Journal of Nursing Scholarship最新文献

Background: Postoperative nausea and vomiting (PONV) is a common adverse event after general surgery. This study aimed to examine the effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) for the prevention of nausea and vomiting after laparoscopic surgery.

Method: The Cochrane Library, Pubmed, Embase, and Web of Science databases were accessed from inception to 23 January 2024. The incidence of PONV was the primary outcome measure. The required information size (RIS) of each outcome was estimated by Trial sequential analysis (TSA). The RoB 2.0 tool was used to assess the risk of bias and GRADE to assess the quality of evidence.

Results: Seventeen RCTs including 3698 participants were included. In comparison to the control group, TEAS reduced the incidence of PONV (13 trials, n = 3310; RR, 0.56; 95% CI, 0.46-0.67; I² = 64%; p < 0.01; RIS = 1100), with the level of evidence graded as low. TEAS reduced the incidence of PON (9 trials, n = 2762; RR, 0.64; 95% CI, 0.52-0.79; I² = 57%, p < 0.01; RIS = 1595), and was also associated with a lower incidence of POV (9 trials, n = 2797; RR, 0.53; 95% CI, 0.45-0.63; I² = 0%, p < 0.01; RIS = 773).

Conclusion: The current meta-analysis and TSA provide reliable evidence that TEAS is an effective and safe method to prevent PONV. It may reduce the workload of nursing professionals, alleviate emotional stress, and decrease exposure risk. Adverse events related to TEAS were mild.

Clinical relevance: Nurses can incorporate TEAS into the rehabilitation nursing of patients experiencing PONV.

Purpose: Pain is a frequent post-stroke health concern, and several non-pharmacological interventions are commonly employed to manage it. However, few reviews have examined the effectiveness of such interventions, making it difficult to draw conclusions about their usefulness. Furthermore, subgroup analysis based on post-stroke pain level or intervention characteristics is rarely performed. This study aimed to investigate the effectiveness of non-pharmacological interventions and evaluate the significant factors associated with post-stroke pain through subgroup analysis.

Design: Systematic review and meta-analysis.

Methods: Relevant studies were obtained from seven databases, from their commencement up to March 2024, as well as from the gray literature. The PICOS approach was used to evaluate the eligibility criteria of the studies. The RoB-2 tool was used to determine the risk of bias in each randomized trial. Pooled estimations of standardized mean difference and heterogeneity (quantified with I²) were obtained using a random-effects model. The stability of the pooled result was then assessed using the leave-one-out approach. STATA 17.0 was used to run the meta-analysis.

Findings: Non-pharmacological interventions were effective in reducing pain immediately after intervention (pooled SMDs: -0.79; 95% confidence interval [CI]: -1.06 to -0.53; p < 0.001). The approach involving acupuncture, aquatic therapy, or laser therapy and rehabilitation training was effective for post-stroke hemiplegic shoulder pain. A pooled analysis of non-pharmacological interventions showed that both less than 4 weeks and more than 4 weeks of interventions were effective in alleviating pain in stroke patients.

Conclusion: Non-pharmacological approaches appear to be beneficial for reducing post-stroke pain. The outcomes based on the modalities merit further research.

Clinical relevance: Further studies are needed to determine the effects of different modalities on pain intensity following a stroke. Furthermore, to avoid overestimation of intervention efficacy, future randomized trials should consider blinding approaches to the interventions delivered.

Introduction: Precision Health (PH) holds the promise of revolutionizing healthcare by enabling personalized disease prevention and management through the integration of genomic data, lifestyle factors, environmental influences, and other social determinants of health (SDoH). However, the absence of a baseline assessment of knowledge, skills, and attitudes (KSAs) of practicing nurses' capacity for PH hinders its integration. The purpose of this study is to determine the capacity of practicing Registered Nurses (RNs) for PH across the United States and to assess the validity and reliability of a tool designed for this use-the Precision Health Nurse Capacity Scale (PHNCS).

Design/method: A descriptive exploratory study was conducted to evaluate the capacity of practicing RNs for this evolving phenomenon, PH, using a convenience sample. The survey was sent via email and made available to all members of the American Nurses Association (ANA) who work in a variety of practice environments. The ANA represents the over 4 million nurses practicing in the United States.

Results: The majority of nurse respondents felt it is important for nurses to become more educated about all aspects of PH including SDoH but they lack confidence in the integration of PH. The PHNCS was found to be a valid and reliable tool in measuring the capacity of nurses to practice PH.

Conclusion: The incorporation of PH into nursing practice suffers an immediate impediment: the lack of know-how of the US nursing workforce. This inaugural data on KSAs for PH establishes a logical baseline from which the requisite education and training should commence.

Clinical relevance: Precision Health is an emerging healthcare approach in the United States and globally. Enabling it will require a nursing workforce prepared with the requisite KSAs. Determining the capacity of the nursing workforce is a foundational step to begin this process.

Introduction: Given that stroke is a leading cause of disability and mortality worldwide, there is an urgent need for a coordinated healthcare approach to mitigate its effects. The objectives of this study were to perform a systematic review and meta-analysis of stroke integrated care models and develop recommendations for a representative model.

Design: A systematic review and meta-analysis.

Methods: The literature search identified randomized controlled trials comparing integrated care models with standard care for stroke patients. The included studies followed PICOs inclusion criteria. The qualitative analysis included creating a flowchart for the literature screening process, and tables detailing the basic characteristics of the included studies, the adherence to the ten principles and the results of the quality assessments. Subsequently, quantitative meta-analytical procedures were conducted to statistically pool the data and quantify the effects of the integrated care models on stroke patients' health-related quality of life, activities of daily living, and depression. The China National Knowledge Infrastructure (CNKI), Wanfang Data, Chongqing VIP Chinese Science and Technology Periodical Database (VIP), China Biology Medicine Disc (CBMDISC), Cochrane Library, Cumulated Index to Nursing and Allied Health Literature (CINAHL), PubMed, Web of Science, Embase, Google Scholar, and Clinical Trials were searched from inception to March 13, 2024.

Results: Of the 2547 obtained articles, 19 were systematically reviewed and 15 were included in the meta-analysis. The integrated care models enhanced stroke patients' health-related quality of life, ability to perform activities of daily living, and reduced depression. Adherence to the 10 principles varied: comprehensive services, patient focus, and standardized care delivery had strong implementation, while gaps were noted in geographic coverage, information systems, governance structures, and financial management.

Conclusion: Integrated care models improve outcomes for stroke patients and adherence to the 10 principles is vital for their implementation success. This study's findings call for a more standardized approach to implementing integrated care models, emphasizing the need for integrated services, patient-centred care, and interdisciplinary collaboration, while also addressing the identified gaps in terms of integration efforts.

Clinical relevance: This study provides evidence-based recommendations on the most effective integrated care approaches for stroke patients, potentially leading to better patient outcomes, reduced healthcare costs, and improved quality of life.