Nursing Open最新文献

Aims: This review aims to classify the evidence from randomised controlled trials (RCTs) on mental health services (MHS) for people with serious mental illness (SMI) available in the Cochrane Schizophrenia Group's (CSzG) specialised register.

Design: Scoping review.

Methods: We retrieved and screened RCTs of service-level interventions considering non-pharmacological approaches for mental healthcare of the CSzG register. We classified and collected the main characteristics of the RCTs using a customised data extraction and charting form based on DESDE-LTS classification.

Results: We included 233 out of 262 total trial registries. Most of the studies were conducted in China, 136 (58%), 57 (24%) North America and 26 (11%) Europe. We classified the studies as ambulatory assistance 80 (34%), day services/out-patient care 38 (16%), residential services 44 (19%), accessibility to care 19 (8%), information/assessment 39 (17%), self-help and voluntary help 10 (4%), e-health 52 (22%), and discharge services 17 (7%).

Conclusions: We found a large number of trials that investigated the effects of mental health services for people with SMI. Trials classification was difficult due to the poor report of the characteristics of these complex interventions. This database can be used to plan and prioritise systematic reviews according to the needs of stakeholders.

Relevance statement: The study is of interest to mental health nursing because it studies the different services in which nurses play a fundamental role with implications in the nursing practice, education, research or leadership and management.

Aim: This study aimed to assess the levels of maternal perception of control and support during birth and the factors influencing them in the postpartum period.

Design: A cross-sectional design was employed. The STROBE checklist was used.

Methods: The study was conducted between July 2021 and March 2022 with 400 mothers who were in their first 2 months postpartum and lived in Türkiye. Data were collected online using a Maternal Descriptive Information Form and the Support and Control in Birth (SCIB) Questionnaire. Descriptive statistics, such as percentage, mean, standard deviation and multiple linear regression analysis, were employed for data evaluation.

Results: The mean score on the total SCIB was 92.4 ± 13.01. Vaginal birth and caesarean section accounted for 47.3% and 52.7% of the study group, respectively, with only 35% being assisted by a midwife. Variables of age, education level, number of pregnancies, mode of birth and health professionals assisting birth showed no significant effect on the total SCIB score (p > 0.05). Maternal satisfaction with birth scores, satisfaction with health professionals involved birth and fulfilled expectations from health professionals were positively associated with high SCIB scores (p < 0.05).

Conclusion: The level of SCIB in our study fell within a 'moderate' range, considering the lowest and highest scores on the scale. Notably, increased satisfaction with birth experience and healthcare professionals, positively influenced maternal perceptions of control and support during birth. In contrast, certain socio-demographic and obstetric characteristics did not demonstrate a significant impact. To enhance the sense of support and control during childbirth, it is crucial to identify and fulfil the expectations of mothers from midwives and birth supportive care to ultimately elevate maternal satisfaction in the childbirth experience.

Patient or public contribution: None.

Aim: To determine the views and experiences of inpatient nurses receiving care.

Background: Switching from the care provider role to being a patient allows nurses to realise patients' real care expectations and to test their colleagues' care practices. Nurses' experience as inpatients is essential for understanding patients' care-related expectations and improving care quality by reflecting on their practices.

Design: This qualitative study used a descriptive phenomenological design.

Methods: Data were collected from nine volunteer nurses between July 2018 and June 2020 in Ankara, Türkiye, through face-to-face interviews using semi-structured questionnaires and audio recordings. The research data were analysed by following the descriptive phenomenological data analysis steps. The Consolidated Criteria for Reporting Qualitative Research [COREQ] checklist was used to report study findings.

Results: Three themes emerged from the views and experiences of nurses receiving inpatient care: care-receiving experiences, components of good nursing care and change in perception of care.

Conclusion: It is important to reveal the opinions and experiences of hospitalised nurses regarding care to understand the expectations of the care recipients and to increase the quality of the care provided. The study revealed that the experiences of nurses receiving inpatient care improved their professional sensitivity and this was reflected in the quality of the nursing care they provided.

Implication for nursing: Nurses can provide higher quality and humanistic care by combining their professional knowledge and skills with the increased awareness of the inpatient experience of nurses. No patient or public contribution.

Aim: We explored demoralisation syndrome among post-operative patients with breast cancer and its relationship with patients' body image and marital intimacy.

Design: A cross-sectional study.

Methods: In this cross-sectional study, 237 patients with breast cancer who were hospitalised in the breast surgery department of Grade A tertiary hospital in Xiamen, China from June 2022 to December 2023 and met the standards of adaxation were selected by the convenience sampling method. The survey tool consists of four parts: general data questionnaire, demoralisation scale-II (DS-II), quality of relationship index (QRI) and body image scale (BIS).

Results: In this study, we examined the demoralisation syndrome in 237 post-operative breast cancer patients, predominantly aged 45-59 years (47.3%), with the majority living with family (94.1%) and having children (95.4%). A small proportion (5.9%) lived alone, and 3% were uninsured, opting to pay for their treatment out-of-pocket. The majority (83.1%) had undergone mastectomy, and 51.9% visited the hospital for chemotherapy, with 5.1% experiencing disease recurrence. The mean demoralisation score was 8.52 (SD = 8.47). We found that 22.8% had moderate and 14.8% had severe demoralisation symptoms. Socioeconomic factors such as age, residence, income, tumour staging, post-operative time, hospital purpose and disease recurrence were associated with demoralisation. Multivariate analysis revealed that income, cancer stage, recurrence, quality of recovery index (QRI) and BIS were independent influencing factors for demoralisation syndrome after breast cancer surgery. These findings highlight the importance of considering a range of patient characteristics when addressing demoralisation in post-operative breast cancer patients.

Patient contribution: Demoralisation syndrome in patients after breast cancer surgery is influenced by a combination of sociodemographics, disease, intimate relationship and body image. Clinical medical staff should accurately evaluate and identify patients with demoralisation syndrome after breast cancer surgery and formulate and implement personalised intervention strategies according to their physical conditions and possible influencing factors, so as to reduce the incidence of demoralisation syndrome and improve the quality of life.

Aim: This study was conducted to examine elder abuse and death anxiety in older adults who had chronic diseases.

Design: The present study is a cross-sectional and correlational study.

Methods: This study was conducted with 200 patients who met the research criteria and agreed to participate in the study and who were admitted to the internal medicine outpatient clinics of a university hospital in Elazig, eastern Turkey. Data were collected by using 'Descriptive Information Form' Hwalek-Sengstock Elderly Abuse Screening Test (H-S/EAST) 'Death Anxiety Scale (DAS)'.

Results: The mean DAS score of 8.66 ± 2.87 was evaluated as high and the mean H-S/EAST score of 6.41 ± 3.78 was evaluated as moderate risk of abuse. It was found that the independent variable H-S/EAST total score affected DAS total score positively (β = 0.633) and explained 38% (p < 0.001). Among the variables included in the model, gender, age and employment status were found to be positive (β = 0.243, β = 0.222, β = 0.222) statistically significant predictors of H-S/EAST total score. In addition, it was found that gender was a positive (β = 0.318) and statistically significant predictor of DAS total score (p < 0.05).

Conclusions: Older individuals with chronic illness have a moderate risk of abuse and a high level of death anxiety. As the risk of elder abuse increases, death anxiety also increases. In addition, gender is an important predictor of elder abuse and death anxiety. In line with these results, it is recommended to identify groups with high potential for abuse, to organise awareness-raising training programs to prevent abuse and to conduct evaluations for abuse and death anxiety at regular intervals. Also, the results of this research will contribute to nursing literature and will be useful for future interventional research.

Public contribution: There is no public contribution.

Aim: Social anxiety is common among students, yet research specifically on undergraduate nursing students is scarce. Previous studies have identified various influencing factors but lack a clear ranking of their importance, making it challenging to implement effective intervention strategies with limited resources. This study aims to assess the level of social anxiety in undergraduate nursing students and rank the importance of its influencing factors, providing essential insights for developing efficient and targeted interventions.

Design: A cross-sectional study was conducted with 546 undergraduate nursing students in China.

Methods: Data were collected via a web-based questionnaire, which included the fear of positive and negative evaluation scale, the self-efficacy scale, and the social anxiety scale. The random forest model was employed to analyse the data and rank the importance of the influencing factors.

Results: The total social anxiety score among undergraduate nursing students was 11.20 ± 4.71. Social anxiety had a positive correlation with both fear of positive evaluation (r = 0.521, p < 0.001) and fear of negative evaluation (r = 0.648, p < 0.001) and a negative correlation with self-efficacy (r = -0.273, p < 0.001). According to the random forest model, the top five predictors of social anxiety in this study were fear of negative evaluation, fear of positive evaluation, personality traits, self-efficacy, and academic performance.

Conclusion: Attention to social anxiety in undergraduate nursing students is necessary, particularly for those with a higher fear of evaluations, introverted personalities, lower self-efficacy, and poor academic performance. Nursing educators should consider recognising social anxiety and developing personalised interventions tailored to the specific characteristics of these students.

Patient or public contribution: All participants contributed to the conducting of this study by completing self-reported questionnaires.

Aim: To explore what characterises communication and collaboration within a patient and professional partnership in outpatient care settings garnered from the experiences of persons living with long-term conditions.

Design: A qualitative descriptive study design.

Methods: Semi-structured individual interviews were conducted with 15 persons with long-term condition/s who experienced outpatient treatment or follow-up care. Data were explored through inductive thematic analysis. The COREQ checklist was followed.

Results: The analysis revealed five themes: adapting and self-managing in daily life, handling and carrying information, building trust and continuity, acting in a flexible and transparent dialogue and sharing the way forward. The participants described their personal and informal resources, and their actions to take control and manage health and well-being. A person-centred approach, sharing of knowledge and communication skills enabled the development of trust in the healthcare providers and their treatment and care. Communication was facilitated through availability, shared documentation, continuity and coordination of care. Collaboration was described as a flexible dialogue with mutual trust and transparency, shared learning and problem-solving. Sharing the way forward was a process, alongside and important to the life-changing process to cope with the illness.

Conclusions: Prerequisites for the collaboration in outpatient settings were availability, continuity and a healthcare system that acknowledged, empowered and adapted to patients' health status, resources, everyday life and a patient's coping processes to manage their disease. For a co-created, person-centred outpatient care, it is important to acknowledge and/or collaborate with the patient's team of other healthcare providers and informal caregivers.

Relevance to clinical practice: The study contributes to better understanding of patient preferences and prerequisites how to work in partnership and how to develop future services and person-centred care for persons living with long-term conditions.

Patient and public contribution: Patients included in this study were participants during the data collection process.

Aim: (1) To classify patients with community-acquired pressure injury (CAPI) according to the risk factors of PI and to assess validity of the classified groups. (2) To clarify characteristics of each group for CAPI prevention and care.

Design: This study is designed to classify CAPI patients into clusters based on a retrospective study of medical records, followed by cluster analysis and description of each cluster's characteristics.

Methods: Risk factors and status of CAPI, as well as discharge destination, were investigated based on 1 year's worth of medical records of patients with CAPI on hospital admission during 2018-2019. After calculating descriptive statistics, cluster analysis was conducted by Ward's method of Euclidean distance referring to risk factors of PI. Lastly, each of the defined clusters underwent multiple comparisons.

Results: From 324 patients with CAPI, 272 patients were selected as the study subjects, due to availability of sufficient information regarding risk factors of PI. After classification into three groups, data were interpreted by Euclidean distance and comparison between 'attribute and risk factors of PI' and 'PI and destinations after discharge'.

Patient or public contribution: Patients with CAPI were classified into three clusters and validity of the classification was assessed. Patients who had 'maintained ADL', as well as cognitive status, were expected to be capable of self-care and self-management. Patients with 'low ADL' were characterised by insufficient self-care or home care resulting in having CAPI and would require aged care service. Patients who were at 'very high risk' of having PI were characterised by incurring significant burden on caregivers and need of medical services that prospects terminal care.

Aims: To explore all medication administration errors (MAEs) throughout the entire process of medication administration by nurses in the inpatient setting, to describe their prevalence, and to analyse associated factors, including deviation from the good practice standards.

Background: Worldwide, MAEs are very common and regarded as a serious risk factor to inpatient safety. Nurses assume an essential role in the hospital setting during the administration of medications.

Design: The prospective observational study was carried out in accordance with the STROBE guidance.

Methods: This study was conducted in four regional hospitals from June to August 2021. MAEs were collected when nurses administered medications to the adult inpatients during the morning, noon, and evening medication rounds at the internal, surgical, and follow-up care departments in each hospital over three consecutive days. Direct observation by the multidisciplinary team was employed. MAEs were classified as major MAEs (from the potentially most serious and common to all drug forms), specific MAEs (specific to a drug form), and procedural MAEs (e.g., patient identification, hygiene standards, or generic drug substitution). Predictors of either major MAE or specific MAE frequency were analysed using the generalised linear model and the decision tree model.

Results: Overall, 58 nurses administering medication to 331 inpatients at 12 departments were observed. In total, 6356 medication administrations were observed, of which 461 comprised major MAEs, 1497 specific MAEs, and 12,045 procedural MAEs. The predictors of the occurrence of major MAEs and specific MAEs were the specific hospital, the nurse's length of practice (less than 2 years), and two procedural MAEs (the unclear prescription and the wrong strength).

Conclusions: Non-adherence to the standard processes in healthcare facilities for prescribing and administering drugs increased the prevalence of severe MAEs. Determinants of MAE occurrence such as incorrect prescriptions or limited experience of nurses should be considered.

Implication for the profession and patient care: The identified determinants of MAE should be considered by hospital stakeholders in their support programs to reduce the level of burden for nurses during medication administration.

Patient or public contribution: Neither patients nor public was not involved in the design, data collection, or dissemination plans of this study. The researchers observed nurse care delivery at medical departments acting as passive participants.

Aims: The objective of this study is to ascertain the suitability of haemoglobin as a screening factor for falls among obstetrics and gynaecology inpatients and to formulate a stratified scheme for assessing fall risk based on haemoglobin.

Design: A retrospective analysis and Delphi surveys were employed for this investigation.

Methods: Initially, a retrospective survey analysed falls among obstetrics and gynaecology inpatients in two hospitals from January 1, 2020, to July 10, 2022. Descriptive statistics, receiver operating characteristic (ROC) curve analysis, Youden index, sensitivity and specificity were utilised for data examination. The conclusions drawn were subsequently validated by Delphi surveys, featuring 21 experts participating in five rounds of consultation. The Kappa value and the coefficient of variation (CV) were employed to assess expert advice.

Results: The area under the Receiver Operating Characteristic curve (AUC) of haemoglobin was 0.762 ± 0.030, 95% CI (0.703, 0.821). The highest Youden index was 0.425, with sensitivity at 0.705 and specificity at 0.720 when haemoglobin was 107.5 g/L. Two consensuses were reached by experts: anaemia was important in causing falls in obstetrics and gynaecology wards, and haemoglobin should be employed as a screening factor for falls. The stratification of anaemia was developed as follows: ≥ 110; 90-109; 60-89; and < 60 g/L. Approval for the final results was unanimous among all experts. The Kappa value (K*) was 1, and the CV of expert advice ranged from 0.092 to 0.219.

Conclusions: Haemoglobin could potentially be used as a predictor of fall risk in Gynaecological and Obstetric Wards. The recommended stratified scheme for anaemia in fall risk assessment is as follows: ≥ 110; 90-109; 60-89; and < 60 g/L.

Implications for the profession and/or patient care: What problem did the study address? The study revealed a relationship between falls and haemoglobin in obstetrics and gynaecology inpatients. It also proposed a stratification scheme for assessing fall risk based on haemoglobin levels. What were the main findings? Haemoglobin has a good performance on fall risk prediction in Gynaecological and Obstetric Wards. The stratified scheme of anaemia for fall risk assessment was suggested as follows: ≥ 110; 90-109; 60-89; and < 60 g/L. Where and on whom will the research have an impact? Nurses and inpatients in obstetrics and gynaecology wards will be affected by the results of this study, and it provided a reference for fall prevention.

Reporting method: This study has adhered to relevant EQUATOR guidelines and named the reporting method. No Patient or Public Contribution.