Nursing Open最新文献

Aims: This study examined patient perspectives of the factors that contributed to their falls in a medical ward and how patient understanding of the implemented fall prevention strategies influenced their perceptions of their fall risk.

Design: An exploratory sequential mixed methods design.

Methods: Quantitative data were obtained from the RiskMan fall database and auditing of the Patient-Centred Care Plan to identify patients who experienced a fall on the ward. From this cohort, seven inpatients were interviewed using a structured interview questionnaire to explore their perceptions of why they fell. Other complexities of fall management in the ward were discussed, including the assessment and identification of high fall risk patients and the effectiveness of patient education.

Results: Five contributing factors were seen to have led to inpatient falls in the medical ward: (1) there seems to be little, if any, patient engagement with the advice in the fall prevention brochure distributed on admission; (2) insufficient patient awareness of the various fall prevention strategies; (3) inadequate bathroom supervision provided by nurses; (4) patient call bells not answered promptly, which encouraged patients engaging in risk-taking behaviour and (5) a breakdown in communication between nursing staff and patients. The study identified several factors that should be included in fall administrative data, such as the duration of call-bell response, the quality of nurse-patient communication and the determinants influencing patient response to fall prevention strategies. The study findings offer valuable insights to enhance the efficacy and implementation of fall prevention strategies to improve patient outcomes.

Patient contribution: Patients who had experienced a fall during their current hospital admission were interviewed. For each patient, the interview was a communication medium to explore the factors surrounding the occurrence of their fall and their knowledge of their fall risk.

Aim: To evaluate a postgraduate educational intervention that integrates communication and technical skills in critical healthcare situations for interprofessional teams from the perspective of students and lecturers.

Methods: In phase 1, students and lecturers participated in the evaluation of the strengths, weaknesses, opportunities, and threats of the Sim-IPE educational intervention included in a postgraduate program, generating a list of improvement actions. In phase 2, an expert panel prioritized the items on the list.

Results: Both groups addressed nearly identical themes, albeit with different points of view, allowing the panellists to have a broad vision of the issue. Students identified six themes: competence acquisition, pre-briefing, debriefing, fidelity, resources, and teaching team. Lecturers added a seventh theme related to how students systematically emphasize technical skills over communication skills, and the difficulties in balancing interprofessional groups and scenarios with students with varying professional experiences. A list of 23 improvement actions was generated. Panellists prioritized nine action points for improvement and grouped them into three categories (competitiveness of the program, aspects of the pre-briefing, and aspects of the debriefing).

Conclusions: The program is expected to promote Sim-IPE intervention through the master's degree website, generate a complete preplanned briefing script, and sensitize students to the relevance of integrating communication skills in critical situations. Academic institutions will achieve quality educational intervention that is updated and aligned with best academic practices and equip students with the skills and knowledge necessary to succeed academically and professionally.

Reporting method: This research has adhered to relevant EQUATOR guidelines, the consolidated criteria for reporting qualitative studies (COREQ 32-item checklist).

Patient or public contribution: Sixteen participants from a master's degree in emergencies and disasters and seven panellists completed the research.

Aim: Young children depend on their parents to develop in a positive and healthy way. For parents to promote and maintain good health for their children, parent's level of health literacy and self-efficacy is important. The aim of this study was to explore health literacy in parents of toddlers and investigated the associations between parental health literacy and self-efficacy.

Design: The study utilised a quantitative cross-sectional design.

Method: Parents (N = 76) with children between the ages of 6 weeks and 12 months were recruited from a public health centre in Norway. Multidimensional health literacy was measured using the Health Literacy Questionnaire-Parent version while self-efficacy was measured using the General Self-Efficacy Scale. The health literacy domains are presented by descriptive analysis. The associations among health literacy domains, demographic variables and self-efficacy were analysed using bivariate correlations and non-parametric tests.

Results: Health literacy scores were overall high, and self-efficacy was positively associated with all nine health literacy dimensions. The highest score of health literacy was found for the feel that healthcare providers understand and support my child's situation dimension (median 3.8 with interquartile range 3.3-4.0). The lowest scores of health literacy were found for the appraisal of health information dimension (median 3.2 with interquartile range 3.0-3.8). Self-efficacy had a score of median 3.5 with interquartile range 3.2-3.7.

Conclusion: The parents of toddlers in this study had high parental health literacy and self-efficacy. Self-efficacy was positively associated with all nine health literacy constructs. Future research should include multiple measure points to assess the dynamic variation on both parental health literacy, self-efficacy and demographic variables.

Patient or public contribution: No patient or public contribution.

Aim: To compile a questionnaire Knowledge, Attitude and Practices (KAP) of ICU nurses on central venous catheter maintenance and test the reliability and validity of the questionnaire.

Design: Compile a questionnaire, conduct a questionnaire survey and test the reliability and validity of the questionnaire.

Methods: The initial questionnaire was formed based on the theory of KAP, combined with literature review and Delphi expert correspondence method; a questionnaire survey was conducted among 334 ICU nurses in five tertiary hospitals, and the reliability and validity of the questionnaire were tested and a formal questionnaire was compiled.

Results: The ICU nurses' CVC maintenance KAP questionnaire included 31 items in three dimensions of knowledge, attitude and behaviour. The item content validity (I-CVI) and questionnaire content validity (S-CVI) were 0.889 ~ 1.000 and 0.974, respectively. Exploratory factor analysis extracts three common factors (dimensions), the cumulative variance contribution rate is 65.656%, the Cronbach'α coefficient of the total questionnaire is 0.843, and the Cronbach's α coefficients of the three dimensions of KAP are 0.754, 0.887 and 0.940, respectively. The split-half reliability is 0.816. The test-retest reliability of the total questionnaire is 0.813.

Conclusion: The ICU nurses' CVC maintenance KAP questionnaire has good reliability and validity, stable results, comprehensive coverage, and high feasibility. It can be used as a measurement tool to evaluate the maintenance level of CVC for ICU nurses in China.

No patient or public contribution: No patient or public contribution.

Objective: This study aimed to investigate the effect of progressive muscle relaxation exercises on the ability to cope with stress and anxiety level in caregivers of palliative care patients.

Design: The study was conducted as a single-blind study with pretest-posttest randomised control group.

Method: The study was conducted between May 11 and July 22, 2021. The caregivers in the experimental group were asked to perform a total of 28 sessions of progressive muscle relaxation exercise for 30 min a day for 4 weeks. No interventions were made in the control group during the study. Data were collected using the 'Caregiver Information Form,' 'State-Trait Anxiety Inventory (STAI)' and 'Stress Coping Styles Scale (SCSS).' Number and percentage, mean, standard deviation, Chi-Square Test, independent groups t-test, dependent groups t-test, Mann-Whitney U Test, Wilcoxon Signed Rank Test and simple linear regression analysis were used to summarise the data obtained from the study.

Results: A total of 66 caregiver patient relatives, 33 in the experimental group and 33 in the control group, were included in the study. When the posttest mean scores of caregivers in the experimental and control groups were compared, it was found that the experimental group's STAI and negative SCSS subscale mean scores decreased compared to the control group's mean scores, while the positive SCSS subscale mean scores increased, and the difference was statistically significant (p < 0.05). It was found that the variable of progressive muscle relaxation exercise had a negative effect on anxiety (β = -0.962), helpless approach (β = -0.535) and submissive approach (β = -0.643), while it had a positive and significant effect on seeking social support (β = 0.765), self-confident approach (β = 0.832) and optimistic approach (β = 0.493) (p < 0.001).

Conclusion: It was found that after progressive muscle relaxation exercises, the anxiety of caregivers of palliative care patients decreased, the use of positive stress coping methods increased and the use of negative stress coping techniques decreased.

Patient or public contribution: It is not necessary.

Trial registration: ClinicalTrials.gov identifier: NCT04880941.

Aim: This study aims to evaluate the effectiveness of supportive nursing care interventions in reducing depression and anxiety among mothers with infants in the neonatal intensive care unit.

Design: Systematic review and meta-analysis.

Methods: Randomised controlled trials conducted in mothers with infants admitted to the neonatal intensive care unit with any form of supportive nursing interventions compared to no intervention or usual care in terms of either reduction in depression or reduction in anxiety level of the mothers reported in both groups were included. The GRADE approach assessed the quality of evidence, while the pooled standardised mean difference with 95% confidence intervals (CIs) was calculated using a random-effects model.

Results: Overall, 18 studies were included. For depression, the pooled standardised mean difference was -0.24 (95% CI: -0.44 to -0.04), indicating a significant reduction in depression levels among mothers receiving supportive nursing care compared to standard care. In anxiety, pooled standardised mean difference was -0.61 (95% CI: -0.96 to -0.25), showing substantial reduction in anxiety levels. GRADE findings indicated moderate quality of evidence for depression and very low quality for anxiety, mainly due to heterogeneity and publication bias in anxiety outcomes.

Patient or public contribution: No patient or public contribution.

Aim: Frailty is a risk factor for adverse events in older individuals; however, it has not been fully verified in patients undergoing dialysis. Our aim was to verify the association between frailty and adverse outcomes consisting of mortality, falls and hospitalisation among patients undergoing dialysis by a systematic review and meta-analysis.

Design: Systematic review and meta-analysis.

Methods: Multiple internet databases, were searched from the establishment of each database to April 2022, including the PubMed, EMbase, Cochrane, CNKI, WanFang and China Science and Technology Journal (VIP) databases. Cohort studies exploring the association between frailty and adverse outcomes among patients undergoing dialysis were analysed. The Newcastle Ottawa Scale (NOS) was used to assess the risk of bias in the included studies. A random effects model was used to pool the effect size, and comprehensive analyses consisting of subgroup analysis, sensitivity analysis and publication bias were assessed.

Results: The search initially identified 2744 studies from six databases. After the screening, 26 studies including 14,089 patients with dialysis aged 44.95-78.10 years were included in the final analysis, all of which were observational cohort studies. The pooled results showed that frailty was a powerful predictor of adverse outcomes (mortality, falls and hospitalisation) among the patients. Therefore, dialysis patients should be screened for early frailty and appropriate interventions should be implemented to improve adverse outcomes.

Aim: This study aimed to explore the perspectives and experiences of Nursing Practice Supervisors and Assessors, referred to as Nurse Educators, regarding their support for students with mental health needs during mental health clinical placements.

Design: A qualitative survey design was employed to delve into Nurse Educators' views and experiences at two Mental Health Trusts in the Southeast of England, UK.

Methods: Data were collected using Google Forms to create an anonymous online questionnaire. Thirty-five Nurse Educators, comprising Practice Supervisors and Practice Assessors from two National Health Trusts, providing placements for two universities in the Southeast of England, responded to the survey. Thematic analysis was conducted to interpret the responses.

Results: Factors which facilitated and inhibited Nurse Educators efforts to supporting students' mental health needs during placements were identified. They encompassed personal, professional, and procedural issues which were intricately intertwined to support students with mental health needs. While most Nurse Educators expressed a willingness to support students with mental health needs, challenges regarding the reasonableness of adjustments and their impact on Nurse Educators' practice were widely reported. Recommendations include a review of learning arrangements, guidelines, and policies for students with mental health needs in clinical placements, as well as tailored training of students' inclusive needs for Nurse Educators. No patient or public contribution.

Aims: To adapt the Clinical Frailty Scale (CFS) into Spanish and assess its concordance with the Spanish version of the FRAIL scale (FRAIL-Es) in the context of intensive care.

Design: Validation study of frailty assessment scales in critically ill patients.

Methods: The study was conducted in two phases. The first phase consisted of translating, culturally adapting, and validating the CFS into Spanish. The second phase consisted of a metric descriptive study to assess the concurrent criterion validity of the adapted CFS with FRAIL-Es in a cohort of intensive care patients. Both scales were assessed upon admission to intensive care and at 3, 6, 9, and 12 months post-hospital discharge. Analysis was performed using T-Student/Mann-Whitney, chi-squared and Cohen's Kappa tests.

Results: Successful adaptation of the CFS with minimal changes was achieved, demonstrating its applicability in the evaluated context. The pilot study indicated that CFS-Es is easy to assess, but some subjectivity in interpretation was noted. CFS-Es and FRAIL-Es were applied to 212 patients, revealing variations in frailty prevalence. The concordance and correlation between the CFS and FRAIL scales are robust. These differences suggest that the choice of scale may impact the identification of frail patients. These results emphasise the importance of considering specific characteristics of each scale when assessing frailty in critically ill patients, providing valuable information for clinical implementation and research in this field.

Patient or public contribution: Assessing frailty upon admission can be helpful in the care of frail patients, allowing the development of specific care plans based on pre-existing frailty.

Aim: Health literacy is considered as key factor to empower women to participate in self-care and child-care activities. The purpose of the present study is to determine the relationship between health-promoting behaviours and health literacy among pregnant women.

Design: A cross-sectional study.

Methods: This study surveyed 308 pregnant women in 2022 using questionnaires, including the Health Promoting Lifestyle Profile II (HPLP II) and the Health Literacy for Iranian Adults (HELIA). Descriptive and inferential statistics were employed to analyse the data by IBM SPSS 23.0 statistics package program.

Results: The mean scores for women's health literacy and health-promoting behaviours were 70.31 ± 13.56 and 135.56 ± 17.38, respectively. The lowest score in the health literacy subscales was related to the appraisal (66.07 ± 17.81) and in the health-promoting lifestyle dimensions was associated with the physical activity dimension (13.87 ± 3.87). There was a significant and positive correlation between health literacy and health-promoting behaviours (r = 0.53, p < 0.001). Among the health literacy dimensions, decision-making showed the strongest correlation with health-promoting lifestyle (r = 0.55, p < 0.001).

Patient or public contribution: The results of this study demonstrated that pregnant women with higher health literacy scores exhibited a higher level of engagement in health-promoting behaviours. Assessing health-promoting behaviours in pregnant women by health providers during prenatal care helps identify dimensions receiving less attention during pregnancy, and solutions can be provided to women to address these issues.