Journal of Clinical Nursing最新文献

Aim: To synthesise evidence from qualitative studies on community-dwelling older adults' experiences of social interactions in group interaction programmes.

Design: A systematic review and meta-synthesis based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines.

Methods: Two independent researchers screened the titles and abstracts of all retrieved studies based on eligibility criteria. Quality appraisal was conducted based on the comprehensive Critical Appraisal Skills Programme checklist. Data were extracted through an adapted Data Extraction Tool from the Joanna Briggs Institute Qualitative Assessment and Instrument. Findings were synthesised through the JBI meta-aggregation approach.

Data sources: A literature search for peer-reviewed studies was conducted across seven databases from inception to September 2023.

Results: Our review included the experiences of 395 community-dwelling older adults across 25 studies, yielding the overarching theme of 'Navigating relationships and facilitating growth in a supportive community'. Five themes were identified: feeling safe in a familiar environment, bringing people together, establishing meaningful relationships, improving personal well-being and facing socialising challenges.

Conclusion: Our findings provided not just theoretical insights but also practical implications. They can serve as a solid foundation for formulating or enhancing similar programmes, directly addressing the pervasive issues of loneliness and social isolation among the ageing population worldwide.

Implications for nursing: This review improves our understanding of the social, emotional and personal benefits for older adults upon engaging in group interaction programmes. The insights into the elements of successful group interaction programmes for older adults, include providing a safe and familiar setting and bringing people together for socialisation. Future interventions should incorporate these elements to promote social interactions and community engagement more effectively to mitigate loneliness among older adults. Finally, the diverse range of programmes explored in this review demonstrates that future programmes can be flexibly formulated to suit different interests.

Patient and public contribution: The authors have nothing to report.

Protocol registration: The review protocol has been registered on PROSPERO.

Aim: We aim the isolated and combined effects of sedentary behaviour exposure time and physical activity levels on muscle strength in older adults.

Design: This prospective observational cohort study, analytical in nature, using exploratory survey methods and physical performance testing. With 5-year longitudinal follow-up (2015-2020).

Methods: A total of 459 older adults participated in the baseline, with a total of 224 being included/located again in the follow-up. We evaluate muscle strength using handgrip tests and sit-to-stand tests. The international physical activity questionnaire was used to measure physical activity and sedentary behaviour. Generalised Estimation Equations tested both independent and combined effects, reporting results as β coefficients and confidence intervals.

Results: Older adults exhibiting low sedentary behaviour displayed enhanced handgrip strength compared to those with high sedentary behaviour. Notably, older adults who were sufficiently active with low sedentary behaviour, sufficiently active with high sedentary behaviour, and insufficiently active with low sedentary behaviour showed increased handgrip strength compared to their counterparts who were insufficiently active with high sedentary behaviour. This trend was consistent for lower limb strength.

Conclusion: Interventions that encourage a reduction in sedentary behaviour and an increase in physical activity are essential to maintain muscle strength among older adults.

Implications for practice: The findings of this study underscore the importance of addressing both sedentary behaviour and physical activity levels in clinical interventions aimed at preserving muscle strength in older adults. Routine assessments of physical activity and sedentary behaviour could help tailor personalised exercise programs, potentially enhancing functional independence and reducing the risk of frailty and disability in older patients.

Patient or public contribution: Patients were involved in the sample of the study.

Reporting method: This study was conducted in accordance with the Strengthening Research in Observational Studies in Epidemiology (STROBE) guidelines.

Aim: To integrate experiences and perceptions about stroke survivors during the transition from hospital-to-home care.

Data sources: Seven databases, including PubMed, Embase, Cochrane Library, Ovid, Web of Science, EBSCO and MEDLINE, were searched comprehensively from inception to March 2024, including qualitative studies published in English.

Design: A qualitative systematic review.

Methods: The search followed the Preferred Reporting Items report for Systematic Reviews and Meta-analysis (PRISMA 2020). The included research quality was assessed according to the Critical Appraisal Skills Programme (CASP). Meta-aggregation was used to develop analytical themes. Confidence in the Evidence from the Reviews of Qualitative Research (GRADE-CERQual) framework was applied to the findings.

Results: Fifteen qualitative studies were included, from which 54 findings were extracted. Similar findings were summarised into eight categories, resulting in four synthesised findings: Joy and sadness intertwined, Destruction of sense of self and life, External support and internal motivation, and Emotional longings and practical needs.

Conclusion: Stroke can lead to devastating changes in survivors' sense of self and physically. Through external support from family members and healthcare professionals, as well as internal motivation to cope positively, stroke survivors positively accept and adapt to life. Meanwhile they still have high expectations for personal independence and reintegration into society.

Impact: The review findings can guide health professionals, survivors and families in optimising care during the hospital-to-home transition.

Protocol registration: PROSPERO [CRD42024522555].

Reporting: ENTREQ. No Patient or Public Contribution.

Background: Pregnancy is a special time for women that involves substantial emotional, physical, social, and family changes, which can lead to physical and psychological harm. The rapid development of e-health has provided a favourable platform for managing health-related outcomes in pregnant women, and nurses are the professional group that is most likely to provide e-health services. Nurse-led e-health interventions have attracted increasing attention, but their effects are uncertain.

Objective: To identify the effectiveness of nurse-led e-health interventions in improving health-related outcomes in pregnant women.

Design: A systematic review.

Data sources: The PubMed, PsycINFO, EMBASE, CINAHL, ProQuest, MEDLINE, Scopus, Web of Science and Cochrane Library databases were searched from inception to March 2023.

Methods: Two reviewers independently assessed study eligibility and extracted data. The Cochrane risk of bias tool was used for quality assessment. The findings of this review are presented using a narrative synthesis.

Results: This review included 14 studies involving 2016 participants. Three out of five studies reported that nurse-led e-health interventions significantly reduced depressive symptoms. Four studies reported significant improvements in stress and self-efficacy after the intervention. Two studies reported significant improvements in anxiety symptoms, self-management ability, and quality of life after the intervention. One study showed that weight gain and physical activity significantly improved after the intervention. Due to the heterogeneity in the included studies, no meta-analysis was conducted.

Conclusions: Nurse-led e-health interventions may be beneficial for improving anxiety symptoms, depressive symptoms, stress, self-efficacy, weight gain, self-management ability, physical activity, and quality of life in pregnant women.

Relevance to clinical practice: Nurse-led e-health interventions could provide individualised, economic, interactive, and convenient nursing modes for pregnant women. Rigorous and high-quality evidence confirming the long-term effects of these interventions on pregnant women is necessary.

No patient or public contribution: The patients had no direct involvement in the present study.

Registration number: PROSPERO registration ID: CRD42023401973.

Aim: To explore residents' experiences of the mealtime environment in nursing home.

Design: An exploratory qualitative design was employed to gain in-depth insights.

Methods: Twenty semi-structured interviews were conducted with residents at a nursing home. Data were analysed using thematic analysis as outlined by Braun and Clarke. The consolidated criteria for Reporting Qualitative research checklist were used to support the research process.

Results: Four main themes emerged from the analysis: (1) The significance of food, emphasising the centrality of food quality and variety in residents' mealtime experiences. (2) Security through routines, illustrating how established mealtime routines provide comfort and predictability. (3) Variability in staff influence, reflecting residents' perceptions of staff competence and their impact on the dining experience. (4) Limited social interactions, highlighting the varied social dynamics and their effects on residents' sense of community and isolation.

Conclusion: The study underscores the critical importance of food quality, staff compliance and consistent routines in enhancing mealtime experiences in nursing homes. Additionally, it reveals that the ability to choose social interactions plays a significant role in residents' satisfaction and social well-being.

Implication for patient care: This study provides valuable insights for improving mealtime experiences in nursing homes, suggesting that person-centred care and resident involvement in meal planning can enhance satisfaction and nutritional intake.

Impact: The findings offer practical guidance for healthcare management, emphasising the need to prioritise and personalise mealtime environments to better meet residents' needs and preferences.

Objective: To analyse risk factors for early neurological damage in young and middle-aged stroke cases.

Methods: Totally 405 young and middle-aged stroke patients in the neurocritical care unit (NCU) were selected and divided into the developmental (260 patients) and validation (145 patients) sets. The 405 cases were also grouped based on whether early neurological deterioration (END) occurred. The influencing factors of END were analysed by logistic regression, followed by the construction of a nomogram for predicting the risk of END. The Bootstrap method was applied to internally verify the predictive value of the model, using validation set data.

Results: Age, type of stroke, diabetes, mechanical ventilation, pulse, initial National Institute of Health stroke scale (NIHSS), Barthel index (BI), haemoglobin, hypersensitive C-reactive protein (hs-CRP), triglyceride glucose (TyG) index and CONUT showed statistically significant differences (p < 0.05). Logistic regression analysis revealed type of stroke, initial NIHSS, CONUT, TyG index and hs-CRP were risk factors for END in young and middle-aged stroke cases (OR > 1, p < 0.05). The area under the curve (AUC) for the developmental set was 0.842, and internal validation results showed a C-index of 0.843; the AUC for the validation set was 0.843.

Conclusion: The nomogram constructed in this study has good predictive efficacy and can provide reference for early clinical prediction of END in young and middle-aged stroke cases.

Relevance to clinical practice: The importance of this research lies in shedding light on the significant impact of early neurological deterioration on the health outcomes of young and middle-aged stroke patients, particularly in the short term. To guide clinical workers to identify risk factors early and improve the prognosis of stroke patients.