Applied Nursing Research最新文献

Background

Among all infections in nursing homes, pneumonia has the highest mortality. Nurses have a 24-h relationship with patients and have a key role in identifying and preventing adverse outcomes. However, tools to engage nurses in pneumonia patient outcomes evaluation have not occurred.

Purpose

This study aimed to develop and validate a prediction model to predict the outcome of elderly patients with nursing home-acquired pneumonia (NHAP).

Methodology

A retrospective observational study was conducted with 219 elderly NHAP patients. Baseline characteristics, health history, and treatment/nursing status were collected. Variables for constructing nomograms were screened by univariate and multivariate analysis. The nomogram model was evaluated using the concordance index (C-index), decision curve analysis (DCA) curves, and receiver operating characteristic (ROC) curves.

Results

9 independent risk factors were identified and assembled into the nomogram. The nomogram exhibited reasonably accurate discrimination (area under the receiver operating characteristic curve (AUC-ROC): 0.931, P < 0.05) and calibration (C-index: 0.931, 95 % CI: 0.898–0.964) in the validation cohort. DCA and clinical impact curves demonstrated that the nomogram was clinically beneficial.

Conclusions

A visualization nomogram model was successfully established for predicting the outcome of the NHAP elderly patients. The model has extremely high reliability, extremely high predictive ability, and good clinical applicability.

Aim

To examine the effectiveness of a comprehensive diabetes education class on improving nurses' self-efficacy in glycemic management and physician communication, with a focus on using the SMILE (Sugar Trend, Medications, Intravenous fluid, Labs, and Eating) SBAR (Situation, Background, Assessment, Recommendation) as a communication tool. The secondary aim of this study was to investigate the translation of knowledge into practice, in this case, inpatient glycemic control.

Background

Inpatient glycemic management for patients living with diabetes can be challenging. Therefore, as patient advocates, nurses must be able to identify what clinical data warrants a call to the physician to facilitate timely decisions and interventions.

Methods

Data was collected from a purposive sample of 28 registered nurses from a single general medicine unit. A t-test was used to analyze nurses' pretest-posttest perceptions of self-efficacy in nine content areas. Kruskal-Wallis H analysis was also conducted on patients' median blood glucose values over four months (July–October 2023).

Results

The results suggest the class was effective in improving nurses' perceived knowledge and self-efficacy in all nine content areas, with the highest mean difference increase of 1.46 for I have sufficient knowledge regarding the SMILE SBAR and [will] use it as a tool for communicating with the physician, p < 0.05. A comparison of 403 patients' median blood glucose values were also statistically significantly different across four months, χ²(3) = 21.088, p < 0.0001.

Conclusions

Continued efforts to prevent and manage inpatient glycemic control should focus on enhancing nurse-physician communication and teamwork with simple yet effective tools such as the SMILE SBAR.

Background

Support interventions often address both self-care and coping. Different approaches are used to promote self-care and coping so clarifying the intervention effect can guide clinicians and researchers to provide interventions that achieve benefit.

Purpose

To compare two models to determine whether self-care improves coping or coping improves self-care.

Methods

We used cross-sectional data from 248 caregivers obtained at enrollment into a randomized controlled trial testing the efficacy of a support intervention. Factor scores for scales measuring caregiver demand, self-care, coping, stress appraisal, and mental health were derived from exploratory factor analysis. Structural equation models were analyzed using the factor scores as estimates of each construct. To control possible spurious effects caregiver age, gender, relationship with the patient, and income adequacy were included.

Results

Both models were compatible with the data, but the self-care model was stronger than the coping model. That model had a non-significant chi square and an excellent fit to the data, χ²(4, N = 248) = 2.64, p = .62. The percentage of variance explained by the self-care model was 54 % for mental health, 42 % for stress appraisal, 10 % for avoidance coping, and 6 % for active coping. In the coping model the explained variance of stress appraisal dropped to 33 %, avoidance coping dropped to 0 %, and active coping dropped to 3 %.

Conclusions

The self-care model was strongest, illustrating that self-care decreases stress, promotes coping, and improves mental health. These results suggest that promoting self-care may be more effective in improving mental health than interventions aimed at improving coping.

Caregivers who provide transitional care to people with functional dependence require the mastery of skills that ensure successful continuity of care. This domain of care requires nursing interventions to support the caregiver. This study aims to understand aspects of the development of caregiver mastery for continuity of care after hospital discharge. Method: Exploratory, qualitative research carried out in a university hospital in Salvador, Bahia, Brazil, from July to December 2022, with fourteen qualified caregivers participating. Data was organized using the software Web Qualitative Data Analysis, analyzed by thematic content analysis, and discussed in light of the Theory of Transitions proposed by Dr. Afaf Meleis. Results: The caregivers were women who cared for functionally dependent individuals and received training for care during hospitalization and telephone follow-up after discharge. Twelve achieved mastery; those with less experience needed more calls to acquire mastery. Conclusions: Discharge planning and caregiver education are essential to support them in safe and effective hospital-home transitions.

Purpose

Virtual reality technology has been used to establish a risk-free environment in which students can practice psychiatric nursing. A quasi-experimental study was conducted to examine the effects of a virtual reality (VR) based mental health nursing simulation on practice performance of undergraduate nursing students.

Methods

A quasi-experimental, pre- and post-test design was used. A total of 68 students were randomly assigned to an experimental group (n = 32) and a control group (n = 36). The control group received conventional simulation using text scenario-based role play. The intervention group received VR software consisting of 360° video clips and related quiz questions.

Results

The self-reported perceived competency in nursing performance showed no statistically significant improvement in the experimental group, whereas the control group showed a statistically significant improvement in symptom management (t = 2.84, p = 0.007) and nurse-patient interaction (t = 2.10, p = 0.043). Scores from the assessor showed better performance scores in the experimental group in symptom management (t = −2.62, p = 0.011), violence risk management (t = −3.42, p = 0.001), and nurse-patient interaction (t = −3.12, p = 0.003).

Conclusions

The findings of this study indicate the potential of using VR for optimized mental health nursing simulation. VR technology allowed realistic experiences which may ensure students have a more comprehensive understanding of mentally ill patients and in doing so, overcome barriers of traditional simulation, resulting in better learning outcomes.

Background

To achieve suitable diabetes care, understanding the factors that affect self-care behaviors is necessary.

Objective

To construct a model of dispositional mindfulness, internal environmental factors, external environmental factors, and self-care behaviors in people with diabetes.

Design and methods

This cross-sectional study analyzed a convenience sample of 311 people with type 2 diabetes in Taiwan. Data were collected through questionnaires, including the Diabetes Symptoms Checklist, Emotional Distress Scale, Empowerment Process Scale, Interpersonal Communication Scale and Self-Care Behavior scale.

Results

Structural equation modeling indicated that a model of dispositional mindfulness, internal environmental factors, external environmental factors, and self-care behaviors in the patients with diabetes best fit the data. Dispositional mindfulness (β = 0.39), internal environmental factors (β = 0.52), and external environmental factors (β = 0.71) directly influenced self-care behaviors in the patients with diabetes. Dispositional mindfulness significantly indirectly affected self-care behaviors via internal and external environmental factors.

Conclusions

To improve self-care behaviors, interventions should consider mindfulness training, and also include internal environmental factors and external environmental factors in the mindfulness training.

Objective

To understand the relationship between the need for continuing care services and influencing factors, social support, readiness for discharge among discharged pulmonary tuberculosis (PTB) patients.

Methods

A cross-sectional study was conducted among 170 patients from a database of discharged patients with PTB from September 2023 to January 2024. A demographic and disease characteristics questionnaire, continuing care services basic modality questionnaire, continuing care services need questionnaire, the Social Support Rating Scale (SSRS), and the Readiness for Hospital Discharge Scale (RHDS) were used for this investigation. Univariate analysis and multiple linear regression analysis were used to analyze the associated factors.

Results

The mean total score for the need for continuing care services among patients with PTB discharged from the hospital was (121.61 ± 22.98). The dimension with the highest score was health education guidance need. Compared to the the original hospital medical personnel, the primary source of care information after discharge was the local medical institutions was statistically significant and negatively correlated with continuing care service need (P = 0.005). Social support was positively associated with need for continuing care services (P = 0.042).

Conclusion

Discharged PTB patients had a high degree of continuing care service need. Factors influencing the need for continuing care services are the primary source of care information after discharge was the local medical institutions, the social support. Medical staff need to provide targeted continuing care services based on relevant influencing factors to meet the discharge needs of patients.

Aim

To investigate the perceptions of Jordanian nurses regarding Non-Nursing Tasks (NNTs) and their consequences, as well as the underlying factors that contribute to the occurrence of NNTs.

Background

Nurses play a crucial role in providing high-quality patient care, but they often engage in NNTs, which can hinder their ability to deliver care effectively. Western countries have primarily conducted research on NNTs, while Middle Eastern countries such as Jordan have received limited attention. Expanding our understanding of NNTs is essential for improving nursing care.

Methods

A qualitative-exploratory approach was adopted. The research was conducted at three hospitals in Amman, Jordan. A purposeful sampling approach was used to select the participant and a focus group-interview method was used to gather the data. The derived data were analyzed using a thematic analysis approach.

Results

The final sample of this study included 38 participants. The findings highlighted that nurses often perform NNTs due to staff shortages and limited resources, as well as weaknesses in nursing administration and education. The finding also highlights the consequences of NNTs on nurses' professional lives, including impaired nursing care, physical and mental health strain, and a lack of efficiency and productivity.

Conclusions

The present study's results provide valuable insights into the impact of NNTs on nurses in Jordan. These findings underscore the need for healthcare stakeholders to actively address the issue of NNTs. It also emphasized the need for more explicit job descriptions and processes, along with support for nurses to fulfilling their responsibilities and prioritizing patient care.