Nursing Open最新文献

Aim: To assess the occurrence and risk factors of gastrointestinal (GI) dysfunction during enteral nutrition (EN) in critically ill patients supported with mechanical ventilation.

Design: Prospective observational study.

Methods: Totally 252 patients admitted at a mixed medical-surgical ICU were enrolled. GI symptoms and the potential risk variables were recorded during the first 14 days of EN.

Results: The incidence of GI dysfunction was 65.5%, and the incidence of diarrhoea, constipation, abdominal distension, and upper GI intolerance was 28.2%, 18.3%, 6.7% and 12.3%, respectively. The median onset days of constipation, diarrhoea, abdominal distension and UDI was 3, 5, 5 and 6 days, respectively. Multivariable Cox regression analysis showed a significant relationship between GI dysfunction and age (HR = 2.321, 95% CI: 1.024-5.264, p = 0.004), APACHE-II score at ICU admission (HR = 7.523, 95% CI: 4.734-12.592, p = 0.018), serum albumin level (HR = 0.594, 95% CI: 0.218-0.889, p = 0.041), multidrug-resistant bacteria-positive culture (HR = 6.924, 95% CI: 4.612-10.276, p<0.001), negative fluid balance (HR = 0.725, 95% CI: 0.473-0.926, p = 0.037), use of vasopressor drugs (HR = 1.642, 95% CI: 1.297-3.178, p<0.001), EN way (HR = 6.312, 95% CI: 5.143-11.836, p<0.001), infusion rate (HR = 1.947, 95% CI: 1.135-3.339, p<0.001), and intra-abdominal hypertension (HR = 3.864, 95% CI: 2.360-5.839, p<0.001).

Conclusion: Critically ill patients supported with mechanical ventilation are at a high risk of GI dysfunction. Interventions such as the use of laxatives or prokinetic agents, control of EN infusion rate, and maintaining a normal state of hydration, might be beneficial for the prevention of GI dysfunction in critically ill patients.

Patient or public contribution: No.

Aim: This study aimed to explore the experiences of hospitalised patients with Covid-19 in terms of the meeting of their comfort needs and the source of discomfort during isolation precautions.

Design: Qualitative descriptive phenomenological approach was applied in this study.

Methods: There were 16 hospitalised patients with Covid-19 and 11 nurses who were thoroughly interviewed. Content analysis was conducted to examine the data of the interviews and then managed using Atlas ti-9 software.

Results: Five central themes were identified that describe the comfort needs and the source of discomfort, as follows: (1) nursing professionalism; (2) physical discomfort; (3) psychological responses; (4) poor sleep quality; and (5) spiritual adaptations.

Public contribution: The study promoted further explanation about comfort need in patients with Covid-19 in isolation room. This study also highlighted that nursing care played a pivotal part in assisting patients to reach their highest comfort level.

Background: Mothers of high-risk neonates experience tremendous stress during neonatal intensive care unit (NICU) admission. This stress has a negative impact on mothers' participation in neonatal care activities, psychological health and coping skills in the NICU.

Objective: To determine the impact of interventional strategies to reduce maternal stress and enhance coping skills during neonatal admission to the NICU.

Design: A scoping review was carried out following the methodological framework outlined by Arksey and O'Malley.

Methods: This scoping review was conducted as per the Joanna Briggs Institute guidelines, including a quality appraisal checklist for randomised and nonrandomised controlled trials. Patterns, advances, gaps, evidence for practice and research recommendations from the review (PAGER framework) were used to report the results. The following international databases were used to search for primary articles: Medline via PubMed, EBSCOhost via CINAHL, Scopus, Web of Science and the ProQuest Medical Library. Original studies published in English between January 2011 and January 2023 from low- and middle-income countries (LMICs) that assessed maternal stress and coping skills during neonatal NICU admission were included in the review.

Results: The review included 15 articles from LMICs, of which 60% were from middle-income, 25% were from lower-middle-income and 15% were from low-income countries. Interventional strategies were described under five categories. Maternal stress decreased significantly across all three subscales of the PSPS: 'sight and sound', 'baby looks and behavior' and 'parental relationship with baby and role alteration' during neonatal NICU admission. Interventional strategies involving family-centred care and emotional and psychological supportive care have been reported to have a consistently positive impact on alleviating maternal stress and enhancing coping skills in the NICU.

Conclusion: Healthcare professionals, especially nurses, are pivotal in promptly recognising maternal stress and NICU stressors. The participation of mothers in neonatal care, such as through family-centred care and emotional support interventions, significantly reduces maternal stress and enhances coping skills.

Aim: The effects of COVID-19 have brought numerous changes in society in the past several months. Lifestyles, business sectors, educational facilities and healthcare services have been greatly affected, causing individuals to be alarmed about future repercussions. This study investigated the various challenges of nursing faculties in conducting online teaching during the COVID-19 pandemic crisis.

Design: Qualitative description.

Method: Individual interviews were conducted among 20 nurse educators and faculty members, including professors, lecturers and demonstrators utilising a semistructured interview guide. This study utilised qualitative content analysis. COREQ criteria list was used in the qualitative data reporting.

Result: Three major themes were generated from the experiences of the participants namely: (1) 'lack of teacher-student interaction' (2) 'digital literacy and technical issues' and (3) 'curriculum structure and programme quality'. The study's benefits will enable the nurse faculties to realise and conceptualise ways and means to mitigate the challenges in conducting online teaching since the effects of COVID-19 continue to increase. Nurse faculties must prepare various strategies approach to deliver education without compromising their quality.

Patient or public contribution: Experts from various fields were consulted in the planning of the data gathering procedures, analysis of data and reviewing of the manuscript.

Aims: This study analysed the status of nurse-authored patents and their influencing factors. In particular, this study examined the effects of nurses' innovative behaviour and creative self-efficacy on nurse-authored patent output via structural equation modelling (SEM).

Design: A descriptive cross-sectional study.

Methods: Nurses were recruited from one tertiary cancer hospital in Beijing, China. Among them, 352 oncology nurses completed the online versions of the Nurse Innovative Behavior Scale and Creative Self-Efficacy Scale in 2023.

Results: We collected a total of 332 valid questionnaires. Fifty-seven (17.2%) nurses had 1-3 patents, and only 6 (1.8%) had more than three patents. The final model revealed a chain reaction between creative self-efficacy, innovation behaviour and nurse-authored patent output (χ² = 11.962, df = 7, p = 0.102). Significant differences were observed in the number of nurse-authored patents and based on age, educational profile, professional title, length of service, position, participation in science and technology innovation training, and experience in project presentation (all p < 0.05).

Conclusion: Nurses still play a minor role in the field of medical technology innovation. It is necessary to promote innovative behaviour among nurses and improve their creative self-efficacy in terms of innovation.

Impact: Developing intervention strategies to encourage nurses to pursue clinical innovations is crucial for nursing managers and technological innovation promoters.

Aims and objectives: To describe psychiatric nursing staff´s experiences of working with suicide risk assessment instruments.

Background: Around the world, approximately 720,000 people die by suicide each year, of which almost 20% have an ongoing contact with specialist psychiatry during their last month alive. To identify which patients have an increased risk of suicide is a highly important task for nursing staff. Suicidal behaviour is complex and unpredictable. Nursing staff work closely with patients in everyday psychiatric care and often possess unique patient knowledge. These professionals must therefore be able to know when a patient's eventual suicidality requires further attention and efforts.

Design: A descriptive qualitative study.

Methods: Convenience sampling including nursing staff with more than 2 years of experience in specialist psychiatry. The data collection took place through semi-structured interviews and was then analysed according to conventional content analysis.

Results: The nursing staff felt that a natural conversation is superior suicide risk assessment instruments and that experience and patient knowledge are the primary factors for facilitating a suicide risk assessment. This meant that some nursing staff rarely used suicide risk assessment instruments, although they sometimes could be a useful support in the conversation and provided a sense of personal security when documenting results.

Conclusion: Suicide risk assessment instrument can be significant and helpful in certain cases, but the essential components of a suicide risk assessment consist of a conversation to understand the meaning of suicide from the patient's perspective.

Patient or public contribution: Psychiatric nursing staff contributed to this study by sharing their experiences through interviews.

Aims: This study aimed to assess nursing workload in Cardiac Intensive Care Unit (CICU) after three cardiothoracic surgery procedures during first four postoperative days using Nursing Activities Score (NAS) and Nine Equivalents of Nursing Manpower Use Score (NEMS) systems, to compare their performance for that purpose and to investigate association between nursing workload and type of surgery.

Design: A comparative study.

Methods: The research environment includes CICU of the University Hospital for Cardiovascular Diseases in Serbia. A total of 808 patients who underwent coronary, valvular, or combined surgery, resulting in 2282 filled NAS and NEMS pairs chart. Statistical analysis was performed using SPSS-19. The correlation between NAS and NEMS was tested by Spearman's correlation coefficient. Differences were considered statistically significant at p < 0.05.

Results: The lowest median of cumulative NAS 176 (175-257) and NEMS 76 (64-91) had coronary surgery patients, the highest NAS 224.5 (178-334.5) and NEMS 83 (69-121) had those with combined surgery; this difference was statistically significant (p < 0.001). The median of both scores decreased after surgery, with the following values from the first to the fourth postoperative day: NAS from 104 (102-105) to 81 (74-85) and NEMS from 46 (42-46) to 30 (30-37). The difference in mean values of both scores between the first and the fourth postoperative day was statistically significant (p < 0.001). NAS and NEMS were in a positive, strong correlation (r = 0.913; p < 0.005).

Conclusion: Both scores can be used to measure nursing workload, identify the required number of nurses in CICU, and support task allocation. NAS may have an advantage because it better describes extensive postoperative monitoring and care needed for cardiac surgery patients. Nursing workload is associated with type of surgery, with the highest workload measured in patients who underwent combined surgery procedure and on the first postoperative day.

Aim: To explore the relationship between midwives' psychological resilience and posttraumatic growth, and the mediating role of perceived stress and positive coping strategies.

Design: A multicentre cross-sectional survey was used.

Review methods: Data were conducted among 339 midwives from 24 Grade III A hospitals in Sichuan Province from April to July 2023, using the Chinese version of the Connor Davidson Resilience Scale, Chinese version Perceived Stress Scale, Simplified Coping Style Questionnaire, Chinese-Posttraumatic Growth Inventory and General Demographic Data Questionnaire. A descriptive statistical approach, Pearson's correlation analysis and the Mplus 8.3 were used to analyse the available data.

Results: There was a significant correlation between psychological resilience, perceived stress, positive coping strategies and PTG. Psychological resilience could have a direct positive impact on PTG of midwives, but it could also indirectly affect PTG of midwives through three pathways: the mediating effect of perceived stress, the mediating effect of positive coping strategies and the chain mediating effect of perceived stress and positive coping strategies.

Conclusion: Results suggest that nursing managers should help to improve the psychological resilience of midwives and to reduce individual stress perception, enhance coping abilities and achieve positive growth.

Impact: Prior to data collection, we obtained approval from the nursing department of each hospital. Midwives who met the inclusion and exclusion criteria gave informed consent and invited to participate in this study.

Reporting method: This study was guided by STROBE.

Patient or public contribution: During the data collection phase, 349 midwives took the time to carefully answer the questionnaire items related to this study.

Aim: To establish consensus on the priorities of nursing research in Qatar regarding nursing administration, nursing practice and nursing education for the years 2023-2033.

Design: Classic Delphi format over three phases.

Methods: The first phase involved a qualitative round where participants identified 10 research priorities. In phase two, the collected sentences were analysed and grouped into themes. Participants were then requested to rate these sentences based on their perceived importance. During phase three, participants received their individual responses, the consolidated group response from the second round, and were given the opportunity to agree or disagree with the group ranking. The panel of experts consisted of 32 participants who agreed to participate in all three rounds. They included a mixture of nursing academics, clinical managers and nursing directors from public sectors and nursing schools in Qatar.

Results: The experts reached a consensus on the research priorities for Qatar. These prioritized topics focused on improving patient care outcomes, enhancing workforce development, strengthening nursing leadership, integrating technology to improve nursing and nursing education and promoting evidence-based practice.

Conclusion: This research emphasizes the importance of progress in nursing to meet healthcare demands. Findings showed the need of future research to focus on improving nursing workforce and well-being, leadership styles and technology, and evidence-based practice and technology in nursing education.

Impact: The impact of identifying nursing research priorities in Qatar will improve healthcare practices, fostering a culture of evidence-based care. These advancements will motivate nurses to engage more actively in research, thereby enhancing overall healthcare outcomes.

Public contribution: Not applicable.

When people talk about their healthcare experience, compassion is often a common ingredient in the stories they share. After a decade of healthcare reforms and research on compassion, the experience of receiving compassionate care has been shown to be important to patients and their families. Yet, there is little guidance to inform compassionate practice in the context of providing mental health care. In this article, the authors suggest three things that mental health nurses can use in their practice to demonstrate compassion.