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Supportive Care Needs Trajectories in Patients With Advanced Non-Small-Cell Lung Cancer Receiving Chemotherapy: A Longitudinal Study. 接受化疗的晚期非小细胞肺癌患者的支持性护理需求轨迹:一项纵向研究
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2023-06-01 DOI: 10.1097/jnr.0000000000000556
Chun-Ju Yen, Hsin-Tien Hsu, Hsiu-Fen Hsieh, Ying-Ju Chen, Ming-Shyan Huang, Pei-Chao Lin

Background: The supportive care needs trajectories in patients with advanced non-small-cell lung cancer (NSCLC) during chemotherapy and the related factors have yet to be explored or addressed in the literature.

Purpose: This study was designed to investigate supportive care needs trajectories in patients with advanced NSCLC receiving chemotherapy and the association between the sociodemographic and disease characteristics of these patients over the four cycles of chemotherapy.

Methods: For this longitudinal study, 95 patients with advanced NSCLC were recruited using convenience sampling at a medical center in Taiwan. The supportive care needs of the participants were assessed in each of the four chemotherapy cycles using the Needs Evaluation Questionnaire-Chinese version (NEQ-C) with 23 dichotomous items on the day before and the seventh day after the end of each cycle. Group-based trajectory modeling was applied to identify the classes of supportive care needs trajectories, whereas chi-square tests were used to examine the factors related to these classes.

Results: Seventy-one participants completed all eight questionnaire sessions across the four cycles. The mean NEQ-C scores for these participants ranged between 14.4 and 14.6. Three classes of supportive care needs trajectories (low, moderate, and high) were identified for the entire NEQ-C and for each domain. Marital status was found to be associated with the classes of trajectories related to supportive care and assistance/care needs, spouse as the primary caregiver was found to be associated with the classes of trajectories related to information needs, and educational level was found to be associated with the classes of trajectories related to psychoemotional support needs.

Conclusions: The results of this study indicate that marital status and spouse as primary caregiver relate significantly to supportive care needs trajectories in patients with advanced NSCLC during chemotherapy. Healthcare professionals should provide continuous, tailored supportive care interventions that address the needs of patients and their spouses/partners.

背景:晚期非小细胞肺癌(NSCLC)患者化疗期间的支持性护理需求轨迹及其相关因素在文献中尚未探讨或解决。目的:本研究旨在调查晚期非小细胞肺癌接受化疗患者的支持性护理需求轨迹,以及这些患者在四个化疗周期中社会人口学与疾病特征之间的关系。方法:采用方便抽样的方法,在台湾某医疗中心招募了95例晚期非小细胞肺癌患者。在每个化疗周期结束的前一天和结束后的第7天,采用包含23个分项的需求评估问卷中文版(NEQ-C)对参与者在每个化疗周期中的支持护理需求进行评估。采用基于组的轨迹模型来确定支持性护理需求轨迹的类别,而卡方检验用于检查与这些类别相关的因素。结果:71名参与者在四个周期内完成了所有8个问卷。这些参与者的NEQ-C平均得分在14.4到14.6之间。在整个NEQ-C和每个领域中确定了三类支持护理需求轨迹(低、中、高)。婚姻状况与支持性护理和辅助/护理需求相关的轨迹类别相关,配偶作为主要照顾者与信息需求相关的轨迹类别相关,教育水平与心理情感支持需求相关的轨迹类别相关。结论:本研究结果表明,婚姻状况和配偶作为主要照顾者与晚期非小细胞肺癌化疗期间的支持性护理需求轨迹显著相关。医疗保健专业人员应提供持续的、量身定制的支持性护理干预措施,以满足患者及其配偶/伴侣的需求。
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引用次数: 0
Consolidating an Integrative Healthcare Delivery Service. 巩固综合医疗保健服务。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2023-06-01 DOI: 10.1097/jnr.0000000000000564
Li-Chan Lin
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引用次数: 0
Exploring Mental Health and Psychosocial Well-Being in Recovered Jordanian Individuals With COVID-19: A Phenomenological Study. 探索约旦COVID-19患者康复后的心理健康和社会心理健康:现象学研究
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2023-06-01 DOI: 10.1097/jnr.0000000000000559
Ayman M Hamdan Mansour, Anas H Khalifeh, Ahmad N Alshibi, Shaher H Hamaideh, Feda' M Abu Al-Khair, Omar Khraisat, Fadwa N Alhalaiqa

Background: COVID-19-related healthcare services focus primarily on medical and physical treatments. Related treatments for psychosocial and mental health needs have not been a priority for healthcare professionals. Understanding the process by which individuals who have recovered from COVID-19 adapt psychologically will allow better planning for mental healthcare and healthcare outcomes.

Purpose: The purpose of this study was to explore how recovered individuals with COVID-19 adapted to related psychological and social stressors during the infection period.

Methods: A descriptive phenomenological approach was used to investigate a purposive sample of 13 individuals in Jordan who had recovered from COVID-19. Data were collected using semistructured interviews.

Results: Perceptions related to being diagnosed with COVID-19 were distinguished into four major themes: conscious awareness (acceptance, victimization, and normalizing), uncertainty (apprehension and poor communication), sources of psychosocial support (caring family, healthcare professionals' support, and self-grieving), and resilience (optimism, positive thinking, and spirituality).

Conclusions: The findings of this study indicate the need to integrate psychosocial and mental healthcare services into healthcare plans provided to individuals with COVID-19 and similar pandemic infections.

背景:与covid -19相关的卫生保健服务主要集中在医疗和物理治疗上。针对社会心理和精神健康需求的相关治疗一直不是卫生保健专业人员的优先事项。了解从COVID-19中恢复过来的个体在心理上适应的过程,将有助于更好地规划心理保健和医疗保健结果。目的:本研究的目的是探讨COVID-19康复个体在感染期间如何适应相关的心理和社会压力。方法:采用描述现象学方法对约旦13名COVID-19康复个体的目的样本进行调查。数据收集采用半结构化访谈。结果:与被诊断为COVID-19相关的认知分为四个主要主题:有意识的意识(接受、受害和正常化)、不确定性(恐惧和沟通不良)、社会心理支持来源(关怀家庭、卫生保健专业人员的支持和自我悲伤)和恢复力(乐观、积极思考和灵性)。结论:本研究结果表明,有必要将社会心理和精神卫生保健服务纳入为COVID-19和类似大流行感染患者提供的医疗保健计划中。
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引用次数: 1
Development of the Acute Care Nurse Practitioner Competencies Scale: An Exploratory and Confirmatory Factor Analysis. 急症护理护士执业能力量表的开发:探索性和验证性因素分析。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2023-06-01 DOI: 10.1097/jnr.0000000000000551
Shiow-Luan Tsay, Kevin Kau, Sheng-Shiung Huang, Shu-Chen Chang

Background: Nurse practitioners (NPs) play a vital role in healthcare, particularly in acute care settings in Taiwan. The professional competencies of NPs are essential for providing safe and effective care to patients. To date, no measurement tool is available for assessing the clinical competencies of NPs in acute care practices.

Purpose: The aim of this study was to develop and investigate the psychometric properties of the Acute Care Nurse Practitioner Competencies Scale (ACNPCS).

Methods: Mixed-method research was employed using samples of experienced NPs. First, we used a focus group of seven experienced NPs who worked for medical centers, community hospitals, and regional hospitals to identify clinical competencies content. Second, we implemented consensus validation using two rounds of the Delphi study and revised it to a 39-item ACNPCS. Third, we conducted content validity with nine NP experts and modified the competency content to 36 items. Finally, we conducted a national survey of 390 NPs from 125 hospitals to determine the extent to which the NP competency content relates to their clinical practice. To examine the reliability of the tool, we tested the internal consistency reliability and test-retest reliability. Exploratory factor analysis, confirmatory factor analysis, and known-group validity were used to test the construct validity of the ACNPCS.

Results: The Cronbach's alpha coefficient for the overall scale was .92, with subscale coefficients ranging from .71 to .89. Test-retest reliability showed the two scores of the ACNPCS on the two occasions tested to be highly correlated ( r = .85, p < .001). Exploratory factor analysis revealed that the scale had six factors: providing healthcare, evaluating care, collaboration, education, care quality/research, and leadership/professionalism. Factor loadings for each factor item ranged from .50 to .80 and explained 72.53% of the total variance in the NPs' competencies. Confirmatory factor analysis indicated that the six-factor model showed satisfactory model fit (χ 2 = 780.54, p < .01), and the fit indices met the standards for adequate fit (goodness-of-fit index = .90, comparative fit index = .98, Tucker-Lewis index = .97, root mean square error of approximation = .04, and standardized root mean residual = .04). Known-group validity revealed that the total scores for novice NPs differed significantly from those of expert NPs in terms of the competencies ( t = 3.26, p < .001). These results validated the psychometric soundness of the newly developed ACNPCS.

Conclusions: The newly developed ACNPCS exhibited satisfactory reliability and validity, supporting the use of the ACNPCS as a tool to assess the clinical competencies of NPs in acute care settings.

背景:执业护士(NPs)在医疗保健中扮演着至关重要的角色,特别是在台湾的急性护理环境中。护士的专业能力对于向患者提供安全有效的护理至关重要。迄今为止,没有测量工具可用于评估NPs在急性护理实践中的临床能力。目的:本研究的目的是开发和调查急症护理护士执业能力量表(ACNPCS)的心理测量特性。方法:采用混合方法,以经验丰富的np为样本进行研究。首先,我们使用了一个由七个在医疗中心、社区医院和地区医院工作的经验丰富的np组成的焦点小组来确定临床能力的内容。其次,我们使用两轮德尔菲研究实施共识验证,并将其修改为39个项目的ACNPCS。第三,我们对9位NP专家进行了内容效度测试,并将胜任力内容修改为36项。最后,我们对全国125家医院的390名NP进行了调查,以确定NP能力内容与临床实践的关系程度。为了检验工具的可靠性,我们测试了内部一致性信度和重测信度。采用探索性因子分析、验证性因子分析和已知组效度对ACNPCS的构念效度进行检验。结果:总体量表的Cronbach's alpha系数为0.92,次量表系数为0.71 ~ 0.89。重测信度显示两种情况下的ACNPCS得分高度相关(r = 0.85, p < .001)。探索性因素分析显示,量表有六个因素:提供医疗保健、评估护理、协作、教育、护理质量/研究和领导/专业。每个因子项目的因子负荷范围为0.50至0.80,解释了NPs胜任力总方差的72.53%。验证性因子分析结果表明,六因素模型拟合满意(χ 2 = 780.54, p < 0.01),拟合指标符合适当拟合标准(拟合优度指数= 0.90,比较拟合指数= 0.98,Tucker-Lewis指数= 0.97,近似均方根误差= 0.04,标准化均方根残差= 0.04)。已知组效度显示,新手np与专家np在胜任力方面的总分差异显著(t = 3.26, p < 0.001)。这些结果验证了新开发的ACNPCS的心理测量合理性。结论:新开发的ACNPCS具有令人满意的信度和效度,支持将ACNPCS作为评估急性护理环境中NPs临床能力的工具。
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引用次数: 0
Predictors of Abnormal Sleep Duration in Older Adults With Hip Fracture and Diabetes. 老年髋部骨折和糖尿病患者异常睡眠时间的预测因素。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2023-04-01 DOI: 10.1097/jnr.0000000000000550
Wen-Yu Kuo, Min-Chi Chen, Yea-Ing Lotus Shyu

Background: Abnormal sleep duration affects recovery in older adults with hip fracture and diabetes mellitus (DM) negatively. However, the predictors of abnormal sleep duration in this population remain unknown.

Purpose: This study was designed to explore the predictors of abnormal sleep duration among older adults with hip fracture and DM within 6 months of hospital discharge.

Methods: A longitudinal study using secondary data from a randomized controlled trial was implemented. Data on fracture-related factors (diagnosis, surgical methods) were collected from medical charts. Information on the duration of DM, methods of DM control, and diabetes-related peripheral vascular disease was collected by asking simple questions. Diabetic peripheral neuropathy was assessed using the Michigan Neuropathy Screening Instrument. Sleep duration outcomes were determined using data collected from a SenseWear armband.

Results: Having more comorbidities (OR = 3.14, p = .04), having undergone open reduction (OR = 2.65, p = .005), having undergone closed reduction with internal fixation (OR = 1.39, p = .04), and having DM (OR = 1.18, p = .01), diabetic peripheral neuropathy (OR = 9.60, p = .02), or diabetic peripheral vascular disease for a longer duration (OR = 15.62, p = .006) were all associated with a higher risk of abnormal sleep duration.

Conclusions: The findings indicate that patients with more comorbidities or who had undergone internal fixation, had a long DM history, or had complications are more likely to have abnormal sleep duration. Thus, greater attention should be focused on the sleep duration of diabetic older adults with hip fracture who are affected by these factors to achieve better postoperative recovery.

背景:异常睡眠时间对老年髋部骨折合并糖尿病(DM)患者的康复有不利影响。然而,在这一人群中异常睡眠时间的预测因素仍然未知。目的:本研究旨在探讨老年髋部骨折合并糖尿病患者出院后6个月内异常睡眠时间的预测因素。方法:采用随机对照试验的二次资料进行纵向研究。从病历中收集骨折相关因素(诊断、手术方法)的数据。通过询问简单的问题收集有关糖尿病病程、糖尿病控制方法和糖尿病相关周围血管疾病的信息。使用密歇根神经病变筛查仪评估糖尿病周围神经病变。使用从SenseWear臂环收集的数据确定睡眠时间结果。结果:合并症较多(OR = 3.14, p = 0.04)、切开复位(OR = 2.65, p = 0.005)、闭合复位内固定(OR = 1.39, p = 0.04)、糖尿病(OR = 1.18, p = 0.01)、糖尿病周围神经病变(OR = 9.60, p = 0.02)、糖尿病周围血管病变持续时间较长(OR = 15.62, p = 0.006)与睡眠时间异常的风险较高相关。结论:研究结果表明,合并症较多、内固定、DM病史较长或有并发症的患者更容易出现睡眠时间异常。因此,对于受这些因素影响的老年糖尿病髋部骨折患者,应更加关注其睡眠时间,以获得更好的术后恢复。
{"title":"Predictors of Abnormal Sleep Duration in Older Adults With Hip Fracture and Diabetes.","authors":"Wen-Yu Kuo,&nbsp;Min-Chi Chen,&nbsp;Yea-Ing Lotus Shyu","doi":"10.1097/jnr.0000000000000550","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000550","url":null,"abstract":"<p><strong>Background: </strong>Abnormal sleep duration affects recovery in older adults with hip fracture and diabetes mellitus (DM) negatively. However, the predictors of abnormal sleep duration in this population remain unknown.</p><p><strong>Purpose: </strong>This study was designed to explore the predictors of abnormal sleep duration among older adults with hip fracture and DM within 6 months of hospital discharge.</p><p><strong>Methods: </strong>A longitudinal study using secondary data from a randomized controlled trial was implemented. Data on fracture-related factors (diagnosis, surgical methods) were collected from medical charts. Information on the duration of DM, methods of DM control, and diabetes-related peripheral vascular disease was collected by asking simple questions. Diabetic peripheral neuropathy was assessed using the Michigan Neuropathy Screening Instrument. Sleep duration outcomes were determined using data collected from a SenseWear armband.</p><p><strong>Results: </strong>Having more comorbidities (OR = 3.14, p = .04), having undergone open reduction (OR = 2.65, p = .005), having undergone closed reduction with internal fixation (OR = 1.39, p = .04), and having DM (OR = 1.18, p = .01), diabetic peripheral neuropathy (OR = 9.60, p = .02), or diabetic peripheral vascular disease for a longer duration (OR = 15.62, p = .006) were all associated with a higher risk of abnormal sleep duration.</p><p><strong>Conclusions: </strong>The findings indicate that patients with more comorbidities or who had undergone internal fixation, had a long DM history, or had complications are more likely to have abnormal sleep duration. Thus, greater attention should be focused on the sleep duration of diabetic older adults with hip fracture who are affected by these factors to achieve better postoperative recovery.</p>","PeriodicalId":49158,"journal":{"name":"Journal of Nursing Research","volume":"31 2","pages":"e269"},"PeriodicalIF":2.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9282540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Satisfaction With Care of Patients With Schizophrenia in Taiwan: A Cross-Sectional Survey of Patient-Centered Care Domains. 台湾精神分裂症患者照护满意度:以患者为中心照护领域之横断面调查。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2023-04-01 DOI: 10.1097/jnr.0000000000000549
Tsung-Tai Chen, Ke-Hsin Chueh, Kao-Chen Chen, Chi-Ling Chou, Jing-Jung Yang

Background: Pharmacological interventions combined with nonpharmacological treatments such as patient-centered care (PCC)-related activities are widely used to enhance outcomes in patients with schizophrenia. However, few studies have examined and identified the PCC factors essential to achieving better outcomes in patients with schizophrenia.

Purpose: This study was designed to identify the Picker-Institute-identified PCC domains associated with satisfaction and to determine which of these domains are most important in the context of schizophrenia care.

Methods: Data were collected using patient surveys in outpatient settings and record reviews at two hospitals in northern Taiwan between November and December 2016. PCC data were collected in five domains: (a) support of patient autonomy; (b) goal setting; (c) collaboration and integration of healthcare services; (d) information, education, and communication; and (e) emotional support. The outcome measure was patient satisfaction. The study controlled for demographic factors, including age, gender, education, occupation, marriage, and urbanization level in the respondent's area of residence. Clinical characteristics included the Clinical Global Impressions severity and improvement index scores, previous admission, previous emergency department visit, and readmission within 1 year. Methods were adopted to prevent common method variance bias. Multivariable linear regression with stepwise selection and the generalized estimating equation were used to analyze the data.

Results: After controlling for confounding factors, the generalized estimating equation model found only three PCC factors significantly associated with patient satisfaction, which differed slightly from the results of the multivariable linear regression. These three factors are as follows, in order of importance: information, education, and communication (parameter = 0.65 [0.37, 0.92], p < .001); emotional support (parameter = 0.52 [0.22, 0.81], p < .001); and goal setting (parameter = 0.31 [0.10, 0.51], p = .004).

Conclusions: The three critical PCC-related factors were evaluated in terms of enhancing patient satisfaction in patients with schizophrenia. Practicable strategies related to these three factors should also be developed for implementation in clinical settings.

背景:药物干预与非药物治疗相结合,如以患者为中心的护理(PCC)相关活动被广泛用于改善精神分裂症患者的预后。然而,很少有研究检查并确定PCC因素对精神分裂症患者获得更好的预后至关重要。目的:本研究旨在确定picker - institute确定的与满意度相关的PCC域,并确定其中哪些域在精神分裂症护理中最重要。方法:采用2016年11 - 12月台湾北部两家医院门诊病人调查和病历回顾的方法收集资料。PCC数据收集在五个领域:(a)支持患者自主;(b)目标设定;(c)保健服务的协作和整合;(d)信息、教育和传播;(e)情感支持。结果测量是患者满意度。该研究控制了人口因素,包括年龄、性别、教育、职业、婚姻和被调查者居住地区的城市化水平。临床特征包括临床总体印象严重程度和改善指数评分,既往入院,既往急诊就诊,1年内再入院。采用了防止常见方法方差偏差的方法。采用逐步选择多变量线性回归和广义估计方程对数据进行分析。结果:在控制混杂因素后,广义估计方程模型发现只有3个PCC因素与患者满意度显著相关,与多变量线性回归的结果略有不同。这三个因素的重要性依次为:信息、教育、沟通(参数= 0.65 [0.37,0.92],p < .001);情感支持(参数= 0.52 [0.22,0.81],p < .001);目标设定(参数= 0.31 [0.10,0.51],p = 0.004)。结论:在提高精神分裂症患者满意度方面,评估了三个关键的pcc相关因素。还应制定与这三个因素有关的切实可行的战略,以便在临床环境中实施。
{"title":"The Satisfaction With Care of Patients With Schizophrenia in Taiwan: A Cross-Sectional Survey of Patient-Centered Care Domains.","authors":"Tsung-Tai Chen,&nbsp;Ke-Hsin Chueh,&nbsp;Kao-Chen Chen,&nbsp;Chi-Ling Chou,&nbsp;Jing-Jung Yang","doi":"10.1097/jnr.0000000000000549","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000549","url":null,"abstract":"<p><strong>Background: </strong>Pharmacological interventions combined with nonpharmacological treatments such as patient-centered care (PCC)-related activities are widely used to enhance outcomes in patients with schizophrenia. However, few studies have examined and identified the PCC factors essential to achieving better outcomes in patients with schizophrenia.</p><p><strong>Purpose: </strong>This study was designed to identify the Picker-Institute-identified PCC domains associated with satisfaction and to determine which of these domains are most important in the context of schizophrenia care.</p><p><strong>Methods: </strong>Data were collected using patient surveys in outpatient settings and record reviews at two hospitals in northern Taiwan between November and December 2016. PCC data were collected in five domains: (a) support of patient autonomy; (b) goal setting; (c) collaboration and integration of healthcare services; (d) information, education, and communication; and (e) emotional support. The outcome measure was patient satisfaction. The study controlled for demographic factors, including age, gender, education, occupation, marriage, and urbanization level in the respondent's area of residence. Clinical characteristics included the Clinical Global Impressions severity and improvement index scores, previous admission, previous emergency department visit, and readmission within 1 year. Methods were adopted to prevent common method variance bias. Multivariable linear regression with stepwise selection and the generalized estimating equation were used to analyze the data.</p><p><strong>Results: </strong>After controlling for confounding factors, the generalized estimating equation model found only three PCC factors significantly associated with patient satisfaction, which differed slightly from the results of the multivariable linear regression. These three factors are as follows, in order of importance: information, education, and communication (parameter = 0.65 [0.37, 0.92], p < .001); emotional support (parameter = 0.52 [0.22, 0.81], p < .001); and goal setting (parameter = 0.31 [0.10, 0.51], p = .004).</p><p><strong>Conclusions: </strong>The three critical PCC-related factors were evaluated in terms of enhancing patient satisfaction in patients with schizophrenia. Practicable strategies related to these three factors should also be developed for implementation in clinical settings.</p>","PeriodicalId":49158,"journal":{"name":"Journal of Nursing Research","volume":"31 2","pages":"e268"},"PeriodicalIF":2.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9282544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Predictors of Self-Management Behaviors After Discharge Among Unplanned Dialysis Patients. 非计划透析患者出院后自我管理行为的预测因素。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2023-04-01 DOI: 10.1097/jnr.0000000000000523
Yu-Yin Kao, Chien-Te Lee, Ruey-Hsia Wang

Background: Patients with unplanned dialysis must perform self-management behaviors to maintain their health in the community after discharge. Understanding the factors that predict the postdischarge self-management behaviors of patients with unplanned dialysis can assist nurses to implement appropriate discharge plans for this population.

Purpose: This study was designed to predict the effects of uncertainty in illness, self-care knowledge, and social-support-related needs during hospitalization on the self-management behaviors of patients with unplanned dialysis during their first 3 months after discharge from the hospital.

Methods: One hundred sixty-nine patients with unplanned dialysis from the nephrology department of a medical center in Taiwan were enrolled in this prospective study using convenience sampling. At hospital admission, demographic, uncertainty in illness, self-care knowledge, and social support information was collected using a structured questionnaire. Information on self-management behavior was collected at 3 months postdischarge when the patients visited outpatient clinics.

Results: Hierarchical multiple regression analyses showed that self-care knowledge, uncertainty in illness, and social support were important predictors of self-management behaviors at 3 months postdischarge, explaining 65.6% of the total variance in self-management behaviors. Social support increased the variance in self-management behaviors by 27.9%.

Conclusions/implications for practice: Comprehensive discharge planning to improve the postdischarge self-management behaviors of patients with unplanned dialysis should involve interventions to improve self-care knowledge, reduce uncertainty in illness, and increase social support. Building social support should be given priority attention.

背景:非计划透析患者出院后必须在社区中进行自我管理行为以维持健康。了解预测非计划透析患者出院后自我管理行为的因素,可以帮助护士针对这一人群实施合适的出院计划。目的:本研究旨在预测住院期间疾病不确定性、自我护理知识和社会支持相关需求对非计划透析患者出院后3个月自我管理行为的影响。方法:采用方便抽样的方法,对台湾某医学中心肾内科的169例非计划透析患者进行前瞻性研究。入院时,采用结构化问卷收集人口统计、疾病不确定性、自我保健知识和社会支持信息。患者出院后3个月到门诊就诊时收集自我管理行为信息。结果:分层多元回归分析显示,自我护理知识、疾病不确定性和社会支持是出院后3个月自我管理行为的重要预测因子,可解释自我管理行为总方差的65.6%。社会支持使自我管理行为的变异增加了27.9%。结论/实践意义:综合出院计划改善非计划透析患者出院后自我管理行为应包括干预措施,提高自我保健知识,减少疾病不确定性,增加社会支持。应优先注意建立社会支助。
{"title":"Predictors of Self-Management Behaviors After Discharge Among Unplanned Dialysis Patients.","authors":"Yu-Yin Kao,&nbsp;Chien-Te Lee,&nbsp;Ruey-Hsia Wang","doi":"10.1097/jnr.0000000000000523","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000523","url":null,"abstract":"<p><strong>Background: </strong>Patients with unplanned dialysis must perform self-management behaviors to maintain their health in the community after discharge. Understanding the factors that predict the postdischarge self-management behaviors of patients with unplanned dialysis can assist nurses to implement appropriate discharge plans for this population.</p><p><strong>Purpose: </strong>This study was designed to predict the effects of uncertainty in illness, self-care knowledge, and social-support-related needs during hospitalization on the self-management behaviors of patients with unplanned dialysis during their first 3 months after discharge from the hospital.</p><p><strong>Methods: </strong>One hundred sixty-nine patients with unplanned dialysis from the nephrology department of a medical center in Taiwan were enrolled in this prospective study using convenience sampling. At hospital admission, demographic, uncertainty in illness, self-care knowledge, and social support information was collected using a structured questionnaire. Information on self-management behavior was collected at 3 months postdischarge when the patients visited outpatient clinics.</p><p><strong>Results: </strong>Hierarchical multiple regression analyses showed that self-care knowledge, uncertainty in illness, and social support were important predictors of self-management behaviors at 3 months postdischarge, explaining 65.6% of the total variance in self-management behaviors. Social support increased the variance in self-management behaviors by 27.9%.</p><p><strong>Conclusions/implications for practice: </strong>Comprehensive discharge planning to improve the postdischarge self-management behaviors of patients with unplanned dialysis should involve interventions to improve self-care knowledge, reduce uncertainty in illness, and increase social support. Building social support should be given priority attention.</p>","PeriodicalId":49158,"journal":{"name":"Journal of Nursing Research","volume":"31 2","pages":"e267"},"PeriodicalIF":2.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9634254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development and Psychometric Testing of the Clinical Reasoning Scale Among Nursing Students Enrolled in Three Types of Programs in Taiwan. 台湾三种护生临床推理量表之编制与心理测验。
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2023-04-01 DOI: 10.1097/jnr.0000000000000547
Hui-Man Huang, Chu-Yu Huang, Kuan-Chia Lin, Chia-Hui Yu, Su-Fen Cheng

Background: There is no instrument currently available to assess the essential nursing competency of clinical reasoning (CR).

Purpose: The purpose of this study was to develop and test the psychometric properties of CR assessment instrument appropriate for use with nursing students across different types of programs.

Methods: H. M. Huang et al.'s (2018) Framework of Competencies of Clinical Reasoning for Nursing Students was used to guide this study. Two rounds of Delphi study and confirmatory factor analysis (CFA) were conducted to test content and construct validity. Internal consistency was tested for reliability.

Results: The four-domain, 16-item Likert-scale Clinical Reasoning Scale (CRS) was developed. One thousand five hundred four nursing students currently enrolled in three different types of nursing programs completed the CRS. The content validity index was .85-1.0, the CFA indicated goodness of fit, and the Cronbach's α score range was .78-.89.

Conclusion: The CRS is a valid and reliable tool for assessing CR in nursing students in different types of nursing program.

背景:目前尚无评估临床推理(CR)基本护理能力的工具。目的:本研究的目的是开发和测试适用于不同类型护生项目的CR评估工具的心理测量特性。方法:采用H. M. Huang等(2018)的《护生临床推理能力框架》作为本研究的指导。采用两轮德尔菲研究和验证性因子分析(CFA)对内容和结构效度进行检验。内部一致性测试信度。结果:编制了李克特临床推理量表(CRS)。目前有1400名护理专业的学生参加了三种不同类型的护理项目,完成了CRS。内容效度指数为0.85 ~ 1.0,CFA表示拟合优度,Cronbach’s α评分范围为0.78 ~ 0.89。结论:CRS是一种有效、可靠的工具,可用于评估不同类型护理专业护生的CR。
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引用次数: 0
A Feasibility Evaluation of the Need-Centered Watch-Assess-Need Intervention-Think Education and Training Program for Behavioral and Psychological Symptoms of Dementia. 以需求为中心的观察-评估-需求干预-思考教育与训练方案对痴呆行为与心理症状的可行性评估
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2023-04-01 DOI: 10.1097/jnr.0000000000000548
Yueh-Ying Yang, Ya-Ping Yang, Kuei-Min Chen, Chi-Jane Wang, Su-Hsien Chang, Jing-Jy Wang

Background: Despite the high prevalence of dementia among residents living in long-term care facilities in Taiwan, most care providers in these facilities have not received adequate training to deal with the behavioral and psychological symptoms of dementia (BPSD). An original care and management model for BPSD has been developed, and model-based recommendations for an education and training program have been made. However, empirical testing has not yet been conducted to determine the efficacy of this program.

Purpose: This study was designed to evaluate the feasibility of using the Watch-Assess-Need intervention-Think (WANT) education and training program for BPSD in long-term care settings.

Methods: A mixed-method design was used. Twenty care providers and 20 corresponding care receivers (residents with dementia) from a nursing home in southern Taiwan were enrolled. Data were collected using a variety of measurement tools, including the Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia, Attitude towards Dementia Care Scale, and Dementia Behavior Disturbance Self-efficacy Scale. Qualitative data, including care-provider perspectives on the efficacy of the WANT education and training program, were also collected. Repeated measures were conducted on the results of quantitative data analysis, whereas content analysis was performed on the results of qualitative data analysis.

Results: Findings indicate that the program relieves agitated behavior (p = .01), alleviates depression in those with dementia (p < .001), and enhances care-provider attitudes toward dementia care (p = .01). However, no significant improvement was found in self-efficacy among the care providers (p = .11). In terms of qualitative outcomes, care providers indicated they perceived improved self-efficacy in managing BPSD, improved ability to view problems from a more need-centered perspective, improved attitudes toward dementia and patients' BPSD, and decreased care burden and stress.

Conclusions/implications for practice: The study found the WANT education and training program to be feasible in clinical practice. Because of this program's simple and easy-to-remember characteristics, it is recommended that it be vigorously promoted to care providers in both long-term institutional and home care settings to help them effectively address the BPSD.

背景:尽管台湾居住在长期照护机构的居民有较高的痴呆症患病率,但这些机构的大多数照护提供者并未接受足够的训练来处理痴呆症的行为和心理症状(BPSD)。已经为BPSD开发了一个原始的护理和管理模式,并提出了基于模型的教育和培训计划建议。然而,尚未进行实证测试来确定该计划的有效性。目的:本研究旨在评估观察-评估-需要-干预-思考(WANT)教育和培训计划在BPSD长期护理机构中的可行性。方法:采用混合法设计。本研究选取台湾南部一家养老院的20名照护提供者和20名相应的照护接受者(痴呆症患者)。数据收集使用多种测量工具,包括Cohen-Mansfield躁动量表、Cornell痴呆抑郁量表、痴呆护理态度量表和痴呆行为障碍自我效能量表。还收集了定性数据,包括护理提供者对WANT教育和培训计划有效性的看法。对定量数据分析结果进行重复测量,对定性数据分析结果进行内容分析。结果:研究结果表明,该项目可减轻痴呆患者的激动行为(p = 0.01),减轻痴呆患者的抑郁(p < 0.001),并提高护理人员对痴呆护理的态度(p = 0.01)。然而,护理人员的自我效能感没有显著改善(p = 0.11)。在定性结果方面,护理提供者表示他们在管理BPSD方面提高了自我效能,从更以需求为中心的角度看待问题的能力提高了,对痴呆和患者BPSD的态度改善了,护理负担和压力减轻了。结论/实践意义:研究发现WANT教育和培训计划在临床实践中是可行的。由于这个程序简单易记的特点,建议大力推广给长期机构和家庭护理机构的护理提供者,以帮助他们有效地解决BPSD。
{"title":"A Feasibility Evaluation of the Need-Centered Watch-Assess-Need Intervention-Think Education and Training Program for Behavioral and Psychological Symptoms of Dementia.","authors":"Yueh-Ying Yang,&nbsp;Ya-Ping Yang,&nbsp;Kuei-Min Chen,&nbsp;Chi-Jane Wang,&nbsp;Su-Hsien Chang,&nbsp;Jing-Jy Wang","doi":"10.1097/jnr.0000000000000548","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000548","url":null,"abstract":"<p><strong>Background: </strong>Despite the high prevalence of dementia among residents living in long-term care facilities in Taiwan, most care providers in these facilities have not received adequate training to deal with the behavioral and psychological symptoms of dementia (BPSD). An original care and management model for BPSD has been developed, and model-based recommendations for an education and training program have been made. However, empirical testing has not yet been conducted to determine the efficacy of this program.</p><p><strong>Purpose: </strong>This study was designed to evaluate the feasibility of using the Watch-Assess-Need intervention-Think (WANT) education and training program for BPSD in long-term care settings.</p><p><strong>Methods: </strong>A mixed-method design was used. Twenty care providers and 20 corresponding care receivers (residents with dementia) from a nursing home in southern Taiwan were enrolled. Data were collected using a variety of measurement tools, including the Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia, Attitude towards Dementia Care Scale, and Dementia Behavior Disturbance Self-efficacy Scale. Qualitative data, including care-provider perspectives on the efficacy of the WANT education and training program, were also collected. Repeated measures were conducted on the results of quantitative data analysis, whereas content analysis was performed on the results of qualitative data analysis.</p><p><strong>Results: </strong>Findings indicate that the program relieves agitated behavior (p = .01), alleviates depression in those with dementia (p < .001), and enhances care-provider attitudes toward dementia care (p = .01). However, no significant improvement was found in self-efficacy among the care providers (p = .11). In terms of qualitative outcomes, care providers indicated they perceived improved self-efficacy in managing BPSD, improved ability to view problems from a more need-centered perspective, improved attitudes toward dementia and patients' BPSD, and decreased care burden and stress.</p><p><strong>Conclusions/implications for practice: </strong>The study found the WANT education and training program to be feasible in clinical practice. Because of this program's simple and easy-to-remember characteristics, it is recommended that it be vigorously promoted to care providers in both long-term institutional and home care settings to help them effectively address the BPSD.</p>","PeriodicalId":49158,"journal":{"name":"Journal of Nursing Research","volume":"31 2","pages":"e266"},"PeriodicalIF":2.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9282542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Information Needs of Patients With Breast Cancer Undergoing Treatment in Vietnam and Related Determinants. 越南乳腺癌患者接受治疗的信息需求及相关决定因素
IF 2.7 3区 医学 Q1 NURSING Pub Date : 2023-04-01 DOI: 10.1097/jnr.0000000000000546
Nguyen Thi Son, Hsin-Tien Hsu, Pham Thi Thu Huong, Truong Quang Trung

Background: Patients with cancer who are not well informed often experience dissatisfaction with care, difficulty coping with their disease, and feelings of helplessness.

Purpose: This study was designed to investigate the information needs of women with breast cancer undergoing treatment in Vietnam and the determinants of these needs.

Methods: One hundred thirty women undergoing chemotherapy for breast cancer in the National Cancer Hospital in Vietnam enrolled as volunteers in this cross-sectional descriptive correlational study. Self-perceived information needs, body functions, and disease symptoms were surveyed using the Toronto Informational Needs Questionnaire and the 23-item Breast Cancer Module of the European Organization for Research and Treatment of Cancer questionnaire, which consists of two (functional and symptom) subscales. Descriptive statistical analyses included t test, analysis of variance, Pearson correlation, and multiple linear regression.

Results: The results revealed participants had high information needs and a negative future perspective. The highest information needs related to potential for recurrence, interpretation of blood test results, treatment side effects, and diet. Future perspective, income level, and educational level were identified as determinants of information needs, explaining 28.2% of the variance in the need for breast cancer information.

Conclusions/implications for practice: This study was the first to use a validated questionnaire to assess information needs in women with breast cancer in Vietnam. Healthcare professionals may refer to the findings of this study when designing and delivering health education programs designed to meet the self-perceived information needs of women with breast cancer in Vietnam.

背景:不了解情况的癌症患者往往对护理感到不满,难以应对疾病,感到无助。目的:本研究旨在调查越南接受治疗的乳腺癌妇女的信息需求及其决定因素。方法:在越南国立癌症医院接受乳腺癌化疗的130名妇女作为志愿者参加了这项横断面描述性相关研究。自我感知的信息需求、身体功能和疾病症状使用多伦多信息需求问卷和欧洲癌症研究和治疗组织问卷的23项乳腺癌模块进行调查,该问卷由两个(功能和症状)分量表组成。描述性统计分析包括t检验、方差分析、Pearson相关和多元线性回归。结果:被试具有较高的信息需求和消极的未来观。最高的信息需求与复发的可能性、血液检查结果的解释、治疗副作用和饮食有关。未来前景、收入水平和教育水平被确定为信息需求的决定因素,解释了28.2%的乳腺癌信息需求差异。结论/实践意义:本研究首次使用有效的问卷来评估越南乳腺癌妇女的信息需求。医疗保健专业人员在设计和提供健康教育方案时,可参考本研究的结果,以满足越南乳腺癌妇女自我感知的信息需求。
{"title":"Information Needs of Patients With Breast Cancer Undergoing Treatment in Vietnam and Related Determinants.","authors":"Nguyen Thi Son,&nbsp;Hsin-Tien Hsu,&nbsp;Pham Thi Thu Huong,&nbsp;Truong Quang Trung","doi":"10.1097/jnr.0000000000000546","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000546","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer who are not well informed often experience dissatisfaction with care, difficulty coping with their disease, and feelings of helplessness.</p><p><strong>Purpose: </strong>This study was designed to investigate the information needs of women with breast cancer undergoing treatment in Vietnam and the determinants of these needs.</p><p><strong>Methods: </strong>One hundred thirty women undergoing chemotherapy for breast cancer in the National Cancer Hospital in Vietnam enrolled as volunteers in this cross-sectional descriptive correlational study. Self-perceived information needs, body functions, and disease symptoms were surveyed using the Toronto Informational Needs Questionnaire and the 23-item Breast Cancer Module of the European Organization for Research and Treatment of Cancer questionnaire, which consists of two (functional and symptom) subscales. Descriptive statistical analyses included t test, analysis of variance, Pearson correlation, and multiple linear regression.</p><p><strong>Results: </strong>The results revealed participants had high information needs and a negative future perspective. The highest information needs related to potential for recurrence, interpretation of blood test results, treatment side effects, and diet. Future perspective, income level, and educational level were identified as determinants of information needs, explaining 28.2% of the variance in the need for breast cancer information.</p><p><strong>Conclusions/implications for practice: </strong>This study was the first to use a validated questionnaire to assess information needs in women with breast cancer in Vietnam. Healthcare professionals may refer to the findings of this study when designing and delivering health education programs designed to meet the self-perceived information needs of women with breast cancer in Vietnam.</p>","PeriodicalId":49158,"journal":{"name":"Journal of Nursing Research","volume":"31 2","pages":"e265"},"PeriodicalIF":2.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9649600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of Nursing Research
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