Pub Date : 2024-05-30DOI: 10.1101/2024.05.28.24307871
Emmanuel Dapilah, Andrews Adjei Druye
Background Intention to quit among nurses is increasingly recognized as a serious predictor of voluntary turnover. Voluntary turnover on the other hand is a significant factor fueling the shortage of nurses globally which could partly be blamed on negative workplace behaviors including but not limited to workplace bullying. Even though the relationship between workplace bullying and the intention to quit has been studied extensively, little is known about these concepts among nurses in Ghana.
{"title":"Investigating Workplace Bullying, Intention to Quit and Depression Among Nurses in the Upper West Region of Ghana","authors":"Emmanuel Dapilah, Andrews Adjei Druye","doi":"10.1101/2024.05.28.24307871","DOIUrl":"https://doi.org/10.1101/2024.05.28.24307871","url":null,"abstract":"<strong>Background</strong> Intention to quit among nurses is increasingly recognized as a serious predictor of voluntary turnover. Voluntary turnover on the other hand is a significant factor fueling the shortage of nurses globally which could partly be blamed on negative workplace behaviors including but not limited to workplace bullying. Even though the relationship between workplace bullying and the intention to quit has been studied extensively, little is known about these concepts among nurses in Ghana.","PeriodicalId":501260,"journal":{"name":"medRxiv - Nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141189446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-08DOI: 10.1101/2024.05.07.24307001
Bethany Hillier, Katie Scandrett, April Coombe, Tina Hernandez-Boussard, Ewout Steyerberg, Yemisi Takwoingi, Vladica Velickovic, Jacqueline Dinnes
Background Pressure injuries (PIs) pose a substantial healthcare burden and incur significant costs worldwide. Several risk prediction models to allow timely implementation of preventive measures and potentially reduce healthcare system burden are available and in use. The ability of risk prediction tools to correctly identify those at high risk of PI (prognostic accuracy) and to have a clinically significant impact on patient management and outcomes (effectiveness) is not clear. We aimed to evaluate the prognostic accuracy and clinical effectiveness of risk prediction tools for PI, and to identify gaps in the literature.
背景 压力伤害（PIs）在全球范围内造成了巨大的医疗负担，并产生了可观的费用。目前已有多种风险预测模型可供使用，以便及时实施预防措施，并有可能减轻医疗系统的负担。目前尚不清楚风险预测工具是否能正确识别那些有高风险的损伤患者（预后准确性），以及是否能对患者管理和预后产生显著的临床影响（有效性）。我们旨在评估 PI 风险预测工具的预后准确性和临床有效性，并找出文献中的不足之处。
{"title":"Accuracy and clinical effectiveness of risk prediction tools for pressure injury occurrence: An umbrella review","authors":"Bethany Hillier, Katie Scandrett, April Coombe, Tina Hernandez-Boussard, Ewout Steyerberg, Yemisi Takwoingi, Vladica Velickovic, Jacqueline Dinnes","doi":"10.1101/2024.05.07.24307001","DOIUrl":"https://doi.org/10.1101/2024.05.07.24307001","url":null,"abstract":"<strong>Background</strong> Pressure injuries (PIs) pose a substantial healthcare burden and incur significant costs worldwide. Several risk prediction models to allow timely implementation of preventive measures and potentially reduce healthcare system burden are available and in use. The ability of risk prediction tools to correctly identify those at high risk of PI (prognostic accuracy) and to have a clinically significant impact on patient management and outcomes (effectiveness) is not clear. We aimed to evaluate the prognostic accuracy and clinical effectiveness of risk prediction tools for PI, and to identify gaps in the literature.","PeriodicalId":501260,"journal":{"name":"medRxiv - Nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140933754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-08DOI: 10.1101/2024.05.07.24306999
Bethany Hillier, Katie Scandrett, April Coombe, Tina Hernandez-Boussard, Ewout Steyerberg, Yemisi Takwoingi, Vladica Velickovic, Jacqueline Dinnes
Background Pressure injuries (PIs) place a substantial burden on healthcare systems worldwide. Risk stratification of those who are at risk of developing PIs allows preventive interventions to be focused on patients who are at the highest risk. The considerable number of risk assessment scales and prediction models available underscore the need for a thorough evaluation of their development, validation and clinical utility.
{"title":"Development and validation of risk prediction tools for pressure injury occurrence: An umbrella review","authors":"Bethany Hillier, Katie Scandrett, April Coombe, Tina Hernandez-Boussard, Ewout Steyerberg, Yemisi Takwoingi, Vladica Velickovic, Jacqueline Dinnes","doi":"10.1101/2024.05.07.24306999","DOIUrl":"https://doi.org/10.1101/2024.05.07.24306999","url":null,"abstract":"<strong>Background</strong> Pressure injuries (PIs) place a substantial burden on healthcare systems worldwide. Risk stratification of those who are at risk of developing PIs allows preventive interventions to be focused on patients who are at the highest risk. The considerable number of risk assessment scales and prediction models available underscore the need for a thorough evaluation of their development, validation and clinical utility.","PeriodicalId":501260,"journal":{"name":"medRxiv - Nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140933642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-04DOI: 10.1101/2024.05.02.24306749
Zoe Chui, Emma Caton, Habib Naqvi, Edward Baker, Juliana Onwumere, Geraldine A Lee, Stephani L Hatch
Background Workplace violence is a serious threat to staff safety and leads to mental and physical health problems that have negative consequences for the recruitment and retention of nurses, amid the worst staffing crisis in the history of the National Health Service (NHS) in the United Kingdom.
{"title":"“I didn’t come into nursing to be attacked and constantly abused”: A qualitative study of exposure to violence for nurses across ethnic groups in the United Kingdom","authors":"Zoe Chui, Emma Caton, Habib Naqvi, Edward Baker, Juliana Onwumere, Geraldine A Lee, Stephani L Hatch","doi":"10.1101/2024.05.02.24306749","DOIUrl":"https://doi.org/10.1101/2024.05.02.24306749","url":null,"abstract":"<strong>Background</strong> Workplace violence is a serious threat to staff safety and leads to mental and physical health problems that have negative consequences for the recruitment and retention of nurses, amid the worst staffing crisis in the history of the National Health Service (NHS) in the United Kingdom.","PeriodicalId":501260,"journal":{"name":"medRxiv - Nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140933824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1101/2024.04.30.24306612
Violet Manonyana Chewe, Johanna Mmabojalwa Mathibe-Neke
Background Pregnancy outcomes are determined by the type of antenatal care a woman receives. The purpose of this review was to conduct a critical analysis of the literature on the provision of holistic antenatal care to pregnant women.
{"title":"Holistic antenatal care during pregnancy: A systematic review","authors":"Violet Manonyana Chewe, Johanna Mmabojalwa Mathibe-Neke","doi":"10.1101/2024.04.30.24306612","DOIUrl":"https://doi.org/10.1101/2024.04.30.24306612","url":null,"abstract":"<strong>Background</strong> Pregnancy outcomes are determined by the type of antenatal care a woman receives. The purpose of this review was to conduct a critical analysis of the literature on the provision of holistic antenatal care to pregnant women.","PeriodicalId":501260,"journal":{"name":"medRxiv - Nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140881384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-15DOI: 10.1101/2024.04.14.24305628
Grace Kistner, Shannon Macfarlan
We present one method of a Training-of-Trainers (ToT) program supported by a partnership between a low-middle income country (LMIC) hospital and a high income country (HIC) organization through lectures, group discussions, assessments, and bedside coaching over a period of two weeks. The goal was to build capacity in ICU nurses by teaching standards of care and documentation, improving interdisciplinary communication, and scaling up participants’ knowledge and comfort levels in providing quality care. Nurse educators from the Alliance for Global Clinical Training (Alliance) designed the program and conducted the critical care nursing curriculum. Topics were selected by Muhimbili National Hospital (MNH) nursing peers who also provided facility information. Understanding what resources and infrastructure are routinely available is essential to applying concepts to practice. The MNH administrative team and nursing education liaison sought out the best suited participants. Identifying talent in participants for ToT programs is crucial to their success. Nurse participants were chosen as effective representatives of their individual units to be future agents of change. Participants described what they most wanted from the program, including: increased knowledge in documentation, communication, and overall critical care specialized training. Pre- and post-knowledge assessments tested critical care knowledge. The nursing process ADPIE (Assessment, Diagnosis, Problem, Intervention, Evaluation) and SBAR communication (Situation, Background, Assessment, Recommendation) were provided tools for standard operating procedures which enhance interdisciplinary management of care. Clear and consistent documentation with ADPIE requires clinical assessment and evidence-based diagnoses. Standardized communication with SBAR provides an organized framework to professionally relay critical information and provide recommendations. All materials were provided in an open-access format for the program to be easily replicated by the participants. A long-term goal of this training was to assess impact and sustainability.
我们介绍了一种培训培训师（ToT）计划的方法，该计划由一家中低收入国家（LMIC）医院和一家高收入国家（HIC）机构合作支持，通过为期两周的讲座、小组讨论、评估和床边指导来进行。目标是通过传授护理标准和文件记录、改善跨学科交流以及提高参与者在提供优质护理方面的知识水平和舒适度，增强重症监护室护士的能力。来自全球临床培训联盟（Alliance for Global Clinical Training）的护士教育工作者设计了该计划，并开设了重症监护护理课程。主题由 Muhimbili 国立医院（MNH）的护理同行选定，他们还提供了设施信息。了解日常可用的资源和基础设施对于将概念应用于实践至关重要。MNH 行政团队和护理教育联络员寻找最合适的参与者。发现 ToT 项目参与者的才能对于项目的成功至关重要。护士学员被选为其所在单位的有效代表，成为未来变革的推动者。参与者描述了他们最希望从项目中获得的东西，包括：增加文档记录、沟通和整体重症监护专业培训方面的知识。前期和后期知识评估测试了重症护理知识。护理流程 ADPIE（评估、诊断、问题、干预、评价）和 SBAR 沟通（情况、背景、评估、建议）为标准操作程序提供了工具，从而加强了跨学科护理管理。使用 ADPIE 进行清晰一致的记录需要进行临床评估和循证诊断。使用 SBAR 进行标准化交流为专业地传递关键信息和提供建议提供了一个有组织的框架。所有材料均以开放获取的形式提供，便于学员复制。此次培训的长期目标是评估其影响和可持续性。
{"title":"A Training-of-Trainers Program for Nurses in Tanzania: ICU Standards of Care, Documentation, and Communication","authors":"Grace Kistner, Shannon Macfarlan","doi":"10.1101/2024.04.14.24305628","DOIUrl":"https://doi.org/10.1101/2024.04.14.24305628","url":null,"abstract":"We present one method of a Training-of-Trainers (ToT) program supported by a partnership between a low-middle income country (LMIC) hospital and a high income country (HIC) organization through lectures, group discussions, assessments, and bedside coaching over a period of two weeks. The goal was to build capacity in ICU nurses by teaching standards of care and documentation, improving interdisciplinary communication, and scaling up participants’ knowledge and comfort levels in providing quality care. Nurse educators from the Alliance for Global Clinical Training (Alliance) designed the program and conducted the critical care nursing curriculum. Topics were selected by Muhimbili National Hospital (MNH) nursing peers who also provided facility information. Understanding what resources and infrastructure are routinely available is essential to applying concepts to practice. The MNH administrative team and nursing education liaison sought out the best suited participants. Identifying talent in participants for ToT programs is crucial to their success. Nurse participants were chosen as effective representatives of their individual units to be future agents of change. Participants described what they most wanted from the program, including: increased knowledge in documentation, communication, and overall critical care specialized training. Pre- and post-knowledge assessments tested critical care knowledge. The nursing process ADPIE (Assessment, Diagnosis, Problem, Intervention, Evaluation) and SBAR communication (Situation, Background, Assessment, Recommendation) were provided tools for standard operating procedures which enhance interdisciplinary management of care. Clear and consistent documentation with ADPIE requires clinical assessment and evidence-based diagnoses. Standardized communication with SBAR provides an organized framework to professionally relay critical information and provide recommendations. All materials were provided in an open-access format for the program to be easily replicated by the participants. A long-term goal of this training was to assess impact and sustainability.","PeriodicalId":501260,"journal":{"name":"medRxiv - Nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140616192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-12DOI: 10.1101/2024.04.09.24305579
Shu Li, Jiani Pan, Yan Xu, Shiyu Tian, Zhengyue Dai, Qiong Fang
Objectives To explore factors affected untimely receiving intravitreal anti-Vascular endothelial growth factor (VEGF) injection based on the Capability, Opportunity and Motivation-Behavior (COM-B) model in patients with Diabetic Macular Edema (DME) and regard these factors as main targets for interventions.
{"title":"Exploring factors affected timely receiving intravitreal anti-VEGF treatment in patients with Diabetic Macular Edema: a qualitative interview study analyzed with COM-B model","authors":"Shu Li, Jiani Pan, Yan Xu, Shiyu Tian, Zhengyue Dai, Qiong Fang","doi":"10.1101/2024.04.09.24305579","DOIUrl":"https://doi.org/10.1101/2024.04.09.24305579","url":null,"abstract":"<strong>Objectives</strong> To explore factors affected untimely receiving intravitreal anti-Vascular endothelial growth factor (VEGF) injection based on the Capability, Opportunity and Motivation-Behavior (COM-B) model in patients with Diabetic Macular Edema (DME) and regard these factors as main targets for interventions.","PeriodicalId":501260,"journal":{"name":"medRxiv - Nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140577678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28DOI: 10.1101/2024.03.26.24304939
Edimar Alcides Bocchi, Guilherme Veiga Guimaraes, Cristian Espinoza, Silvia Moreira-Ferreira, Bruno Biselli, Paulo Chizzola, Robinson Mulhoz, Julia Tizue Fukushima, Fatima Cruz
Background: Heart failure (HF) is associated with frequent hospitalization and worse prognosis. Prognosis factors and survival in very long-term follow-up have not been reported in HF. HF disease management programs(DMP) results are contradictory. DMP efficacy in very long-term follow-up is unknown. We studied the very long-term follow-up of up to 23.6 years and prognostic factors of HF in 412 patients under GDMT included in the REMADHE trial. Methods: The REMADHE trial was a prospective, single-center, randomized trial comparing DMP versus usual care(C). The first patient was randomized on October 5, 1999. The primary outcome of this extended REMADHE was all-cause mortality. Results: The all-cause mortality rate was 88.3%. HF was the first cause of death followed by death at home. Mortality was higher in the first 6-year follow-up. The predictive variables in multivariate analysis associated with mortality were age >52 years (P=0.015), Chagas etiology (P=0.010), LVEF <45% (P=0.008), use of digoxin (P=0.002), functional class IV (P=0.01), increase in urea (P=0.03), and reduction of lymphocytes (P=0.005). In very long-term follow-up, DMP did not affect mortality in patients under GDMT. HF as a cause of death was more frequent in the C group. Chagas disease, LVEF <45%, and renal function were associated with different modes of death. Conclusion: DMP was not effective in reducing very-long term mortality; however, the causes of death had changed. Our findings that age, LVEF, Chagas disease, functional class, renal function, lymphocytes, and digoxin use were associated with poor prognosis could influence future strategies to improve HF management.
{"title":"Very Long-term Longitudinal Follow-up of Heart Failure on the REMADHE Trial","authors":"Edimar Alcides Bocchi, Guilherme Veiga Guimaraes, Cristian Espinoza, Silvia Moreira-Ferreira, Bruno Biselli, Paulo Chizzola, Robinson Mulhoz, Julia Tizue Fukushima, Fatima Cruz","doi":"10.1101/2024.03.26.24304939","DOIUrl":"https://doi.org/10.1101/2024.03.26.24304939","url":null,"abstract":"Background: Heart failure (HF) is associated with frequent hospitalization and worse prognosis. Prognosis factors and survival in very long-term follow-up have not been reported in HF. HF disease management programs(DMP) results are contradictory. DMP efficacy in very long-term follow-up is unknown. We studied the very long-term follow-up of up to 23.6 years and prognostic factors of HF in 412 patients under GDMT included in the REMADHE trial. Methods: The REMADHE trial was a prospective, single-center, randomized trial comparing DMP versus usual care(C). The first patient was randomized on October 5, 1999. The primary outcome of this extended REMADHE was all-cause mortality. Results: The all-cause mortality rate was 88.3%. HF was the first cause of death followed by death at home. Mortality was higher in the first 6-year follow-up. The predictive variables in multivariate analysis associated with mortality were age >52 years (P=0.015), Chagas etiology (P=0.010), LVEF <45% (P=0.008), use of digoxin (P=0.002), functional class IV (P=0.01), increase in urea (P=0.03), and reduction of lymphocytes (P=0.005). In very long-term follow-up, DMP did not affect mortality in patients under GDMT. HF as a cause of death was more frequent in the C group. Chagas disease, LVEF <45%, and renal function were associated with different modes of death.\u0000Conclusion: DMP was not effective in reducing very-long term mortality; however, the causes of death had changed. Our findings that age, LVEF, Chagas disease, functional class, renal function, lymphocytes, and digoxin use were associated with poor prognosis could influence future strategies to improve HF management.","PeriodicalId":501260,"journal":{"name":"medRxiv - Nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140324009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-16DOI: 10.1101/2024.03.15.24304355
Helen Wilde LaPlant, Confidence Francis-Edoziuno, Zhe Guan, Tumilara Aderibigbe, Xiaolin Chang, Ashwag Alhabodal, Kristen Delaney, Dana Scott, Mary Marshall-Crim, Idelisa Freytes, Wendy A Henderson, Stephen Walsh, Ruth F Lucas
Abstract Introduction: Women below the poverty threshold have lower representation and retention in breastfeeding studies. Methods: A secondary analysis of a longitudinal randomized controlled self-management for breast and nipple pain during breastfeeding study. Participants completed online surveys at discharge, weeks 1, 2, 3, 6, 9, 12, 18, and 24, with face-to-face interviews at 6 and 24 weeks. Text messages were sent to participants when modules and surveys were due. Retention was assessed in R with descriptive statistics, Mann-Whitney, Pearsons chi-square, and Cox Proportional Hazard Regression. Results: Two hundred and forty-four women (89 ≤$50,000 and 155 >$50,000) were recruited. Retention rates at 1 (93%), 2 (87%), 6 (82%), 9 (77%) and 24 (72%) weeks. For women of low income compared to those of high income there was a hazard ratio (HR) of 2.5 (p=0.0001) for retention. For non-Hispanic Black and Hispanic women compared to the combined non-Hispanic White and Other group, HRs for retention were 3.3 and 2.6 respectively (p=0.0001). Adjustment for age in the final hazard regression model of income, age, race and ethnicity decreased the HR for women of low income to 1.6 and HRs for non-Hispanic Black and Hispanic women to 2.1 and 1.9, respectively (p=.0001). However, none of the individual factors in the model achieved statistical significance. Discussion: Retention in breastfeeding studies impacts breastfeeding duration, a key lifelong preventative health behavior. Despite accessible study design, retention of women desiring to breastfeed was adversely affected by the intersection of income, race and ethnicity, and age.
{"title":"Retention and the Intersection of Structural Inequities in a Breastfeeding Intervention Study","authors":"Helen Wilde LaPlant, Confidence Francis-Edoziuno, Zhe Guan, Tumilara Aderibigbe, Xiaolin Chang, Ashwag Alhabodal, Kristen Delaney, Dana Scott, Mary Marshall-Crim, Idelisa Freytes, Wendy A Henderson, Stephen Walsh, Ruth F Lucas","doi":"10.1101/2024.03.15.24304355","DOIUrl":"https://doi.org/10.1101/2024.03.15.24304355","url":null,"abstract":"Abstract\u0000Introduction: Women below the poverty threshold have lower representation and retention in breastfeeding studies. Methods: A secondary analysis of a longitudinal randomized controlled self-management for breast and nipple pain during breastfeeding study. Participants completed online surveys at discharge, weeks 1, 2, 3, 6, 9, 12, 18, and 24, with face-to-face interviews at 6 and 24 weeks. Text messages were sent to participants when modules and surveys were due. Retention was assessed in R with descriptive statistics, Mann-Whitney, Pearsons chi-square, and Cox Proportional Hazard Regression.\u0000Results: Two hundred and forty-four women (89 ≤$50,000 and 155 >$50,000) were recruited. Retention rates at 1 (93%), 2 (87%), 6 (82%), 9 (77%) and 24 (72%) weeks. For women of low income compared to those of high income there was a hazard ratio (HR) of 2.5 (p=0.0001) for retention. For non-Hispanic Black and Hispanic women compared to the combined non-Hispanic White and Other group, HRs for retention were 3.3 and 2.6 respectively (p=0.0001). Adjustment for age in the final hazard regression model of income, age, race and ethnicity decreased the HR for women of low income to 1.6 and HRs for non-Hispanic Black and Hispanic women to 2.1 and 1.9, respectively (p=.0001). However, none of the individual factors in the model achieved statistical significance.\u0000Discussion: Retention in breastfeeding studies impacts breastfeeding duration, a key lifelong preventative health behavior. Despite accessible study design, retention of women desiring to breastfeed was adversely affected by the intersection of income, race and ethnicity, and age.","PeriodicalId":501260,"journal":{"name":"medRxiv - Nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140154487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-13DOI: 10.1101/2024.03.11.24304110
Ntombifikile Klaas, Onalenna Baliki
Background: Decision making in the intensive care unit (ICU) is often complex, involving frequent interactions between patients, families, and health care professionals. Family members play an important role as surrogate decision markers because patients admitted in ICU lack decision- making capacity due to their critical state. Lack of regular, timeous, up to date and honest information provided by the ICU healthcare professionals may negatively influence the family members’ decision making ability and overall satisfaction. Aim: To identify existing literature that describe family satisfaction with involvement in decision making in the intensive care unit. Methods: A scoping review of literature guided by Arksey and O ‘Malley’s framework was conducted. Literature search was completed using five databases. Primary studies published in English between 2010 and 2023 were retrieved and analyzed using thematic analysis. Results: Of the 152 studies identified during the search, 23 were eligible for inclusion. Most of the studies (n = 19; 83%) focused on family satisfaction with care and decision making and four (n=4; 17%) focused on strategies aimed at enhancing family involvement in decision making. These strategies included: testing the effects of using information booklets, structured attendance of interdisciplinary ward rounds, development and implementation of evidence-based communication algorithm and exploring the culture of interprofessional collaboration. The three themes that emerged from the scoping review were: satisfaction with involvement, communication, and support. Conclusion: The use of structured communication programs as well as regular, timeous and honest information about the patient’s diagnosis, treatment plan and prognosis are vital measures to enhancing family involvement in decision making.
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