Nursing Open最新文献

Aim: To evaluate the accuracy and completeness of information generated by ChatGPT models in preventing peripheral intravenous catheter-related infections.

Background: Peripheral intravenous catheters are vital for administering medication and fluids but often cause complications like life-threatening infections. These issues increase healthcare costs and patient discomfort. Nurses are crucial in managing these catheters, yet studies show they often lack knowledge and adherence to best practices.

Method: This descriptive study utilised a 10-question Information Form for Preventing Peripheral Venous Catheter-Related Infections. By presenting the form to ChatGPT models (GPT-3.5, GPT-4, and GPT-4o), it was requested that each multiple-choice question be answered and a brief explanation provided as to why that option was correct. Responses were evaluated for correctness (0-10), accuracy (1-5), and completeness (1-3) using Likert scales.

Results: GPT-3.5 and GPT-4o each scored 5 out of 10 on the Information Form for Preventing Peripheral Venous Catheter-Related Infections, while GPT-4 scored 3 out of 10. All models correctly answered questions on catheter replacement, selection, and dressing regimens (time of replacement) but struggled with hand hygiene, aseptic technique, and catheter dressing regimens (type of dressing). Accuracy scores averaged 3.9 for GPT-3.5, 3.5 for GPT-4, and 3.4 for GPT-4o. Completeness scores averaged 1.8 for GPT-3.5, 1.6 for GPT-4, and 1.8 for GPT-4o. There were no significant differences in accuracy and completeness scores between the models (p > 0.05).

Conclusion: The findings highlight that although ChatGPT models can provide supportive information, their limitations in accuracy and completeness may pose risks for patient safety, particularly in critical domains such as aseptic technique and hand hygiene. It was emphasised that expert supervision is needed in the use of artificial intelligence tools to provide information in healthcare services.

Impact: Future improvements in artificial intelligence models are necessary to enhance their effectiveness in medical applications. It is crucial to ensure that healthcare professionals are aware of the current limitations of artificial intelligence tools and continue to rely on expert knowledge and supervision in clinical settings.

Patient or public contribution: No patient or public contribution.

Aim: The aim of this study was to describe nurses' experiences of the required competencies working in home care.

Design: A qualitative design with semi-structured interviews was used.

Methods and data source: Eleven nurses from home care units in one wellbeing services county in Finland participated in the individual interviews between October and December 2022. The data were analysed with thematic analysis.

Results: The analysis led to eight themes of competence requirements: Individual and holistic support for living at home in agreement with the client, Working in interaction and cooperation as a part of a multiprofessional network, Situational awareness, Technological skills in home care, Leadership and management, Continuous learning and development, Ethical competence, and Holistic client services in home care.

Conclusion: The findings indicated that nurses in home care need to have wide knowledge, skills, and attitudes to work in home care.

Implications of profession: Changes in home care services in Finland and the number of home care clients with different diseases require continuous competence development.

Impact: The findings provide information for both registered and licenced practical nurse education and competence development in home care units.

Reporting method: The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used for reporting the study.

No patient or public contribution: Nurses in home care were involved in the interviews.

Aim: The aim of this study was to establish an indexing system for training courses based on post-competency for gynaecological specialist nurses.

Design: A mixed-methods study.

Methods: We employed literature reviews and semi-structured interviews to develop a preliminary index system. Subsequently, a two-round Delphi consultation survey was conducted to get insights from 15 experts regarding the index for evaluating the post-competency of gynaecological specialist nurses and to obtain qualitative feedback on their assessments. Following the finalisation of the competency index system, a 3-month training programme was implemented with 75 specialist nurses to evaluate its practical application. These nurses completed the training and returned to their clinical duties after successfully passing the competency evaluation.

Results: The comprehensive training course index system for post-competency gynaecological specialist nurses comprises four primary indices: gynaecological-specialised theoretical knowledge, gynaecological-specialised practical skills, communication and coordination management skills and clinical thinking and research management skills. This system further includes 12 secondary indexes and 58 tertiary indexes. The response rates for the two expert consultation rounds were 100%. The expert authority coefficients were 0.943 and 0.942 in the initial and subsequent rounds of consultation, respectively. During the second round of consultation, the initial and subsequent indices of Kendall's coefficient of concordance were 0.210 and 0.257, respectively (p < 0.05). Seventy-five specialist nurses in gynaecology completed 4 weeks of theoretical education and 8 weeks of practical training. The mean score of gynaecological specialist nurses on the theoretical examination increased from 65.4 before training to 91.2 after training (p < 0.001); the mean score on the self-assessment of post-competency rose from 39.5 prior to training to 86.8 subsequent to training (p < 0.001); the comparison of pre-training and post-training results was statistically significant.

Conclusions: The index system for the training course of gynaecological specialist nurses was designed in a logical and thorough manner, and the findings from its empirical study provided a foundation for the formation of a scientific and systematic gynaecology specialist nursing team.

Aims: This study was aimed at understanding the relationship between trait anxiety levels and coping strategies and social support in Turkish patients undergoing haemodialysis.

Design: The cross-sectional design was used in the study.

Methods: The sample consisted of 462 patients undergoing haemodialysis selected through the convenience sampling method. The study data were collected from patients undergoing haemodialysis at seven private haemodialysis centres in Ankara, the capital of Turkey, between August 2019 and March 2020.

Results: Findings revealed that the level of trait anxiety in these patients fell within the low anxiety range but was close to the threshold for moderate anxiety, indicating that the participants' anxiety levels were on the higher end of the low range. Religion/spirituality, acceptance and positive reframing were the most frequently used problem-focused coping strategies, and self-distraction, venting and self-blame were the most frequently used emotion-focused coping strategies reported by the participants. Significant correlations were determined between the participants' trait anxiety levels, emotional and problem-focused coping strategies, social support levels. Social support systems patients undergoing haemodialysis have, and problem-focused coping strategies used by them affect their trait anxiety levels significantly.

Conclusion: The social support systems of patients undergoing haemodialysis and their use of problem-focused coping strategies explained a significant portion of the variance in trait anxiety levels. The findings demonstrated that patients who more frequently employed problem-focused coping strategies reported lower levels of trait anxiety and perceived higher levels of social support.

Impact: This study has the potential to develop effective interventions in clinical practice and at the societal level to improve the psychosocial well-being and quality of life of Turkish patients undergoing haemodialysis treatment by examining in depth the relationships between trait anxiety levels, coping strategies and social support levels.

Patient or public contribution: The study participants were individuals over 18 years of age who were Turkish patients undergoing haemodialysis treatment at the time of completing the questionnaire.

Aim: To explore the latent classes and various characteristics of self-management ability of patients with atrial fibrillation, and to analyse the influencing factors.

Design: A cross-sectional study design.

Methods: A convenience sampling was used to select 208 patients with atrial fibrillation from 2 hospitals in Shandong Province, China between August 2022 and June 2023. The survey tools included the general data questionnaire, Brief Illness Perception Questionnaire and Self-Management Ability Scale for patients with atrial fibrillation. Data were analysed using latent profile analysis, univariate analysis and binary logistic regression.

Results: The results of the latent profile analysis showed that the self-management ability of patients with atrial fibrillation was divided into two different latent classes. Binary logistic regression analysis showed that disease duration, primary caregiver and illness perception were significantly associated with self-management ability.

Conclusions: There are 2 potential categories of self-management ability in patients with atrial fibrillation. Appropriate individualised health management interventions for patients with atrial fibrillation, focusing on the patient's disease duration, primary caregiver and illness perception, may improve self-management in these patients.

Implications for clinical practice: This study is beneficial in providing information reference for medical staff. Medical staff can implement targeted interventions based on the categorical characteristics of the different profiles of self-management ability in patients with atrial fibrillation to improve their self-management ability.

Patient or public contribution: We thank all participants for taking part in the survey throughout the study.

Aim: To develop a format of the behavioural criteria of ethical care with dementia so as to support nursing pedagogy and ethical practice in dementia care.

Design: Literature review, group workshop and Delphi method.

Methods: This project underwent three stages of literature review, initial construction and Delphi method from June 2020 to June 2023. Nine databases were searched with key words for articles relevant to ethical care with dementia that were published before 2022. Johns Hopkins Evidence Level and Quality Guidelines were employed for quality appraisal. A process of highlighting, comparing, merging and categorising was employed by two reviewers for data synthesis. The original behavioural criteria of ethical care with dementia were constructed by team members based on literature review and group discussions. Fifteen experts were invited and two rounds of consultation were completed. Statistics were generated for comprehensive evaluations. Revisions were made with expert suggestions to obtain a final format.

Results: A total of 3299 titles and abstracts were initially retrieved, 242 full text articles were reviewed and 15 articles were included, with evidence type of I to V and evidence level b. Ten ethical principles and 12 categories of ethical issues closely relevant to dementia care were achieved by syntheses. An initial format of the behavioural criteria was developed for the Delphi method. Modestly acceptable correspondence was obtained by two rounds of expert consultation. The final format of the criteria included 10 ethical principles, 37 ethical issues and their corresponding cases, scenarios and three modalities (the recommended, the obscure and the false) of ethical care behaviours with dementia. Therefore, this format of the case-based narrative behavioural criteria could be useful for training the nurses' competencies of ethical reasoning and setting the professional boundaries of nurses' ethical care behaviours, which could facilitate nurses in their pedagogical and clinical practice of ethical care with dementia.

Patient or public contributions: No patient or public contributions.

Aim: This study aims to explore how children with mild intellectual disabilities perceive the nursing profession through the drawing method.

Design: This qualitative descriptive study used visual data analysis and the draw-and-tell technique to explore children's perceptions of nursing.

Methods: Phenomenology, a qualitative research approach, was employed to analyse 66 drawings obtained through the drawing method.

Results: The analysis revealed that children with intellectual disabilities predominantly perceive nurses as female and associate them with syringes. Furthermore, 82% of the children depicted nurses with smiling facial expressions, while only 4% portrayed frightened facial expressions. Through the drawing method, nurses can gain valuable insights into effective approaches when interacting with children with special needs. Moreover, this method has the potential to mitigate fears and foster positive perceptions of nursing among children with mild intellectual disabilities.

Patient or public contribution: A total of 66 participants consisting of children with intellectual disabilities agreed to participate in this study. Interviews with these participants were conducted in special education centres. Their responses contributed significantly to the content of this article. It will contribute to the approach of nurses to children with special needs.

Aim: To adapt and validate the Problem Areas in Diabetes scale in type 2 diabetes patients in Indonesia.

Design: This was a cross-sectional study.

Methods: The study with 1044 participants was conducted at public health centers. The construct validity used an exploratory factor analysis to measure the scale structure, and a confirmatory factor analysis was used to assess model suitability. Reliability was calculated using Cronbach's alpha, composite reliability, average variance extracted and test-retest results. The sample was divided into equal numbers for the exploratory factor analysis and confirmatory factor analysis.

Results: The exploratory factor analysis showed that the Kaiser-Meyer-Olkin test was 0.899, and Bartlett's test of sphericity was significant. Three factors were obtained with a factor loading of > 0.34. Cronbach's alpha for all items was 0.858, and individual factors ranged from 0.636 to 0.864. An interclass correlation coefficient and test-retest reliability analysis of all question items exhibited good results. Pearson correlations for all items or each factor showed significant results. The confirmatory factor analysis showed that the instrument had an acceptable model fit.

Patient or public contribution: Type 2 diabetes patients and nurses in charge at public health centers were involved in this study. The findings show that the instrument is valid and reliable; it can be an option for measuring the stress diabetes mellitus. The subscales in this instrument can be used simultaneously or separately, according to each individual's needs. Indonesian PAID can be used for stress screening in diabetes mellitus patients starting from the primary health service level so that initial treatment can be provided more quickly.

Aims: Patients undergoing colonoscopy often experience anxiety related to bowel preparation, procedural pain, and fear of cancer, which can adversely affect their vital signs. This study aimed to evaluate the effect of virtual reality intervention on anxiety and cardiac vital signs (including systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate) of patients before the colonoscopy procedure.

Design: This study was designed as a randomised, controlled, and double-blind trial.

Methods: The sample of this study consisted of 70 patients undergoing colonoscopy in the endoscopy unit of the general surgery service of a public hospital. Patients were randomly assigned to the groups (intervention group or control group) and were evaluated twice before the colonoscopy procedure. Patients in the intervention group watched a relaxing video via virtual reality glasses for 15 min between the first and second evaluation stages. The Visual Analog Scale for Anxiety was used to evaluate the patients' anxiety levels before colonoscopy, while cardiac vital signs were evaluated using a digital sphygmomanometer.

Results: In the intervention group, anxiety level of the patients significantly decreased during the second evaluation stage compared to the control group (p < 0.001). Additionally, systolic blood pressure, diastolic blood pressure, and mean arterial pressure scores showed significant reductions in the intervention group at the same stage (p < 0.05). Although patients in the intervention group had lower heart rate scores at the second evaluation stage, there was no statistically significant difference between groups (p > 0.05).

Conclusion: Virtual reality intervention has an improving effect on patients' systolic blood pressure, diastolic blood pressure, and mean arterial pressure. It is also effective in reducing patients' anxiety levels. Virtual reality intervention can be used as a distraction method before colonoscopy procedure.

Patient or public contribution: In this study, patients actively participated in the process of evaluating their anxiety levels and vital signs.

Trial registration: ClinicalTrials.gov identifier: NCT06407531.

Aim: To gain insights into the hip fracture recovery journey with a focus on discharge and follow-up interventions through exploration of the lived experience of people post hip fracture, advanced practice nurses and practice nurses.

Design: An interpretive descriptive methodology was used to guide this qualitative study, underpinned by the Health Empowerment theoretical framework.

Methods: Semi-structured interviews were conducted from March to October 2021, eliciting the experiences of recovery from people post-hip fracture, advanced practice nurses, and practice nurses. Interviews were recorded and transcribed. Thematic analysis was applied to the data.

Results: Thirteen participants comprising people post-hip fracture, advanced practice nurses, and practice nurses were interviewed. Connecting with the Human Spirit was a major theme identified, and the Health Empowerment Conceptual Model was developed to represent the care components highlighted within this theme.

Conclusion: Connecting with the Human Spirit was an important finding which incorporated acknowledging the trauma of hip fracture and supported open and honest communication to empower people to actively participate in their recovery. The Health Empowerment Conceptual Model draws together important findings, highlighting the care people post-hip fracture and nurses valued, and the support, education and understanding needed to recover underpinned by an empowerment approach.

Implications for the profession and/or patient care: The Health Empowerment Conceptual Model supports an empowered approach to policy and practice development of nurse-led models of care to effectively manage patients post-hip fracture across the care continuum.

Impact: This study addressed the recovery experiences post-hip fracture. Connecting with the Human Spirit was a major theme, with care component findings informing the Health Empowerment Conceptual Model to support an empowered recovery. Research supports policy and practice development for nurse-led models for health services, clinicians, and people affected by hip fracture.

Reporting method: Consolidated criteria for reporting qualitative research.

Patient or public contribution: The experiences of people post-hip fracture, advanced practice nurses, and practice nurses were elicited in this study.