Applied Nursing Research最新文献

Background

Falls and fear of falling (FOF) are common in patients with diabetic foot disease (DFD).

Purpose

To understand the relationship between falls, FOF, and related factors in patients with DFD.

Method

We recruited 70 patients being treated for DFD at two hospitals in Korea. A structured questionnaire was used in investigating fall experience, FOF, and related factors.

Results

Among the participants, 42.8 % fell in the past year, and FOF was reported in 57.1 %. Rates of “no caregiver,” “DFD duration (>1 year),” and “burning pain” were higher in fallers than non-fallers. The rates of “older adults (≥65 years of age),” “unemployed,” “not using assistive devices,” “visual impairment,” and “hearing impairment” were higher in patients with FOF than in those without FOF. However, the level of balance confidence was lower in patients with FOF.

Conclusions

The fall experience of patients with DFD was associated with the presence of their caregiver, disease-related factors, and foot pain symptoms, while FOF was related to age and fall-related factors.

While case studies can offer an in-depth investigation of a particular issue in healthcare, cultural context may be overlooked. Researchers may want to consider adding a cultural component to the design aimed at identifying and/or explaining values, beliefs, or traditions influencing the case. The addition of focused ethnography as a supplemental component to the research design is one strategy to examine cultural content. In this article, we provide insights gained from using case study research and focused ethnography in a qualitatively-driven mixed method design. Despite a detailed research plan, there were challenges that hindered the implementation of the design. To help prevent others from experiencing similar methodological challenges, we provide the following lessons learned and recommended strategies: discussion of structured procedures for intentional observations, reflexivity to guide decision-making, and refinement of processes using a pilot study.

Introduction

Maternal anxiety and depression are major public health issues with prevalence as high as one in five women. There is a need to focus on preventative strategies to enable women to self-monitor their mental health status during pregnancy and postnatally.

Aim

To co-design and test a perinatal mental health digital tool to enable women to self-monitor their mental wellbeing during pregnancy and early parenting and promote positive self-care strategies.

Methods and ethics

A sequential mixed methods study utilising two stages 1) co-design workshops; 2) fit for purpose pilot with women through a purpose designed survey to evaluate acceptability, useability, functionality, and satisfaction.

Findings

Mothers, midwives, design researchers and students, participated in co-designing a digital tool and prototype application, YourTime. Fourteen participants engaged in the pilot, with all women agreeing that the tool would be beneficial in alerting them to changes in mental wellbeing. Seventy-seven percent agreed that this prototype had the potential to positively affect wellbeing during the perinatal period.

Discussion

The need to develop a perinatal mental health digital tool that enables women to self-monitor their wellbeing was identified. Women reported the YourTime app offered an acceptable and effective means to self-assess and monitor their wellbeing.

Conclusion

The YourTime app responds to the growing agenda for digital approaches to address perinatal mental health challenges. The pilot study demonstrated that the app offered potential to alert women to changes in mental wellbeing, but functionality need further development.

Background

The emergence of the coronavirus disease (COVID-19) has had an impact on nearly every human being with millions of related infections and deaths. The negative impact of the pandemic on individuals' mental health such as fear and stress, particularly among university students, have been reported. While the switch to online teaching and learning played an important mitigating role, it also had presented additional challenges to students' mental health.

Aim

To examine the prevalence of fear and stress among undergraduate nursing students in Qatar and the factors associated with fear of COVID-19.

Method

A cross-sectional design. An online survey was sent to students at the University of Calgary in Qatar.

Results

135 participants completed the survey. The findings showed differences in fear of COVID-19 and stress and satisfaction with the measures proposed by the academic institution based on participants' demographic and COVID-19 profiles. Furthermore, fear of COVID-19 was associated with the age group (26–35), academic year level, and satisfaction with the measures proposed by the academic institution.

Conclusion

The study found that switching teaching and learning online had a negative impact on participants' fear and stress. Several strategies were suggested to alleviate students' fear and stress and support them during future pandemics.

Although coronary artery bypass graft (CABG) surgery improves the life expectancy of patients with coronary artery disease, it is associated with various short and long-term complications. Early mobilization has been shown to reduce the risk of these complications. This study aimed to compare the effectiveness of different early mobilization protocols on postoperative cognitive dysfunction (POCD), pain intensity, and length of hospital stay (LOS) in patients undergoing CABG. This three-arm parallel randomized controlled trial included 120 patients undergoing CABG surgery who were randomly assigned to Intervention A, which received a four-phase early mobilization protocol; Intervention B, which received a three-phase early mobilization protocol; and the Control group, which received routine care. Postoperative cognitive dysfunction and pain were assessed using Mini Mental State Examination (MMSE) and visual analog scale (VAS), respectively. Groups were comparable in demographic and clinical characteristics and postoperative cognitive dysfunction at baseline. After the intervention, Group B had statistically significantly (p < 0.001) less cognitive dysfunction (25.8 ± 1.7) compared to Group A (24.1 ± 2.2) and the Control Group (23.4 ± 2.7). Likewise, hospital stay was statistically (p < 0.01) shorter for Group B (7.7 ± 1.5) than the Control group (8.9 ± 1.9). However, the experience of pain was statistically significantly lower over time in Group A than in the other groups (p < 0.001). This study concludes that an early mobilization protocol based on deep breathing exercises and chest physiotherapy may better improve postoperative cognitive dysfunction and length of hospital stay than an early mobilization protocol based on passive and active range of motion activities or routine care.

Background

Culture influences the way in which patients, families and professionals provide care and undergo decision-making at the end of life.

Objective

Therefore, our research questions were: How do cultural aspects influence the needs, perceptions, and experiences of patients and their families in end-of-life care? What implications does cultural diversity have for professionals who care for individuals at the end of life?

Methods

A narrative review was conducted between June and July 2022. Articles published between 2017 and 2022 in peer-reviewed journals were included.

Results

A total of 43 studies were included. Our findings were grouped into four themes: 1) places to die and preferences about healthcare interventions (e.g. parts of the immigrant population tend to receive more aggressive and invasive interventions); 2) advance care planning and verbalization of death (e.g. less use of ACP in some minority groups); 3) rituals and family involvement during healthcare; 4) professionals addressing multiculturalism in care at the end of life (e.g. lack of training in addressing the context of multiculturalism).

Conclusions

These findings could contribute to making professionals more aware of cultural aspects that influence the process of death and highlight the need for further training in the handling of such situations.

There is ongoing concern about vaccine hesitancy amongst young adults in Turkey. In October 2021 just 53% of 18‐25-year olds were fully vaccinated. This study aimed to assess the knowledge and attitudes of university students concerning adult immunization, COVID-19 vaccine, and COVID-19 vaccine literacy to better understand why it is difficult to encourage young adults to be vaccinated. This cross-sectional study was conducted with 307 university students that included socio-demographic characteristics, knowledge of adult immunization, attitudes toward COVID-19 vaccination, and vaccine literacy. The data were collected using a socio-demographic characteristics form, a knowledge form for adult immunization, the attitudes toward the COVID-19 vaccine scale, and the COVID-19 vaccine literacy scale. While more than half of the students (52.8%) had a low level of knowledge about adult immunization, half percent of the students (50.5%) stated that they did not know anything about adult vaccination. Twenty-six and half percent of the students stated that they weren't vaccinated because they were afraid of the side effects of the vaccines for adults. The difference between the student's level of knowledge about adult immunization and their mean scores on the attitudes toward the COVID-19 vaccine scale was not statistically significant (p > 0.05); whereas, the difference between their level of knowledge about adult immunization and their mean scores of the COVID-19 vaccine literacy scale was statistically significant (p < 0.05). There were low levels of vaccine literacy amongst Turkish university students and more than half of the students reported that they did not know and twenty-six percent of students (26 %) of the students were fearful of vaccine side effects. Students outside of the faculty of health had a low level of knowledge about vaccines. Examining and improving vaccine literacy amongst university students could lead to improved compliance with vaccination programs for both COVID-19 and other adult vaccines that are important for community health and well-being.

Aim

To co-design an intervention to reduce the burden of clinical documentation for nurses and midwives.

Methods

A clinician-researcher collaboration used an action research approach to co-design an intervention to reduce clinical documentation. The study consisted of three phases: 1) Analysis of pre-intervention data, 2) Evaluation of existing documentation, 3) Intervention co-design and implementation.

Results

A total of 116 documents were reviewed using a three-stage evaluation process, identifying 28 documents that could be discontinued and 33 documents to be modified for the intervention. This resulted in an average of 7 documents for women who had a vaginal birth (decreased from 13), 9 documents for women who had a caesarean (decreased from 18), and 7 documents for newborns (previously 7–10). The minimum number of documents for a mother and baby reduced from 20 pre-intervention to 14 post-intervention.

Conclusion

The collaboration successfully co-designed and implemented an intervention to address the burden of clinical documentation that can be replicated in other healthcare settings.

A critical component for nurses to provide safe and quality care with strong patient outcomes is clinical judgment. This study aimed to identify the difference in the clinical judgment score in newly graduated nurses by implementing Tanner's Clinical Judgment Model. This study followed an experimental design with a pretest-posttest and involved thirty-two newly graduated nurses from three private hospitals in Indonesia. The intervention group had a scheduled post-conference with their preceptors using Tanner's Clinical Judgment Model's guidelines with high-level, open-ended questions for two consecutive weeks. Independent samples t-test was used to compare pre-and post-test scores utilizing the valid and reliable Indonesia version of the Lasater Clinical Judgment Rubric. There was no significant difference between the pre-test results of the intervention and control groups, with a significance value of 0.647. The results indicated a significant difference in the mean clinical judgment scores between the intervention and control groups after two weeks of intervention, where the intervention group's scores were higher than the control group's with a significance value of <0.001 with a mean difference of 6.75 and CI of 95 % (4.18–9.31). Tanner's Clinical Judgment Model showed a significant impact in increasing clinical judgment scores. The Indonesia version of the Lasater Clinical Judgment Rubric is a valuable tool for assessing and evaluating the development of clinical judgment and provides detailed targeted areas needing improvement. Preceptors and nursing leaders in the clinical setting should continue to use this model and tools to assist newly graduated nurses in developing clinical judgment skills during their transition period.

Health disparities affecting persons living with HIV (PLWH) as well as those affecting individuals who use substances have been documented in China. However, health status and outcomes within the intersectional population of those who both live with HIV and use substances is not well understood. One hundred and sixty-nine PLWH receiving care in China completed surveys assessing HIV-clinical factors, substance use, and HIV-related physical health symptoms. We tested associations between substance use and health symptoms using multivariate logistic and ordinal regressions. Using one substance over the past week was associated with greater maximal severity of physical symptoms (p < .01); using two or more substances in the past week was associated with both increased total physical symptom severity (p < .05) and a dosage response in increased maximal severity (p < .01). Findings highlight the need for providers to address substance use for comprehensive care of PLWH to improve overall wellbeing.