Journal of Clinical Nursing最新文献

Aim: To explore the impact of intergenerational relationships on the social resilience of elderly populations in Arab societies. Additionally, the study aimed to identify the factors that influence the quality of these relationships and their role in enhancing or diminishing the resilience of older adults.

Design: A qualitative study.

Method: Semi-structured interviews were conducted between June and July 2024 with 12 elderly participants from urban and semi-urban communities in Al-Ahsa, Saudi Arabia. Data were analysed using both deductive framework analysis, guided by social support theory, and inductive thematic analysis to identify key themes related to intergenerational relationships and social resilience.

Results: The study involved 12 participants aged 61-85 years (average age of 72 years), with a mix of educational backgrounds and living arrangements. Strong intergenerational ties were found to significantly enhance social resilience by providing emotional support and a sense of security. Participants in multi-generational households reported more positive outcomes compared to those with less frequent family contact. However, generational differences and modern-life pressures posed challenges to maintaining these relationships.

Conclusion: The findings underscore the importance of fostering strong intergenerational relationships to support the social resilience of elderly populations in Arab societies. Future research should explore interventions that bridge generational gaps and strengthen family ties, particularly in the context of evolving social structures.

Implication for the profession and/or patient care: Healthcare practitioners and policymakers should consider the role of intergenerational relationships when designing interventions aimed at improving the well-being and resilience of older adults in a culturally sensitive approaches.

Reporting method: The Consolidated Criteria for Reporting Qualitative Research (COREQ).

Patient or public contribution: The engagement and interview data from elderly participants provided valuable insights into the dynamics of intergenerational relationships and their impact on social resilience.

Aims: To map interventions in the sexuality of men with stomas.

Design: Scoping review, following JBI and PRISMA-ScR guidelines to report results.

Methods: Databases consulted were PubMed, via National Library of Medicine, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, Embase, Scientific Electronic Library Online, Brazilian Electronic Library of Thesis and Dissertations, CAPES Catalogue of Thesis and Dissertations and Open Access Scientific Repository of Portugal. Texts were read by independent reviewers, with no time or language restrictions.

Results: The final sample included 10 studies. Data were synthesised and grouped for its similarity to approach models, preoperative orientations, self-care promotion, collecting pouch hygiene and safety, sexual health discussion and education, construction of bonds and sexual function evaluation.

Conclusion: Interventions in the sexuality of men with stomas included adherence to models for approaching sexuality, focusing on the permission and coparticipation of the patient, open conversations on the topic, self-care promotion, collecting pouch hygiene and safety, encouragement to the creation of bonds, sexual function evaluation in pre- and postoperative periods and individual and/or collective sexual health education.

Implications for the profession and/or patient care: This study contributes to the sexuality of men with stomas. It identified recommendations to approach and conduct the topic at hand, addressing the rehabilitation process since the surgery to place the stoma is considered.

Impact (addressing): This study addressed scientific literature on the sexuality of men with stomas. Most were from Europe and results demonstrated a gap in knowledge. This research will impact the stoma therapy research, affecting teams involved in the care to men with stomas, encouraging reflections on the sexuality of these patients.

Reporting method: This study complies with the PRISMA-ScR.

Patient or public contribution: There was no patient or public contribution.

Protocol registration: The protocol of this scoping review was registered in the Open Science Framework, registered under DOI 10.17605/OSF.IO/X9DSC. It can be accessed through the following link: https://osf.io/x9dsc/?view_only=a9c62ef6c11f44499f7b2bfe1fe379f9.

Aim: To explore long-term care recipients' perceptions of high-quality care and how person-centred approaches are applied in the services.

Design: A descriptive explorative qualitative design.

Methods: Data were collected through individual interviews with 19 care recipients and 197 h of participant observation at 10 nursing homes and home care units in three Norwegian municipalities. The data were analysed using qualitative content analysis.

Results: The analysis revealed a main theme-to be seen and cared for as an individual-describing the core of the recipients' perceptions of high-quality care. This main theme encompassed two sub-themes. The first-individually adapted care-showed that the recipients valued whether their healthcare workers understood them and their individual care needs and preferences. The second theme-interpersonal encounters-captured the recipients' appreciation of their healthcare workers' presence and ability to create moments where they were seen and treated as human beings.

Conclusion: From the perspective of care recipients, high-quality care services depend on how they are treated as individuals and how the care they receive is adapted to their individual needs and preferences. These recipients' perceptions of individualised care delivered by healthcare workers are consistent with the goal of person-centred care. These results highlight the value of and need for non-standard approaches to providing high-quality care.

Implications for the profession and/or patient care: Despite the long-term care services' extensive caregiving tasks and time pressure, they should enable healthcare workers to be present in the moment with care recipients.

Reporting method: Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines are used for this study (Tong, Sainsbury, and Craig 2007).

Patient or public contribution: Long-term care recipients and the units where they received care contributed to this study. The recipients' perceptions of the care and the units' arrangements facilitating participant observation played significant roles in this research.

Aim: To identify key factors influencing readiness for hospital discharge and delve into the experiences of stoma patients regarding their discharge.

Design: A mixed-methods study.

Method: A total of 374 colorectal cancer patients with stomas were involved to assess discharge readiness and its influencing factors. Additionally, 28 stakeholders-comprising surgeons, nursing managers, surgical nurses, enterostomal therapists, stoma patients and their family caregivers-participated in semistructured interviews. Data on discharge readiness, discharge teaching quality, stoma self-efficacy and social support were collected using validated scales. In-depth interviews provided further insights into discharge preparation experiences. Multivariate logistic regression analysis using IBM SPSS 26.0 and thematic analysis via NVivo 12.0 were employed for data analysis.

Results: Six variables accounted for 80% of the variance in discharge readiness: quality of discharge teaching, stoma self-efficacy, social support, age, gender and family income. Four main themes emerged: ambivalence towards discharge, insufficient preparation time, inadequate communication of discharge information and personal planning needs.

Conclusion: Discharge readiness among stomas patients is influenced by perceived discharge teaching quality, self-efficacy, social support, age, gender and family income. Insufficient preparation and poor communication hinder effective discharge information transfer. Enhanced, patient-centred discharge planning is expected to improve the transition from hospital to home.

Implications for the profession and/or patient care: To improve hospital discharge readiness and facilitate a smooth transition to family care, it is essential to implement patient-centred discharge planning.

Reporting method: Reported with the Mixed Methods Reporting in Rehabilitation & Health Sciences guidelines.

Patient or public contribution: None.

Trial registration: ClinicalTrials.gov identifier: ChiCTR2200058756. https://www.chictr.org.cn/bin/home.

Aims: This study aimed to develop and validate a risk prediction model for cognitive frailty in elderly patients with Type 2 diabetes mellitus (T2DM).

Design: A cross-sectional design.

Methods: From February to November 2023, a convenience sample of 430 older adults with T2DM was enrolled at a tertiary hospital in Jinzhou. The study analysed 22 indicators, including sociodemographic characteristics, behavioural factors, information related to T2DM, nutritional status, instrumental activities of daily living (IADL) and depression. Independent risk factors related to cognitive frailty were identified using LASSO and multivariate logistic regression analysis. A prediction model was created using a nomogram. The calibration curve, decision curve analysis (DCA) and receiver operating characteristic (ROC) curve were used to evaluate model performance. This study was reported using the STARD checklist (Data S1).

Results: The study found that cognitive frailty was prevalent in 30.7% of elderly patients with T2DM. Age, physical activity, glycosylated haemoglobin (HBA1c), duration of diabetes, nutritional status, IADL and depression were predictors of cognitive frailty. The ROC curve shows that the nomogram has good discriminative power. The calibration plots demonstrated a good fit between the observed and ideal curves. Additionally, DCA highlighted the clinical application of the nomogram.

Conclusions: This study provided an effective and convenient approach to evaluating the risk of cognitive frailty among elderly T2DM patients, which can help in the clinical screening of high-risk individuals.

Impact: Nurses should emphasise the care of comorbid cognitive frailty in elderly patients with T2DM. The intuitive and noninvasive nomogram can help clinical nurses assess the risk probability of cognitive frailty in this population. Tailored prevention strategies for high-risk populations can be rapidly developed with this tool, significantly improving patients' quality of life.

Patient or public contribution: Some patients were involved in data interpretation. No public contribution.

Aims: To examine survivors' experiences of discharge information including risk communication after hospitalisation for a stroke and the characteristics associated with receiving information in accordance with their preferences.

Background: With advances in acute stroke care and an ageing population, the number of survivors of stroke is increasing. It is important that healthcare providers ensure patients have adequate information after a stroke-related hospitalisation.

Design: Cross-sectional study.

Methods: Adults recently discharged after a stroke from eight Australian hospitals were mailed a survey. Items examined risk and discharge care information, with participants asked to indicate both their preferences for and receipt of the information. Concordance with preferences was calculated, and characteristics associated with information preference concordance were assessed with binomial logistic regression. Study reported in accordance with STROBE Checklist.

Results: Of 1161 eligible patients invited, 403 (35%) completed the survey. All items were endorsed by 80% or more of respondents as being wanted. However, for all items, fewer respondents reported the care as received. Only 28% of participants received information on all five items according to their preferences. Hospital site, Body Mass Index and age were statistically significantly associated with participants receiving information in accordance with their preferences.

Conclusion: Most participants indicated a preference to receive recommended discharge information. Findings suggest that patients may benefit from increased information provision prior to hospital discharge after stroke.

Relevance to clinical practice and patient care: Nurses have an important role in the provision of stroke care and information. The findings of this study may be used to improve the provision of post-hospital discharge care and support for survivors of stroke, and assist in identifying patients at lower odds of experiencing information aligned with their preferences and who may benefit from support.

Reporting method: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies.

Patient or public contribution: No patient or public contribution.

Aims: To understand the current capacity and capability for nursing, midwifery and allied health professional (NMAHP) principal investigator roles in England.

Design: Quantitative online survey.

Methods: Online national quantitative survey across England analysed using descriptive statistics.

Results: The number of NMAHP PIs in an organisation was unrelated to the size of the NMAHP workforce. NMAHP PIs were more common in non-CTIMP studies. A quarter of organisations had no specific education or support for NMAHP PIs. Most respondents indicated that a national approach to support and training would be helpful.

Conclusions: Having more research-active NMAHPs provides career progression, improved staff retention and improves the evidence base for practice. Having a broader range of CI/PIs allows for more targeted and specialty-specific oversight of research studies and streamlines the acceptance process to allow research to be delivered in a more timely manner.

Implications for practice: This will require more collaboration between NMAHP, medical and industry communities to promote a multidisciplinary approach to healthcare research delivery and to ensure that CI/PI roles are fulfilled by the most appropriate person, regardless of their profession.

Impact: To ascertain NMAHP capacity and capability for PI research roles. Shows where national and organisational effort should be focused to increase this nationally.

Reporting method: Cross reporting guidance for survey studies was utilised.

Patient contribution: No patient or patient contribution.