Applied Nursing Research最新文献

Background

During the SARS-CoV-2 pandemic, as in past disasters and emergencies, nurses around the world play an important role. What is more, the unprecedented pressure exerted by the pandemic on healthcare systems in every country brings big challenges to nurses, which may affect their well-being, work efficacy and job satisfaction.

Objective

The main objective of the presented studies was to describe anxiety factors related to the work of nurses during the SARS-CoV-2 pandemic; to assess the intensity of coronavirus anxiety and job satisfaction experienced by nurses at that time; to assess predictors of job satisfaction of nurses during the COVID-19 pandemic; to assess the differences in the intensity of job satisfaction and coronavirus anxiety depending on the selected variables related to their experiences during the COVID-19 pandemic.

Design

Anonymous questionnaire surveys were conducted online among the participants between 23 June 2020 and 23 March 2022 in Poland.

Participants

433 nurses from 15 Polish provinces were included in the studies (age range 22–68; M = 41.63). Nursing seniority M = 18.6.

Methods

The studies were based on: Satisfaction with Job Scale (SSP), Coronavirus Anxiety Scale (CAS), and a self-report structured questionnaire.

Results

The most respondents indicated that they were afraid of becoming infected with SARS-CoV-2 (25.4 %), transmitting infection to the family (22.4 %), becoming sick with COVID-19 and experiencing health complications (6.7 %) and of excessive work responsibilities and physical fatigue (6.5 %). Based on the bivariate correlation, it can be concluded that job satisfaction of the respondents during the COVID-19 pandemic was on an average level (M = 19.9); coronavirus anxiety was on an average level (M = 4.9), and stress at work was on a high level (M = 7.1). Coronavirus anxiety did not constitute statistically significant predictors of job satisfaction of subjects studied during the pandemic (SE = 0,048; β = 0,05; p = 0.942).

Conclusions

Coronavirus anxiety wasn't associated with job satisfaction of nurses directly. Job satisfaction of nurses during the COVID-19 pandemic was likely to be shaped by a range of different factors.

Tweetable abstract

In Polish nurses coronavirus anxiety was average and wasn't associated with their job satisfaction.

Objective

The current study focuses on organizational culture as a determinant of well-being among nurses.

Background

Nurse well-being is an increasing concern for organizational operations and patient care quality. There are limited studies on the aspects of organizational culture, such as leadership and perception of organizational mission, that relate to clinician well-being.

Methods

A cross-sectional survey study was conducted among nurses in a U.S. hospital. Measures were professional quality of life, organizational culture, and authentic leadership. Statistical methods were used to analyze findings.

Results

Among the nurses (N = 147), after controlling for significant demographic factors, organizational culture and authentic leadership had significant correlations with burnout, secondary traumatic stress, and compassion satisfaction. In multivariate analyses, organizational culture was a significant predictor for burnout and compassion satisfaction.

Conclusion

This study provides empirical evidence that organizational behavior is important to staff well-being. Organizations that act with fidelity to their missions of caring and quality patient care are more likely to have nursing staff that are emotionally healthy in the workplace.

Post-acute COVID-19 syndrome (PCS) is defined as an ongoing symptomatic illness in patients who have recovered from their initial COVID-19 infection which causes long term respiratory problems, muscle atrophy, etc. So, the current research aimed to examine effectiveness of the acceptance and commitment therapy on resilience and health-related quality of life of PCS patients. The research deployed a quasi-experimental design with pre- and post-tests and 3-month follow-up with wait-list group. Thirty PCS patients from a specialized facility in Iran were recruited using available sampling method and were randomly assigned to either treatment or wait-list groups, each group 15 subjects. The subjects answered to Connor and Davidson's (2003) Resilience Scale (CD-RISC) and the World Health Organization's (1995) Quality of Life Questionnaire (WHOQOL-BREF). The posttest score of resilience in the treatment and wait-list groups were 19.6 and 14.47, respectively, and their follow-up scores were 17.13 and 14.55, respectively. Also, total score of HRQoL in the treatment and wait-list groups in the posttest were 65.07 and 55.73 and in the follow-up were 63.27 and 54.6, respectively. The results showed that there were significant differences in the posttest scores of the dependent variables based on the groups. Also, the MANCOVA showed that the acceptance and commitment therapy was still significantly effective on the dependent variables three months after the last session. The ACT can significantly increase PCS patients' resilience and HRQoL even 3 months after the intervention. The implications and limitations of the research are further discussed.

Purpose

The Area Deprivation Index (ADI) measures the relative disadvantage of an individual or social network using US Census indicators. Although a strong re-hospitalization predictor, ADI has not been routinely incorporated into rehabilitation research. The purposes of this paper are to examine the use of ADI related to study recruitment, association with carepartner psychosocial factors, and recruitment strategies to increase participant diversity.

Methods

Descriptive analysis of baseline data from a pilot stroke carepartner-integrated therapy trial. Participants were 32 carepartners (N = 32; 62.5 % female; mean age 57.8 ± 13.0 years) and stroke survivors (mean age (60.6 ± 14.2) residing in an urban setting. Measures included ADI, Bakas Caregiver Outcome Scale, Caregiver Strain Index, and Family Assessment Device.

Results

Most carepartners were Non-Hispanic White participants (61.3 %), part or fully employed (43 %), with >$50,000 (67.7 %) income, and all had some college education. Most stroke survivors were Non-Hispanic White participants (56.3 %) with some college (81.3 %). Median ADI state deciles were 3.0 (interquartile range 1.5–5, range 1–9), and mean national percentiles were 41.7 ± 23.5 with only 6.3 % of participants from the most disadvantaged neighborhoods. For the more disadvantaged half of the state deciles, the majority were Black or Asian participants. No ADI and carepartner factors were statistically related.

Conclusions

The use of ADI data highlighted a recruitment gap in this stroke study, lacking the inclusivity of participants from disadvantaged neighborhoods and with lower education. Using social determinants of health indicators to identify underrepresented neighborhoods may inform recruitment methods to target marginalized populations and broaden the generalizability of clinical trials.

Background

In the first 24 h after surgery, it is necessary to evaluate the patient responses to pain, analgesia and patient satisfaction to prevent complications related to the pain management process.

Aim

To evaluate patients' outcomes (pain qualities, side effects of the pain management, pain treatment satisfaction, non-pharmacological pain treatment methods, predictors of pain management satisfaction and percentage of pain relief) according to the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) in the first 24 h.

Design

Cross-sectional study.

Methods

The study sample was comprised of 700 patients, who were surgically treated at the surgical clinics of a university hospital and completed the first postoperative 24 h. The data was collected through the “Patient Information Form” and the “Turkish version of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)”.

Results

The medians of the lowest and the worst postoperative pain severity level were 3.0 and 7.0, respectively. Patients experienced severe pain in 60 % of the first postoperative 24 h and reported that 70 % of their pain eventually decreased. A positive and significant correlation was found between pain interference, pain-affected mood/emotions, the severity of pain-related side effects, the least and worst pain severity levels and severe pain, and the percentage of time experienced with severe pain.

Conclusions

Most of the patients experienced severe pain, which restricted their daily life activities and led to negative emotions. Acute postoperative pain may negatively affect patient outcomes and delay postoperative recovery during the early period. Therefore, pain should be managed in the early period to prevent physical and psychological side effects.

Background

Early breastfeeding initiation (EBI) within the first hour after birth has the potential to reduce neonatal mortality. However, the prevalence of EBI still falls short of the 70 % target set by the WHO for 2030. Limited research has been conducted on this issue. Therefore, the study aimed to assess the prevalence and factors of EBI in the Philippines.

Methods

This study is a secondary analysis of the data from the Philippine National Demographic and Health Survey (PNDHS) in 2017. Women survey participants aged 15 to 49 (n = 3750) who had given birth within the two years prior to the survey were included in this study. A p-value < 0.05 was used to define statistical significance when identifying the factors associated with EBI using hierarchical logistic regression analysis.

Results

Women who were more likely to practice EBI were those from the Cordillera Administrative Region, who read newspaper/magazines, and delivered infants at 2 or later birth order. On the contrary, women from Central Luzon, CALABARZON (Cavite, Laguna, Batangas, Rizal, and Quezon provinces), Central Visayas, Eastern Visayas, and the Autonomous Region of Muslim Mindanao; who listen to the radio at least once a week; and give birth through cesarean section were less likely to practice EBI.

Conclusion

Channeling breastfeeding messages through printed mass media and provision of specialized breastfeeding support to mothers with cesarean section delivery may help in reducing the barriers to early breastfeeding initiation. Targeted interventions and strategies that promote breastfeeding practices, particularly among primigravida women and in regions with lower rates of EBI contribute to increased rate of optimal breastfeeding.

Background and aims

The SARS-Cov-2 virus (COVID-19) has not only threatened the health of the world's population but also presented challenges for conducting human subject research studies. Although many institutions have now established guidelines for conducting research during the COVID-19 pandemic, reports of the practical experiences of researchers are limited. This report presents the challenges nurse researchers encountered when conducting a randomized controlled trial to develop an arthritis self-management application during the COVID-19 pandemic in Taiwan and how researchers responded to the challenges.

Methods

Qualitative data from five nurse researchers were collected from August 2020 to July 2022 at a rheumatology clinic in northern Taiwan. This collaborative autoethnographic report was drawn from data comprised of detailed field notes and weekly discussions regarding research challenges we were confronting. Data were analyzed to determine successful strategies employed to overcome the challenges and allow for completion of the study.

Results

Minimizing the risk of exposure to the virus for researchers and participants resulted in four major challenges to conducting our research: patient screening and recruitment, delivery of the intervention, obtaining follow-up data, and unanticipated budget increases.

Conclusions

Challenges reduced sample size, altered intervention delivery, increased time and money beyond what was originally budgeted, and delayed completion of the study. Adapting to a new healthcare environment required flexibility for recruitment, alternate means of providing intervention instructions, and an awareness of disparities in participants' internet proficiency. Our experiences can serve as an example for other institutions and researchers faced with similar challenges.

Purpose

Pain is “an unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of damage”. Stimulating the skin by rubbing, stroking, massaging, or applying pressure near the injection site is pain-relieving. Needle-related procedures induce anxiety, distress, and fear in children and adults. The present study aimed to test the effectiveness of massaging the access site in reducing pain associated with intravenous access.

Design

After obtaining institutional ethics committee approval, this prospective randomized single-blinded study was performed on 250 ASA I-II patients 18 to 65 years old, scheduled for elective minor general surgery under general anaesthesia.

Methods

Patients were randomized into the Massaging Group (MG) and the Control Group (CG). A Situational Trait Anxiety Inventory (STAI) was conducted to evaluate the anxiety levels of the patients. In addition, the skin adjacent to the intravenous access site was massaged for 15 s in circular motions with moderate intensity by the investigator's right thumb before performing the intravenous access in the MG. The CG did not receive any massage adjacent to the access site. The primary endpoint, the intensity of perceived pain, was rated on a non-graduated 10-cm Visual Analogue Score (VAS).

Findings

The groups' demographic data and STAI I-II scores were similar. There was a significant difference between the VAS scores of the two groups (p < 0.05).

Conclusions

Our results support massaging as an effective pain-relieving technique before intravenous intervention. As massaging is a universal and non-invasive intervention that requires no advanced preparation, we recommend massaging before each intravenous cannulation to reduce pain caused by intravenous access.

The purpose of this study was to examine predictors of self-advocacy among patients with chronic heart failure (HF) as they were unknown. A convenience sample of 80 participants recruited from one Midwestern HF clinic completed surveys related to relationship-based predictors of patient self-advocacy including trust in nurses and social support. Self-advocacy is operationalized using the three dimensions of HF knowledge, assertiveness, and intentional non-adherence. Hierarchical multiple regression was used showing that trust in nurses predicted HF knowledge (ΔR² = 0.070, F = 5.91, p < .05), social support predicted advocacy assertiveness (ΔR² = 0.068, F = 5.67, p < .05), and ethnicity predicted overall self-advocacy (ΔR² = 0.059, F = 4.89, p < .05). These findings suggest that support from family and friends can give the patient the needed encouragement to advocate for what they need. A trusting relationship with nurses impacts patient education so that patients not only understand their illness and its trajectory but also use that understanding to speak up for themselves. African American patients, who are less likely to self-advocate than their White counterparts, could benefit from nurses recognizing the impact of implicit bias so that these patients do not feel silenced in their care.

Background

Self-affirmations help one focus on positive outcomes and adapt to new situations both psychologically and physiologically by the repetition of positive affirmation sentences. This method, which has promising results in symptom management, is predicted to have effective results in the management of pain and discomfort in patients undergoing open-heart surgery.

Aim

To investigate the effect of self-affirmation on anxiety and perceived discomfort in patients who have undergone open-heart surgery.

Methods

This study adopted a randomized controlled pretest-posttest follow-up research design. The study was conducted at a public training and research hospital (Istanbul, Turkey) specialized in thoracic and cardiovascular surgery. The sample consisted of 61 patients randomized into two groups: intervention (n = 34) and control (n = 27). The participants of the intervention group listened to a self-affirmation audio recording for three days after surgery. Anxiety levels and perceived discomfort regarding pain, dyspnoea, palpitations, fatigue and nausea were measured daily. The State Trait Anxiety Inventory (STAI) was used to measure the level of anxiety, meanwhile perceived discomfort regarding pain, dyspnoea, palpitations, fatigue and nausea were measured by a 0 to 10 Numeric Rating Scale (NRS).

Results

The control group had significantly higher anxiety than the intervention group three days after surgery (P < 0.001). The intervention group had less pain (P < 0.01), dyspnoea (P < 0.01), palpitations (P < 0.01), fatigue (P < 0.001) and nausea (P < 0.01) than the control group.

Conclusions

Positive self-affirmation helped reduce anxiety and perceived discomfort in patients who underwent open-heart surgery.

ClinicalTrials.gov Identifier: NCT05487430.