were more frequently reported among 12-h shift nurses, while other safety incidents showed no significant variation. A multiple regression model predicting QOL was significant (F(16, 83) = 9.64, p < 0.001, adjusted R ² = 0.583). Satisfaction with shift was the strongest positive predictor (β = 0.432, p < 0.001, 95% CI [0.117, 0.287]), while working a 12-h shift had a significant negative association with QOL (β = -0.232, p=0.004, 95% CI [-0.603, -0.117]). Marital status showed a marginally significant positive effect (β = 0.180, p=0.051, 95% CI [-0.001, 0.555]). Conclusion: Despite increased fatigue, nurses working 12-h shifts reported higher quality of life, possibly due to more days off and enhanced work-life balance. However, elevated fatigue and fall rates warrant caution. The findings underscore the importance of implementing flexible and individualized scheduling policies rather than universally adopting 12-h shifts. Further longitudinal studies are needed to explore long-term effects of shift length on nurse and patient outcomes.

Background: Pain remains a complex and multifaceted challenge in healthcare, affecting patient outcomes, quality of life, and healthcare costs. Significant gaps in knowledge and attitudes among nurses can hinder effective pain management, patient outcomes, and satisfaction. Purpose: This study assesses nurses' knowledge and attitudes regarding pain assessment and management. Methods: A quantitative descriptive cross-sectional design was employed. Convenience sampling was used to recruit 161 registered nurses from various wards at a hospital in Riyadh, Saudi Arabia, between January and April 2024. Data were collected using the Knowledge and Attitude Survey Regarding Pain (KASRP) and analyzed using descriptive statistics, one-way ANOVA, and independent t-tests. Results: The nurses' knowledge and attitudes regarding pain were moderate (M = 25.62, SD ± 6.4). Less than a quarter of participants demonstrated a good level according to the KASRP (22.36%). The score was greater among nurses working in surgical, emergency, and hemodialysis units (F = 2.47, p=0.03), those with good perceived competency levels in pain management (t = 3.41, p < 0.001) and knew about the availability of pain management protocols in the unit (t = 2.81, p=0.003). Conclusion: The findings underscore the need for enhanced educational strategies to improve nurses' knowledge of pain assessment and pharmacological interventions, and to address misconceptions about opioid use and opioid dependency, as well as the ethical implications of placebo use. Continued professional development and the implementation of standardized protocols are recommended to improve nursing practice in this area.

Introduction: Diabetic ketoacidosis (DKA) is an acute, progressive, and life-threatening complication of uncontrolled diabetes mellitus requiring immediate and aggressive intervention. If not treated appropriately, DKA can be fatal. Nurses' knowledge and attitudes in critical care units are crucial for providing quality care to minimize the mortality, morbidity, and complications associated with DKA. Objectives: This study assessed the knowledge and attitudes of critical care unit nurses toward DKA in the Southern West Bank hospitals. Methods: A cross-sectional study was conducted with a convenience sample of 178 nurses working in critical care units in Southern West Bank hospitals during February and March 2024. A self-administered questionnaire, developed by the researchers, assessed nurses' knowledge and attitudes toward DKA. The survey included 18 knowledge-based questions covering causes, symptoms, diagnostics, and management, as well as 15 attitude-based items rated on a five-point Likert scale. Data analysis was performed using SPSS Version 23, employing descriptive statistics, t-tests, and one-way ANOVA to assess differences between groups. Results: The analysis indicated that the majority of nurses, 109 (61.2%), had a low level of knowledge about the management of DKA. In addition, more than half of the nurses, 96 (53.9%), exhibited a fair attitude toward the management of DKA. There was a significant difference between nurses' knowledge about DKA management and the age of the participants (p < 0.05). However, no significant difference was found between nurses' attitudes toward DKA management and their professional characteristics (p > 0.05). Conclusion: Findings highlight the need for targeted educational programs to improve nurses' knowledge and attitudes toward DKA management. Implementing standardized training, ensuring access to updated clinical guidelines, and integrating DKA management into continuous professional development can enhance patient outcomes. Future research should explore institutional barriers and effective interventions for improving nurses' competencies in DKA care.