Nursing & Health Sciences最新文献

End-stage renal disease (ESRD) requires lifelong maintenance hemodialysis (MHD), and patients commonly experience a high symptom burden that affects their quality of life. This study explores the impact of dialysis vintage on symptom burden and quality of life in ESRD patients undergoing MHD. Our cross-sectional study of 213 Chinese hemodialysis patients found that symptom burden tended to increase with longer dialysis duration (Dialysis Symptom Index score from < 1 to > 10 years, p = 0.084), while urine output (p = 0.032) and Kt/V (p = 0.004) significantly decreased. Interestingly, quality of life improved across multiple domains as dialysis duration increased, including Kidney Disease Targeted Areas (KDTA) (p = 0.005), Symptom/Problem List (SPL) (p < 0.001), Effects of Kidney Disease (EKD) (p = 0.004), and Burden of Kidney Disease (BKD) (p < 0.001). These findings suggest that longer dialysis is associated with greater symptoms but also notable improvements in certain quality of life aspects. Personalized care is essential to address the evolving needs of long-term MHD patients and enhance their well-being.

This study adopted a qualitative design to explore lived experiences related to barriers in self-management among hypertensive patients. The study site was a tertiary general hospital in northeast China. Purposive sampling was used to select 12 patients hospitalized in four cardiovascular departments in the hospital. Semi-structured interviews were conducted to obtain information from patients between January 2021 and March 2021, and the data were stored using a digital recorder. Data management was accomplished by NVivo 12, and thematic approach was performed for data analysis. Three themes emerged from this study: (1) effect of individual beliefs on blood pressure, (2) challenges in self-management of the disease, and (3) insufficient resources support. The findings offer guidance for healthcare professionals to develop more effective self-management interventions to lower blood pressure and enhance self-management level for hypertensive patients. The results also provide evidence that can inform administrators and departments' supervisors in implementing supportive measures for self-management of hypertension.

Long-term hyperglycemia poses an elevated risk of infection, organ dysfunction, and increased mortality. Despite the availability of strategies for managing hyperglycemia, implementation effectiveness remains suboptimal. Therefore, this study investigates the factors hindering successful implementation and identifies potential change strategies. This study established evidence-based questions and formulated quality indicators. A baseline survey assessed existing practices. Subsequently, obstacle factors were analyzed using the Ottawa Model of Research Use, considering three dimensions: innovation, potential adopters, and practice environment; change strategies were then developed. The study revealed a significant gap between evidence and practice in hyperglycemia management during enteral nutrition in critically ill patients; adherence to 20 of 25 quality indicators was below 60%. Key obstacle factors included inadequate medical staff knowledge, a lack of standardized management processes, and the complexity of the evidence base. To address these challenges, the research team proposed intervention strategies including strengthening standardized hyperglycemia management protocols, establishing multidisciplinary teams, and providing systematic training. This study offers a framework for improving the quality of hyperglycemia management during enteral nutrition in critically ill patients and promoting the translation of evidence-based practice. Trial Registration: Fudan University Center for Evidence-Based Nursing: ER20240865.

Hip fracture is a catastrophic traumatic injury for the older adults, early ambulation is crucial for recovery. Prior researchers explored a number of influencing factors, but there is still a pressing need for synthesizing the evidence. A systematic literature review was conducted for original studies by searching electronic databases included PubMed, Embase, CINAHL, Scopus, web of science and Cochrane Library from inception till July 2023. The odds ratio and 95% confidence interval were calculated for the combined risk factors using Review Manager 5.4. Finally, 2665 articles were initially assessed, and 26 studies were ultimately deemed eligible for inclusion in this meta-analysis, contributing a collective total of 18 698 subjects to the analysis. The following factors were showed strong association with early ambulation: age (OR: 1.04, 95% CI: 1.03-1.05); low pre-fracture functional level (OR: 1.39, 95% CI: 1.25-1.54); anemia (OR: 2.81, 95% CI: 1.79-4.42); vitamin D deficiency (OR: 2.73, 95% CI:1.64-4.56); poor nutritional status (OR:2.08, 95% CI: 1.56-2.77); cognitive impairment (OR: 1.16, 95% CI: 1.09-1.22); Charlson Comorbidity Index (OR: 0.80, 95% CI: 0.72-0.90); intertrochanteric fracture (OR: 3.24, 95% CI: 1.99-5.28). For patients presenting with the aforementioned influencing factors, targeted preventive approaches and management strategies should be employed to facilitate rapid postoperative recovery.

Supporting youth mental health is a priority; currently, one in 10 young people experience a mental health disorder. Accordingly, integrated youth health services are a focus for service development both in the United Kingdom and internationally. Less attention is given to inpatient settings and the experiences of young people who use them. This in-depth qualitative study aimed to understand the experiences of people aged 16-25 years, admitted to inpatient mental health settings, and the experiences of staff caring for them. Individual interviews with seven inpatient young people and three focus groups with staff (N = 27) were conducted. An Interpretative Phenomenological Analysis (IPA) methodology with a polyvocal design was used. Young people reported how the impact of restriction, lack of inclusion, information, and transparency affected their experiences. Relationships with other young people and staff were important while shared experiences were especially salient. Staff identified difficulties of working within a system divided into separate services while attempting to work flexibly with young people. Future practice needs to enhance relational, inclusive, and flexible working practices to optimize care delivery.

The COVID-19 pandemic has severely impacted global healthcare systems and significantly affected individuals living with HIV. In South Africa, where the HIV epidemic is prevalent, strict lockdown measures were introduced to curb COVID-19 transmission. This study explores the effects of these lockdown regulations on the initiation of antiretroviral therapy (ART) among HIV-positive individuals in Johannesburg. Employing a quantitative retrospective chart review design, the research analyzed ART initiation trends in Soweto before, during, and after the lockdowns using medical records from selected clinics in Region D. Data were collected with a checklist, and descriptive analysis was performed. The findings revealed a 40% decrease in ART initiation at community health centers (CHCs) during the lockdowns, compared to a 20% decrease in clinics. Additionally, clinics maintained a patient retention rate of 75%, whereas CHCs saw only 55%. These results highlight significant disparities in healthcare access and outcomes during the pandemic, indicating that COVID-19 threatens to reverse progress in the global HIV response, emphasizing the need for targeted interventions to sustain advancements in fighting HIV.

To investigate the predictive relationships between frailty, nutritional factors, and Quality of Life (QoL) on the vulnerability of older adults enrolled in Primary Health Care (PHC) in an urban area. This was a cross-sectional study conducted with community-dwelling older adults. Participants receiving care in PHC in two Brazilian municipalities located in a sparsely populated region were recruited. The instruments used were Vulnerable Elders Survey (VES-13), Mini Nutritional Assessment (MNA), Edmonton Frailty Scale (EFS), and Medical Outcomes Study Short Form-36 (SF-36). Association analyses, Spearman's correlation, and binary logistic regression were used. A total of 323 individuals were included. Binary logistic regression revealed frailty (EFS) as the main predictor of vulnerability (R² = 0.20; p < 0.001; OR = 1.35 [95% CI: 1.24-1.48]), with functional independence (R² = 0.25; p < 0.001; OR = 3.9 [95% CI: 2.74-5.73]) and functional performance (R² = 0.17; p < 0.001; OR = 3.21 [95% CI: 2.21-4.67]) being the domains that most strongly increased the odds of vulnerability. Impaired nutrition showed a consistent predictive association (R² = 0.11; p < 0.001; OR = 0.82 [95% CI: 0.76-0.89]). Frailty and poor nutritional status were predictors of vulnerability, with particular emphasis on physical-functional aspects. QoL showed a moderate to strong correlation with vulnerability, especially in the physical domains.

This study aimed to develop and validate the Scale of Women's Privacy Perception in Infertility Treatment (SWPPIT) to assess privacy perceptions during infertility diagnosis and treatment. A methodological design was used in two phases. In phase one, scale items were developed through qualitative observations and interviews with women undergoing ART. In phase two, validity and reliability were tested on 370 women at a private IVF center. Construct validity was established via exploratory and confirmatory factor analyses, and reliability was assessed using Cronbach's alpha and test-retest methods. The SWPPIT revealed a single-factor structure, explaining 45.19% of the variance, with factor loadings between 0.30 and 0.87. It demonstrated high internal consistency (Cronbach's alpha = 0.949) and excellent test-retest reliability (r = 0.98, p < 0.001). The final scale comprises 37 items rated on a 5-point Likert scale. The SWPPIT is a reliable and valid tool for evaluating women's privacy perceptions in ART settings, enabling healthcare professionals to address privacy concerns and enhance patient-centered care.

The purpose of this study was to explore the experience of treatment-related decision fatigue in patients with recurrent papillary thyroid cancer. Patients with recurrent papillary thyroid carcinoma who were followed up in thyroid surgery wards and outpatient clinics of three tertiary hospitals in Jiangsu Province were included in this study. Semi-structured interviews were conducted from January to April 2024. Inductive content analysis was used to identify themes. A total of 21 participants, aged 24-58 years, were interviewed. Two themes and six sub-themes were identified: manifestations of decision fatigue including impulsive decision making, hesitation, aggravation of negative emotions, and decision making is a burden; and consequences of decision fatigue including decision regret and delay in decision making. Our study identified the manifestations and adverse consequences of decision fatigue in patients with recurrent papillary thyroid cancer, and helped medical staff to identify and develop personalized interventions as early as possible to help patients make appropriate treatment decisions and improve the quality of decision-making and patient treatment outcomes.

The global rise in infertility highlights the need for personalized informational and psychological support. Digital health technology offers a promising avenue; however, knowledge gaps remain regarding optimal delivery methods, outcomes, and limitations. This scoping review synthesizes recent evidence on complementary interventions using technology for individuals with infertility undergoing reproductive technology-assisted interventions and evaluates their effectiveness and limitations. Seven databases were systematically searched to identify studies published in English or Korean between 2000 and December 2023. The risk of bias was assessed using the Joanna Briggs Institute checklist, and data were synthesized using a standardized template. Of 1353 screened studies, 16 were selected, featuring interventions such as web-based programs, mobile applications, and online meetings. Positive outcomes were observed in knowledge, stress reduction, self-efficacy, coping, and dietary behaviors. However, mixed results were found for fertility-related stress, depression, and anxiety, with no significant improvements in fertility-related quality of life, health behaviors, and pregnancy rates. While digital interventions show promise, further research is needed to validate their effectiveness through large-scale randomized controlled trials and to develop standardized assessment tools for better implementation and evaluation.