Journal of Clinical Nursing最新文献

Objective: Conduct a systematic review of existing studies on intrinsic capacity (IC) and a meta-analysis of studies to assess the overall effectiveness of ICOPE in improving IC in older adults.

Methods: Ten databases were systematically searched from inception to November 8, 2023, and the search was last updated on January 2, 2024. Randomised controlled trials (RCTs) were included. The main outcomes were IC (cognition, psychological, sensory, vitality and locomotion).

Results: The results showed ICOPE had a significant effect in improving cognitive function (SMD = 0.36; 95% CI, 0.17 to 0.56, p < 0.001, 12 RCTs, 7926 participants) and depressive symptoms (SMD = -0.70; 95% CI, -0.96 to -0.43, p < 0.001, 26 RCTs, 11,034 participants), but there was no statistically significant difference in improving locomotion (SMD = 0.16; 95% CI, -0.03 to 0.34, p = 0.098, 3 RCTs, 1580 participants). Meta-regression analysis shows that intervention duration should be paid attention to when the source of heterogeneity is discussed on the cognition.

Conclusion: The results suggest that ICOPE may be a potentially effective approach to help improve the IC in older adults, showing significant potential for improving cognitive function and reducing depressive symptoms in particular.

Implications for the profession and/or patient care: ICOPE is expected to provide effective strategies to enhance issues such as IC and may be an innovative way to improve the overall health of older adults. This result provides strong support for geriatric nursing practice and encourages the adoption of ICOPE as a viable nursing approach to promote healthy ageing.

Aim(s): To provide an introduction to the Good Nursing Care Scale (GNCS) and systematically review the application of the scale in health research.

Design: Systematic review.

Methods: Empirical studies published in English or Finnish in peer-reviewed journals or as a summary of a PhD thesis where the scale was used for data collection amongst patients were included. Analysis was made by using descriptive statistics, narrative analysis, and evaluation of psychometric properties.

Data sources: PubMed, CINAHL, Cochrane, and Scopus in October 2023.

Results: A total of 26 full-text studies and summaries of PhD theses were included in the review. The GNCS has been developed systematically, and the theoretical structure has remained stable. The studies indicate a high level of patient-centered quality of nursing care. Validity and reliability evaluation and reporting were systematic in the studies and mainly indicate sufficient level. Variations between countries are not large, supporting the international use of the GNCS.

Conclusions: Patient-centered quality of nursing care is predominantly at high levels. However, systematic evaluation is needed to provide longitudinal data. For that purpose, the GNCS is one potential instrument.

Implications for the profession and patient care: Support for the use of existing, tested instruments is encouraged to provide critical ideas for the future needs of nurse practitioners, managers, teachers and researchers.

Impact: This paper impacts researchers interested in systematic evaluation of the patient-centered quality of nursing care and for practitioners taking care of patients. For researchers, it introduces a relevant instrument, the GNCS, for analysing the quality or for comparing the quality with other instruments. For practitioners, it produces evidence of the usability of the GNCS.

Reporting method: PRISMA guided the systematic review, and the COSMIN guideline was used for quality appraisal of included studies.

Patient or public contribution: No Patient or Public contribution.

Background: Breast cancer patients experience various adverse symptoms during adjuvant chemotherapy. These adverse symptoms often form symptom clusters and have a negative impact on patients.

Aims: To summarise common symptom clusters in different dimensions and their longitudinal changes among breast cancer patients receiving adjuvant chemotherapy.

Design: A systematic review.

Data sources: Ten electronic databases were searched from 2001 to January 2024, and the search was last updated on 16 August 2024.

Methods: Two reviewers independently assessed the eligibility of each study and extracted data. The Standard Quality Assessment Criteria for Evaluating Primary Research Papers was used to evaluate the quality of included studies. The findings were synthesised narratively. This systematic review has been registered (CRD42022370210).

Results: Nine studies with a total of 1454 participants were included. The common symptom clusters in breast cancer patients receiving adjuvant chemotherapy were the gastrointestinal symptom cluster (nausea-lack of appetite), the fatigue-pain-sleep disturbance symptom cluster and the psychological symptom cluster (worry-sadness-nervousness-distress-feeling irritable-difficult concentrating). The severity dimension was the most frequently utilised in identifying symptom clusters, with the number and concurrence of symptom clusters showing variation over time.

Conclusions: This study summarised common symptom clusters in breast cancer patients receiving adjuvant chemotherapy and revealed their changes from symptom dimensions and the chemotherapy process. These findings support further exploration of symptom cluster changes and underlying mechanisms, facilitating the design of targeted management strategies, including appropriate interventions and measurement dimensions in clinical nursing, to ultimately reduce patients' symptom burden.

Impact: Common symptom clusters have been identified in breast cancer patients receiving adjuvant chemotherapy. Clinical nursing in oncology can prioritise these symptom clusters and provide patients with targeted management strategies.

Reporting methods: PRISMA guidelines and SWiM guidelines.

Patient or public contribution: No patient or public contribution.

Aims: To explore the incidence and factors influencing medication administration errors (MAEs) among nurses.

Background: Medication administration is a global concern for patient safety. Few studies have assessed the incidence of MAEs or explored factors that considered the interplay between behaviour, the individual and the environment.

Methods: This retrospective study included 342 MAEs reported in the electronic nursing adverse event reporting system between January 2019 and September 2023 at a university-affiliated teaching hospital in China. Data on nurses' demographics and medication administration were extracted from the nursing adverse event reports. The reports were classified according to the severity of patient harm. The causes of the 342 MAEs were retrospectively analysed using content analysis based on Bandura's social cognitive theory. Descriptive statistics were used to calculate the proportion of medication errors and the distribution of subcategories.

Results: In total, 74.3% of MAEs were adverse events owing to mistakes and resulted in no harm or only minor consequences for patients. Nurses aged 26-35 years and those with 6-10 years of experience were the most common groups experiencing MAEs. Factors influencing MAEs included personal ('knowledge and skills' and 'physical state'), environmental ('equipment and infrastructure,' 'work settings' and 'workload and workflow') and behavioural ('task performance' and 'supervision and communication') factors. The study further highlighted the interrelationships among personal, behavioural and environmental factors.

Conclusion: Multiple factors influence MAEs among nurses. Nurse-related MAEs and the relationship between behaviours, individual factors and the environment, as well as ways to reduce the occurrence of MAEs, should be considered in depth.

Relevance to clinical practice: Understanding the factors influencing MAEs can inform training programs and improve the clinical judgement of healthcare professionals involved in medication administration, ultimately improving patient prognoses and reducing MAEs.

Patient or public contribution: The findings can help develop clinical guidelines for preventing MAEs.

Aims: The study investigated the influence of quality of discharge teaching (QDT) on readiness for hospital discharge (RHD) and pathways involved in patients with first-episode stroke, aiming to provide a theoretical framework for enhancing RHD levels and reducing readmission rates.

Design: Cross-sectional study.

Methods: A total of 372 inpatients completed the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Chronic Disease Self-efficacy Scale and Southampton Stroke Self-Management Questionnaire. Structural equation modelling and Pearson's correlation analysis were utilised to elucidate relationships and action pathways among these variables.

Results: The correlation analysis demonstrated significant positive pairwise correlations between QDT, RHD, self-efficacy and self-management (r = 0.376-0.678, p < 0.01). The final model exhibited a good fit with the following indices: χ²/df = 3.286, RMSEA = 0.078, SRMR = 0.0303, GFI = 0.984, AGFI = 0.926, CFI = 0.991 and TLI = 0.970. The impact of QDT on RHD in patients with first-episode stroke was observed through one direct and three indirect pathways: (1) QDT exerted a direct influence on RHD (p < 0.001); (2) QDT indirectly influenced RHD via self-efficacy (p < 0.001); (3) QDT indirectly affected RHD through self-management (p < 0.001); and (4) QDT had an indirect effect on RHD via both self-efficacy and self-management (p < 0.05).

Conclusion: QDT was found to directly influence RHD in patients with first-episode stroke and also exerted indirect effects through self-efficacy and self-management, either independently or in combination. Early screening of RHD levels in patients before discharge is recommended, along with the enhancement of QDT through the development of tailored guidance plans according to different disease stages, ultimately improving RHD levels and facilitating a safer transition from hospital to home or community.

Relevance to clinical practice: Healthcare professionals should assess both QDT and RHD levels to provide targeted interventions. The establishment of transitional care teams and implementation of long-term poststroke management are essential for reducing stroke recurrence and mortality rates.

Purpose: Patients with coronary heart disease (CHD) will have a series of sexual problems, and their sexual life quality can be affected. However, a standardised evaluation tool for patients with CHD was lacking. Therefore, this study aimed to develop a sexual life quality questionnaire for patients with CHD and to evaluate its psychometric properties.

Methods: Based on previous phenomenological studies, literature analysis and group discussion, questionnaire items were formed. After two rounds of expert consultation and pre-survey, the questionnaire items were modified. Items were screened by item analysis. Exploratory factor analysis and confirmatory factor analysis were used to explore and confirm the structure of the questionnaire. Content validity and criterion validity were evaluated using the expert consultation and correlation analysis, respectively. The questionnaire reliability was evaluated using internal consistency, split half reliability, and test-retest reliability.

Results: The sexual life quality questionnaire of patients with CHD was developed, which included two versions: male version and female version. The male version of the questionnaire contains 3 dimensions and 20 items, while the female version contains 3 dimensions and 17 items. After reliability and validity test, the two versions of the questionnaire have good reliability and validity.

Conclusions: In this study, the sexual life quality questionnaire of patients with CHD was developed and its psychometric properties were confirmed, which can be used to evaluate the sexual life quality of patients with CHD.

Implications for clinical practice: The development of a sexual life quality evaluation tool for patients with coronary heart disease to provide objective and quantitative tools for clinical staff to evaluate patients' sexual life status.

Patient contribution: Patients were invited to participate in a questionnaire survey for this study.