Journal of Nursing Scholarship最新文献

Aim(s): To determine the correlation between preoperative health education and the emotions of lung cancer patients, artificial intelligence software was used.

Design: This was a cross-sectional study.

Methods: This study included 210 lung cancer patients from Sun Yat-sen University Cancer Center and examined the impact of health education on patient emotions using an AI-based emotion analysis tool.

Results: This study indicated a significant relationship between the tone and emotional content of health education materials and patient emotions. Specifically, educational materials with an explanatory tone and negative sentiment appeared to impact patients' emotional states.

Conclusion: Quality improvements in health education can potentially benefit lung cancer patients' emotional well-being by minimizing the use of both explanatory tone and negative sentiment in educational content.

Implications for the profession and/or patient care: This research suggests that the careful crafting of health education materials, taking into consideration tone and emotional expressions, can have a tangible positive effect on the emotional state of lung cancer patients.

Reporting method: The study was reported in accordance with the STROBE guidelines.

Patient or public contribution: No patients, service users, caregivers, or members of the public were involved in the design, conduct, collection, analysis, or interpretation of the data for this study, nor were they involved in writing the manuscript.

Introduction: Nurses' job satisfaction in hospitals is fundamental for the quality of care and the safety of patients. However, sociodemographic trends require moving care to patients' homes, and the predictors of job satisfaction for nurses working in the home care settings remain largely unknown. Therefore, the aim of this study was to investigate job satisfaction of nurses working in Italian home care settings and its determinants.

Design: Multicenter observational cross-sectional study.

Methods: This study was conducted in the districts of 70 local health authorities in Italy. Data on the characteristics of the organization and nurses were collected. Nursing job satisfaction was evaluated on a four-point scale ranging from "very satisfied" to "very dissatisfied." Additionally, the following variables were assessed: workload, quality of leadership, work-private life conflict, burnout symptoms, possibility for development, staffing and resource adequacy, nurse manager ability, safety climate, and teamwork climate. A logistic regression analysis was conducted to identify factors influencing job satisfaction.

Results: Only organizational variables had a predictive value for nurses' job satisfaction. Workload (OR = 1.01; p = 0.033), work-private life conflict (OR = 1.02; p < 0.001), burnout (OR = 1.02; p < 0.001), and staffing inadequacy (OR = 1.44; p = 0.003) predicted higher levels of nurse dissatisfaction. Instead, high-quality leadership (OR = 0.981; p < 0.001), possibility for development (OR = 0.973; p < 0.001), and good teamwork climate (OR = 0.994; p = 0.003) were predictors of better levels of satisfaction.

Conclusions: This study suggested that home care nurses are generally satisfied with their jobs. To enhance job satisfaction, it is essential to improve nurses' work environment, the leadership quality and ensure professional development.

Clinical relevance: Our results are globally relevant as they contribute to the limited evidence available on this topic in home care settings. This study emphasizes the need of measuring nurses' job satisfaction and implementing interventions to promote healthy work environments.

Introduction: Adverse childhood experiences (ACEs) are associated with an increased risk of developing chronic health conditions, including Alzheimer's disease and related dementias (ADRD) and subjective cognitive decline (SCD), self-reported confusion/memory loss, and an early clinical manifestation of ADRD. While ACEs and SCD have both been individually studied in transgender and nonbinary (TGN) adults, no study has examined the relationship between the two among this population. This study sought to establish the prevalence of ACEs and their association with SCD among TGN adults.

Design: Cross-sectional, secondary analysis of publicly available data.

Methods: 2019-2021 Behavioral Risk Factor Surveillance System data, representing 16 US states that assessed ACEs, SCD, and self-reported gender identity were used to determine the association between ACEs and SCD among TGN adults aged 45+ (N = 206). Pearson's chi-squared/Fisher's exact tests assessed the association between ACEs (individual, categorical, sum score) and SCD. Crude and adjusted odds ratios (aORs) along with 95% confidence intervals (CIs) were calculated to investigate the associations between ACEs and SCD.

Results: 18% (n = 38) of TGN adults in the sample endorsed SCD, 60% (n = 120) experienced any ACE, 20% (n = 41) 1 ACE, and 18% (n = 37) experienced > 4 ACEs. Nearly 50% experienced childhood abuse (n = 94) or household dysfunction (n = 92). Among those with SCD, 34% (n = 13) reported > 4 ACEs, and 73% (n = 26) reported childhood abuse or household dysfunction (n = 27). Most ACES were associated with and increased the risk of SCD, even after adjusting for BRFSS year, age, race, education, and employment. The odds of SCD increased 40% as the number of ACEs increased (aOR = 1.4, 95% CI: 1.2-1.6, p < 0.0001). The odds of SCD were higher with childhood abuse (aOR = 4.3, 95% CI: 1.88-10.02, p < 0.01) or household dysfunction (aOR = 4.7, 95% CI: 2.00-11.07, p < 0.01).

Conclusion: ACEs increase the risk of SCD among TGN adults. Gender-affirming and trauma-informed nursing care are important, and screening and interventions for ACEs and SCD are needed to help reduce the risk of SCD and ADRD.

Clinical relevance: Examining how adverse childhood experiences impact different aspects of health, including brain health, is important to nursing practice as it can provide clinical care strategies and identify interventions to specifically address ways to improve the health and well-being of transgender and nonbinary people.

Aim: To describe the development and implementation of evidence-based teaching strategies for assessing and classifying pressure injuries in older nursing home individuals ≥ 60 years old with darker skin tones.

Design: Pressure injury assessment learning interventions based on pre- and post-test assessments.

Methods: The learning interventions were developed by experts in pressure injury education and were based on empirical evidence, international clinical practice guidelines, and underpinned by social constructivism theory and the integrated interactive teaching model. The teaching strategy was developed to educate research assistants in the assessment of pressure injuries in darker skin tone individuals. The content included requisite knowledge and skills for pressure injury assessment and classification in darker skinned individuals. Using evidence-based teaching strategies, the content was delivered through face-to-face lectures, small group discussions, and practical application sessions delivered using classroom and practical-based activities. Photographic images were used to assess their knowledge and skills in classifying pressure injuries. Four Bachelor of Nursing-qualified registered nurses in Sri Lanka were recruited as research assistants using the new education resource. Using scores from 1 to 20 points, mastery of the theory and practice components was assessed.

Results: The mean pre-test score was 9 ± 1.6 (95% confidence interval 6.4-11.6), demonstrating that assessment and classification of pressure injury knowledge were lacking. The mean post-test score was 16 ± 0.8 (95% confidence interval 14.7-17.3) indicating an improvement in the participants' ability to assess and staging pressure injuries.

Conclusion: Early pressure injury detection among older individuals with darker skin tones is challenging. This evidence-based teaching approach can be used to educate clinical nurses and research assistants in assessing pressure injuries in individuals with darker skin tones.

Clinical relevance: This study contributes to the body of knowledge by improving the early detection and accurate classification of pressure injuries in older nursing home residents with darker skin tones, addressing a significant gap in current nursing practice.

Background: Depressive symptoms are common, worsening heart failure (HF) progression and reducing quality of life. While supervised structured exercise training is effective for managing depressive symptoms, it often demands a substantial time commitment or intensive activity that may discourage participation.

Objective: Evaluate the impacts of reducing sedentary time with short bouts of light physical activities or greater intensity levels on depressive symptoms after HF patients' enrollment in a home-based intervention.

Methods: A total of 127 HF patients participated in an experimental two-group design, randomly allocated to either delayed or immediate decreasing sedentary time intervention. The immediate group started the intervention immediately, while the delayed group began after the first group finished their intervention. The 8-week intervention, guided by the Theory of Planned Behavior, focused on interrupting 30 min of sedentary behavior with short bouts of light- or greater intensity physical activities. Demographic and clinical variables were collected at baseline. Depressive symptoms were assessed at baseline, pre-intervention, and post-intervention. Physical activity (daily steps) was monitored daily during the study period using the Samsung mobile health app.

Results: Both groups demonstrated reduced sedentary time during the intervention, with improvements in HF symptom burden. Repeated measures analysis of variance revealed a significant reduction in depressive symptoms in both groups post-intervention, with a greater reduction seen in the immediate group before the delayed group began the intervention.

Conclusion: The study highlights the effectiveness of interrupting sedentary behavior with light- or greater intensity activities in managing depressive symptoms among HF patients. The home-based intervention, facilitated by mobile technology, provides a feasible and accessible approach to improving mental well-being.

Clinical relevance: The findings support the broader implementation of home-based interventions addressing sedentary time reduction as a valuable strategy for enhancing the mental health of HF patients, particularly those facing challenges with traditional rehabilitation programs or intense exercise.