Japan Journal of Nursing Science最新文献_第9页

Mental health of midwives during the COVID-19 pandemic: A scoping review COVID-19 大流行期间助产士的心理健康：范围审查。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-07-03 DOI: 10.1111/jjns.12612

Mayumi Uchimura, Ai Miyauchi, Myori Takahashi, Erika Ota, Shigeko Horiuchi

Aim

A summary of studies focusing on the mental health of midwives during the COVID-19 pandemic has not yet been conducted. This review aims to comprehensively understand the current state of midwives' mental health in the context of the COVID-19 pandemic and to provide valuable insights to guide future research.

Methods

This study was based on a framework for conducting scoping reviews. The protocol was registered before conducting this review and procedures were carried out according to that protocol. Article searches were conducted in four databases from December 2019 to December 2023. From 921 articles selected according to pre-registered protocol criteria, the analysis finally included 14 studies.

Results

A total of 13 studies were cross-sectional and one was longitudinal, with pre-pandemic data. More than 80% of the studies began data collection within approximately 1 year after the pandemic was declared by the World Health Organization (by February 2021). Half of the studies were conducted in Asia. Burnout and turnover intentions were investigated in several studies but used different measures. Only two studies were aimed at positive aspects such as job satisfaction and well-being.

Conclusions

Most research on midwives' mental health during the COVID-19 pandemic has focused on negative aspects such as burnout and turnover intentions. However, most results were cross-sectional, with studies in the early stages of the pandemic, so continued follow-up is needed.

目的：目前尚未对 COVID-19 大流行期间助产士心理健康的研究进行总结。本综述旨在全面了解 COVID-19 大流行期间助产士的心理健康现状，并为指导未来研究提供有价值的见解：本研究以范围界定综述的框架为基础。方法：本研究以范围综述框架为基础，在进行综述前对综述方案进行了注册，并根据该方案执行了相关程序。从 2019 年 12 月至 2023 年 12 月，在四个数据库中进行了文章检索。根据预先登记的协议标准，从921篇文章中筛选出了14项研究，最终进行了分析：共有 13 项研究为横断面研究，1 项为纵断面研究，研究数据均为大流行前的数据。超过 80% 的研究在世界卫生组织宣布大流行后约 1 年内（2021 年 2 月前）开始收集数据。半数研究在亚洲进行。多项研究对职业倦怠和离职意向进行了调查，但使用了不同的测量方法。只有两项研究针对工作满意度和幸福感等积极方面：大多数关于助产士在 COVID-19 大流行期间心理健康的研究都集中在消极方面，如职业倦怠和离职意向。然而，大多数研究结果都是横断面的，而且研究还处于大流行的早期阶段，因此还需要继续跟踪。

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引用次数: 0

Mother's perception of early introduction of complementary feeding affecting stunting in Ghana: A qualitative research 加纳母亲对过早添加辅食影响发育的看法：定性研究。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-06-23 DOI: 10.1111/jjns.12611

Ayame Ikemi, Shigeko Horiuchi

Objectives

The study aimed to explore mothers' perceptions for timely introduction of complementary feeding through interviews with 2–12-month-old infants' mothers in Ghana.

Methods

Qualitative descriptive research with 16 semi-structured interviews with mothers attending the Child Welfare Clinic at Ejisu Hospital was conducted from June 2022 to May 2023. The study was guided by the Declaration of Helsinki, and all participants were instructed about informed consent for the study. Interviews and analysis were guided by Theory of Planned Behavior. NVivo 1.5 was used throughout the coding procedure. This study was conducted after the approval from St. Luke's International University.

Results

Four themes were revealed: (1) attitude toward the behavior based on the mothers' experience raising children, (2) attitude toward the behavior influenced by subjective norm (grandmothers' recommendation), (3) attitude toward the behavior influenced by perceived behavioral control (difficulty in continuing breastfeeding), and (4) mothers who are worried about underweight despite timely introduction of complementary feeding. Attitudes toward the behavior were influenced by mothers' experiences raising children and grandmothers' recommendations. Surroundings disruptive of breastfeeding also influenced attitudes toward intentions and behavior. Moreover, some mothers suffered from underweight even if they introduce complementary feeding at an optimal time.

Conclusion

Supporting to continue breastfeeding and conducting re-education for grandmothers is a key recommendation for midwives and pediatric nurses. Moreover, pediatric nurses are required to further enhance not only health education regarding the timing of initiating complementary feeding but also support after the introduction.

研究目的本研究旨在通过对加纳 2-12 个月大婴儿的母亲进行访谈，探讨她们对及时添加辅食的看法：研究于 2022 年 6 月至 2023 年 5 月进行，对在埃吉苏医院儿童福利诊所就诊的母亲进行了 16 次半结构式访谈。本研究以《赫尔辛基宣言》为指导，所有参与者都接受了关于本研究知情同意的指导。访谈和分析以计划行为理论为指导。整个编码过程使用了 NVivo 1.5。本研究在获得圣路加国际大学批准后进行：研究揭示了四个主题：（1）基于母亲养育子女经验的行为态度；（2）受主观规范（祖母的建议）影响的行为态度；（3）受感知行为控制（继续母乳喂养的困难）影响的行为态度；（4）尽管及时添加辅食但仍担心体重不足的母亲。对该行为的态度受母亲的育儿经验和祖母建议的影响。周围环境对母乳喂养的干扰也影响了对母乳喂养意愿和行为的态度。此外，一些母亲即使在最佳时间添加辅食，也会出现体重不足的情况：结论：支持继续母乳喂养并对祖母进行再教育是助产士和儿科护士的一项重要建议。此外，儿科护士不仅要进一步加强有关添加辅食时机的健康教育，还要加强添加辅食后的支持。

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引用次数: 0

Impact of the child's birth weight on maternal misperceptions of young children's weight: A retrospective study with nationally representative data 儿童出生体重对母亲对幼儿体重误解的影响：一项具有全国代表性数据的回顾性研究。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-06-18 DOI: 10.1111/jjns.12610

Sangmi Lee

Aim

A young child's abnormal birth weight (BW) can affect a mother's misperceptions of her child's weight, potentially hindering the child's health management. Therefore, this study investigated the impact of children's BW on maternal misperceptions of children's weight during early childhood.

Methods

A retrospective study was conducted for 485,095 children who were 54–60 months of age, born between 2011 and 2013, and participated in South Korea's Sixth National Health Screening Program for Infants and Children (NHSPIC). Data on BW, weight, sex, birth year, preterm birth, breastfeeding history, maternal age, mothers' perceptions of the child's weight, and socioeconomic status were collected and incorporated in the final analysis via data linkage between the NHSPIC and Korean healthcare claims information. Multiple logistic regression analysis was applied to identity the impact of BW on mothers' misperceptions of children's weight, after adjustment for all variables.

Results

Low BW (LBW) children had the lowest proportion (57.1%) of mothers who accurately identified their child's weight compared to normal or high BW. LBW was an independent factor affected maternal misperception of the child's weight (underestimation: adjusted odds ratio [aOR]: 1.46, 95% confidence interval [CI]: 1.41–1.52; overestimation: aOR: 0.84, 95% CI: 0.73–0.97). Overweight or underweight status, male gender, preterm birth, a younger mother, and low socioeconomic status were also associated with both underestimation and overestimation.

Conclusion

LBW emerged as an important risk factor for maternal misperception of a child's weight. Therefore, pediatric nurses need to apply interventions to improve perceptions of children's weight among mothers of young LBW children.

目的：幼儿异常的出生体重（BW）会影响母亲对其子女体重的错误认知，从而有可能妨碍子女的健康管理。因此，本研究调查了儿童出生体重对幼儿期母亲对儿童体重错误认知的影响：本研究对韩国第六次全国婴幼儿健康检查计划（NHSPIC）中的 485 095 名 54-60 个月大的儿童进行了回顾性研究。通过 NHSPIC 和韩国医疗保健索赔信息之间的数据链接，收集了有关体重、体重、性别、出生年份、早产、母乳喂养史、母亲年龄、母亲对孩子体重的看法以及社会经济状况的数据，并将其纳入最终分析。在对所有变量进行调整后，采用多元逻辑回归分析来确定体重对母亲错误认知儿童体重的影响：结果：与正常体重或高体重儿童相比，低体重（LBW）儿童的母亲准确识别其子女体重的比例最低（57.1%）。低体重是影响母亲错误估计孩子体重的一个独立因素（低估：调整赔率 [aOR]：1.46，95% 置信区间：1.46，95% 置信区间 [CI]：1.41-1.52；高估：aOR：0.84，95% 置信区间：0.73-0.97）。超重或体重不足、男性、早产、母亲较年轻以及社会经济地位低也与低估和高估有关：结论：低体重儿是导致母亲错误估计儿童体重的一个重要风险因素。因此，儿科护士需要采取干预措施，改善低体重儿母亲对儿童体重的认知。

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引用次数: 0

Development of an e-learning program for biofeedback in pelvic floor muscle training for adult women using self-performed ultrasound: An observational study 利用自制超声波为成年妇女开发盆底肌肉训练生物反馈电子学习程序：一项观察性研究。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-06-16 DOI: 10.1111/jjns.12609

Miyako Muta, Toshiaki Takahashi, Nao Tamai, Hiromi Sanada, Gojiro Nakagami

Introduction

Pelvic floor muscle training (PFMT) for urinary incontinence (UI) is recommended in combination with biofeedback to visualize pelvic floor muscles. The focus is on non-invasive hand-held ultrasound (US) measurement methods for PFMT, which can be performed at home. Recently, self-performed US measurements in which the patient applies the US to themself have gradually spreading. This study aimed to develop an educational program for the biofeedback method using self-performed US and to evaluate its feasibility.

Methods

This study was an observational study. The ADDIE model (Analysis, Design, Development, Implementation, and Evaluation) was utilized to create an e-learning program for women aged ≥40 years with UI. Participants self-performed bladder US via e-learning, using a hand-held US device with a convex probe. The primary outcome was the number of times the bladder area was successfully extracted using an existing automatic bladder area extraction system. The secondary outcome was the total score of the technical evaluation of the self-performed US, which was evaluated across three proficiency levels. Descriptive statistics were conducted for participant characteristics, presenting categorical variables as percentages and continuous variables as means ± SD.

Results

We included 11 participants with a mean age of 56.2 years. Nine participants were able to record US videos, and two were unable to record bladder videos. Regarding the technical evaluation scores, all participants scored ≥80%; four had perfect scores.

Conclusions

This study showed that transabdominal self-performed bladder US can be performed in 81.8% of women with UI in their 40–60s by using an e-learning program.

简介：治疗尿失禁（UI）的盆底肌肉训练（PFMT）建议与生物反馈相结合，以可视化盆底肌肉。重点是用于盆底肌肉训练的无创手持式超声波（US）测量方法，这种方法可在家中进行。最近，由患者自己使用超声波进行自我测量的方法逐渐普及。本研究旨在为使用自我操作 US 的生物反馈法制定一个教育计划，并评估其可行性：本研究是一项观察性研究。方法：本研究是一项观察性研究，采用 ADDIE 模型（分析、设计、开发、实施和评估）为年龄≥40 岁的 UI 女性设计了一个电子学习项目。参与者通过电子学习软件，使用带有凸面探针的手持式膀胱造影设备，自行进行膀胱造影。主要结果是使用现有的自动膀胱区提取系统成功提取膀胱区的次数。次要结果是自我操作 US 的技术评估总分，评估分为三个熟练级别。我们对参与者的特征进行了描述性统计，分类变量以百分比表示，连续变量以均数±标度表示：我们共纳入了 11 名参与者，平均年龄为 56.2 岁。九名参与者能够录制美国视频，两名参与者无法录制膀胱视频。在技术评估得分方面，所有参与者的得分均≥80%；其中四人获得满分：本研究表明，通过使用电子学习程序，81.8% 的 40-60 岁患有尿道炎的女性可自行进行经腹膀胱造影。

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引用次数: 0

Anxiety among Japanese nursing researchers before and after dispatch for COVID-19 pandemic support: Effects of anxiety-enhancing and buffering factors 日本护理研究人员在派遣 COVID-19 大流行病支援前后的焦虑：焦虑增强因素和缓冲因素的影响。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-06-02 DOI: 10.1111/jjns.12608

Yoko Imazu, Akiko Kondo, Mitsuko Ushikubo, Sakiko Kanbara, Noriko Kawahara, Mari Kondo

Aim

We investigated the levels of anxiety and the factors influencing it among Japanese nursing researchers before and after engaging in dispatch support activities during the COVID-19 pandemic. This study also tested the relationships between pre- and post-relief anxiety and their enhancing and buffering factors.

Methods

A web-based survey was conducted with 9832 members from the Japan Academy of Nursing Science, covering 15 items related to participant attributes such as age and disaster relief qualifications, factors affecting anxiety about support activities such as the content and duration of one activity, and the level of anxiety before and after activities. After performing multiple regression analyses on the effects of the attributes and the factors influencing anxiety before and after support activities, path analysis was conducted on the adopted independent variables to examine their influence on anxiety before and after support activities.

Results

Of the 886 participants, 82.3% were affiliated with educational institutions and 94.8% had no qualifications in disaster relief. Most of the support involved vaccination and activities at health centers. The relationship between pre- and post-relief activities and factors influencing anxiety constituted a high goodness-of-fit, with health center assistance being both a direct and indirect reinforcer of post-relief anxiety.

Conclusions

Participants expressed anxiety enhanced by activities at the health center both before and after support activities in the wake of the COVID-19 pandemic. Intervention research should examine anxiety-buffering and -enhancing factors, and a support system to respond to rapidly increasing medical needs is necessary.

目的：我们调查了日本护理研究人员在 COVID-19 大流行期间参与派遣支持活动前后的焦虑水平及其影响因素。本研究还检验了救援前后焦虑及其增强和缓冲因素之间的关系：方法：对日本护理科学学会的 9832 名会员进行了一项网络调查，调查内容包括 15 个项目，涉及参与者的年龄和救灾资格等属性、活动内容和持续时间等影响支援活动焦虑的因素，以及活动前后的焦虑程度。在对参与者属性和活动前后焦虑影响因素的影响进行多元回归分析后，对所采用的自变量进行了路径分析，以考察它们对活动前后焦虑的影响：在 886 名参与者中，82.3% 隶属于教育机构，94.8% 没有救灾资质。大部分支援活动涉及疫苗接种和医疗中心的活动。救灾前后的活动与影响焦虑的因素之间的关系具有很高的拟合度，卫生中心的援助既是救灾后焦虑的直接强化因素，也是间接强化因素：结论：COVID-19疫情发生后，在医疗中心开展支持活动之前和之后，参与者的焦虑感都得到了增强。干预研究应该对缓解和增强焦虑的因素进行研究，同时有必要建立一个支持系统来应对快速增长的医疗需求。

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引用次数: 0

Chewing ability and its associated factors among community-dwelling older adults in Chengdu, China: A cross-sectional study 中国成都社区老年人的咀嚼能力及其相关因素：横断面研究

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-05-20 DOI: 10.1111/jjns.12603

Hongmiao Ji, Sikai Tang, Xing Liu

Aim

To investigate the current status of chewing ability and analyze the risk factors among Chinese community-dwelling older adults.

Methods

In this cross-sectional study, color-changeable gum and a color difference meter were used to assess chewing ability in the population. The statistical analysis employed multivariate logistic regression models to identify and quantify the factors influencing chewing ability.

Results

A total of 373 community-dwelling adults aged 65 and older in Chengdu, in the west of China, were included in this study; 64 individuals (17.2%) exhibited signs of poor chewing ability. Female (odds ratio [OR]: 0.124, 95% CI: 0.057–0.268, p < .001), education level with college degree and above (OR: 0.114, 95% CI: 0.030–0.434, p = .001), number of teeth less than 20 (OR: 5.401, 95% CI: 2.509–11.626, p < .001), and decreased oral diadochokinesis (OR: 4.445, 95% CI: 1.775–11.132, p = .001) were significant factors in chewing ability in this study, after adjustment for potential variables.

Conclusions

The prevalence of decreased chewing ability among Chinese community-dwelling older adults was 17.2% and decreased chewing ability was associated with men, lower education level, less than 20 teeth and decreased oral diadochokinesis.

目的：调查中国社区老年人的咀嚼能力现状并分析其风险因素：在这项横断面研究中，使用变色口香糖和色差计来评估人群的咀嚼能力。统计分析采用多变量逻辑回归模型来识别和量化影响咀嚼能力的因素：本研究共纳入了中国西部成都市 373 名 65 岁及以上的社区居民，其中 64 人（17.2%）有咀嚼能力差的表现。女性（几率比 [OR]：女性（几率比 [OR]：0.124，95% CI：0.057-0.268，P中国社区老年人咀嚼能力下降的发生率为 17.2%，咀嚼能力下降与男性、教育水平较低、牙齿少于 20 颗和口腔舒张功能下降有关。

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引用次数: 0

Effect of perioperative oral care on postoperative infections in patients with cancer: A systematic review and meta-analysis 围手术期口腔护理对癌症患者术后感染的影响：系统回顾和荟萃分析。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-05-16 DOI: 10.1111/jjns.12600

Aoi Kubo, Kumiko Sakai, Shingo Ueki, Kimie Fujita

Aim

This systematic review aimed to assess the effect of non-pharmacologic perioperative oral hygiene care on reduced incidence of postoperative pneumonia (PP), surgical site infection (SSI), and the length of hospital stay in patients with cancer, and to describe the details of oral hygiene care.

Methods

We searched seven databases. Eligibility criteria were based on perioperative oral hygiene care provided by healthcare professionals to patients aged ≥18 years who were surgically treated under general anesthesia and were evaluated for the incidence of PP and SSI. We reported risk ratios (RR) for dichotomous outcomes for PP and SSI using a fixed-effects model of meta-analysis.

Results

The search resulted in 850 articles, among which two were randomized controlled trials (RCTs) and 21 were observational studies. Most studies indicated that dentists and medical care providers performed a combination of oral cleaning, and oral hygiene instructions. In RCTs, perioperative oral hygiene care significantly reduced the incidence of PP (RR, 0.86; p = .60), while in observational studies, perioperative oral hygiene care significantly reduced the incidence of PP (RR, 0.55; p < .001) and SSI (RR, 0.47; p < .001). The length of hospital stay was also significantly reduced (p < .05). However, the effectiveness of nursing intervention was not clear.

Conclusions

Perioperative oral hygiene care implemented by healthcare professionals prevented PP and SSI and reduced length of hospital stays for patients after cancer surgery. As daily perioperative oral hygiene care is performed by nurses, it is necessary to research the effects of oral hygiene by nurses in the future.

目的：本系统性综述旨在评估非药物性围手术期口腔卫生护理对降低癌症患者术后肺炎（PP）、手术部位感染（SSI）发病率和缩短住院时间的效果，并描述口腔卫生护理的细节：我们检索了七个数据库。资格标准基于医护人员为年龄≥18岁、在全身麻醉下接受手术治疗的患者提供的围手术期口腔卫生护理，并对PP和SSI的发生率进行了评估。我们采用固定效应荟萃分析模型报告了PP和SSI二分结果的风险比（RR）：搜索结果显示有 850 篇文章，其中 2 篇为随机对照试验 (RCT)，21 篇为观察性研究。大多数研究表明，牙医和医疗服务提供者结合实施了口腔清洁和口腔卫生指导。在随机对照试验中，围手术期口腔卫生护理可显著降低 PP 的发生率（RR，0.86；p = .60），而在观察性研究中，围手术期口腔卫生护理可显著降低 PP 的发生率（RR，0.55；p 结论：围手术期口腔卫生护理可显著降低 PP 的发生率：由医护人员实施的围手术期口腔卫生护理可预防 PP 和 SSI，并缩短癌症手术后患者的住院时间。由于围手术期的日常口腔卫生护理是由护士进行的，因此今后有必要对护士进行口腔卫生护理的效果进行研究。

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引用次数: 0

The effect of abdominal massage and in-bed ROM exercise on gastrointestinal complications and comfort in intensive care unit patients receiving enteral nutrition: A randomized controlled trial 腹部按摩和床上 ROM 运动对接受肠内营养的重症监护病房患者胃肠道并发症和舒适度的影响：随机对照试验。

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-05-08 DOI: 10.1111/jjns.12602

Mensure Turan, Zeliha Cengiz

Aim

Abdominal massage facilitates gastric and colonic motility, reduces intra-abdominal distension and increases circulation. In-bed range of motion (ROM) exercise has effects on muscle strength, cardiac parameters and excretion. The aim of this study was to assess the effects of abdominal massage and in-bed ROM exercise on gastrointestinal complications and patient comfort in intensive care patients receiving enteral nutrition.

Methods

This randomized controlled trial was conducted in the internal intensive care units of two tertiary public hospitals. The sample consisted of 130 patients randomly assigned to three groups (abdominal massage = 44, in-bed ROM exercise = 43, control = 43). The individuals received abdominal massage and in-bed ROM exercises every morning before enteral feeding for 3 days. We assessed gastrointestinal complications and comfort levels of the patients 24 h after each intervention.

Results

While the differences in abdominal distention, defecation status, constipation, and gastric residual volume complications were significant (p < .05), there was no significant difference in diarrhea and vomiting (p > .05). Comfort level showed a statistically significant change in the experimental groups in the in-group comparison (p < .05).

Conclusion

Abdominal massage and in-bed ROM exercise reduce abdominal distention, constipation and gastric residual volume. Abdominal massage affects the frequency of defecation; and, both interventions increase the comfort while reducing the pain level over time.

目的：腹部按摩可促进胃和结肠蠕动，减轻腹内胀气，促进血液循环。床上运动（ROM）对肌肉力量、心脏参数和排泄物有影响。本研究旨在评估腹部按摩和床上 ROM 运动对接受肠内营养的重症监护患者胃肠道并发症和患者舒适度的影响：这项随机对照试验在两家三级公立医院的内部重症监护病房进行。样本包括随机分配到三组的 130 名患者（腹部按摩组 44 人、床上 ROM 锻炼组 43 人、对照组 43 人）。这些患者每天早上在肠道喂养前接受腹部按摩和床上 ROM 锻炼，为期 3 天。每次干预 24 小时后，我们对患者的胃肠道并发症和舒适度进行评估：结果：腹胀、排便状况、便秘和胃残余容积并发症的差异显著（P .05）。在组内比较中，实验组患者的舒适度有显著统计学变化（P 结论：实验组患者的舒适度与对照组相比有显著统计学变化（P.05）：腹部按摩和床上 ROM 运动可减少腹胀、便秘和胃残余容积。腹部按摩会影响排便频率；随着时间的推移，这两种干预措施都会提高舒适度，同时降低疼痛程度。

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引用次数: 0

Framework to elicit consent from lightly sedated mechanically ventilated intensive care patients in nursing practice 在护理实践中征得轻度镇静的机械通气重症监护患者同意的框架

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-05-02 DOI: 10.1111/jjns.12601

Yoko Onishi, Yoshiko Murai, Emiko Nakajima

Aim

The study aimed to ascertain a framework of nursing practices to elicit consent from lightly sedated ventilated patients.

Methods

Study participants were nurses working in intensive care and critical care wards, whose observations and semi-structured interviews were assessed using a modified grounded theory approach.

Results

A total of 15 concepts were generated, from which three categories and three subcategories were generated. Category 1: Nurses taking the lead in providing assistance by sharing signs of change while continuing the invasive treatment, working to maintain the patient's life, alleviation of pain, promotion of awareness of the current situation, and acclimating them to the treatment environment as the basis for building a relationship between patients and nurses. Category 2: Searching for points of agreement and reaching a compromise involves the nurse drawing out the patient's thoughts, hopes, and expectations, and transforming the relationship into a patient-centered one by sharing goals with the patient in order to achieve them. Category 3: Organizing collaboration within care supported the patient's ability to move safely while maintaining the patient's pace to achieve shared goals, and guided the patient's independent actions.

Conclusions

Even when patients recover from an acute life-threatening situation, their physical sensations remain vague and their functional decline continues. Rather than simply eliciting consent from patients, the structure of nursing practice to elicit such response from patients involves drawing out the patient's thoughts, hopes, and expectations, as well as guiding the patient toward goals that they have created together with the nurse and utilizing the patient's strengths to achieve these goals.

方法研究参与者为在重症监护室和危重症监护病房工作的护士，采用改良的基础理论方法对他们的观察和半结构式访谈进行评估。结果总共产生了 15 个概念，从中产生了三个类别和三个子类别。第一类：护士带头提供帮助，在继续进行侵入性治疗的同时分享变化的迹象，努力维持病人的生命，减轻疼痛，促进对现状的认识，使他们适应治疗环境，以此作为建立病人与护士之间关系的基础。第二类：寻找共同点并达成妥协，护士要了解病人的想法、希望和期望，并通过与病人分享目标，将护患关系转变为以病人为中心的关系，以实现这些目标。第三类：在护理中组织协作，支持患者安全移动的能力，同时保持患者的步伐以实现共同目标，并指导患者独立行动。护理实践的结构不是简单地征得患者的同意，而是要引出患者的想法、希望和期望，引导患者实现与护士共同制定的目标，并利用患者的优势来实现这些目标。

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引用次数: 0

Effects of an individualized nutritional educational program in pregnant women: A randomized controlled trial in Japan 孕妇个性化营养教育计划的效果：日本的随机对照试验

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science

Pub Date : 2024-04-18 DOI: 10.1111/jjns.12599

Hisae Fujimoto, Mariko Iida, Shoko Takeuchi, Eriko Shinohara, Kazumi Kubota, Sachiyo Nakamura

Aim

To evaluate the effectiveness of an individualized nutritional education program in promoting adequate nutrient intake in pregnant women.

Methods

A stratified randomized controlled trial was conducted. Participants were stratified by factors affecting the primary outcome and randomly assigned to the intervention or control groups. Intervention group participants received an individualized 30-min booklet-based education program in their 2nd and 3rd trimesters; the control group received usual care. The primary outcome was protein intake after the intervention, which was compared between the intervention and control groups. Secondary outcomes included comparing the amount of increase of protein before and after the intervention. Nutrient intake was measured using a self-administered short dietary history questionnaire, and analyses of covariance and t tests were performed.

Results

Of the 130 participants, 66 were assigned to the intervention group and 64 to the control group. There was no difference in protein intake between the two groups after the intervention (p = .051, 95% CI [−0.021, 12.4]). Comparing the increase in protein intake before and after intervention, the intervention group was 7.4 g/day higher than that of the control group (p = .040; F = 4.31; effect size = 0.36).

Conclusions

The primary outcome, a comparison of protein intake between the groups after the program, revealed no significant differences. However, on comparing the amount of protein increase before and after the intervention, the intervention group's increase was significantly higher than that of the control group. Results indicate the potential for individualized face-to-face interventions for pregnant women in Japan.

目的评估个性化营养教育计划在促进孕妇摄入充足营养方面的效果。方法进行分层随机对照试验。根据影响主要结果的因素对参与者进行分层，并随机分配到干预组或对照组。干预组的参与者在怀孕第 2 和第 3 个月接受 30 分钟基于小册子的个性化教育计划；对照组接受常规护理。主要结果是干预后的蛋白质摄入量，并在干预组和对照组之间进行比较。次要结果包括比较干预前后蛋白质的增加量。营养素摄入量采用自填式简短饮食史问卷进行测量，并进行协方差分析和 t 检验。干预后，两组的蛋白质摄入量没有差异（p = .051，95% CI [-0.021, 12.4]）。比较干预前后蛋白质摄入量的增加情况，干预组比对照组每天多摄入 7.4 克蛋白质（p = .040；F = 4.31；效应大小 = 0.36）。然而，在比较干预前后蛋白质的增加量时，干预组的增加量明显高于对照组。研究结果表明，针对日本孕妇的个性化面对面干预很有潜力。

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引用次数: 0