Nursing & Health Sciences最新文献

The cardio-ankle vascular index (CAVI) is superior to traditional methods of measuring arterial stiffness. However, its application in clinical practice has lagged behind the science. This study aimed to (1) examine its test-retest reliability and agreement between repeated measurements, (2) identify the correlation with fatigue and sleep quality, and (3) compare the CAVI values of the bilateral sides of people with stroke, and those of stroke survivors with and without fatigue. Participants (n = 67) were assessed using the CAVI, Fatigue Assessment Scale, and Pittsburgh Sleep Quality Index. The test-retest reliability ranged from 0.77 to 0.86. The Bland-Altman plots showed good agreement between test and retest. The standard error of measurement ranged from 0.59 to 0.66. The minimal detectable change ranged from 1.15 to 1.29. The CAVI values of the bilateral sides correlated with fatigue and those at the paretic side correlated with sleep quality. The CAVI values of the paretic side were higher than those of the non-paretic side in people with stroke. Stroke participants with fatigue had higher CAVI values than those without fatigue. CAVI has good test-retest reliability and agreement between repeated measurements for clinical use.

Rebound exercise (RE) increases mobility in hospitalized adults with neurological disorders (AwND), but its feasibility in community settings remains largely unexplored. This study evaluates the practicality of implementing RE in the community, particularly for AwND. The feasibility study involved 53 community-dwelling AwND engaging in RE sessions for 30 min, once- or twice-weekly, over 12 weeks. Feasibility was assessed through recruitment rates, adherence, attrition, and participant feedback. The study measured blood pressure (BP), walking speed (WS), and physical activity level (PAL) at baseline, 6 weeks, and 12 weeks. Repeated measures ANOVA and the Friedman tests were used to test for significant differences across the time points. The study demonstrated high recruitment (70.59%) and retention (98.1%) rates, with most participants (76.9%) preferring once-weekly sessions due to time constraints. There were no reported injuries or adverse events. Most participants were older adults (50%), females (67.3%), and retired (55.8%). Significantly lower resting BP (p < 0.001), higher WS (p < 0.001), and PAL (p = 0.000) were observed after 12 weeks of RE. In conclusion, RE is a feasible, safe, and acceptable intervention for supervised community-dwelling AwND and could be a valuable tool for promoting PAL in this population.

The National Institute for Health and Care Research (NIHR) has significantly contributed to the growth of clinical research activities in the United Kingdom. Central to this expansion is the pivotal role of Clinical Research Practitioners (CRPs) within the healthcare organization. This narrative explores reflective practice as a dynamic tool and essential requirements for their transformation and development into competent CRPs. Additionally, this article adds to the growing literature to highlight the benefits of having a professionally registered CRP for NHS organizations. By weaving together personal insights, professional development, and the integration of acquired knowledge, the narrative illuminates the profound impact of reflective practice on the evolution of a skilled and adept CRP. This review adds to the current literature on the importance of reflective practice in improving professionalism and competency for registered CRPs. The narrative emphasizes lifelong learning and reflective practice integration in clinical research training programs. It suggests further research on workplace reflection for knowledge integration. This resource is valuable for CRPs, organizations, and policymakers, emphasizing professionalism, competency development, and reflective practice in clinical research.

Health screening is crucial for individuals with disabilities because they are likely to experience preventable health challenges, leading to poor health outcomes. However, there is limited insight into barriers to health screening for them after arriving at a healthcare facility. Thus, this study aimed to explore the association between disability status/type and health screening test completion and the reasons for incomplete tests after arriving at a healthcare facility. We reviewed 767 electronic health records of individuals who underwent health screening in a healthcare facility over one year. Chi-square or Fisher's exact tests were used to explore differences in test completion. Levesque's access to care framework was used to categorize the reasons for incomplete tests into provider- and patient-related domains. The findings showed associations between disability status and health screening completion. Both provider- and patient-related barriers were recorded as the reasons for incomplete tests for cases with disabilities. The associations found suggest potential disparities individuals with disabilities experience upon arrival at healthcare facilities. Further prospective studies are needed to test and validate the healthcare utilization disparities in disability.

Elevated glycated hemoglobin (HbA1c) levels and longer disease duration increase the risk of complications in type 2 diabetes mellitus (T2DM), highlighting the need for continuous management. This study evaluated the 18-month effects of the Automated Personalized Self-Care (APSC) program on self-care self-efficacy, diabetes self-care, and complication risk indices in T2DM patients through a randomized controlled trial. Participants aged 40-69 years were assigned to either an intervention group using the APSC mobile app, which provided personalized goals, automated feedback, and monthly support, or a comparison group. The final analysis included 43 engaged participants from the intervention group and 78 from the comparison group. Data were collected at baseline, 6, 12, and 18 months using structured questionnaires and medical record reviews and analyzed using generalized estimating equations. Significant effects were observed for self-care self-efficacy, diabetes self-care activities, vegetable intake, HbA1c, and total cholesterol levels. The APSC program showed potential to improve long-term self-care and reduce complication risk in T2DM patients. Further research with a larger samples and strategies to promote long-term engagement is needed for its integration into routine diabetes care. Trial Registration: Clinical Research Information Service: KCT0007672.

Experiencing side effects when wearing N95/P2 masks has negative impacts on health workers and increases exposure to pathogens. While side effects of wearing P2/N95 masks have been reported previously, these masks have never been used as widely as during the COVID-19 pandemic. This study examines Australian hospital nurses' experiences and perceptions of P2/N95 mask usage and its impacts on patient care at a time when P2/N95 masks were widely used. A qualitative exploratory-descriptive design involving semistructured interviews and focus groups was conducted with 12 nurses employed at a public health service in Melbourne, Australia. The data were thematically analyzed. Participants shared experiences resulted in four themes derived from the data: "adverse health impacts," "occupational challenges caused by scarcity of P2/N95 masks," "impact of wearing P2/N95 masks on patient care and work practices," and "adaptive strategies to improve patient care." Nurses experienced notable adverse effects from P2/N95 masks, affecting patient care quality. This study's findings underscore the importance of enhancing training, education, and policies regarding mask usage to uphold high standards of patient care and reduce exposure to pathogens.

The study aimed to investigate nutrition-related health behaviors among nursing and medical students compared to healthcare workers (HCWs), including nurses and physicians. A cross-sectional survey was conducted between May and November 2022, using the I-MEDAS and lifestyle-related behavior questionnaires. The participants included nursing and medical students, nurses, and physicians, with a total of 384 participants: 16.9% physicians, 23.17% nurses, and 59.9% students, 93% of whom were nursing students. The average I-MEDAS score (out of 17) was 7 for physicians, 8 for nurses, and 8 for students, with no significant differences in lifestyle behavior scores between the groups (p = 0.11), although nurses tended to score lower. Nurses also had a significantly higher BMI compared to physicians and students (p < 0.001). Physicians and nurses reported lower engagement in leisure activities and household chores, fewer sleep hours, and poorer sleep quality. The findings highlight a decline in healthy lifestyle behaviors and poor adherence to the Mediterranean diet among HCWs and students, particularly nurses, emphasizing the need for interventions to promote healthier habits in these groups.

Patient participation plays a vital role in evidence-based practice (EBP), yet its development in clinical nursing is slow. Current research has focused on identifying barriers to patient participation in everyday care, with less research on barriers to patient participation in EBP. Therefore, a questionnaire containing basic information and open-ended questions was used to explore nursing staff attitudes and barriers to patient participation in EBP. Responses to the open-ended question were analyzed with content analysis. Four roles of patient participation, positive and negative attitudes toward patient participation, and 134 barriers to patient participation in EBP were extracted from 121 nursing staff responses through content analysis. Five categories of barriers were extracted from the 134 barriers to patient participation, including patient, cost-effectiveness of EBP, healthcare staff, organization, and resource. This study found that patients' acceptance and trust in EBP also influenced their participation in the practices. Moreover, nursing staff have little knowledge of engaging patients in EBP. More educational strategies and organizational support should be provided to patients and nurses to promote patient participation.

Understanding the relationships between comorbidity, disability, and home health-care services aids in user-centered care design. This study identifies patterns of these factors among older adults with physical disability living at home and explores their associations. This cross-sectional study included community-dwelling older adults assessed for Long-term Care Insurance from September 1 to December 31, 2018, in Yiwu, Zhejiang, China. We analyzed deidentified data on sociodemographics, physical disability, chronic conditions, and care plans for 1882 participants using latent class analysis and multinomial logistic regression. Five comorbidity patterns (other sporadic diseases, cancer comorbidity, other sporadic comorbidities, coronary atherosclerotic heart disease, and fracture) and four home health-care service patterns (assistance & facilitation of elimination, bedridden assistance & stoma care, bedside assistance & stoma care, and assistance & tube feeding) were identified. Four disability patterns emerged (bedridden without incontinence, bedridden & with upper limb mobility, off-bed & ADLs limited, and bedridden with incontinence). Complex associations between these patterns were observed. The study highlights the heterogeneity and complexity of the above patterns, emphasizing the importance of person-centered home health-care services and technology-supported care strategies.