Journal of Nursing Scholarship最新文献

Introduction: Non-ventilator hospital-acquired pneumonia (NV HAP) is a common complication for hospitalized patients. NV HAP develops when patients aspirate oral secretions containing pathogenic bacteria. Appropriate oral hygiene can help mitigate NV HAP development. Hospital staff, including nursing assistants, play an important role in ensuring that these cares are completed.

Design: A quasi-experimental pre-post design was used to evaluate outcomes before and after implementation of a structured oral hygiene education program.

Methods: A structured oral hygiene program was developed and implemented in a large quaternary hospital. Change in NA knowledge, attitudes, and behaviors before and after implementation of the oral hygiene program was evaluated. Retrospective patient outcomes before and after the intervention were analyzed to detect changes in NV HAP rates.

Results: Following the education, nursing assistant knowledge of recommended frequency of oral care for patients who are NPO increased (67.2% vs. 82.1%, p = 0.003). NAs were more likely to report oral hygiene tools including oral suctioning (80.8% vs. 90.2%, p = 0.005) and toothbrushes (89.3% vs. 95.3%, p = 0.031). The unadjusted incidence of NV HAP was significantly lower in the post-intervention cohort (0.25%) compared to the pre-intervention cohort (0.74%), p < 0.001. In the adjusted model, non-invasive positive pressure ventilation increased the odds of NV HAP by nearly sevenfold (AOR = 6.88, 95% CI: 3.99, 11.39).

Conclusion: Focused education for NAs is an effective strategy to increase knowledge related to oral hygiene. Implementing a structured oral hygiene program for NAs appears to be a promising practice to decrease NV HAP.

Introduction: The effectiveness of health interventions delivered via a combination of in-person and electronic social networking services for caregivers of stroke survivors remains uncertain. This study evaluates the feasibility of implementing educational and peer support programs for these caregivers through such platforms.

Design: Quasi-experimental design.

Methods: This study included 105 caregiver-survivor dyads, with 54 dyads allocated to the intervention group and the remaining 51 to the control group. The LINE intervention comprised a combination of in-person and electronic social networking services including stroke and rehabilitation education, problem-solving skills training, long-term care information support, and 24-h peer and professional support for caregivers. The outcomes were assessed at baseline, after 1 month, and after 3 months, and encompassed caregivers' care burden, depressive symptoms, perceived social support, and quality of life, as well as the rehabilitation adherence and depressive symptoms of stroke survivors. Generalized estimating equations were used to examine group differences. The data were collected between August 2021 and October 2022.

Results: The average age of the caregivers was 48.3 years. Caregivers in the intervention group reported reduced care burdens and enhanced perceptions of social support and quality of life as compared to those in the control group. Additionally, stroke survivors in the intervention group were less likely to exhibit high-risk depressive symptoms.

Conclusion: Delivering a stroke caregiver support intervention via in-person and electronic social networking services, such as LINE, effectively reduced the care burden for caregivers of stroke survivors. Additionally, it enhanced caregivers' perceived social support and quality of life.

Clinical relevance: This study demonstrated that caregiver education and peer support programs administered through a combination of in-person and electronic social networking services can serve as an effective support system for the psychosocial health of stroke caregivers. These findings support the integration of such interventions into standard clinical practice by healthcare providers or governmental bodies.

Introduction: While the nurse practice environment's vital role in shaping patient care outcomes is well established, the precise mechanisms through which it influences missed nursing care remain unexplored. Hence, this study examined the mediating role of adherence to clinical safety guidelines in the relationship between the nurse practice environment and missed nursing care.

Methods: This descriptive, cross-sectional study involved 1237 nurses from 11 governorates in the Sultanate of Oman. Data were collected using three standardized scales: the Patient Safety Adherence Scale, the Practice Environment Scale of the Nursing Work Index, and the Missed Nursing Care Scale.

Results: A favorable nurse practice environment was associated with higher adherence to clinical safety guidelines (β = 2.492, p < 0.001) and a lower frequency of missed nursing care (β = -0.2919, p = 0.015). Adherence to clinical safety guidelines partially mediated the relationship between the nurse practice environment and missed nursing care (β = -0.055, p < 0.001).

Conclusion: Enhancing the nurse practice environment plays a crucial role in improving nurses' adherence to clinical safety guidelines, which in turn reduces compromised nursing care.

Clinical relevance: Healthcare administrators and policymakers should prioritize improving working conditions to enhance nurses' adherence to clinical safety guidelines, thereby minimizing the occurrence of missed care and improving overall patient outcomes.

Introduction: Building resilience among nurses has been postulated as one of the key strategies to support nurses and retain them in the profession. This study aimed to evaluate the effectiveness, of spaced education pedagogy in enhancing Nurses' knowledge on emotional resilience. Secondary objectives include evaluation of the usability and acceptability of delivery of the training via a mobile application in one's own mobile device.

Design: A quasi-experimental study with single group pre-test and post-test trial was conducted.

Methods: Full-time registered nurses working in an acute care hospital were invited to participate from June 2021 to June 2022. The group used the mobile application daily for 1 month. Pre-test measurement includes socio-demographic data and baseline resilience level before the intervention. Post-test measurement includes resilience level, usability and acceptability of mobile-assisted cognitive-behavioral therapy measured upon completion of the training. The mobile application enabled the delivery of resilience educational content in small quantities through a repeating manner, with a concurrent evaluation of learner's understanding.

Results: When compared to their baseline (mean = 24.38, SD = 5.50), participants reported significant increase in the Connor-Davison Resilience Scale score (mean = 26.33, SD = 5.57) (t = -4.40, p < 0.001). Upon 1 month usage of the mobile application, a higher percentage of the participants reported intermediate to high level of resilience (57.4%), as compared to prior usage (54.7%). Respondents reported knowledge of most useful strategies for their daily lives including: (i) managing negative emotions (54.1%); (ii) psychoeducation about mental health and the risks of burnout (44.7%); (iii) achieving work and life balance (43.5%); and (iv) depiction of workplace scenarios to demonstrate what can be and cannot be controlled during times of change (43.5%). Participants reported usability of the mobile application with a mean SUS score 70.5 (SD = 13.0), which was considered "acceptable." Overall, 82.3% of the participants found the mobile application appealing, 64.7% reported they were likely to use the mobile application in the future and 72.9% would recommend it to other nurses.

Conclusion: The mobile application provided nurses with the availability and convenience to access resilience building learning content integrated with the spaced education pedagogy.

Clinical relevance: The use of mobile-assisted cognitive behavioral training can aid in increasing nurses' resilience level. Nurses provided acceptable usability ratings and satisfactory acceptance of receiving training via the mobile application, showing promising opportunities in the improvement of overall well-being.

Introduction: The increase in risky sexual behaviors among adolescent students has sparked alarm and has become an area of research interest. As adolescents prioritize confidentiality and accessibility, digital interventions are becoming increasingly relevant in sex education. We therefore posed the following research question: Are digital application interventions effective to prevent risky sexual behaviors in school adolescents?

Design: A systematic peer review was conducted between January and December 2023 in five databases (PubMed, Web of Science, Scopus, EMBASE, and PsycINFO) without restricting for language or year of publication.

Method: We included randomized control trials or quasi-experimental studies that measured the effectiveness of interventions targeting young people aged 10-19 years or their parents and developed in a school setting. Interventions aimed at young people with intellectual disabilities, learning difficulties, or any disease requiring a specific intervention were excluded.

Results: The search ultimately yielded 27 studies covering a total of 18 digital interventions that demonstrated positive effects, not maintained over time, on knowledge, attitudes, and behaviors, although the latter to a lesser extent.

Discussion: We have found very interesting digital interventions with effects, among others, on knowledge, attitudes, and contraceptive use in adolescents. In general, digital interventions have positive effects on knowledge and attitudes, but it is more difficult to modify behaviors with strictly digital interventions or combined with complementary face-to-face sessions or group class activities.

Conclusion: We thus believe that digital interventions are adequate to reduce adolescent sexual risk behaviors, and our systematic review facilitates the implementation of these interventions by sharing existing digital interventions that have had positive effects, as well as the main characteristics a digital intervention should possess to reduce sexually risky behaviors in adolescents.

Clinical relevance: Digital interventions with adolescents improve sexual behaviors and can be a valuable resource in education on this topic due to their accessibility and confidentiality, two key points for young people.