Applied Nursing Research最新文献

Objectives

The primary goal of this study was to identify and understand the burden experienced by informal caregivers of patients with HF at the time of hospital discharge. The researchers aimed to guide future education interventions and promote informal caregiver burden screening.

Design

The researchers administered the Zarit Burden Interview (ZBI) as a quantitative tool to assess informal caregiver burden. The ZBI is a standardized questionnaire used to measure the extent of burden experienced by informal caregivers. After administering the ZBI, the researchers conducted semi-structured interviews with five informal caregivers of patients with HF. These interviews were guided by probing questions related to ZBI items that were rated with high levels of burden (3 “quite frequently” or 4 “nearly always”).

Results

The quantitative data showed that the informal caregivers' burden scores on the ZBI ranged from 4 to 41. Male informal caregivers tended to report lower burden scores. The non-spouse informal caregiver had the highest burden score at 41. The qualitative analysis of the interviews revealed several themes related to informal caregiver burden, including fear, patient expectations, patient dependence on caregivers, social isolation, and stressors associated with medication changes after discharge. Despite the qualitative insights into specific burden-related issues, the quantitative analysis of the ZBI scores showed that, on average, informal caregivers reported little to no burden at the time of acute exacerbation of HF in the patient.

Conclusion

The study's findings suggest that while informal caregivers may not report prominent levels of overall burden, they do face specific challenges and stressors, such as social isolation and managing medication changes post-discharge. These findings can inform the development of targeted support and interventions for informal caregivers of patients with HF.

Idiopathic pulmonary fibrosis (IPF) is a restrictive chronic lung disease that results in scarring of the tissue due to an unknown cause. Dyspnea is experienced by 90 % of patients and is correlated with reduced quality of life and survival times. Breathing techniques can improve perceived dyspnea, however, are not readily taught outside of inpatient hospital settings and pulmonary rehabilitation programs, the latter being accessed by only 3 % of patients with chronic lung disease. Telehealth may be an option to increase access to this imperative symptom management education to improve symptom management and patient outcomes.

Aims

1) To determine the feasibility of a telehealth breathing intervention for patients living with IPF; 2) To determine the usability of the telehealth system; 3) To describe within-group changes in dyspnea, quality of life, anxiety, and depression.

Design

A single-group, pre-post intervention.

Methods

Study participants were recruited from community-dwelling patients living with IPF. Pre-intervention data was collected on symptoms using standardized questionnaires. Participants enrolled in one telehealth Zoom session per week over the course of four weeks and practiced breathing exercises 10-minutes per day. Following the intervention, participants completed post-intervention, feasibility, and usability questionnaires. Data were analyzed using descriptive statistics.

Results

All feasibility benchmarks were met. Following the intervention, mean symptom scores improved, however were not statistically significant.

Conclusion

These data indicate that a telehealth breathing intervention is a feasible option to increase access to the symptom management strategy of breathing techniques to manage perceived dyspnea to positively influence symptoms experienced by patients living with idiopathic pulmonary fibrosis.

Purpose

The purpose of this study was to describe beliefs and attitudes that underpin vaccine confidence and hesitancy in nurses who chose not to vaccinate for COVID-19. The research question that guided this work was: What are the beliefs and attitudes of nurses who chose to not vaccinate for COVID-19?

Methods

This study followed a focus group methodology to collect qualitative data from focused discussions to gather insights into the beliefs and attitudes of participants. Two focus groups consisting of 3 to 5 participants were conducted virtually.

Results

Using open coding, six themes were generated. Based on descriptors provided by participants, two themes were focused on beliefs, and four were related to attitudes about the vaccine. Findings suggest that participants' beliefs and attitudes were strengthened during this time in the pandemic. This event further divided nurses included in this study from their peers who chose to vaccinate and their employers who mandated inoculation.

Conclusions

Understanding the perceptions of this sample has given insight into the thoughts and feelings of nurses who chose not to vaccinate against COVID-19. This is a perspective that is often absent from scientific literature. Knowledge gained from this study may assist in supporting strategies such as open communication, conflict resolution, and collaboration in an effort to mitigate the divide within the nursing workforce, which may ultimately contribute to nursing retention in clinical settings.

A number of countries now recommend population-wide depression screening for perinatal women, using validated tools. A stepped-approach to screening – involving universal screening with a brief measure, followed by targeted screening using a longer measure for those women identified as at greater risk – is used in some settings. This brief report describes the test performance characteristics of a 3-item mood screening instrument, developed for use within a digital parenting program. Participants (n = 404) in this cross-sectional study were mothers of children aged up to 3 years. The majority (65.5 %) were first-time mothers, and their mean age was 32.8 years. Data were collected using an online survey. The test performance of the brief 3-item mood screening instrument (possible score range = 0–300) was examined using Receiver Operating Characteristic (ROC) analysis, with a score of 13 or more on the Edinburgh Postnatal Depression Scale (EPDS) used as the reference standard. The mood screening instrument demonstrated excellent range when compared to the reference standard. Optimal balance between sensitivity (0.77) and specificity (0.78), was achieved at a cut-point of 160 or less. Analysis was limited by using only the EPDS as the reference standard. This preliminary data supports the use of this 3-item mood screening instrument to screen for postnatal depression symptoms and may be integrated into a mobile Health or online tool. Future research should examine the test performance of the 3-item mood screening instrument against a diagnostic tool.

Aim

To understand the implementation process and outcomes of nurses' work related low back pain (WLBP) prevention and care guideline.

Background

WLBP is a common occupational injury for clinical nurses. We developed the first evidence-based guideline of nurses' WLBP prevention and care of its kind both at home and abroad, and it is necessary for us to explore its feasibility, appropriateness and effectiveness in practice.

Methods

Based on the model of the integrated Promoting Action on Research Implementation in Health Services, we performed a four-phase implementation study in a tertiary hospital. The study was a non-randomized concurrent controlled trial design，and multilevel measures were examined including implementation outcomes and clinical outcomes.

Results

For the implementation outcomes, the tailored recommendations of the guideline were found to be acceptable, appropriate, feasible, and well adopted both at the unit level and the hospital level. The clinical outcomes indicated that, compared with the control unit, nurses of the treatment unit performed better in awareness, knowledge, practice of WLBP prevention and care.

Conclusions

The implementation study supports the successful application of the guideline, which can serve as a valuable evidence-based document to improve back health of nursing personnel.

Aims

This study examined the relationship between the experience of violence, social support, nursing practice environment, and mental health among South Korean mental health nurses.

Methods

Structured questionnaires were distributed to participants who worked in twelve mental health hospitals, each with at least 200 beds, in South Korea. We analyzed 243 questionnaires and used AMOS 25.0 to explore the relationships between the constructs.

Results

The total and indirect effects of the experience of violence and of social support on mental health were significant. The effects of burnout and of the nursing practice environment on mental health were positively significant. Burnout revealed a mediating association with the relationship between the experience of violence, social support, and mental health.

Conclusion

The study confirmed that the experience of violence negatively affects burnout among mental health nurses, while social support relieves burnout and strengthens mental health.

Implementation

Our research model shows that the experience of violence could affect burnout and mental health among mental health nurses. Therefore, nursing administrators should develop violence prevention policies and manuals for coping with the violence that can frequently occur in psychiatric wards.

Background

Quality of life (QoL) is a measure to evaluate kidney transplant (KT) results.

Aim

To describe the QoL profile in a larger sample of Brazilian patients who underwent KT according to age, sex, and access to KT.

Methods

We conducted a secondary data analysis of the ADHERE BRAZIL multicenter cross-sectional study including 1105 patients from 20 centers, considering KT access region and transplant activity. QoL was assessed by the WHOQOL-BREF. Data was compared using Generalized Estimating Equations.

Results

Overall, 58.5 % of the patients were men, mean age of 47.6 ± 12.6 years. The general QoL score was 81 ± 15.1, 58.6 ± 11.6 for physical, 65.5 ± 11.4 for psychological, 68.3 ± 17.1 for social relationships, and 64.2 ± 13.3 for environmental domain. Higher QoL scores were observed in men compared to women in three WHOQOL-BREF domains: psychological (OR:2.62; CI, 1.29 ̶ 3.95, p < 0.0001), social relationships (OR:3.21; CI, 1.2 ̶ 5.23, p = 0.002) and environmental (OR:3.79; CI:2.23 ̶ 5.35, p < 0.0001). Younger patients (18–44 years) had higher scores in the psychological (OR:-2.69; CI, −4.13 ̶ -1.25; p < 0.001; OR:-3.52; CI, −5.39 ̶ -1.66; p < 0.001) and social (OR:-3.46; CI, −5.64 ̶ -1.27; p = 0.002; OR:-7.17; CI, −10 ̶ -4.35; p < 0.0001) domains than older ones (45–59 and > 60 years, respectively). Patients from higher KT access region had higher scores in environmental domain (OR:3.53; CI, 0.28 ̶ 6.78; p = 0.033).

Conclusions

Featuring the results of KT under patient view, the physical and social relationships domains were the most and least affected, respectively. Lower QoL subgroups (females and age > 45 years) should be targeted in future multi-professional interventions.

Aim

This study aimed to describe the levels of self-care behaviors and self-care self-efficacy in patients with Marfan syndrome and to identify the individual-level determinants of self-care behaviors.

Background

The behaviors aimed at maintaining health stability (self-care maintenance), monitoring signs and symptoms (self-care monitoring), and taking action when signs and symptoms occur (self-care management) are key aspects of the care for addressing the complexity of care of patients with Marfan syndrome. However, the description of self-care behaviors and their determinants in patients with Marfan syndrome are highly under-described.

Methods

The adopted design was descriptive observational with a cross-sectional data collection on 111 patients with MFS in a single Italian specialized and reference center for this disease between 2020 and 2021.

Results

Performing healthy activities and managing illness, therapies, and follow-ups to maintain health over time (self-care maintenance) was almost adequate (mean score = 67.87 ± 13.17), as well as the ability to recognize signs and symptoms promptly (self-care monitoring, mean score = 67.95 ± 26.70). The ability to respond to symptoms when they occur (self-care management, mean score = 54.17 ± 19.94) was sub-optimal. The stronger positive predictor of each self-care behavior was self-care self-efficacy.

Conclusions

This study suggested prioritizing educational activities focused on enhancing self-care management in patients with Marfan syndrome and strengthening their self-care self-efficacy. Researchers should develop and validate evidence-based educational approaches to enhance self-care in patients with Marfan syndrome, and clinical nurses should strengthen their focused educational activities to improve the self-care management of these patients.

Aim

To assess basic data for developing appropriate interventions by examining the effects of patient-centered care (PCC) on the mental health of patients with heart failure in the intensive care unit (ICU).

Background

Patients with heart failure are frequently admitted to ICUs, and ICU stays are associated with prolonged mental health problems.

Methods

We conducted a systematic review using the CINAHL, Cochrane Library, Embase, MEDLINE, PsycINFO, and gray literature databases. Inclusion criteria were studies with participants aged ≥18 years with heart failure in the ICU who received a PCC intervention, and studies that described the outcomes for mental health problems. Data were extracted from five selected studies published after 2020 and analyzed.

Results

PCC is classified into three areas: comprehensive nursing, multidisciplinary disease management, and targeted motivational interviewing with conventional nursing. The two specific areas of focus for PCC regarding mental health were integrated mental healthcare and specific psychological nursing. Specific psychological nursing comprised relationship building, therapeutic communication, relaxation and motivational techniques, active therapeutic cooperation, psychological status evaluation, music therapy, and environmental management.

Conclusions

This review provides a distinctive understanding of multidisciplinary and multicomponent PCC interventions for patients with heart failure in the ICU as an effective approach for improving their mental health. Future PCC intervention strategies aimed at patients with heart failure in the ICU should consider their preferences and family participation.

Background

Pre-hospital delay is the major cause of stroke treatment delay, and behavioral intention is considered to be the most direct predictor of behavior. Therefore, to effectively reduce stroke pre-hospital delay, it is essential to further understand the relationship between stroke pre-hospital delay intention (SPDBI) and its social-psychological influencing factors, namely personality traits, social support and coping style.

Aim

This study aims at examining the relationships among personality traits, coping style, social support, and SPDBI.

Methods

A cross-sectional, self-administered questionnaire was distributed to 845 residents. The content of the questionnaire included demographic information, the knowledge of “Stroke 120”, Ten-Item Personality Inventory-Chinese version, Simplified Coping Style Questionnaire, Perceived Social Support Scale and SPDBI Scale. Path analysis was used to investigate the relationship among SPDBI and its psychosocial influencing factors.

Results

The final path model showed a good fit to the data (χ²/df = 2.981, RMSEA = 0.048, GFI = 0.936, CFI = 0.941). Extroversion (β = 0.106), positive coping (β = −0.110), negative coping (β = 0.150) and the knowledge of “Stroke 120” (β = −0.152) had only direct effects on SPDBI. While agreeableness (β = 0.113), openness (β = −0.121) and social support (β = −0.118) had direct effects on SPDBI, they also had indirect effects (β = −0.009; −0.022; −0.049) on SPDBI though positive coping.

Conclusions

Adequate social support and positive coping of health threat may reduce residents' SPDBI. Meanwhile, the interventions to reduce SPDBI should take personality differences into consideration.