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Spiritual interventions on physical and psychological outcomes in adults receiving haemodialysis: A systematic review and meta-analysis of randomized controlled studies 精神干预对接受血液透析的成人生理和心理结果的影响:随机对照研究的系统回顾和荟萃分析
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2025-06-01 Epub Date: 2025-03-01 DOI: 10.1016/j.apnr.2025.151918
Şefika Tuğba Yangöz , Selma Turan Kavradim , Zeynep Özer

Background

Adults receiving haemodialysis experience several physical and psychological problems. Recently, spiritual interventions have been commonly performed for haemodialysis, but evidence of their effectiveness is lacking.

Aim

To synthesize the effects of spiritual interventions on physical and psychological problems in haemodialysis.

Methods

The study protocol was registered with PROSPERO. We searched 11 electronic databases from inception to August 2024. Participants included: 1) adults 18 years and older receiving haemodialysis for at least three months; 2) studies implementing spiritual interventions; 3) studies evaluating spiritual interventions' effects on physical and psychological outcomes. Data synthesis was undertaken using Comprehensive Meta-analysis version 3. Random-effects meta-analysis was conducted to pool effects of interventions. The Grading of Recommendations, Assessment, Development, and Evaluations assessed evidence certainty.

Results

Twelve trials with 869 participants were included. Only one trial assessed physical outcomes, so they weren't included in the meta-analysis. For psychological outcomes, this intervention was not effective for anxiety and depression symptoms, with low-quality evidence. This intervention showed a medium positive effect on improving hope, with high-quality evidence. Subgroup analysis demonstrated that spiritual intervention, with or without prayer, was effective, and there was no difference between these variables in improving hope. Additionally, eight spiritual intervention sessions were more effective than fewer than eight sessions in improving hope for haemodialysis population.

Conclusions

This meta-analysis shows that spiritual interventions moderately improve hope with high-quality evidence but do not affect anxiety and depression symptoms in haemodialysis. Nurses and health professionals can use these interventions to enhance hope as evidence-based practice in haemodialysis.
接受血液透析的成年人会经历一些生理和心理问题。最近,精神干预通常用于血液透析,但缺乏其有效性的证据。目的综合精神干预对血液透析患者生理和心理问题的影响。方法研究方案在PROSPERO注册。我们检索了从成立到2024年8月的11个电子数据库。参与者包括:1)18岁及以上接受血液透析至少三个月的成年人;2)实施精神干预的研究;3)评估精神干预对生理和心理结果影响的研究。采用第3版综合meta分析进行数据综合。进行随机效应荟萃分析,汇总干预措施的效果。建议、评估、发展和评估的分级评估证据的确定性。结果共纳入12项试验,869名受试者。只有一项试验评估了身体结果,因此它们没有被纳入荟萃分析。对于心理结果,这种干预对焦虑和抑郁症状无效,证据质量低。这种干预在改善希望方面显示出中等的积极作用,有高质量的证据。亚组分析表明,有或没有祈祷的精神干预是有效的,这些变量之间在改善希望方面没有差异。此外,在改善血液透析人群的希望方面,8次精神干预比少于8次更有效。结论本荟萃分析显示,精神干预可适度提高血液透析患者的希望,但不影响血液透析患者的焦虑和抑郁症状。护士和卫生专业人员可以使用这些干预措施来增强血液透析循证实践的希望。
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引用次数: 0
Adjustment to a temporary compared to a permanent ostomy: A qualitative analysis of survey responses 临时造口与永久性造口的比较:调查结果的定性分析
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2025-06-01 Epub Date: 2025-03-22 DOI: 10.1016/j.apnr.2025.151945
Ian Whiteley , Fiona F. Stanaway , Sue Randall

Aims

To describe differences and similarities in adaptation or adjustment to a new temporary compared to a new permanent ostomy.

Background

Few studies have assessed differences in adjustment between temporary and permanent ostomies. This is important as some evidence suggests that individuals with a temporary ostomy defer returning to pre-ostomy life until the ostomy is reversed, while those with a permanent ostomy adjust more quickly. Qualitative data can offer deeper insights by exploring personal perspectives, beliefs, and attitudes as people adapt and adjust to a new ostomy.

Design

This is a multicentre, longitudinal observational study in which adjustment to an ostomy was measured using open-ended, short answer questions added to the Ostomy Adjustment Inventory (OAI-23).

Methods

Sample: Seven hundred participants were recruited through 11 care facilities, 397 had a temporary ostomy and 303 had a permanent ostomy. This paper explores the 626 responses to open-ended questions.
Data analysis: Data was uploaded into NVivo (14) software and responses were analysed as data corpus using thematic analysis.

Findings

The formation of a new temporary or permanent ostomy required a period of adaptation and adjustment. Thirteen sub-themes were identified and further refined into three major themes, adjusting to the unfamiliar and unpredictable body; navigating uncharted territory; and psychological adjustment. Whilst some minor differences were noted, these were far overshadowed by the similarities in adjustment between the two groups.

Conclusion

Adaptation to a temporary or permanent ostomy is an ongoing process with many similarities influencing adjustment outcomes. Improved comprehension of ostomy adjustment will assist planning services to meet the needs of this population.
目的描述新的临时造口与新的永久性造口在适应或调整方面的异同。背景:很少有研究评估临时造口和永久性造口在调整方面的差异。这一点很重要,因为一些证据表明,临时造口术患者在造口术逆转之前会推迟回到造口术前的生活,而永久性造口术患者则会更快地适应。定性数据可以通过探索人们在适应和调整新造口术时的个人观点、信仰和态度,提供更深入的见解。设计:这是一项多中心的纵向观察性研究,在该研究中,对造口术的调整采用开放式的、简短的回答问题,并添加到造口术调整量表(OAI-23)中。方法:通过11家护理机构招募了700名参与者,其中397例为临时造口术,303例为永久性造口术。本文探讨了对开放式问题的626个回答。数据分析:将数据上传到NVivo(14)软件中,并使用主题分析将响应作为数据语料库进行分析。发现新的临时或永久造口的形成需要一段时间的适应和调整。确定了13个子主题,并进一步细化为三大主题,以适应不熟悉和不可预测的身体;在未知领域航行;还有心理调整。虽然我们注意到了一些细微的差异,但这些差异远远被两组之间在调整方面的相似之处所掩盖。结论对暂时性或永久性造口术的适应是一个持续的过程,有许多相似之处影响着适应的结果。提高对造口调整的理解将有助于规划服务以满足这一人群的需求。
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引用次数: 0
Delirium in older adults following traumatic brain injury during the acute stage: Validation of the Chinese version of the confusion assessment method 老年人创伤性脑损伤急性期谵妄:中文版神志不清评定方法的验证
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2025-06-01 Epub Date: 2025-03-11 DOI: 10.1016/j.apnr.2025.151943
Chia-Jou Lin RN , Yun-Hsuan Lai RN, MSN , Donna Marie Fick RN, PhD , Chia-Chi Hsiao RN , Yi-Chen Chen RN , Sheng-Wen Huang MD , Hsiao-Yean Chiu RN, PhD

Aim

To translate and validate the confusion assessment method into traditional Chinese (CAM-TC) and explore the incidence of delirium following traumatic brain injury (TBI) in the ward setting.

Background

The CAM is a widely recognized tool for screening delirium, but it has not been translated into Traditional Chinese version, and it has seldom been used to assess delirium in TBI survivors in general wards.

Methods

Patients aged 20 years or older, diagnosed with TBI, and with a Glasgow Coma Scale (GCS) score of 9 or higher at admission were included. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria were employed as the gold standard. Cohen's kappa was used to calculate inter-rater reliability.

Results

Our study enrolled 100 patients with a mean age of 68.5 years and mild TBI. Post-TBI delirium was diagnosed in 10 % of the sample using DSM-5-TR criteria. A subset of 10 patients was selected for inter-rater reliability analysis, and a kappa value of 1.0 was obtained. The sensitivity, specificity, and area under the receiver operating characteristic curve values were 0.90, 0.98, and 0.94, respectively.

Conclusions

The CAM-TC is a reliable tool for screening delirium following TBI in the ward setting. Our findings provide new insights into post-TBI delirium in this environment. Implementing an applicable delirium screening tool for post-TBI patients could facilitate further research on prevention and intervention strategies.
目的将认知混乱评估方法(CAM-TC)翻译成中文并进行验证,探讨创伤性脑损伤(TBI)后谵妄在病房的发生率。CAM是一种被广泛认可的谵妄筛查工具,但尚未翻译成繁体中文版本,在普通病房中很少用于评估TBI幸存者的谵妄。方法纳入年龄在20岁及以上,诊断为TBI,入院时格拉斯哥昏迷评分(GCS)为9分及以上的患者。《精神障碍诊断与统计手册,第五版,文本修订版》(DSM-5-TR)标准被用作金标准。采用Cohen's kappa法计算评分者间信度。结果我们的研究纳入了100例平均年龄68.5岁的轻度TBI患者。根据DSM-5-TR标准,10%的样本被诊断为脑外伤后谵妄。选取10例患者进行评分间信度分析,kappa值为1.0。灵敏度为0.90,特异度为0.98,受试者工作特征曲线下面积为0.94。结论CAM-TC是一种可靠的筛查创伤性脑损伤后谵妄的工具。我们的发现为这种环境下的脑外伤后谵妄提供了新的见解。实施一种适用于脑外伤后患者的谵妄筛查工具,有助于进一步研究预防和干预策略。
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引用次数: 0
Transcultural challenges in the nurse-migrant patient caring relationship: a phenomenological study 护士-流动病人护理关系中的跨文化挑战:现象学研究
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2025-06-01 Epub Date: 2025-04-16 DOI: 10.1016/j.apnr.2025.151954
Arianna Anzini , Gabriele Caggianelli , Rita Patrizia Tomasin , Alessia Segala , Stefania Giangrazi , Chiara Paccagnella , Stefano Mancin , Fabio Petrelli , Valentina Vanzi , Giovanni Cangelosi , Irene Dello Iacono

Background/aim

The rising migration to EU Member States has increased demographic diversity, posing challenges for healthcare systems in delivering culturally competent care. Nurses, often the first healthcare providers to interact with migrant patients, play a crucial role in addressing cultural differences. However, a lack of awareness and preparedness can negatively impact the nurse-patient relationship and overall care quality. This study aimed to explore the transcultural challenges nurses encounter when caring for migrant patients.

Methods

A qualitative phenomenological approach was used to examine the experiences of 19 nurses from two hospitals in Italy. Semi-structured interviews were conducted between June and August 2024. Giorgi's phenomenological method was applied to analyze the data and identify key themes related to transcultural care challenges.

Results

The findings revealed that language barriers significantly hinder communication, often requiring nurses to rely on non-verbal strategies. Cultural differences in health beliefs and expectations necessitate continuous adaptation of care plans. Building trust and empathy is crucial in fostering effective relationships, yet nurses face emotional and ethical challenges when patient values conflict with standard practices. Culturally competent staff act as essential mediators, bridging gaps in understanding and care delivery.

Conclusions

This study highlights the need for tailored interventions to support nurses in managing transcultural challenges. Addressing communication barriers and ethical dilemmas through training and the inclusion of cultural mediators is crucial to improving care quality for migrant patients. Further research is needed to develop evidence-based strategies for culturally competent nursing care.
背景/目的向欧盟成员国移民的增加增加了人口多样性,对医疗保健系统在提供文化上合格的护理方面提出了挑战。护士通常是第一个与移民患者互动的医疗保健提供者,在解决文化差异方面发挥着至关重要的作用。然而,缺乏意识和准备会对护患关系和整体护理质量产生负面影响。本研究旨在探讨护士在照顾流动病人时所遇到的跨文化挑战。方法采用定性现象学方法对意大利两所医院19名护士的护理经历进行分析。半结构化访谈于2024年6月至8月进行。Giorgi的现象学方法被用于分析数据,并确定与跨文化护理挑战相关的关键主题。结果研究发现,语言障碍严重阻碍了护士的沟通,往往需要依靠非语言策略。在健康信仰和期望方面的文化差异要求不断调整护理计划。建立信任和同理心对于培养有效的关系至关重要,然而,当患者的价值观与标准做法发生冲突时,护士面临情感和道德上的挑战。具有文化能力的工作人员充当重要的调解人,弥合理解和提供护理方面的差距。结论:本研究强调需要有针对性的干预措施来支持护士应对跨文化挑战。通过培训和接纳文化调解人来解决沟通障碍和道德困境,对于提高流动患者的护理质量至关重要。需要进一步的研究来制定基于证据的文化能力护理策略。
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引用次数: 0
Effects of a 12-week lower limb resistance training with breathing regulation in patients with diabetes-related foot ulcers: A randomized controlled trial 12周下肢阻力训练与呼吸调节对糖尿病相关足溃疡患者的影响:一项随机对照试验
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2025-04-01 Epub Date: 2025-01-31 DOI: 10.1016/j.apnr.2025.151911
Jia-Ling Wu MS, RN , Mei-Ling Yeh PhD, DMS, RN, FAAN (Distinguished Professor) , Jocelyn Liao
Patients with diabetes-related foot ulcers may require hospitalization and face an increased risk of amputation, which can significantly impact their quality of life. One potential solution is exercise, which can regulate blood glucose levels, improve wound healing, and enhance overall well-being. This randomized controlled trial aimed to evaluate the impact of a lower limb resistance training program combined with breathing-regulation techniques on glycemic control, wound healing, and quality of life in patients with diabetes-related foot ulcers. Patients hospitalized for type 2 diabetes-related foot ulcers were recruited from a single medical center and randomly divided into two groups. The control group (n = 31) received standard treatment, while the exercise group (n = 28) received standard treatment along with lower limb resistance training and breathing-regulation techniques. Assessments of fasting blood glucose levels, hemoglobin A1c (HbA1c) levels, wound healing, and quality of life were carried out at the start of the study and week 4, week 8, and week 12 of the intervention. The exercise group demonstrated significant improvements in fasting blood glucose and HbA1c levels, as well as in physical health, psychological well-being, social relationships, and environmental aspects of quality of life over the 12 weeks compared to both the control group and the baseline (p < .05). However, no significant change was observed in wound healing (p > .05). The resistance training program for the lower limbs, combined with breathing-regulation techniques, is recommended for improving blood glucose levels and quality of life over 12 weeks.
患有糖尿病相关足部溃疡的患者可能需要住院治疗,并面临截肢的风险增加,这可能严重影响他们的生活质量。一个潜在的解决方案是运动,它可以调节血糖水平,促进伤口愈合,提高整体健康水平。这项随机对照试验旨在评估下肢阻力训练计划结合呼吸调节技术对糖尿病相关足部溃疡患者血糖控制、伤口愈合和生活质量的影响。因2型糖尿病相关足部溃疡住院的患者从单一医疗中心招募,随机分为两组。对照组(n = 31)采用标准治疗,运动组(n = 28)采用标准治疗,同时进行下肢阻力训练和呼吸调节技术。在研究开始时以及干预的第4周、第8周和第12周进行空腹血糖水平、血红蛋白A1c (HbA1c)水平、伤口愈合和生活质量的评估。与对照组和基线相比,运动组在12周内表现出空腹血糖和HbA1c水平的显著改善,以及身体健康、心理健康、社会关系和生活质量的环境方面(p <;. 05)。然而,在伤口愈合方面没有观察到明显的变化(p >;. 05)。建议将下肢阻力训练项目与呼吸调节技术相结合,在12周内改善血糖水平和生活质量。
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引用次数: 0
“Improving postnatal maternity care following severe perineal trauma by evaluating end-user's experiences of a pilot trial exploring laxative management; A qualitative study” “通过评估最终用户对探索泻药管理试点试验的体验,改善严重会阴创伤后的产后产妇护理;一项定性研究”
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2025-04-01 Epub Date: 2025-01-25 DOI: 10.1016/j.apnr.2025.151913
R. Sfreddo RM , V. Hoang MBBS PhD , E.M.A. Murphy MBBS PhD , B. Turner BSc , K. Juszczyk MBBS , J. Barnes MBBS , A. Parange MBBS , J. Tucker RM PhD

Background

Trauma to the anal sphincter following vaginal birth increases the risk of anal incontinence. Laxative management in the postnatal period is recommended to improve defecation and reduce the risk of wound breakdown. Research underpinning management guidelines is lacking and omits end-users (clinicians and birthing women) involvement in evaluating pilot studies. Incorporating end-users' enhances the relevance of the research to those being investigated, improves the design, and translation of findings into clinical practice. No studies have evaluated end-users' experiences in research which investigates laxative management following anal sphincter injury.

Aim

This study identifies the barriers and facilitators in a pilot study research design and suggests improvements to inform larger scale research to improve clinical practice.

Methods

A phenomenological qualitative study using semi-structured interviews was adopted. Purposeful sampling of health professionals (n = 85) involved in the direct care of women following OASIs and women (n = 64) sustaining OASIs during the recent pilot trial. Data analysis employing thematic analysis.

Findings

The consensus from interviews (n = 23) highlighted the research was feasible with suggested improvements to enhance future recruitment, information for linguistically diverse women and review of quality-of-life tools. The evaluation process enhanced future research engagement.

Conclusions

The reliability and validity of future research can be improved adopting a qualitative framework and end-users' to evaluate pilot studies. Findings from this pilot study identified issues including recruitment, CALD participant information and accuracy of QoL data collection tools that needed to be addressed enhancing future findings that are relevant to the needs of the study population and enhance translation into practice.
阴道分娩后肛门括约肌损伤增加肛门失禁的风险。建议在产后使用泻药,以改善排便,减少伤口破裂的风险。缺乏支持管理指南的研究,并且忽略了最终用户(临床医生和分娩妇女)参与评价试点研究。将最终用户纳入研究,增强了研究与被调查对象的相关性,改进了设计,并将研究结果转化为临床实践。在调查肛门括约肌损伤后泻药管理的研究中,没有研究评估最终用户的经验。目的本研究确定了试点研究设计中的障碍和促进因素,并提出了改进建议,为更大规模的研究提供信息,以改善临床实践。方法采用半结构化访谈法进行现象学定性研究。在最近的试点试验中,有目的的抽样调查了参与直接护理接受绿洲治疗的妇女的卫生专业人员(n = 85)和维持绿洲治疗的妇女(n = 64)。数据分析采用主题分析。调查结果从访谈(n = 23)中得出的共识强调了该研究的可行性,并提出了改进建议,以加强未来的招聘,为语言多样化的女性提供信息,并审查生活质量工具。评估过程加强了未来的研究参与。结论采用定性框架和最终用户评价试点研究,可提高未来研究的信度和效度。这项试点研究的结果确定了需要解决的问题,包括招募、CALD参与者信息和生活质量数据收集工具的准确性,这些问题可以增强与研究人群需求相关的未来研究结果,并增强对实践的转化。
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引用次数: 0
The cultural difference between empowerment and job satisfaction among nurses: An umbrella review 授权与护士工作满意度之间的文化差异:概括性回顾
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2025-04-01 Epub Date: 2025-01-25 DOI: 10.1016/j.apnr.2025.151912
Shih-Yu Chang, Shu-Zhuan Wang, Huan-Fang Lee

Aim

To synthesize and analyze the relationship between empowerment and job satisfaction among nurses in the cultural context using an umbrella review.
Background: Empowerment improves individual autonomy, rights, and responsibilities, allowing employees to feel more control and accountability in their work and improving job satisfaction. Cultural differences also influence perceptions of power and responsibility, affecting empowerment, acceptance, and job satisfaction. Although some systematic reviews explored the relationship between empowerment and job satisfaction among nurses, the results were inconsistent, especially because of cultural contexts. Umbrella review can integrate and analyze the gap and provide final evidence.

Methods

An umbrella review was conducted using the JBI guidelines. Seven academic databases were searched, and papers were published from database inception until June 2024. Inclusion criteria were the systematic review related to the relationship between empowerment and job satisfaction among nurses.

Results

A total of five systematic reviews, including 67 single studies, were included. Empowerment is positively correlated with job satisfaction. Cultural differences may influence the levels of empowerment provided to nurses and the relationship between cultural differences and various forms of empowerment related to job satisfaction among nurses. Although the relationship between structural empowerment and job satisfaction does not show significant differences in cultural differences, psychological empowerment reveals weakness to moderate correlations, especially in Western contexts.

Conclusion

Enhancing psychological empowerment can improve job satisfaction, especially in Western cultures. Managers should consider cultural background to provide suitable empowerment, improve job satisfaction, potentially increase commitment and effectiveness, and reduce turnover.

Registration

This umbrella review has been registered in PROSPERO (CRD42024580679).
目的运用总括性回顾法,综合分析文化背景下护士赋权与工作满意度的关系。背景:授权提高了个人的自主权、权利和责任,让员工在工作中感受到更多的控制和责任,提高了工作满意度。文化差异也影响对权力和责任的看法,影响授权、接受和工作满意度。虽然一些系统的评论探讨了授权和护士工作满意度之间的关系,但结果是不一致的,特别是因为文化背景。伞式审查可以整合和分析差距,并提供最终证据。方法采用JBI指南进行总括性综述。检索了7个学术数据库,从数据库建立到2024年6月发表的论文。纳入标准是对护士授权与工作满意度关系的系统评价。结果共纳入5项系统综述,包括67项单项研究。授权与工作满意度呈正相关。文化差异可能会影响护士的授权水平,以及文化差异与护士工作满意度相关的各种授权形式之间的关系。虽然结构授权与工作满意度之间的关系在文化差异中不存在显著差异,但心理授权表现出弱至中等相关性,特别是在西方语境中。结论增强心理授权可以提高工作满意度,尤其是在西方文化中。管理者应该考虑文化背景,以提供适当的授权,提高工作满意度,潜在地增加承诺和有效性,并减少人员流失。该伞状审查已在PROSPERO注册(CRD42024580679)。
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引用次数: 0
Charting the future of applied nursing research: Priorities, opportunities, and vision 绘制应用护理研究的未来:优先事项,机会和愿景
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2025-04-01 Epub Date: 2025-01-22 DOI: 10.1016/j.apnr.2025.151904
Stephen McGhee
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引用次数: 0
Efficacy of complex decongestive therapy in managing limb swelling, pain, and enhancing functional recovery after arthroscopic reconstruction of anterior cruciate ligament 关节镜下前交叉韧带重建术后肢体肿胀、疼痛和增强功能恢复的综合降压治疗效果
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2025-04-01 Epub Date: 2025-01-25 DOI: 10.1016/j.apnr.2025.151915
Yuxiang Ren , Ruolan Ge , Cong Yang, Yanrong Tan, Huanhuan Song, Rui Liu, Miaomiao Huang, Zhenyu Niu, Li Yang, Weixuan Liu M.D.

Objective

To evaluate the efficacy of Complex Decongestive Therapy (CDT) in managing limb swelling, alleviating pain, and promoting functional recovery in patients following anterior cruciate ligament reconstruction (ACLR).

Method

This was a randomized controlled trial (RCT) involving 160 patients who underwent ACLR at a tertiary hospital in Shenzhen between August 2021 and April 2023. The study compared the outcomes of conventional nursing care with complex decongestive therapy (CDT). The differences in leg circumference, Visual Analog Scale (VAS) pain scores, and Active Range of Motion (AROM) were assessed at six time points during the perioperative period and up to 30 days post-surgery.

Results

This study included 69 patients in the experimental group and 64 patients in the control group. After one month of treatment with CDT, significant differences in calf circumference were observed between the experimental and control groups on the 3rd (t = −2.083, P = 0.039) and 5th (t = −2.078, P = 0.040) postoperative days. Regarding changes in central patellar circumference, a significant difference was noted on the 5th postoperative day (t = −2.092, P = 0.038) in the experimental group. However, no significant differences in thigh circumference were observed at any of the six time points (P > 0.05). Visual analog scale (VAS) pain scores were significantly different on the 1st (t = −1.978, P = 0.048) and 3rd (t = −2.530, P = 0.011) postoperative days. Lysholm scores showed a significant difference between the groups on the 30th postoperative day (t = −3.438, P = 0.001), with no significant difference observed before surgery (P > 0.05). Significant differences in AROM were found on the 14th (t = −3.919, P = 0.000) and 30th (t = −2.615, P = 0.009) postoperative days.

Conclusion

CDT can effectively reduce limb swelling on the 3rd and 5th postoperative days, alleviate pain on the 1st and 3rd postoperative days, and enhance joint functional recovery on the 14th and 30th postoperative days.
目的评价复合减充血性治疗(CDT)对前交叉韧带重建术(ACLR)术后肢体肿胀、疼痛缓解及功能恢复的疗效。方法采用随机对照试验(RCT),纳入160例于2021年8月至2023年4月在深圳某三级医院行ACLR手术的患者。本研究比较了常规护理与综合减充血性治疗(CDT)的效果。在围手术期和术后30天的六个时间点评估腿围、视觉模拟评分(VAS)疼痛评分和活动范围(AROM)的差异。结果实验组69例,对照组64例。CDT治疗1个月后,实验组和对照组在术后第3天(t =−2.083,P = 0.039)和第5天(t =−2.078,P = 0.040)观察到小腿围有显著差异。术后第5天实验组髌骨中央围度变化差异有统计学意义(t =−2.092,P = 0.038)。然而,在6个时间点,大腿围均未观察到显著差异(P >;0.05)。术后第1天(t = - 1.978, P = 0.048)和第3天(t = - 2.530, P = 0.011)视觉模拟评分(VAS)疼痛评分差异有统计学意义。两组术后第30天Lysholm评分差异有统计学意义(t = - 3.438, P = 0.001),术前Lysholm评分差异无统计学意义(P >;0.05)。术后第14天(t = - 3.919, P = 0.000)和第30天(t = - 2.615, P = 0.009) AROM差异有统计学意义。结论cdt能有效减轻术后第3、5天肢体肿胀,缓解术后第1、3天疼痛,促进术后第14、30天关节功能恢复。
{"title":"Efficacy of complex decongestive therapy in managing limb swelling, pain, and enhancing functional recovery after arthroscopic reconstruction of anterior cruciate ligament","authors":"Yuxiang Ren ,&nbsp;Ruolan Ge ,&nbsp;Cong Yang,&nbsp;Yanrong Tan,&nbsp;Huanhuan Song,&nbsp;Rui Liu,&nbsp;Miaomiao Huang,&nbsp;Zhenyu Niu,&nbsp;Li Yang,&nbsp;Weixuan Liu M.D.","doi":"10.1016/j.apnr.2025.151915","DOIUrl":"10.1016/j.apnr.2025.151915","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy of Complex Decongestive Therapy (CDT) in managing limb swelling, alleviating pain, and promoting functional recovery in patients following anterior cruciate ligament reconstruction (ACLR).</div></div><div><h3>Method</h3><div>This was a randomized controlled trial (RCT) involving 160 patients who underwent ACLR at a tertiary hospital in Shenzhen between August 2021 and April 2023. The study compared the outcomes of conventional nursing care with complex decongestive therapy (CDT). The differences in leg circumference, Visual Analog Scale (VAS) pain scores, and Active Range of Motion (AROM) were assessed at six time points during the perioperative period and up to 30 days post-surgery.</div></div><div><h3>Results</h3><div>This study included 69 patients in the experimental group and 64 patients in the control group. After one month of treatment with CDT, significant differences in calf circumference were observed between the experimental and control groups on the 3rd (<em>t</em> = −2.083, <em>P</em> = 0.039) and 5th (<em>t</em> = −2.078, <em>P</em> = 0.040) postoperative days. Regarding changes in central patellar circumference, a significant difference was noted on the 5th postoperative day (<em>t</em> = −2.092, <em>P</em> = 0.038) in the experimental group. However, no significant differences in thigh circumference were observed at any of the six time points (<em>P</em> &gt; 0.05). Visual analog scale (VAS) pain scores were significantly different on the 1st (<em>t</em> = −1.978, <em>P</em> = 0.048) and 3rd (<em>t</em> = −2.530, <em>P</em> = 0.011) postoperative days. Lysholm scores showed a significant difference between the groups on the 30th postoperative day (<em>t</em> = −3.438, <em>P</em> = 0.001), with no significant difference observed before surgery (<em>P</em> &gt; 0.05). Significant differences in AROM were found on the 14th (<em>t</em> = −3.919, <em>P</em> = 0.000) and 30th (<em>t</em> = −2.615, <em>P</em> = 0.009) postoperative days.</div></div><div><h3>Conclusion</h3><div>CDT can effectively reduce limb swelling on the 3rd and 5th postoperative days, alleviate pain on the 1st and 3rd postoperative days, and enhance joint functional recovery on the 14th and 30th postoperative days.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151915"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143271807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Does confidence mirror competence? Outcomes following Stop the Bleed® training among lay community members 自信能反映能力吗?在非专业社区成员中进行Stop the Bleed®培训后的结果
IF 2.7 4区 医学 Q1 NURSING Pub Date : 2025-04-01 Epub Date: 2025-02-27 DOI: 10.1016/j.apnr.2025.151928
Allison R. Jones , Rebekah D. Day , Penni I. Watts

Aim

To evaluate and compare pre- and post-STB training outcomes of bleeding control knowledge, willingness to act and confidence in doing so.

Background

Stop the Bleed® (STB) training improves trainees' willingness to intervene in pre-hospital bleeding emergencies and confidence in doing so, but few studies report associated knowledge-based outcomes.

Methods

A cross-sectional, observational study was performed using a pre-/post-test approach. Lay community members aged ≥18 who read and spoke English were included. On enrollment, participants completed the Stop the Bleed Training Survey (STB-TS) (five self-assessment and three knowledge-based items), and provided demographics and work history data; the STB-TS was completed again immediately after training. Descriptive statistics were used to characterize the sample. Paired t-tests were used to compare STB-TS self-assessment items. McNemar's Test was used to compare proportions of correct answers to STB-TS knowledge-based items.

Results

Trainees (N = 31) had a mean age of 33 ± 16 years, identified as mostly female (58.1 %) and people of color (54.8 %), and reported little experience with bleeding control emergencies. Total STB-TS scores increased from 14.4 ± 6.7 to 17.0 ± 10.8 (p = .26), indicating greater knowledge, confidence, and willingness to act. Correct response rates increased significantly from pre- to post-training (27.6 % vs 69.2 %, p = .003) on only one of the knowledge-based items: proper tourniquet application.

Discussion

Findings suggest a disconnect among trainees' willingness to act and confidence in doing so compared to their knowledge of bleeding control intervention. Incorporating use of high-fidelity simulation and standardized evaluation instruments may enhance content and skill mastery.
目的评价和比较性病患者出血控制知识、行动意愿和信心培训前后的效果。stop the Bleed®(STB)培训提高了受训者对院前出血紧急情况进行干预的意愿和信心,但很少有研究报告相关的基于知识的结果。方法采用前/后测试方法进行横断面观察性研究。年龄≥18岁、能阅读和说英语的外行社区成员被纳入研究对象。在入组时,参与者完成了停止流血培训调查(STB-TS)(5项自我评估和3项基于知识的项目),并提供了人口统计和工作经历数据;STB-TS在训练后立即再次完成。使用描述性统计来描述样本的特征。采用配对t检验比较STB-TS自评项目。McNemar's Test用于比较STB-TS知识题的正确答案比例。结果31例患者平均年龄(33±16岁),以女性(58.1%)和有色人种(54.8%)为主。STB-TS总分从14.4±6.7分上升到17.0±10.8分(p = 0.26),表明患者的知识、信心和行动意愿增强。正确反应率从培训前到培训后显著增加(27.6% vs 69.2%, p = 0.003),只有一个基于知识的项目:正确使用止血带。研究结果表明,与他们对出血控制干预的了解相比,受训者采取行动的意愿和信心存在脱节。结合使用高保真仿真和标准化评估工具可以提高内容和技能掌握。
{"title":"Does confidence mirror competence? Outcomes following Stop the Bleed® training among lay community members","authors":"Allison R. Jones ,&nbsp;Rebekah D. Day ,&nbsp;Penni I. Watts","doi":"10.1016/j.apnr.2025.151928","DOIUrl":"10.1016/j.apnr.2025.151928","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate and compare pre- and post-STB training outcomes of bleeding control knowledge, willingness to act and confidence in doing so.</div></div><div><h3>Background</h3><div>Stop the Bleed® (STB) training improves trainees' willingness to intervene in pre-hospital bleeding emergencies and confidence in doing so, but few studies report associated knowledge-based outcomes.</div></div><div><h3>Methods</h3><div>A cross-sectional, observational study was performed using a pre-/post-test approach. Lay community members aged ≥18 who read and spoke English were included. On enrollment, participants completed the Stop the Bleed Training Survey (STB-TS) (five self-assessment and three knowledge-based items), and provided demographics and work history data; the STB-TS was completed again immediately after training. Descriptive statistics were used to characterize the sample. Paired <em>t</em>-tests were used to compare STB-TS self-assessment items. McNemar's Test was used to compare proportions of correct answers to STB-TS knowledge-based items.</div></div><div><h3>Results</h3><div>Trainees (<em>N</em> = 31) had a mean age of 33 ± 16 years, identified as mostly female (58.1 %) and people of color (54.8 %), and reported little experience with bleeding control emergencies. Total STB-TS scores increased from 14.4 ± 6.7 to 17.0 ± 10.8 (<em>p</em> = .26), indicating greater knowledge, confidence, and willingness to act. Correct response rates increased significantly from pre- to post-training (27.6 % vs 69.2 %, <em>p</em> = .003) on only one of the knowledge-based items: proper tourniquet application.</div></div><div><h3>Discussion</h3><div>Findings suggest a disconnect among trainees' willingness to act and confidence in doing so compared to their knowledge of bleeding control intervention. Incorporating use of high-fidelity simulation and standardized evaluation instruments may enhance content and skill mastery.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151928"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
期刊
Applied Nursing Research
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