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Nurses' preferences for working in Uber-style ‘Internet plus’ nursing services: A discrete choice experiment 护士对在 Uber 式 "互联网+"护理服务机构工作的偏好:离散选择实验。
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2024-10-01 DOI: 10.1016/j.ijnurstu.2024.104920
Jin Yang , Bingxin Ma , Shixiang Chen , Yaqi Huang , Yulu Wang , Ying Chen , Xiaojun Zhang , Tingting Ma , Yue Zhao , Yaogang Wang , Qi Lu

Background

China's ‘Internet Plus’ nursing services, which are Uber-style home care services with an ‘online application, offline service’ approach, have been evolving over the past five years. Registered nurses' preference for these Uber-style Internet Plus nursing services are crucial for improving human resource management and service efficiency, yet research in this area remains scarce.

Objective

This study aimed to explore registered nurses' preferences for Uber-style Internet Plus nursing services and provide optimization recommendations from a supply-side perspective.

Design

A cross-sectional study utilising a discrete choice experiment.

Setting(s)

Two public tertiary hospitals located in Tianjin, China, which have implemented Internet Plus nursing services.

Participants

211 registered nurses who participated in Internet Plus nursing services.

Methods

The survey was conducted anonymously using an online survey platform. Respondents were presented with choices between two alternatives, based on five key attributes: income, safety and security, patient and family cooperation, commute time, and service type. Mixed logit models estimated the stated preferences for attributes. Relative importance scores, willingness-to-pay estimates, and simulations of service-type uptake rates were calculated. Subgroup analysis and seemingly unrelated regression estimation were performed to examine heterogeneity in preferences.

Results

A total of 3202 choice observations were generated. When sorted by the strength of preference, the five attributes related to registered nurses' choice of Uber-style Internet Plus nursing services, measured by their relative importance scores, are as follows: safety and security (30.89 %), income (27.41 %), patient and family cooperation (18.47 %), service type (11.96 %), and commuting time (11.27 %). Elevating safety and security from low to high levels has the same utility as a 31.81 % increase in monthly income, equivalent to 2586.14 yuan. Subgroup analysis showed that senior nurses place more value on safety and security than junior nurses (β = 1.421 vs.β = 0.725; P = 0.011), and unmarried nurses had a stronger preference for family and caregiver cooperation (β = 1.105 vs.β = 0.314; P = 0.023).

Conclusions

The strength and heterogeneity of registered nurses' preferences should be highlighted in the dispatch algorithms model of Uber-style Internet Plus nursing services, thereby enhancing the efficiency and humanity of Uber-style Internet Plus nursing services.

Tweetable abstract

Registered nurses prioritise safety and security, acknowledging heterogeneous preferences in Uber-style Internet Plus nursing services.
背景:中国的 "互联网+"护理服务是一种 "线上申请、线下服务 "的Uber式居家护理服务,在过去五年中不断发展。注册护士对这些 Uber 式 "互联网+"护理服务的偏好对改善人力资源管理和提高服务效率至关重要,但这方面的研究仍然很少:本研究旨在探讨注册护士对 Uber 式 "互联网+"护理服务的偏好,并从供应方的角度提出优化建议:设计:利用离散选择实验进行横断面研究:参与者:211 名参与 "互联网+"护理服务的注册护士:调查使用在线调查平台匿名进行。受访者可根据收入、安全保障、患者及家属配合度、通勤时间和服务类型这五个关键属性在两个备选方案中做出选择。混合对数模型估算了受访者对属性的陈述偏好。计算了相对重要性得分、支付意愿估计值以及服务类型接受率模拟。为考察偏好的异质性,还进行了分组分析和看似无关的回归估计:共生成了 3202 个选择观测值。按偏好强度排序,与注册护士选择 Uber 式 "互联网+"护理服务相关的五个属性(按相对重要性评分)如下:安全保障(30.89%)、收入(27.41%)、患者和家属合作(18.47%)、服务类型(11.96%)和通勤时间(11.27%)。将安全保障从低水平提升到高水平的效用相当于月收入增加 31.81%,相当于 2586.14 元人民币。亚组分析显示,高年资护士比低年资护士更重视安全保障(β = 1.421 vs.β = 0.725; P = 0.011),未婚护士更倾向于家庭和护理人员的合作(β = 1.105 vs.β = 0.314; P = 0.023):Uber式 "互联网+"护理服务的调度算法模型中应突出注册护士偏好的强度和异质性,从而提高Uber式 "互联网+"护理服务的效率和人性化。Tweetable摘要:注册护士优先考虑安全保障,承认Uber式 "互联网+"护理服务中的异质性偏好。
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引用次数: 0
Unraveling the impact of subjective and objective workload on patient experience: Mediation and moderation by missed nursing care assessments in a nested multisource diary design 揭示主观和客观工作量对患者体验的影响:嵌套式多源日记设计中护理评估缺失的中介和调节作用
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2024-09-27 DOI: 10.1016/j.ijnurstu.2024.104919
Jannat Bayadsi , Anat Drach-Zahavy , Mirit Cohen , Einav Srulovici
<div><h3>Background</h3><div>Patient reporting of their care experience is crucial for evaluating healthcare quality. Negative patient reports are often associated with missed nursing care, with previous research primarily attributing this to objective workload, neglecting the role of subjective workload. Furthermore, there is a gap in understanding the combined impact of patient and nurse assessments of missed nursing care on the overall patient experience.</div></div><div><h3>Objective</h3><div>This study aims to explore how the interaction of objective and subjective workload influences nurse-reported missed nursing care. Additionally, it investigates how the interaction of missed nursing care, as assessed by both patients and nurses, influences the patient's overall experience.</div></div><div><h3>Design</h3><div>A quantitative daily diary design, employing a nested (shifts within nurses) and multi-sourced (nurses, patients, and objective data) approach, was implemented.</div></div><div><h3>Setting</h3><div>The study was conducted in two medium-sized public hospitals, encompassing internal medicine and surgical wards.</div></div><div><h3>Participants</h3><div>A total of 141 registered nurses providing direct patient care and 627 patients treated by these nurses participated in the study.</div></div><div><h3>Methods</h3><div>Participating nurses completed questionnaires during five morning shifts, detailing their experiences with specific patients. Concurrently, the same patients provided feedback through questionnaires. A dual moderated mediation model was analyzed using mixed-model regression analyses, suitable for the nested design.</div></div><div><h3>Results</h3><div>The study supported the dual moderated mediation model. Subjective workload emerged as a statistically significant moderator, influencing the impact of objective workload on nurse-reported missed nursing care (β = −<!--> <!-->0.476, p = .009). Particularly, under high subjective workload, missed nursing care was higher during low compared to high objective workload. Moreover, patient-reported missed nursing care moderated the relationship between nurse-reported missed nursing care and patient experience (β = −<!--> <!-->0.411, p < .001). In instances of high patient-reported missed nursing care, positive patient experiences were observed with low compared to high nurse-reported missed nursing care.</div></div><div><h3>Conclusions</h3><div>This research emphasizes the need to recognize and address subjective aspects of nursing workload. Effectively managing these perceptions is vital for upholding high care standards and enhancing patient experiences. The study advocates for targeted strategies to manage workload effectively and improve patient–nurse communication, especially in high-workload healthcare settings.</div><div><strong>Tweetable abstract</strong>: Exploring the link between nursing workload and patient experience: revealing the impact of patient and nurse assess
背景患者对其护理体验的报告对于评估医疗质量至关重要。患者的负面报告往往与护理服务缺失有关,以往的研究主要将其归因于客观工作量,而忽视了主观工作量的作用。此外,在了解患者和护士对护理服务缺失的评估对患者整体体验的综合影响方面还存在差距。本研究旨在探讨客观和主观工作量的相互作用如何影响护士报告的护理服务缺失。此外,该研究还探讨了由患者和护士共同评估的护理遗漏如何影响患者的整体体验。设计采用嵌套(护士内的轮班)和多来源(护士、患者和客观数据)方法,设计了定量每日日记。参与者共有 141 名直接为患者提供护理服务的注册护士和 627 名接受这些护士治疗的患者参与了这项研究。同时,这些患者也通过问卷提供了反馈意见。采用适合嵌套设计的混合模型回归分析,对双重调节中介模型进行了分析。主观工作量是一个具有统计学意义的调节因素,影响着客观工作量对护士报告的护理遗漏的影响(β = - 0.476,p = .009)。尤其是在主观工作量大的情况下,与客观工作量大的情况相比,主观工作量小的情况下护理失误率更高。此外,患者报告的护理遗漏调节了护士报告的护理遗漏与患者体验之间的关系(β = - 0.411, p <.001)。在患者报告护理遗漏率高的情况下,与护士报告护理遗漏率高的情况相比,患者报告护理遗漏率低的情况下,患者体验积极。有效管理这些认知对于坚持高护理标准和提升患者体验至关重要。该研究提倡采取有针对性的策略,以有效管理工作量并改善护患沟通,尤其是在高工作量的医疗机构中。Tweetable 摘要:探索护理工作量与患者体验之间的联系:揭示患者和护士评估对护理缺失的影响。#HealthcareQuality #NursingResearch.
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引用次数: 0
Signs and symptoms in hospitalized children and adolescents' triggering nurses' awareness – A qualitative study across Denmark and Norway 住院儿童和青少年的体征和症状引发护士的关注--一项横跨丹麦和挪威的定性研究。
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2024-09-27 DOI: 10.1016/j.ijnurstu.2024.104918
Claus Sixtus Jensen , Heidi Holmen , Anette Winger , Marianne Eg
<div><h3>Background</h3><div>Assessment of signs and symptoms in hospitalized children presents unique challenges due to the children's age-related differences, such as vital signs and the broad range of medical conditions that affects children. Early detection of clinical changes in children is crucial to prevent deterioration, and while standardized tools exist, there is a growing recognition of the need to consider subjective factors based on experienced nurses' knowledge and intuition.</div></div><div><h3>Objective</h3><div>To explore which signs and symptoms, apart from vital signs, that trigger nurses' concern regarding deterioration of hospitalized children and adolescents.</div></div><div><h3>Design</h3><div>This study used a descriptive qualitative design.</div></div><div><h3>Settings</h3><div>The study was conducted at three pediatric departments in Denmark and a nursing department of a university in Norway, offering post graduate education programs for health care professions working with children and adolescents throughout Norway.</div></div><div><h3>Participants</h3><div>A total sample of 29 registered nurses with varying levels of experience participated.</div></div><div><h3>Method</h3><div>Four focus group interviews were used to collect data and analyzed with inductive content analysis approach.</div></div><div><h3>Results</h3><div>Nurses' knowledge about children's clinical conditions is influenced by the nurses experience, their use of senses like touching the child with their hands, and the use of various approaches. Information from parents about the child's normal behavior are considered valuable. These sources of information, often difficult to verbalize, might be referred to as intuition or “gut feeling” and often guides the nurses' actions when vital signs appear normal, and nurses rely on their senses to assess the child's condition. Specific indicators triggering concern include changes in respiration, circulation, level of consciousness, and facial expressions. Challenges arise from nighttime assessments, interactions with parents, the presence of electronic devices, and children's ability to compensate. Clinical experience is a significant factor in nurses' ability to recognize changes in in the child's condition.</div></div><div><h3>Conclusion</h3><div>This study highlights the multifaceted nature of nurses' assessments of clinical conditions in hospitalized children. Nurses draw on their experiences, intuition, and interactions with parents to complement vital signs-based assessments. Their intuition, or “gut feeling” serves as a valuable tool when vital signs do not fully capture the child's clinical status. Specific signs and symptoms that trigger nurses' concern, along with the challenges they face, contribute to a comprehensive understanding of the complexity of assessing children's clinical conditions. These findings, emphasize the role of nurses in early recognition of clinical deterioration in hospitalized chi
背景:由于儿童的年龄差异,如生命体征和影响儿童的广泛医疗条件,对住院儿童的体征和症状进行评估是一项独特的挑战。及早发现儿童的临床变化对防止病情恶化至关重要,虽然有标准化的工具,但人们越来越认识到需要根据经验丰富的护士的知识和直觉来考虑主观因素:探讨除生命体征外,哪些体征和症状会引发护士对住院儿童和青少年病情恶化的关注:本研究采用描述性定性设计:研究在丹麦的三个儿科部门和挪威一所大学的护理系进行,这所大学为在挪威各地从事儿童和青少年工作的医疗保健专业人员提供研究生教育课程:方法:采用四次焦点小组访谈的方式,收集了有关儿童和青少年健康问题的信息:方法:通过四次焦点小组访谈收集数据,并采用归纳内容分析法进行分析:结果:护士对儿童临床状况的了解受到护士经验、感官使用(如用手触摸儿童)以及各种方法使用的影响。来自家长的有关儿童正常行为的信息被认为是有价值的。这些信息来源通常难以用语言表达,可以被称为直觉或 "直觉",当生命体征显示正常时,这些信息往往会指导护士的行动,护士依靠感官来评估患儿的病情。引发关注的具体指标包括呼吸、循环、意识水平和面部表情的变化。夜间评估、与家长的互动、电子设备的存在以及儿童的补偿能力都会带来挑战。临床经验是护士识别儿童病情变化能力的重要因素:本研究强调了护士对住院儿童临床状况评估的多面性。护士利用自己的经验、直觉以及与家长的互动来补充基于生命体征的评估。当生命体征不能完全反映患儿的临床状况时,护士的直觉或 "直觉 "就会成为一种宝贵的工具。引发护士关注的具体体征和症状,以及他们所面临的挑战,有助于全面了解评估儿童临床状况的复杂性。这些研究结果强调了护士在早期识别住院儿童临床病情恶化方面的作用,以及除生命体征外进行评估的必要性。
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引用次数: 0
Effectiveness of non-instrumental early mobilization to reduce the incidence of deep vein thrombosis in hospitalized patients: A systematic review and meta-analysis 非器械性早期动员对降低住院患者深静脉血栓发生率的效果:系统回顾和荟萃分析
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2024-09-25 DOI: 10.1016/j.ijnurstu.2024.104917
Julia Raya-Benítez , Alejandro Heredia-Ciuró , Andrés Calvache-Mateo , Javier Martín-Núñez , Geraldine Valenza-Peña , Laura López-López , Marie Carmen Valenza

Background

Deep vein thrombosis (DVT) poses a significant health risk, particularly in hospitalized patients with multiple risk factors (cigarette smoking, hypertension, diabetes and obesity). Despite advances in treatment, DVT remains a prevalent complication of hospitalization.

Objective

To assess the effectiveness of non-instrumental mobilization in hospitalized patients at high risk of DVT, exploring the challenges and variations in intervention protocols.

Design

Systematic review and meta-analysis.

Setting(s)

Not applicable.

Participants

Hospitalized patients at risk of deep vein thrombosis.

Methods

A systematic search of three databases was conducted from interception to September 2023 for randomized controlled trials. This study was registered in PROSPERO (CRD42023460485). This study was conducted according to PRISMA 2020 statement. Two authors independently screened the studies and extracted the data. The quality of the studies was evaluated using the Downs and Black checklist and GRADE system. The amount of evidence certainty was assessed using the Cochrane Risk of Bias Assessment tool. Meta-analysis was performed addressing the incidence of deep vein thrombosis during hospitalization.

Results

7 studies were eligible for inclusion which included a total of 1774 participants. Interventions ranged from active and passive ankle exercises to walking. Meta-analysis demonstrated a significant overall effect in favor of non-instrumental early mobilization compared to usual care (RR = 0.55; 95 % CI = 0.41, 0.73; p < 0.0001). Subgroup analysis comparing type of mobilization revealed significant effects for global (RR = 0.54; 95 % CI = 0.38, 0.78; p = 0.001) and remote mobilization (RR = 0.25; 95 % CI = 0.07, 0.86; p = 0.03).

Conclusions

Non-instrumental early mobilization is beneficial in reducing the incidence of deep vein thrombosis in hospitalized patients.

Registration

PROSPERO, registration number: CRD42023460485.
背景深静脉血栓形成(DVT)对健康构成重大风险,尤其是对具有多种风险因素(吸烟、高血压、糖尿病和肥胖)的住院患者。目的 评估非器械动员对深静脉血栓高危住院患者的有效性,探讨干预方案中存在的挑战和差异。方法 从截取到 2023 年 9 月,对三个数据库中的随机对照试验进行了系统检索。本研究已在 PROSPERO(CRD42023460485)中注册。本研究根据 PRISMA 2020 声明进行。两位作者独立筛选研究并提取数据。研究质量采用 Downs and Black 检查表和 GRADE 系统进行评估。使用 Cochrane 偏倚风险评估工具评估了证据的确定性。针对住院期间深静脉血栓形成的发生率进行了 Meta 分析。结果有 7 项研究符合纳入条件,共纳入 1774 名参与者。干预措施包括主动和被动踝关节锻炼以及步行。Meta 分析表明,与常规护理相比,非器械性早期动员的总体效果显著(RR = 0.55; 95 % CI = 0.41, 0.73; p < 0.0001)。比较动员类型的分组分析显示,整体动员(RR = 0.54; 95 % CI = 0.38, 0.78; p = 0.001)和远程动员(RR = 0.25; 95 % CI = 0.07, 0.86; p = 0.03)具有显著效果:CRD42023460485。
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引用次数: 0
Effectiveness of nurse-led self-care interventions on quality of life, social support, depression and anxiety among people living with HIV: A systematic review and meta-analysis of randomized controlled trials 护士主导的自我护理干预对艾滋病病毒感染者生活质量、社会支持、抑郁和焦虑的影响:随机对照试验的系统回顾和荟萃分析。
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2024-09-23 DOI: 10.1016/j.ijnurstu.2024.104916
Haitao Huang , Xiaona Zhang , Ling Tu , Liao Zhang , Hong Chen

Background

People living with HIV often face challenges related to quality of life, mental health, and social support. Nurse-led self-care interventions have been proposed as a means to address these issues, but their overall effectiveness needs systematic evaluation.

Objectives

To systematically review and meta-analyze the effectiveness of nurse-led self-care interventions on quality of life, social support, depression, and anxiety among people living with HIV.

Design

A systematic review and meta-analysis of randomized controlled trials.

Methods

A systematic search of PubMed, EMBASE, Web of Science (Core Collection), Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Scopus, and PsycINFO (Ovid) was conducted for articles from inception to May 2024. Two authors independently screened studies and extracted data. Randomized controlled trials that investigated the effects of nurse-led self-care interventions on the quality of life, social support, depression, and anxiety in people living with HIV, published in English, were included. The quality of the included studies was assessed using the revised Cochrane risk-of-bias tool for randomized trials. Meta-analyses were conducted using Review Manager 5.3 and Stata17, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

Nineteen randomized controlled trials published between 2003 and 2024 were included. The meta-analysis showed that compared to the control group, nurse-led self-care interventions significantly improved quality of life (SMD = 0.45, 95 % CI: 0.07 to 0.84, P < 0.05) and reduced depression (SMD = − 0.46, 95 % CI: − 0.75 to − 0.17, P < 0.001; RR = 0.80, 95 % CI: 0.68 to 0.94, P < 0.05). The impact on social support was not statistically significant (SMD = − 0.02, 95 % CI: − 0.25 to 0.22, P = 0.89). Only two studies reported beneficial effects on anxiety, indicating a need for further high-quality research.

Conclusion

Nurse-led self-care interventions effectively improve the quality of life and reduce depression in people living with HIV, but current evidence shows these interventions have little impact on social support. The evidence regarding anxiety is limited, indicating a need for more rigorous research to explore the potential benefits of these interventions for anxiety in people living with HIV. These findings support the inclusion of nurse-led self-care interventions in routine HIV care to enhance the well-being of people living with HIV.
Registration number: (PROSPERO): CRD42024548592.
背景:艾滋病病毒感染者通常面临着与生活质量、心理健康和社会支持相关的挑战。已经提出了以护士为主导的自我护理干预措施,作为解决这些问题的一种手段,但其整体效果还需要系统评估:系统回顾和荟萃分析护士主导的自我护理干预措施对艾滋病病毒感染者的生活质量、社会支持、抑郁和焦虑的有效性:设计:对随机对照试验进行系统回顾和荟萃分析:方法:对 PubMed、EMBASE、Web of Science(核心收录)、Cochrane Central Register of Controlled Trials、Cumulative Index to Nursing and Allied Health Literature、Scopus 和 PsycINFO (Ovid) 中从开始到 2024 年 5 月的文章进行系统检索。两位作者独立筛选研究并提取数据。纳入的随机对照试验调查了护士指导的自我护理干预措施对 HIV 感染者的生活质量、社会支持、抑郁和焦虑的影响,这些试验均以英文发表。纳入研究的质量采用修订后的 Cochrane 随机试验偏倚风险工具进行评估。使用 Review Manager 5.3 和 Stata17 进行元分析,并使用建议分级评估、发展和评价方法对证据的确定性进行评级:结果:共纳入了 19 项发表于 2003 年至 2024 年的随机对照试验。荟萃分析表明,与对照组相比,护士主导的自我护理干预能显著改善生活质量(SMD = 0.45,95 % CI:0.07 至 0.84,P 结论:护士主导的自我护理干预能显著改善生活质量:护士主导的自我护理干预能有效改善艾滋病病毒感染者的生活质量并减少抑郁,但目前的证据显示这些干预对社会支持的影响甚微。有关焦虑的证据有限,这表明需要进行更严格的研究,以探索这些干预措施对艾滋病病毒感染者焦虑的潜在益处。这些研究结果支持将护士主导的自我护理干预纳入常规艾滋病护理中,以提高艾滋病病毒感染者的幸福感:CRD42024548592。
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引用次数: 0
Corrigendum to “Outcomes of advanced care management in home-based long-term care: A retrospective population-based observational study” [Int. J. Nurs. Stud. 158 (2024) 104862] 居家长期护理中高级护理管理的结果:基于人口的回顾性观察研究"[Int. J. Nurs. Stud. 158 (2024) 104862]。
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2024-09-21 DOI: 10.1016/j.ijnurstu.2024.104909
Sakiko Itoh , Takahiro Mori , Xueying Jin , Tomoko Ito , Jun Komiyama , Naoaki Kuroda , Kazuaki Uda , Rumiko Tsuchiya-Ito , Xi Vivien Wu , Kana Kodama , Hideto Takahashi , Toshihiro Takeda , Nanako Tamiya
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引用次数: 0
The meaning of obstetric violence experiences: A qualitative content analysis of the Break the Silence Campaign 产科暴力经历的意义:对 "打破沉默运动 "的定性内容分析。
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2024-09-18 DOI: 10.1016/j.ijnurstu.2024.104911
Lorraine M. Garcia , Jacqueline Jones , Jean Scandlyn , E. Brie Thumm , Sara Cohen Shabot
<div><h3>Background</h3><div>Obstetric violence involves the mistreatment, disrespect, and abuse of birthing people and the problem has been recognized in healthcare systems worldwide. Obstetric violence is a gendered, sex-specific form of violence against women that is a public health problem and a violation of human rights. There are an unknowable number of online posts and social media messages that describe obstetric violence experiences. There are no known studies about self-published experiences of obstetric violence in the US maternity care system.</div></div><div><h3>Objective</h3><div>To understand the meaning of obstetric violence experiences in the US maternity care system from a naturally occurring, purposive sample.</div></div><div><h3>Design</h3><div>A secondary analysis of the textual data from the original Break the Silence social media campaign using qualitative content analysis. The theory of social justice in nursing provided a theoretical framework. A healthcare systems approach was used for a wide-angle view of the multidirectional structure, processes, and outcome of obstetric violence.</div></div><div><h3>Setting</h3><div>The study setting is the public Facebook page where the Break the Silence social media campaign can be seen. Break the Silence was an online activism response to the problem of obstetric violence in the US maternity care system with signboard messages posted from 31 known US states. The setting is bounded by the digital page where the campaign is published.</div></div><div><h3>Participants</h3><div>There were 139 participants, and 11 of them posted more than one signboard message. Most participants were birthing people (<em>n</em> = 125) followed by doulas (<em>n</em> = 10).</div></div><div><h3>Methods</h3><div>Krippendorff's methodology for qualitative content analysis was applied to 156 signboard messages posted on Break the Silence from 2014 to 2016. Qualitative content analysis was supported by Atlas.ti 23.</div></div><div><h3>Results</h3><div>Four themes illustrated the meaning of obstetric violence in US maternity care: 1) pregnancy and birth as a battle with healthcare providers and the healthcare system, 2) sacrifice of the maternal body normalized and assumed as a gender stereotype, 3) disrupted rites of passage from childbirth, and 4) abuse of fiduciary power by healthcare providers.</div></div><div><h3>Conclusions</h3><div>This study demonstrated thematic meanings for the experience of obstetric violence in US maternity care with a healthcare systems approach that included structural and organizational considerations to increase understanding. Categories and forms of obstetric violence from the existing literature were expanded and strengthened by findings from this study. Themes were validated in principle with consistency in findings across the international evidence base on obstetric violence.</div><div><strong>Tweetable abstract</strong>: The meaning of #obstetricviolence experiences is inte
背景:产科暴力涉及对分娩者的虐待、不尊重和凌辱,这一问题已被全世界的医疗系统所认识。产科暴力是一种针对妇女的性别暴力,是公共卫生问题,也是对人权的侵犯。描述产科暴力经历的网上帖子和社交媒体信息数量难以估量。目前还没有关于美国产科护理系统中自行发布的产科暴力经历的已知研究:从自然发生的目的性样本中了解美国孕产妇护理系统中产科暴力经历的含义:设计:使用定性内容分析法对原始 "打破沉默 "社交媒体活动的文本数据进行二次分析。护理中的社会公正理论提供了一个理论框架。采用医疗保健系统方法,从广角审视产科暴力的多向结构、过程和结果:研究环境是 "打破沉默 "社交媒体活动的 Facebook 公共页面。打破沉默 "是针对美国孕产妇护理系统中的产科暴力问题而发起的一项在线活动,在美国 31 个已知的州发布了招牌信息。环境以发布活动的数字页面为界:共有 139 名参与者,其中 11 人张贴了不止一条招牌信息。大多数参与者是分娩者(125 人),其次是助产士(10 人):克里彭多夫的定性内容分析方法适用于 2014 年至 2016 年期间在 "打破沉默 "网站上发布的 156 条招牌信息。定性内容分析由 Atlas.ti 23 支持:四个主题说明了美国孕产妇护理中产科暴力的含义:1)怀孕和分娩是与医疗服务提供者和医疗系统的斗争;2)牺牲产妇的身体正常化并被假定为一种性别刻板印象;3)分娩的成年仪式被破坏;4)医疗服务提供者滥用信托权力:本研究以医疗保健系统的方法展示了美国孕产妇护理中产科暴力经历的主题含义,包括结构和组织方面的考虑,以加深理解。本研究的结果扩展并加强了现有文献中产科暴力的类别和形式。Tweetable摘要:#产科暴力经历的意义是人际和结构性的,在国际研究中具有主题一致性。
{"title":"The meaning of obstetric violence experiences: A qualitative content analysis of the Break the Silence Campaign","authors":"Lorraine M. Garcia ,&nbsp;Jacqueline Jones ,&nbsp;Jean Scandlyn ,&nbsp;E. Brie Thumm ,&nbsp;Sara Cohen Shabot","doi":"10.1016/j.ijnurstu.2024.104911","DOIUrl":"10.1016/j.ijnurstu.2024.104911","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Obstetric violence involves the mistreatment, disrespect, and abuse of birthing people and the problem has been recognized in healthcare systems worldwide. Obstetric violence is a gendered, sex-specific form of violence against women that is a public health problem and a violation of human rights. There are an unknowable number of online posts and social media messages that describe obstetric violence experiences. There are no known studies about self-published experiences of obstetric violence in the US maternity care system.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To understand the meaning of obstetric violence experiences in the US maternity care system from a naturally occurring, purposive sample.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A secondary analysis of the textual data from the original Break the Silence social media campaign using qualitative content analysis. The theory of social justice in nursing provided a theoretical framework. A healthcare systems approach was used for a wide-angle view of the multidirectional structure, processes, and outcome of obstetric violence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;The study setting is the public Facebook page where the Break the Silence social media campaign can be seen. Break the Silence was an online activism response to the problem of obstetric violence in the US maternity care system with signboard messages posted from 31 known US states. The setting is bounded by the digital page where the campaign is published.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;There were 139 participants, and 11 of them posted more than one signboard message. Most participants were birthing people (&lt;em&gt;n&lt;/em&gt; = 125) followed by doulas (&lt;em&gt;n&lt;/em&gt; = 10).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Krippendorff's methodology for qualitative content analysis was applied to 156 signboard messages posted on Break the Silence from 2014 to 2016. Qualitative content analysis was supported by Atlas.ti 23.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Four themes illustrated the meaning of obstetric violence in US maternity care: 1) pregnancy and birth as a battle with healthcare providers and the healthcare system, 2) sacrifice of the maternal body normalized and assumed as a gender stereotype, 3) disrupted rites of passage from childbirth, and 4) abuse of fiduciary power by healthcare providers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study demonstrated thematic meanings for the experience of obstetric violence in US maternity care with a healthcare systems approach that included structural and organizational considerations to increase understanding. Categories and forms of obstetric violence from the existing literature were expanded and strengthened by findings from this study. Themes were validated in principle with consistency in findings across the international evidence base on obstetric violence.&lt;/div&gt;&lt;div&gt;&lt;strong&gt;Tweetable abstract&lt;/strong&gt;: The meaning of #obstetricviolence experiences is inte","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104911"},"PeriodicalIF":7.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of aerobic exercise on executive function of healthy middle-aged and older adults: A systematic review and meta-analysis 有氧运动对健康中老年人执行功能的影响:系统回顾和荟萃分析
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2024-09-18 DOI: 10.1016/j.ijnurstu.2024.104912
Mingzhu Ye , Tao Song , Haishuo Xia , Yongqing Hou , Antao Chen

Background

The deterioration of executive function is a hallmark of cognitive aging. Reports indicate that signs of decline in executive function begin to emerge as early as middle age. Aerobic exercise improves executive function in healthy middle-aged and older adults, but the optimal exercise prescription variables are still unclear.

Objective

To investigate the effects of aerobic exercise on executive function of healthy middle-aged and older adults and explore the dose–response relationship and moderators.

Methods

We conducted comprehensive searches of PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, PsycINFO, and SPORTDiscus for English literature, and CNKI, WanFang, and VIP for Chinese literature, covering the period from inception until April 25, 2024. Randomized controlled trials examining the effect of aerobic exercise on executive function in healthy middle-aged and older adults aged 45 or older were included. The Cochrane Collaboration's RoB2 tool was used to assess the methodological quality of the included studies. And subgroup analyses and meta-regressions were conducted to elucidate the impact of aerobic exercise on executive function.

Results

Forty-two eligible randomized controlled trials, involving a total of 2881 participants, met the inclusion criteria for the systematic review and meta-analysis. The pooled results showed that aerobic exercise had positive effects on improving cognitive flexibility (Hedge's g = 0.343, p < 0.001), working memory (Hedge's g = 0.392, p < 0.001), and inhibitory control (Hedge's g = 0.229, p < 0.001) in healthy middle-aged and older adults. However, it did not demonstrate an improvement in planning (Hedge's g = 0.094, p = 0.440). The dose–response relationships between different exercise parameters and subdomains of executive functions revealed that the largest effects on cognitive flexibility were observed after 13–24 weeks of progression-intensity mind–body exercise, 46–60 min per session, and 5–7 days per week. Regarding working memory, the largest effects were observed after 13–24 weeks of progression-intensity general aerobic exercise, 20–45 min per session, and 5–7 days per week. For inhibitory control, the greatest effects were noted after 13–24 weeks of low-intensity general aerobic exercise, 20–45 min per session, and 3–4 days per week.

Conclusion

Aerobic exercise can significantly improve cognitive flexibility, working memory, and inhibitory control in healthy middle-aged and older adults. The effect of aerobic exercise on different aspects of executive function is influenced by specific exercise parameters, suggesting that personalized aerobic exercise programs may be more effective for enhancing executive function of healthy middle-aged and older adults.
背景执行功能的退化是认知老化的一个标志。有报告显示,执行功能的衰退早在中年就已开始显现。目的 研究有氧运动对健康中老年人执行功能的影响,并探讨其剂量-反应关系和调节因素。方法我们全面检索了 PubMed、Embase、Cochrane Central Register of Controlled Trials、Web of Science、Scopus、PsycINFO 和 SPORTDiscus 中的英文文献,以及 CNKI、万方和 VIP 中的中文文献,检索期从开始到 2024 年 4 月 25 日。纳入的随机对照试验研究了有氧运动对 45 岁或以上健康中老年人执行功能的影响。Cochrane 协作组织的 RoB2 工具用于评估纳入研究的方法学质量。结果42项符合条件的随机对照试验符合系统综述和荟萃分析的纳入标准,共涉及2881名参与者。汇总结果显示,有氧运动对改善健康中老年人的认知灵活性(Hedge's g = 0.343,p < 0.001)、工作记忆(Hedge's g = 0.392,p < 0.001)和抑制控制(Hedge's g = 0.229,p < 0.001)有积极作用。然而,它并没有显示出对计划性的改善(Hedge's g = 0.094,p = 0.440)。不同运动参数与执行功能子域之间的剂量-反应关系显示,13-24周的渐进强度身心锻炼、每次锻炼46-60分钟、每周锻炼5-7天后,对认知灵活性的影响最大。在工作记忆方面,13-24 周的渐进强度普通有氧运动、每次运动 20-45 分钟、每周 5-7 天后观察到的效果最大。结论 有氧运动可以显著改善健康的中老年人的认知灵活性、工作记忆和抑制控制能力。有氧运动对执行功能不同方面的影响受特定运动参数的影响,这表明个性化的有氧运动计划对提高健康中老年人的执行功能可能更有效。
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引用次数: 0
Effectiveness of the ‘SELF-program’ on nurses' activity encouragement behavior and nursing home resident's ADL self-reliance; a cluster-randomized trial SELF计划 "对护士活动鼓励行为和养老院居民ADL自立能力的影响;分组随机试验
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2024-09-17 DOI: 10.1016/j.ijnurstu.2024.104914
Stan Vluggen , Janneke de Man-van Ginkel , Gerard van Breukelen , Michel Bleijlevens , Sandra Zwakhalen , Getty Huisman-de Waal , Silke Metzelthin
<div><h3>Background</h3><div>Nurses play a crucial role in encouraging nursing home resident's activity and independent functioning. However, nurses often take over tasks unnecessarily, which can deprive resident's remaining abilities. The Function-Focused Care philosophy offers guidance for developing programs that support nurses to optimize activity and independence of older people. However, such programs developed internationally have demonstrated inconsistent effects. Lessons have been gathered to improve future programs, which led to the development of the ‘SELF-program’: a holistic, interactive and theory-based program that aims to improve activity encouragement behavior of nurses and indirectly to optimize self-reliance of nursing home residents.</div></div><div><h3>Objective</h3><div>The aim of this study was to examine the effectiveness of the SELF-program on nurses' activity encouragement behavior and nursing home residents' self-reliance in activities of daily living.</div></div><div><h3>Method</h3><div>The program's effectiveness was examined in a two-arm (SELF-program vs Care as Usual) cluster-randomized trial in Dutch nursing homes. Wards were recruited as units of intervention. The MAINtAIN questionnaire was used to assess the primary outcome: nurses' activity encouragement behavior regarding self-reliance in activities of daily living. The GARS-4 questionnaire was used to assess the secondary outcome: residents' self-reliance in activities of daily living. Measurements were taken at: 1) baseline, 2) three months after baseline, and 3) six months (for residents) and nine months (for nurses) after baseline. The acquired data was analyzed using mixed linear regression. Both adjusted and unadjusted analyses are reported.</div></div><div><h3>Results</h3><div>Twenty-eight nursing home wards, with 287 nurses and 241 residents participated in the study. A statistically significant treatment by time interaction effect was observed in nurses' activity encouragement behavior at three months (<em>d</em> = 0.53; p = .003; 95 % CI 1.88–8.02) and at nine months (<em>d</em> = 0.38; p = .02; 95 % CI 0.67–7.27). No statistically significant treatment by time interaction effects were observed in residents' self-reliance in activities of daily living. However, a trend was observed towards a less pronounced decrease in self-reliance in those residents allocated to wards that exposed nurses to the SELF-program, reflected by small to medium negative effect sizes at three months (<em>d</em> = −<!--> <!-->0.25; p = .07; 95 % CI -2.21 – 0.09) and at six months (<em>d</em> = −<!--> <!-->0.29; p = .07; 95 % CI -3.22 – 0.11).</div></div><div><h3>Conclusion</h3><div>The SELF-program was effective in improving nurses' activity encouragement behavior. The process evaluation conducted parallel to the trial could yield valuable lessons to further improve the SELF-program before widespread implementation.</div></div><div><h3>Trial-registration</h3><div>The study is
背景护士在鼓励疗养院居民活动和独立生活方面发挥着至关重要的作用。然而,护士经常不必要地接管任务,这可能会剥夺住户的剩余能力。注重功能的护理理念为制定支持护士优化老年人活动和独立性的计划提供了指导。然而,国际上开发的此类计划效果并不一致。为了改进未来的计划,我们总结了一些经验,从而开发出了 "SELF-计划":一个以理论为基础的整体互动计划,旨在改善护士的活动鼓励行为,并间接优化疗养院居民的自立能力。本研究旨在考察 SELF 计划对护士的活动鼓励行为和疗养院居民在日常生活活动中的自立能力的影响。病房作为干预单位进行招募。MAINtAIN 问卷用于评估主要结果:护士在日常生活自理能力方面的活动鼓励行为。GARS-4 问卷用于评估次要结果:住院患者在日常生活活动中的自立能力。测量时间为1)基线,2)基线后三个月,3)基线后六个月(居民)和九个月(护士)。获得的数据采用混合线性回归法进行分析。结果有 287 名护士和 241 名居民参加了这项研究。在三个月(d = 0.53;p = .003;95 % CI 1.88-8.02)和九个月(d = 0.38;p = .02;95 % CI 0.67-7.27)时,护士的活动鼓励行为出现了统计学意义上的治疗与时间交互效应。在居民日常生活自理能力方面,没有观察到有统计学意义的治疗与时间的交互效应。然而,在那些被分配到有护士参与SELF项目的病房的住院者中,却观察到了自立能力下降不明显的趋势,这反映在三个月(d = - 0.25; p = 0.07; 95 % CI -2.21 - 0.09)和六个月(d = - 0.29; p = 0.07; 95 % CI -3.22 - 0.11)的小到中等的负效应大小上。与试验同时进行的过程评估可为在广泛实施 SELF 计划之前进一步改进该计划提供宝贵经验。招募工作于 2021 年 3 月开始。
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引用次数: 0
Interventions to improve illness-related communication between cancer patients and their minor children: A systematic review 改善癌症患者与其未成年子女之间与疾病相关沟通的干预措施:系统回顾
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2024-09-14 DOI: 10.1016/j.ijnurstu.2024.104910
Sha Zhao , Jinnan Xiao , Jiayi Liu , Hong Tao , Huan Liu , Jiarui Chen , Yang Bai , Jinfeng Ding , Siyuan Tang , Hui Huang

Background

Parental cancer conditions significantly impact the physical, social, and emotional well-being of minor children. Effective illness-related communication is crucial for both parents and their children to mitigate these effects.

Objective

To systematically summarize the characteristics and effectiveness of interventions aimed at improving illness-related communication between parents with cancer and their minor children.

Design

A systematic review.

Data sources

Six databases (CINAHL, Web of Science, PubMed, Embase, the Cochrane Library, and PsycINFO) were searched for articles published in English between 2000 and 2023.

Methods

A three-step review process was employed to select articles. Two reviewers independently screened titles and abstracts, reviewed full texts to include studies aimed at facilitating illness-related communication between parents with cancer and their minor children under the age of 18, and assessed study quality using the Joanna Briggs Institute critical appraisal checklist.

Results

The search yielded 9409 articles, of which 21 met the inclusion criteria, 4 were randomized controlled trials and 17 were quasi-experimental studies. These studies involved 213 families, 149 parents, and 192 minor children. The interventions were categorized as family-centered, parent-centered, or children-centered and emphasized disease knowledge, communication skills, emotional management, and future planning in illness-related communication. The synthesized results indicate that family-centered interventions show unique advantages in improving family life; parent-centered interventions bring benefits in enhancing parenting quality, parents' self-efficacy in coping with cancer, and children's social behavior; and children-centered interventions exhibit a significant impact on the psychological well-being of children.

Conclusion

Parent-centered interventions demonstrated significant potential in promoting illness-related communication, particularly by emphasizing the patient's parental role, enhancing intrinsic motivation to sustain communication, and recognizing that patients themselves may be more suitable targets for clinical oncology practice. High-quality research is recommended to enrich the content of parent-centered interventions and encourage the measurement of intervention effects on communication as well as the mechanism of action.

Registration number

The review protocol was registered in PROSPERO under the number CRD42023478107.

背景父母罹患癌症会严重影响未成年子女的身体、社交和情感健康。数据来源检索了六个数据库(CINAHL、Web of Science、PubMed、Embase、Cochrane Library 和 PsycINFO)中 2000 年至 2023 年间发表的英文文章。方法采用三步审查流程筛选文章。两名审稿人独立筛选标题和摘要,审阅全文以纳入旨在促进癌症患者父母与其 18 岁以下未成年子女之间与疾病相关的沟通的研究,并使用乔安娜-布里格斯研究所的批判性评估核对表对研究质量进行评估。结果检索到 9409 篇文章,其中 21 篇符合纳入标准,4 篇为随机对照试验,17 篇为准实验研究。这些研究涉及 213 个家庭、149 名家长和 192 名未成年儿童。干预措施分为以家庭为中心、以父母为中心或以儿童为中心,在与疾病相关的沟通中强调疾病知识、沟通技巧、情绪管理和未来规划。综合结果表明,以家庭为中心的干预措施在改善家庭生活方面具有独特优势;以父母为中心的干预措施在提高父母的养育质量、父母应对癌症的自我效能以及儿童的社会行为方面都有益处;以儿童为中心的干预措施对儿童的心理健康有显著影响。结论 以家长为中心的干预在促进与疾病相关的沟通方面表现出了巨大的潜力,尤其是通过强调患者的家长角色、增强持续沟通的内在动力以及认识到患者本身可能更适合作为肿瘤临床实践的对象。建议开展高质量的研究,以丰富以家长为中心的干预内容,并鼓励测量干预对沟通的影响以及作用机制。注册号该综述方案已在PROSPERO注册,注册号为CRD42023478107。
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引用次数: 0
期刊
International Journal of Nursing Studies
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