Nursing & Health Sciences最新文献

Scleroderma is a complex autoimmune disease with multifaceted involvement, the management of which requires integrated, multidisciplinary care. However, despite its importance, implementing such care faces several challenges within healthcare systems. Accordingly, this study was conducted to explore existing gaps in the implementation of multidisciplinary care for people with scleroderma. This qualitative study used purposive sampling and semi-structured interviews, analyzed through conventional content analysis based on Graneheim and Lundman's approach. The data collection process was conducted in the rheumatology department and rheumatology clinics/outpatient in southwestern Iran. A total of 40 participants took part in the study, including people with scleroderma, family caregivers, and healthcare providers. Five main themes and sixteen subthemes emerged: Siloed Care, Incomplete Care Continuum, Stagnation in Team-Based Approach, Lack of Capacity Building, and Disruption of Supportive Infrastructure. The findings reveal that the current care system is fragmented and uncoordinated, highlighting the need for multidisciplinary care in service delivery. Based on the results, key prerequisites for improving the coherence and quality of care include structural reform, specialized care centers, integrated multidisciplinary teams, and digital infrastructure.

This randomized controlled pilot study, which involved 176 patients, aimed to evaluate the impact of comedy films on preoperative anxiety levels and postoperative pain in patients undergoing abdominal surgery, as well as the feasibility of this intervention. While the patients in the control group did not undergo any intervention other than routine clinical interventions, the patients in the experimental group watched a comedy movie for 25 min. The pretest anxiety score of the experimental group was found to be 57.48 ± 6.09, while the posttest anxiety score of the same group decreased to 37.35 ± 8.10 after watching a comedy movie. The difference between their pretest and posttest anxiety mean scores was statistically significant (Cohen's d: 4.20, 95% CI: 27.8124 to 32.4603, p: 0.000). The mean pretest and posttest pain scores of those in the experimental group were 4.99 ± 1.24 and 4.76 ± 1.33, respectively (Cohen's d: 2.72, 95% CI: -24.6459 to -19.7858, p: 0.003). It was concluded that watching a comedy movie, which is an inexpensive and effective method, reduces preoperative anxiety and postoperative pain in patients undergoing abdominal surgery and provides important information necessary for the design of more precise studies in the future.

Caesarean section (CS) rates are increasing globally. We aimed to understand stakeholders' perspectives on factors driving CS in pregnancy care to inform areas for intervention. Stakeholders from five health services participated in three Group Model Building workshops to identify the drivers of CS and intervention opportunities. A Causal Loop Diagram was developed to identify priority action areas. Workshop transcripts were thematically analyzed to understand the factors influencing CS rates and to identify areas for interventions to improve CS decision-making. Participants identified 29 drivers that were grouped into four priority areas for action: mothers' health and confidence, clinicians providing care, clinical monitoring and intervention, and health system issues. Five major themes emerged from the transcripts: health system issues, maternal factors, clinical factors, clinical management, and guidelines and adherence. Intervention ideas included: feedback data use across health services, improving the quality of data, and modifying data entry prompts. The factors driving CS rates related to clinicians, maternal service users, the health system, and the health service. A standardized audit and feedback tool to assess, monitor, and compare CS rates within health systems may address CS overuse.

Personal protective equipment used to provide protection to healthcare workers during the pandemic was impacted by shortages in supply and side effects from use. The aim of this study was to explore the prevalence of personal protective equipment (PPE) side effects experienced by healthcare workers in France, including access to, use of PPE, and PPE training. A cross-sectional descriptive survey was used. Reporting followed the STROBE statement. Three hundred and forty-six participants completed the survey. Most were female (41.2%), nurses (59.7%) and aged between 31 and 45 years old. Surgical masks were associated with side effects (54.6%), including acne (24.05%), pressure injuries (26.49%) and burning/pain (7.62%). N95 respirator use was associated with side effects (30.43%), of acne (11.88%) and abrasions (11.88%). Side effects were most frequently reported by female participants and those working in COVID-19 areas. The side effects caused by PPE use and the impact this has on healthcare workers cannot be underestimated. Findings in this study identify the need to develop preventative measures to reduce side effects and improve patient interactions.

This study aimed to understand fathers' experiences and perceptions while accompanying their spouses during childbirth and their satisfaction with involvement in the childbirth process. Data were collected from Medline, CINAHL, Scopus, Web of Science, PsycINFO, Embase, Ovid, Cochrane Library, CNKI, and WANFANG between 2014 and 2024. A quality appraisal was conducted using the Critical Appraisal Skills Program, and a thematic synthesis was performed. Fourteen studies from various countries were included, and four main themes emerged: emotional turbulence and coping, recognition of value and personal growth, the multifaceted role of social support, and the influence of culture and values on paternal perceptions. The synthesis revealed consistent patterns in fathers' emotional experiences during childbirth, particularly regarding their perceived value in the process. The review also explored fathers' preferences for medical services, identifying key needs, and highlighted the influence of socio-cultural factors. The findings emphasize the necessity for further research in this area.

Although social support has a positive effect on sense of meaning, its underlying mechanisms are still unclear. This study aimed to explore the chain mediating effects of health literacy and hope on the relationship between social support and sense of coherence in patients with stroke. A total of 296 patients with stroke were recruited from September 2023 to April 2024 from a tertiary care hospital in Henan Province. A demographic and clinical information sheet, Sense of Coherence Scale-13, Social Support Rate Scale, All Aspects of Health Literacy Scale, and Herth Hope Index were used. A chain mediation model was constructed using the PROCESS macro to examine the mediating roles of health literacy and hope in the relationship between perceived social support and sense of coherence. The study showed that health literacy and hope act as a chain mediators between social support and sense of coherence. Medical staff should pay attention to the balance between the mode and content of information transmission, so as to avoid the negative impact of over-interpretation or negative cognition of health information on patients.

Fear of progression is a common problem. This cross-sectional study aimed to identify distinct fear of progression profiles among patients with progressive pulmonary nodules in the preoperative period and to explore the factors associated with these patterns. A total of 259 preoperative patients with pulmonary nodules completed self-reported measures assessing fear of progression and relevant correlates (e.g., health anxiety and positive psychological capital) from February 2024 to August 2024. Latent profile analysis was used to identify heterogeneous subgroups, and the influencing factors were identified via multivariate logistic regression. Latent profile analysis revealed 4 profiles: low, medium, medium-high, and high fear of progression. Positive psychological capital and health anxiety significantly influenced fear of progression. The number of nodules, number of chronic diseases, and medical insurance status were identified as significant independent predictors of the outcome. Through advanced latent profile analysis, we categorized the fear of progression and identified its risk factors. These findings have implications for healthcare strategies and offer new insights for managing the fear of progression and improving patient well-being.

Patients with cardiovascular disease (CVD) often rely on informal caregivers to promote healthy dietary intake and compliance. Dyadic interventions show potential for enhancing patients' healthy diets, yet the effectiveness remains unexplored. A systematic review and meta-analysis were conducted. PubMed, Cochrane Library, Embase, CINAHL Plus, PsycINFO, and Web of Science were searched up to January 10, 2025. This review included 29 articles (i.e., 25 studies) involving 3039 patients and 2706 caregivers. Dyadic interventions significantly reduced patients' sodium intake, fat intake, body mass index, and improved self-care behavior, quality of life, heart disease knowledge, self-efficacy, and perceived support. However, the interventions did not improve patients' blood lipid profiles. Insufficient studies prevented meta-analyses for patients' blood pressure and blood sugar levels, health motivation, communication, mutuality, caregivers' self-care behavior, disease knowledge, quality of life, self-efficacy/caregiver mastery, and caregiver burden. Dyadic interventions showed preliminary evidence for improving CVD patients' diets. High-quality dyadic research is needed to validate current findings, assess the effectiveness on other dietary outcomes, and explore effective intervention characteristics. Trial Registration: PROSPERO number: CRD42023473308 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=473308).

Decannulation is crucial in improving outcomes and quality of life for patients with tracheostomy and neurological injuries. This study aimed to develop and retrospectively assess the NEURODECANN Clinical Score to predict decannulation success. A retrospective cohort of patients with a tracheostomy (n = 117) was analyzed, distinguishing those who achieved decannulation from those who did not. Logistic regression and Random Forest analysis identified key predictors: level of consciousness, diagnosis, blue dye test, amount of secretions, speaking valve use, secretion management, dysphagia, maximum inspiratory pressure, and cough. Model performance was assessed using the area under the curve (AUC), sensitivity, and specificity. NEURODECANN demonstrated excellent predictive accuracy (AUC = 0.95, 95% CI: 0.91-0.98), with a sensitivity of 92.6% and specificity of 87.3%. Patients scoring ≥ 13 points had a high probability of successful decannulation. The NEURODECANN Clinical Score provides a structured, evidence-based framework to support clinician-driven decannulation decisions, optimizing tracheostomy management in people with neurological conditions. Further validation is needed to confirm its applicability across diverse clinical settings.