Journal of Clinical Nursing最新文献

Aims and objectives: To systematically assess the effects of massage and touch on agitation in patients with dementia and to determine the optimal intervention design.

Background: Agitated behaviour is the most common behavioural symptom in patients with dementia and can seriously affect the health status and quality of life of individuals with dementia and their caregivers. Massage and touch have been widely used as a non-pharmacological intervention to address the behavioural issues of dementia. However, current research findings on the effects of massage and touch on agitation in people with dementia are inconsistent.

Design: A meta-analysis of randomised controlled trials.

Methods: This meta-analysis complied with PRISMA guidelines, and relevant literature up to January 2024 was systematically retrieved from PubMed, Embase, Web of Science, the Clinical Trials Registry, Cochrane Library and four Chinese databases. Statistical evaluations were performed utilising Review Manager 5.4, and the included studies' bias risks were assessed with the Cochrane Collaboration tool.

Results: Seventeen randomised controlled trials involving 980 patients with dementia were included. The results of the meta-analysis showed that massage and touch could ameliorate agitation and behaviour problems in dementia. Subgroup analyses based on massage type showed that hand, head and foot massage significantly improved agitation. Massage and touch for ≤ 4 weeks were more effective in reducing agitated behaviour than those for > 4 weeks. Furthermore, subgroup analysis revealed that massages and touch were more effective for individuals with less severe dementia.

Conclusions: Massage and touch in the short term can effectively improve agitation in dementia patients, while hand, head and foot massage can effectively reduce agitation. Thus, clinical nursing staff and caregivers of individuals should be actively helped to apply massage and touch to their patients. However, more studies are needed to validate our results before we can give a more definitive recommendation.

Relevance to clinical practice: This study suggests that massage and touch can be used as complementary treatments for agitation in people with dementia and encourages nursing staff and caregivers to apply massage and touch to better cope with the agitated behaviour of older adults with dementia.

Patient or public contribution: No patient or public contribution.

Trial registration: PROSPERO registration number: CRD42024507133.

Objective: To investigate the status and influencing factors of caring readiness among parents of children undergoing liver transplantation transitioning from the intensive care unit, and to explore the associations between caring readiness and other variables.

Design: A cross-sectional study.

Methods: A total of 126 parents of children who underwent liver transplantation at a tertiary hospital in China took a questionnaire survey via convenience sampling. Independent t-test, ANOVA and correlation analysis were conducted to analyse the data. Multivariable stepwise linear regression was used to analyse the influencing factors of caring readiness. The PROCESS macro (Model 4) was used to verify the mediating effect of caregiver burden between social support and caring readiness.

Reporting method: The STROBE checklist was used as a guideline in this study.

Results: The mean score of caring readiness among parents of children who had undergone liver transplantation and were transitioning from the intensive care unit was 23.62 ± 5.34. Multivariable stepwise linear regression analysis indicated that experience with caregiving, intensive care unit length of stay, social support and caregiver burden were the factors associated with caring readiness, explaining 18.6% of the variance in caring readiness among parents. Caregiver burden partially moderated the relationship between social support and caring readiness (20.93%).

Conclusion: The study shows caring readiness was moderate among parents of children who have undergone liver transplantation and are transitioning from the intensive care unit. It reveals that lack of caregiving experience and children's short intensive care unit length of stay should be emphasised, preventing inadequate readiness of parents. Furthermore, enhancing social support interventions and burden-reduction strategies are important for improving parents' caring readiness.

Implications for the profession and/or patient care: The findings demonstrate that health care professionals should provide timely and appropriate intervention strategies to enhance parents' caring readiness, which could potentially be achieved by increasing social support and reducing caregiver burden.

Patient or public contribution: Parents of children who underwent liver transplantation participated in this study via a questionnaire survey.

Aims: To map the diabetes-related content exposure of older adults with Type 2 diabetes mellitus, and explore the association between the exposure and self-management and the mediation effects of self-efficacy.

Design: Cross-sectional study.

Methods: This study was conducted among 257 eligible older adults with Type 2 diabetes mellitus from five communities in China. Diabetes self-management and self-efficacy were measured with standardised assessment tools. The variable of diabetes-related content exposure was generated by the collection of all content exposure and the transformation of Q-methodology. Descriptive statistics and the relative mediation effect model were used to do the analyses.

Results: Among the participants, 61.1% had hyperbeneficial content exposure, 13.6% had hypobeneficial content exposure, 24.9% had irrelevant content exposure, and 0.4% had harmful content exposure. Compared with those with irrelevant content exposure, older adults with hyperbeneficial content exposure exhibited higher self-management scores (β = 0.448, 95% CI = 0.174-0.721); in the mediation model, the relative direct effect of hyperbeneficial content exposure on self-management remained significant (β = 0.377, 95% CI = 0.104-0.650), and self-efficacy significantly mediated this relationship (β = 0.071, 95% CI = 0.011-0.154). The relative mediation effect accounted for 15.8% of the relative total effect. Conversely, no significant effect of hypobeneficial content exposure on self-management was observed.

Conclusion: Social media can empower the self-management of older adults with Type 2 diabetes mellitus exposed to hyperbeneficial contents, with self-efficacy serving as a significant mediator. In contrast, exposure to hypobeneficial contents on social media did not lead to significant improvement in the self-management. This suggests that not all diabetes-related contents on social media are equally beneficial, and the relevance of information matters.

Implications: Healthcare providers should consider leveraging social media platforms in conjunction with traditional education programmes to enhance the self-management of older adults with Type 2 diabetes mellitus. Older adults with Type 2 diabetes mellitus may search positively diabetes-related hyperbeneficial contents on social media.

Reporting method: The report of this study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines.

Patient or public contribution: No patient or public contribution.

Aim: To construct and validate a prediction model for enteral feeding intolerance in critically ill patients during the first 7 days of enteral feeding.

Design: A retrospective cohort study.

Methods: We reviewed the medical records of two intensive care units from January 2015 to August 2023, to develop a prediction model by univariate analysis and logistic regression analysis. Model's performance was evaluated through discrimination, calibration and decision curve analysis.

Results: This study involved a total of 471 patients, with an enteral feeding intolerance incidence rate of 35.7%. The prediction model comprised six variables, namely neurological disease, chronic gastrointestinal disease, Acute Physiological and Chronic Health Assessment II score, sedatives, acid suppressants and serum albumin. The model showed robust discrimination, calibration and clinical net benefit, indicating significant potential for practical application with readily available variables.

Conclusions: The model demonstrated strong predictive performance in assessing the risk of enteral feeding intolerance during the early stage of nutrition initiation.

Implications for the profession and/or patient care: Enhancing clinicians' capacity to reduce the incidence of enteral feeding intolerance and improve patient outcomes.

Impact: The prediction model shows a good capacity to discriminate critically ill patients at risk of enteral feeding intolerance, is helpful to provide personalised care.

Reporting method: TRIPOD + AI checklist.

Patient or public contribution: No patient or public contribution.

Trial registration: https://www.chictr.org.cn/ ChiCTR2400090757.

Aim: Explore how previous patient safety research has described issues related to patient participation in psychiatric hospital care.

Design: Integrated literature review.

Methods: The literature review was conducted according to Cooper's framework with the following five-step protocol: problem identification, a literature search, data evaluation, data analysis, and the presentation of results.

Data sources: CINAHL, PubMed, PsycINFO, Scopus databases, years 2005-2023. After quality appraisal, a total of 62 articles were reviewed.

Results: Three main categories related to patient participation in psychiatric hospital care were identified: communication (having information, being heard, therapeutic relationships and interaction quality), decision-making (treatment planning, treatment decisions, activities and working on behalf of patients) and restrictive measures (setting limits, exercising power, balancing patient autonomy and safety).

Conclusion: Psychiatric hospital care nursing staff continuously balance patients' autonomy, self-determination, and safety, taking into account their well-being and issues of responsibility. Wider use of positive risk-taking is needed to increase patient participation and safety in psychiatric hospital care.

Implications for the profession and patient care: Nursing staff should create favourable facilities for patient participation, foster an atmosphere of trust, respect, and encouragement, provide patients individual time to improve patient safety and recognise that they can exert power over patients due to constantly balancing patient autonomy and safety.

Reporting method: PRISMA guidelines.

Patient or public contribution: No patient or public contribution.

Aim: To examine the factors affecting the ability of ostomates to perform activities of daily living and manage ostomy self-care.

Design: Mix method design.

Method: This study was undertaken through survey (descriptive and clinical characteristics form and Katz Activities of Daily Living (ADL)) for collecting the quantitative data (n = 60) and semi-structured interviews were conducted with patients unable to perform ostomy self-care for collecting qualitative data (n = 12) between January 2023 and December 2023.

Results: Factors hindering the ability to perform ostomy self-care were physical reasons (68.3%) and psychological reasons (66.7%). Multiple linear regression analysis revealed that individuals with a chronic disease have a Katz ADL score 12.6 times higher than those without a chronic disease (p = 0.004, OR = 12.665, 95% CI: 2.304-69.614). Qualitative analysis identified three themes as challenges, taking over ostomy care and factors improving the quality of life with ostomy.

Conclusion: The findings indicate that having an ostomy impairs individuals' ability to perform daily activities independently and manage their ostomy. Additionally, the presence of a chronic disease in ostomates predicts greater dependence in daily activities. In this regard, support mechanisms should be identified and activated based on the needs of ostomates and chronic diseases, with nursing interventions tailored to address those needs.

Implications for the profession and/or patient care: A dedicated team of specialised ostomy nurses can offer valuable support by focusing on ostomy management and assessing factors that affect both self-care and daily activities.

Impact: This study highlights the impact of coping with an ostomy on daily life and self-care, underscoring the need for targeted support for vulnerable groups and guiding ostomy care nurses in post-discharge follow-up and support group organisation.

Reporting methods: STROBE and GRAMMS checklists.

Patient or public contribution: Patients contributed to the study by sharing their experiences through face-to-face interviews during data collection process.

Aim: The study aims to determine the relationship between e-health literacy level and the care behaviour of neonatal nurses.

Background: E-health literacy is becoming increasingly important, as health-related information can be obtained easily and quickly from electronic sources.

Design: A cross-sectional design was adopted in the survey. The STROBE checklist for cross-sectional studies was used in reporting this study (Data S1). The study was conducted between July and November 2023.

Methods: The sample of the study consists of 384 neonatal nurses working in different hospitals in Türkiye. An introductory form, the E-Health Literacy Scale (eHEALS), and the Care Behaviours Inventory-24 (CBI-24) were used for data collection. The data collection forms were created using Google Forms.

Result: eHEALS 4.32 ± 0.551, CBI-24 5.58 ± 0.567, CBS-24 sub-dimension: Assurance 5.58 ± 0.591, CBS-24 sub-dimension: Knowledge-Skills 5.64 ± 0.561, CBI-24 sub-dimension: Respect 5.56 ± 0.565, CBI-24 sub-dimension: Connectedness 5.52 ± 0.637 was found. It was determined that there was a very weak positive relationship between eHEALS, CBI-24 and sub-dimension scores (p < 0.001). A significant relationship was found between the eHEALS and the independent variables age, female, living in the Southeastern Anatolia region, working in a public hospital, using the internet for their profession, and CBI-24 sub-dimension: assurance (F = 6.111; p < 0.001).

Conclusion(s): The relationship between e-health literacy and care behaviours of neonatal nurses was examined. Neonatal nurses' was found eHEALS, CBI-24, and sub-dimension scores had a high and very weak positive relationship. A significant relationship was found between the eHEALS level and age, female, Southeastern Anatolia region, state hospital, using the internet for their profession, and assurance sub-dimension.

Impact: Study determines the eHEALS of neonatal nurses and provides information about this field. Interventions aimed at eHEALS should be developed and implemented at both the institutional and individual levels.

Reporting: STROBE, No Patient or Public Contribution.