Nursing Open最新文献

Aim: Exploring how nursing home nurses who care for residents with dementia experience moral distress.

Design: A qualitative phenomenography design.

Methods: Phenomenography was used in this qualitative study. In-depth interviews were conducted with 20 nurses caring for residents with dementia at three nursing homes using phenomenographic analysis.

Results: Six categories were divided into two groups. The 'reflection on my nursing' group included the categories 'anguish over qualifications to care for residents', 'uncertainty about the adequacy of the care provided', and 'internal conflict over whether to compromise with unsatisfactory outcomes'. The 'moral awareness' group included 'being aware of deviations from the standards I set and the care I provide', 'recognising when I become insensitive to things I should not do', and 'ruminating about whether it would be okay if I have no choice'. Comprehensively, it was found that moral distress occurs when reflecting on nursing and moral awareness conflicts.

Conclusion: This study provides insight into the various ways in which nursing home nurses experience moral distress when caring for residents with dementia. This study can provide a basis and direction for various strategies to reduce moral distress.

Implication for the profession and/or patient care: Considering the growing interest in the moral distress experienced by nurses, along with the importance of the human rights of residents with dementia in an aging society, these research results will have a positive impact on improving the quality of care provided by nursing home nurses to residents with dementia.

Patient or public contribution: No patient or public contribution.

Reporting method: We have adhered to relevant COREQ guidelines.

Aim: The intersection of heart failure (HF) and serum chloride is of increasing interest; however, estimates of the global prevalence of hypochloremia in HF were inconsistent. This paper aimed to quantify the current prevalence of hypochloremia in patients with HF.

Design: Systematic review and meta-analysis.

Methods: PubMed, Cochrane, Embase, Web of Science, and CINAHL databases were systematically searched from inception to May 24, 2022. Observational studies that clearly defined the cutoff for hypochloremia and provided the prevalence of hypochloremia in patients with HF were included. Stata 17.0 was used for data analysis. Heterogeneity was assessed according to Cochran's Q and I² values, and results were pooled using a random-effects model. Sensitivity analysis, subgroup analysis, and meta-regression were used to explore the sources of heterogeneity.

Results: Sixteen papers reporting 18 studies that involved 29,807 patients with HF were included in the meta-analysis. The pooled prevalence of hypochloremia in HF was 14.0% (95% CI: 11.9%-16.2%; I² = 96.6%, I² CI: 95.6%-97.4%, p < 0.001). Study country and study quality were identified in subgroup analysis and meta-regression as possible sources of heterogeneity. Funnel plot and egger's test revealed publication bias (p = 0.02).

Patient or public contribution: No patient or public contribution.

Aim: To explore the symbolic and functional value that nurses attribute to their uniforms and profession.

Design: An interpretative phenomenological study.

Method: A purposeful sample of 15 nurses who designed their uniforms was enrolled between October 2022 and June 2023. A focus group was held to explore the participant-designed uniforms, and an ideographic analysis was conducted.

Results: Three main Experiential Statements emerged: nurses see their uniforms as tin armour, a wheel of time, and changes in time. Their professional and personal identities are shaped by their work, which also affects their time perception through past, present, and future perceptions. Nurses feel professionally motivated, even outside work, and despite society's recognition, uniforms symbolise their commitment. Nurses' identities are fused by the caring value, symbolised by their uniforms' evolution. Fostering self-worth and professional values among nurses may inspire them, reduce attrition, and boost their professional recognition.

Implications for research and practice: The study emphasises that nurses embrace dual identities as both professionals and citizens, which are unified by their commitment to patient care. Even outside of work, nurses still identify with their profession. Recognising and valuing the role of nurses may encourage more students to pursue nursing and reduce turnover in the profession. Healthcare organisations should implement strategies that underscore the importance of nurses in patient care and how their professional and personal identities shape their lives.

Reporting method: The COnsolidated criteria for REporting Qualitative research checklist was used to conduct and report this study.

Patient or public contribution: No Patient or Public Contribution.

Aim: The aim was to map and describe the state of knowledge regarding interventions to promote thriving amongst older people in care homes and the factors that affect their experience of thriving.

Design: A scoping review.

Review methods: A scoping review based on the methodological framework by Arksey and O'Malley and presented following the PAGER (Patterns, Advances, Gaps, Evidence for Practice, and Research recommendations) framework.

Data sources: Five electronic databases were searched for studies published between 2012 and 2022. From a total of 185 studies found, 17 met the inclusion criteria.

Results: This study recognised five factors that contribute to thriving: the resident's attitude towards living in a care home, the quality of care and caregivers, activities and interactions with others, qualities of the physical environment and health. Two studies reporting interventions were identified.

Conclusion: This scoping review highlights the scarcity of knowledge regarding older people's experience of thriving in care homes. The review results could contribute to our understanding of the factors involved and interventions needed to improve thriving.

Implications for the profession and/or patient care: The focus should be on education and the development of working methods that could improve thriving in care homes.

Reporting method: The Prisma ScR-checklist was used.

Patient or public contribution: No patient or public contribution.

Aim: To examine the correlation between colonial mentality and diabetes self-management among Filipino Americans with T2DM.

Design: Cross-sectional descriptive and correlational survey study.

Methods: This cross-sectional study used the Colonial Mentality Scale for Filipino Americans to measure colonial mentality and the Diabetes Self-Management Questionnaire to measure self-management behaviours. The online survey was administered to Filipino Americans aged 18 or older with type 2 diabetes who resided in the United States. Recruitment was conducted from 2022 to 2023 through social media and Filipino American organisations. Data from 37 participants were analysed using descriptive statistics, an independent t-test, and Pearson's r correlation.

Results: There was a statistically negative moderate association between two manifestations of colonial mentality (internalised cultural/ethnic inferiority and cultural shame) and several diabetes self-management behaviours: glucose control, healthcare use, and overall self-management. Colonial mentality manifestations were greater in males than in females, although not statistically significant. This is the first study to empirically examine the association between colonial mentality and diabetes self-management in Filipino Americans.

Aim: The hospital work environment among cultures and the different social contexts among countries may influence nurses' attitudes towards patient safety. The aim of this study was to compare the attitudes of nurses working in public hospitals in four European countries towards patient safety.

Design: A qualitative study with an ethnographic approach was used to observe and interview nurses at work in four European Union countries: Croatia, Hungary, Sweden and Spain.

Methods: Critical case sampling was used to select participants from two public hospitals in each country. Data were coded and thematically analysed using Atlas.ti software through iterative close reading and open code review.

Results: This is the first multinational ethnographic study of nurses' attitudes towards patient safety. The analysis identified two main categories: structural influences on safety attitudes and safety attitudes in practice. The analysis from this study suggests that the structural influences of safety attitudes (resources) may not be directly correlated with the actual work pressures of nurses in public hospitals in different countries, but are subject to the level of maturity of the institutions.

Patient or public contribution: No patient or public contribution.

Aim: To construct an evidence ecosystem-based postoperative pain management programme for children with postoperative pain management.

Design: A mixed research design that combines qualitative and quantitative studies.

Methods: According to the literature search and analysis, the postoperative pain management programme for children was constructed from three aspects: assessment of pain intensity of children, management principles and management methods, and the preliminary draft of the programme was finally constructed to include three first-level entries and 11 second-level entries. In January-February 2023, the first draft of the postoperative pain management programme for children was developed based on a literature review using the ecosystem of evidence theory as the research framework; in March-April 2023, the postoperative pain management programme for children was revised and finalised through two rounds of Delphi expert consultation.

Results: In the second round of expert consultation, the return rate of valid questionnaires was 100%, the expert authority coefficient was 0.83, the importance scores and feasibility scores of each entry were > 3.5, the coefficients of variation were < 0.25, the Kendall's harmony coefficients of the importance scores of the entries were 0.650 (χ² = 273.134, p < 0.001) and those of the feasibility scores were 0.649 (χ² = 272.720, p < 0.001). The resulting postoperative pain management programme for the affected patients included three level 1, 11 level 2 and eight level 3 entries.

Patient or public contribution: The postoperative pain management programme for children constructed based on the evidence ecosystem is practical and scientific, but its effectiveness in clinical practice needs to be further verified by a controlled study design.

Objectives: Evidence ecosystem; paediatrics, surgery; pain; Delphi method.

Aim: The study aim was to describe the prevalence of pain, its assessment, and its associated characteristics in a university hospital in the French-speaking part of Switzerland.

Background: Despite many advances in its management, pain is still a common and persistent symptom in hospitals. Nurses have a central role in its management. Pain assessment is essential for optimal management; it is nonetheless made insufficiently and randomly.

Design: The design was a monocentric correlational descriptive study.

Methods: This study was based on the secondary analysis of routine data from 22,987 computerised health records of the medical and surgical wards between 1 November 2017 and 31 March 2019.

Results: The results showed that the prevalence of pain was high in medical and surgical wards. Almost one-fifth of the participants suffered from severe pain at least once during their hospital stay. There was no association between the presence of pain and hospital ward, but the likelihood of having severe pain increased if the participant was hospitalised in a medical ward. Close personalised pain monitoring should be promoted to prevent the onset of severe pain. No Patient or Public Contribution.

Aim: To evaluate the effectiveness of nurse-led Transition Care (TC) on quality of life, mortality and readmission among adult stroke survivors.

Design: Systematic review and meta-analysis using the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness.

Methods: Databases were searched from 1st January 2000 to 31st December 2023. Search was done in Medline, Science Direct, Scopus, EBSCOhost, Web of Science and Cochrane Library and Central Registry of Clinical Trials. The randomised controlled trials that assessed the effectiveness of nurse-led TC for adult stroke survivors were included. The primary outcome was 1-year quality of life, whereas the secondary outcomes were mortality and readmission. Two independent reviewers performed data extraction and quality appraisal by using the JBI methodology. Random effect models and pre-specified subgroup analyses were performed using Review Manager Software Version 5.3. and STATA Version 17.

Results: Of 1093 studies retrieved from database search, only 18 studies met the review inclusion criteria. The pooled results show that stroke survivors who were allocated to nurse-led TC programs had a 1-year better quality of life compared to those allocated to usual care (12 studies; SMD = 0.52; 95% CI = 0.20, 0.85; p = 0.002; I² = 94%). However, no significant differences in the odds of mortality and readmission were observed. No patient or public contribution.

Aim: This study aimed to describe supervisors' reasoning about conditions for nursing students' learning and development of clinical competence during their clinical education.

Design: A qualitative design with an inductive approach.

Methods: This study used a focus group methodology. A total of 21 supervisors from various hospital wards in northern Sweden participated in six focus groups. The data were analysed according to Krueger and Casey's description of focus groups.

Results: The analysis resulted in one overarching theme with six subthemes that described the conditions during the final year of clinical education. Students' learning and development of clinical competence was seen as an 'interplay developed over time' between the supervisor and the student, a mutual give-and-take in the supervisory relationship where both parties were responsible for ensuring that it became a growth opportunity.

Conclusion: The major finding was that the learning and development of clinical competence in students was a result of a dynamic interplay between the student and supervisor. This process is time-dependent, and both the student and supervisor share responsibility for this progression.

Implications for the profession and patient care: Active and conscious reflection is a crucial component in achieving clinical competence. Students should be taught and encouraged to apply and develop reflective skills throughout their education.

Reporting method: The study adhered to the COREQ checklist for qualitative studies.

Patient or public contribution: Registered nurses contributed data for this study.