Journal of Nursing Scholarship最新文献_第6页

Global Prevalence, Incidence, and Factors Influencing Falls in Older Adults With Dementia: Implications for Nursing and Healthy Aging 老年痴呆患者跌倒的全球患病率、发病率和影响因素：对护理和健康老龄化的启示

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2025-04-16 DOI: 10.1111/jnu.70012

Tiara Octary, Chien-Mei Sung, Ruey Chen, Kai-Jo Chiang, Chiu-Kuei Lee, Hidayat Arifin, Kondwani Joseph Banda, Kuei-Ru Chou

Introduction

Dementia notably increases fall risk in older adults, leading to major injuries and considerable concerns from health-care professionals. However, comprehensive evidence regarding the prevalence, incidence rate, and moderating factors of falls in institutional settings is limited. This study aimed to evaluate the prevalence, incidence rates, and moderating factors of falls among older adults with dementia in nursing homes and dementia-specialized care units.

Design

A meta-analysis.

Methods

We searched CINAHL, PubMed, Embase, ProQuest, Scopus, Web of Science, and PsycINFO from database inception to April 30, 2024. Older adults with dementia in nursing homes or dementia-specialized care units were included. The pooled prevalence was analyzed using a generalized linear mixed model with random effects using R software. Incidence rates were reported per person-year using comprehensive meta-analysis software. Study quality was assessed using Hoy's criteria. Variations in the pooled prevalence of falls were explored through moderator analyses.

Results

This meta-analysis included 21 studies involving 35,449 participants. The pooled prevalence of falls was 45.6%, with subtypes showing 39.2%, 35.2%, and 29.0% among Alzheimer's dementia, vascular dementia, and mixed dementia subtypes, respectively. Falls were more prevalent in dementia-specialized care units (53.0%) than in nursing homes (42.6%). The overall incidence rate was 3.61 per person-year, higher in dementia-specialized care units (5.80) than in nursing homes (3.17). Subgroup analyses revealed higher fall prevalence in women (70.0%) than in men (30.6%). Meta-regression indicated that comorbidities, including delirium, visual impairment, and arthritis, increased fall risk.

Conclusions

This meta-analysis revealed a high incidence of falls in nearly half of older adults with dementia, particularly among those in dementia specialized care units.

Clinical Relevance

Healthcare professionals should prioritize regular fall risk assessments, tailored interventions, and environmental safety modifications, particularly in dementia-specialized care units, to reduce fall-related injuries and improve patient outcomes.

导言：痴呆症显著增加老年人跌倒的风险，导致重大伤害，并引起卫生保健专业人员的极大关注。然而，关于机构环境中跌倒的患病率、发病率和调节因素的综合证据有限。本研究旨在评估养老院和痴呆症专科护理单位中老年痴呆症患者跌倒的患病率、发病率和调节因素。设计：荟萃分析。方法：检索CINAHL、PubMed、Embase、ProQuest、Scopus、Web of Science、PsycINFO自建库至2024年4月30日的文献。在养老院或痴呆症专门护理单位的老年痴呆症患者也包括在内。采用R软件，采用随机效应的广义线性混合模型对合并患病率进行分析。使用综合荟萃分析软件报告人均年发病率。采用Hoy标准评估研究质量。通过调节分析探讨了跌倒总发生率的变化。结果：本荟萃分析包括21项研究，涉及35,449名参与者。跌倒的总患病率为45.6%，其中阿尔茨海默氏痴呆、血管性痴呆和混合性痴呆亚型分别为39.2%、35.2%和29.0%。跌倒在痴呆症专科护理单位（53.0%）比在养老院（42.6%）更为普遍。总体发病率为每人每年3.61例，在痴呆症专科护理单位（5.80例）高于疗养院（3.17例）。亚组分析显示，女性的跌倒患病率（70.0%）高于男性（30.6%）。荟萃回归显示，包括谵妄、视力损害和关节炎在内的合并症增加了跌倒的风险。结论：这项荟萃分析显示，近一半的老年痴呆症患者跌倒的发生率很高，特别是在痴呆症专科护理病房的患者。临床相关性：医疗保健专业人员应优先考虑定期的跌倒风险评估、量身定制的干预措施和环境安全改造，特别是在痴呆症专科护理单位，以减少跌倒相关伤害并改善患者预后。

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引用次数: 0

The Effect of an Integrative Cognitive Training Program by Family Caregivers on Cognitive Function Among Persons With Traumatic Brain Injury: A Randomized Controlled Trial 家庭照顾者的综合认知训练计划对创伤性脑损伤患者认知功能的影响：一项随机对照试验。

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2025-04-16 DOI: 10.1111/jnu.70011

Uraporn Chuaykarn, Ratsiri Thato, Elizabeth A. Crago

<div> <section> <h3> Purpose</h3> <p>This study aimed to examine the effect of an integrative cognitive training program by family caregivers on cognitive function among persons with traumatic brain injury.</p> </section> <section> <h3> Design</h3> <p>A randomized controlled trial, repeated measures design was utilized.</p> </section> <section> <h3> Methods</h3> <p>The participants were adult persons diagnosed with mild-to-moderate TBI and their family caregivers. They were recruited from the neurology ward at a tertiary hospital in Thailand. One hundred participants were randomly assigned to the experimental group (<i>n</i> = 50) and the control group (<i>n</i> = 50). The experimental group received an integrative cognitive training program from family caregivers based on the theory of neural plasticity in combination with a systematic review, while the control group received usual care. Cognitive function was assessed at baseline and week 2, week 4, and week 6 follow-up using the Montreal Cognitive Assessment. Data were analyzed using descriptive statistics, Chi-square, Fisher's exact test, and repeated measures ANOVA.</p> </section> <section> <h3> Findings</h3> <p>The results showed a significant improvement in cognitive function scores in the experimental group over time (<i>p</i> < 0.001). Additionally, participants in the experimental group who received an integrative cognitive training program by family caregivers demonstrated significantly higher cognitive function scores compared to the control group at week 4 and week 6 follow-up assessments (<i>p</i> < 0.001). The effect sizes were large (<i>η</i> <sup>2</sup> = 0.14) with a test power of 90%.</p> </section> <section> <h3> Conclusions</h3> <p>An integrative cognitive training program can enhance neuroplasticity and improve cognitive function among persons with mild-to-moderate traumatic brain injury. Moreover, involving family caregivers in the rehabilitation process can improve community engagement and cognitive abilities in persons with traumatic brain injury.</p> </section> <section> <h3> Clinical Relevance</h3> <p>Healthcare professionals in neurological settings should incorporate an integrative cognitive training program into their usual care and educate family caregivers to continue the intervention at home for improving cognitive function among persons with mild-to-moderate traumatic brain injury.</p> </section> <section> <h3>

目的：本研究旨在探讨家庭照顾者的综合认知训练计划对创伤性脑损伤患者认知功能的影响。设计：采用随机对照试验，重复测量设计。方法：参与者是被诊断为轻中度TBI的成年人及其家庭照顾者。他们是从泰国一家三级医院的神经内科病房招募的。100名参与者被随机分为实验组（n = 50）和对照组（n = 50）。实验组接受基于神经可塑性理论并结合系统评价的家庭照顾者综合认知训练，对照组接受常规护理。认知功能在基线和第2周、第4周和第6周随访时使用蒙特利尔认知评估进行评估。数据分析采用描述性统计、卡方检验、Fisher精确检验和重复测量方差分析。结果显示实验组的认知功能评分随时间的推移有显著改善（p 2 = 0.14），测试功率为90%。结论：综合认知训练可提高轻中度颅脑损伤患者的神经可塑性，改善认知功能。此外，让家庭照顾者参与康复过程可以提高创伤性脑损伤患者的社区参与和认知能力。临床相关性：神经内科的医疗保健专业人员应该将综合认知训练项目纳入他们的日常护理，并教育家庭护理人员继续在家中进行干预，以改善轻度至中度创伤性脑损伤患者的认知功能。试验报名：TCTR20230828002。

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引用次数: 0

Experiences and Challenges of Rural Nurses in Botswana Handling Births Outside the Hospital Environment 博茨瓦纳农村护士处理医院外分娩的经验和挑战。

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2025-04-15 DOI: 10.1111/jnu.70015

Tebogo T. Mamalelala, William L. Holzemer, Esther S. Seloilwe, Emilia Iwu

Aim

This study aims to explore the experiences and challenges faced by rural nurses in Botswana who manage births outside the hospital environment, providing insights into the impact of these experiences on maternal and neonatal health outcomes.

Design

A qualitative descriptive design was employed to gain a comprehensive understanding of the participants' perspectives and experiences.

Methods

Twenty-six registered nurses from four remote health districts in Botswana were selected using a purposive convenience sampling technique. Semi-structured interviews were conducted to gather in-depth data regarding their experiences managing childbirth in rural settings.

Results

The analysis revealed that nurses face significant emotional and practical challenges, including feeling unprepared for emergencies, lack of access to resources, and high levels of stress associated with managing complications without specialized training. Many participants reported a strong commitment to their communities despite the hurdles, underscoring their vital roles in maternal healthcare.

Discussion

The findings indicate a pressing need for enhanced training programs and support systems for rural nurses to better equip them for the complexities of childbirth management outside hospital settings. Addressing these gaps is essential to improve clinical outcomes for mothers and infants and to minimize the risks associated with unsupervised births.

Clinical Relevance

This study highlights the crucial role rural nurses play in maternal health and stresses the need for targeted training and policy interventions. By strengthening the capacity of these healthcare providers, we can work toward reducing maternal and neonatal morbidity and mortality rates in Botswana and similar rural settings worldwide.

目的：本研究旨在探讨博茨瓦纳农村护士在医院环境外管理分娩所面临的经验和挑战，为这些经验对孕产妇和新生儿健康结果的影响提供见解。设计：采用定性描述性设计来全面了解参与者的观点和经历。方法：采用有目的的方便抽样方法，从博茨瓦纳4个偏远卫生区抽取26名注册护士。进行了半结构化访谈，以收集有关她们在农村环境中管理分娩经验的深入数据。结果：分析显示，护士面临着重大的情感和实际挑战，包括对紧急情况毫无准备，缺乏资源，以及在没有经过专门培训的情况下处理并发症的高水平压力。许多参与者报告说，尽管存在障碍，但他们对社区作出了坚定的承诺，强调了他们在孕产妇保健方面的重要作用。讨论：研究结果表明，迫切需要加强对农村护士的培训计划和支持系统，使她们更好地掌握医院外分娩管理的复杂性。解决这些差距对于改善母亲和婴儿的临床结果以及尽量减少与无监护分娩相关的风险至关重要。临床相关性：这项研究强调了农村护士在孕产妇保健中发挥的关键作用，并强调需要进行有针对性的培训和政策干预。通过加强这些保健提供者的能力，我们可以努力降低博茨瓦纳和世界各地类似农村地区的孕产妇和新生儿发病率和死亡率。

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引用次数: 0

Experiences of Family Caregivers of Children Aged 1–23 Months Who Have Received Pediatric Palliative Care: A Systematic Review With Qualitative Metasynthesis 接受过儿科姑息治疗的 1-23 个月大儿童的家庭照护者的经历：系统综述与定性综合》。

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2025-04-01 DOI: 10.1111/jnu.70008

Juan Manuel Vázquez Sánchez, Manuela Rodríguez Sánchez, Emilio Mota Romero, Ana Alejandra Esteban Burgos, Rafael Montoya Juárez, César Hueso Montoro, Daniel Puente Fernández

<div> <section> <h3> Introduction</h3> <p>Family caregivers of children receiving pediatric palliative care (PPC) play a crucial role in their care and wellbeing, especially during the early stages of life.</p> </section> <section> <h3> Objective</h3> <p>To explore the experience of family caregivers of children aged 1–23 months who are receiving pediatric palliative care (PPC).</p> </section> <section> <h3> Methods</h3> <p>A systematic review of qualitative studies was conducted using the databases PubMed, Scopus, Web of Science, CINAHL, PsycINFO, and Cuiden. The studies were appraised using the Critical Appraisal Skills Programme tool. The selected studies were synthesized using Noblit and Hare's meta-ethnographic method.</p> </section> <section> <h3> Results</h3> <p>Eleven studies, 169 themes, 36 metaphors and four main themes were identified. Caregivers develop coping strategies related to meaning-making, faith, maintaining hope, and decision-making abilities. They perceive limited time with the child due to structural constraints and the child's deteriorating health, which sometimes prevents them from recognizing their child's identity. Caregivers strive to remain united and rebuild the daily family life they long for, but face challenges related to self-care, maintaining employment, and caring for siblings and their partner. In many cases, they are unsatisfied with the care they receive, attributed to a lack of technical training and understanding of the principles of pediatric palliative care (PPC) by healthcare staff, poor communication skills, and inadequate coordination. Caregivers highlight the role of nurses and the PPC team, advanced care planning, and post-mortem care as positive aspects.</p> </section> <section> <h3> Discussion/Conclusion</h3> <p>Caregivers' experiences reveal coping strategies, active decision-making, constant challenges, healthcare interactions, and a need for improved comprehensive support.</p> </section> <section> <h3> Clinical Relevance</h3> <p>This study underscores the importance of addressing the unique needs of family caregivers of children aged 1–23 months receiving pediatric palliative care (PPC), highlighting their struggles with social isolation, neglected self-care, and disrupted family life. Healthcare providers should prioritize age-specific approaches to PPC, focusing on improving communication, care

简介：接受儿科姑息关怀（PPC）的儿童的家庭照护者在儿童的照护和福祉方面发挥着至关重要的作用，尤其是在生命的早期阶段：探讨接受儿科姑息关怀（PPC）的 1-23 个月大儿童的家庭照护者的经验：使用 PubMed、Scopus、Web of Science、CINAHL、PsycINFO 和 Cuiden 等数据库对定性研究进行了系统性综述。研究采用批判性评估技能计划工具进行评估。采用 Noblit 和 Hare 的元人种学方法对所选研究进行了综合：结果：确定了 11 项研究、169 个主题、36 个隐喻和 4 个主要主题。照顾者制定的应对策略与意义建构、信仰、保持希望和决策能力有关。由于结构上的限制和孩子健康状况的恶化，他们认为与孩子在一起的时间有限，这有时会阻碍他们认识到孩子的身份。照顾者努力保持团结，重建他们渴望的日常家庭生活，但他们面临着自我照顾、维持就业、照顾兄弟姐妹和伴侣等方面的挑战。在许多情况下，他们对所接受的护理并不满意，原因在于医护人员缺乏技术培训和对儿科姑息关怀（PPC）原则的理解、沟通技巧不佳以及协调不足。护理者强调护士和姑息关怀团队的作用、晚期护理计划和死后护理是积极的方面：护理人员的经历揭示了应对策略、积极决策、持续挑战、医护互动以及改善全面支持的必要性：本研究强调了满足接受儿科姑息治疗（PPC）的 1-23 个月大儿童的家庭照顾者的独特需求的重要性，突出了他们在社会隔离、自我护理被忽视以及家庭生活被打乱等方面的挣扎。医疗服务提供者应优先考虑针对特定年龄段的姑息治疗方法，重点改善沟通、护理协调和对姑息治疗原则的理解，以更好地支持这些照顾者。

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引用次数: 0

Caregiver Contribution to Patient Self-Care in Multiple Chronic Conditions in a Low-/Middle-Income Country 照顾者对低收入/中等收入国家多种慢性疾病患者自我护理的贡献。

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2025-03-28 DOI: 10.1111/jnu.70010

Sajmira Adëraj, Alta Arapi, Rocco Mazzotta, Manuela Saurini, Dasilva Taҫi, Dhurata Ivziku, Vicente Bernalte-Martí, Alessandro Stievano, Ercole Vellone, Gennaro Rocco, Maddalena De Maria

<div> <section> <h3> Introduction</h3> <p>Caregivers make an essential contribution to the self-care of patients with multiple chronic conditions (MCCs), but no studies have described caregiver contribution (CC) and caregiver self-efficacy in contributing to patient self-care in low-/middle-income countries (LMICs). This study aimed to describe the CC to patient self-care and caregiver self-efficacy of patients affected by MCCs living in a low-middle-income country such as Albania.</p> </section> <section> <h3> Design</h3> <p>A Multicenter cross-sectional study design was used.</p> </section> <section> <h3> Methods</h3> <p>A sample of 376 Albanian caregivers was enrolled if identified by the patient with MCCs as the primary unpaid informal caregiver in outpatient settings in Albania. The Caregiver Contribution to Self-Care of Chronic Illness Inventory (CC-SCCII) and the Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale (CSE-CSC) were used to measure the CC to patient self-care maintenance, monitoring, and management and the caregiver's confidence in their ability to contribute to patient self-care, respectively.</p> </section> <section> <h3> Results</h3> <p>Participants' mean age was 48.10 (15.14) years. Most of the caregivers were women (67.9%), adult children (53.2%) or spouses (46.8%) of the patient. Regarding the CC to self-care maintenance, inadequate behaviors were observed in caregiver recommendations for physical activity (41%) and stress management (33%). In the CC to patient self-care monitoring, inadequate behaviors in recognition of symptoms were reported (20%) by caregivers. In the CC to patient self-care management, inadequate behaviors were found in caregiver ability to recognize reflecting on the effectiveness of the remedy used to manage signs and symptoms of the patient's illness (60%) and in alerting the healthcare provider (25%). Caregiver self-efficacy was lower in the ability to persist in finding a remedy for symptoms of the person for whom they care (27%) and to evaluate the effectiveness of a remedy they used (27%).</p> </section> <section> <h3> Conclusion</h3> <p>We found, on average, adequate CC to patient self-care maintenance, monitoring, management behaviors, and caregiver self-efficacy in contributing to patient self-care of MCCs, but specific CC behaviors were found to be insufficient.</p> </section> <section> <h3> Clinical Relevance</h3> <p>This study described CC and caregiver self-efficacy in contributing to patient self

导言：护理人员对多种慢性疾病患者的自我护理做出了重要贡献，但在中低收入国家（LMICs），没有研究描述护理人员的贡献（CC）和护理人员的自我效能对患者自我护理的贡献。本研究旨在描述生活在阿尔巴尼亚等中低收入国家受mcc影响的患者的CC对患者自我护理和护理者自我效能的影响。设计：采用多中心横断面研究设计。方法：一个样本的376阿尔巴尼亚护理人员被确定，如果患者与mcc作为主要无偿非正式护理人员在门诊设置在阿尔巴尼亚。采用《慢性疾病护理人员自我护理贡献量表》（CC- sccii）和《护理人员自我护理贡献量表》（CSE-CSC）分别测量护理人员自我护理维持、监测和管理能力的CC和护理人员对自我护理贡献能力的信心。结果：参与者平均年龄为48.10岁（15.14岁）。照顾者以女性（67.9%）、成年子女（53.2%）和配偶（46.8%）居多。在自我护理维持的CC方面，护理人员在体力活动建议（41%）和压力管理（33%）方面的行为不足。在CC对患者自我护理监测中，护理人员报告的症状识别行为不足（20%）。在CC患者自我护理管理中，发现护理人员在识别反映用于管理患者疾病体征和症状的补救措施有效性的能力（60%）和提醒医疗保健提供者（25%）方面的行为不足。照顾者的自我效能在坚持为他们所照顾的人的症状寻找治疗方法的能力（27%）和评估他们使用的治疗方法的有效性（27%）方面较低。结论：我们发现，平均而言，足够的CC对患者自我保健维持、监测、管理行为和护理人员自我效能感有助于mcc患者自我保健，但具体的CC行为发现不足。临床相关性：本研究描述了CC和护理人员自我效能感对中低收入国家患者自我护理的贡献。这些知识将使医疗保健专业人员能够确定护理人员对自我保健的贡献不足，并通过有针对性的教育干预措施加强这些贡献，从而优化这些情况下可用的稀缺资源。

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引用次数: 0

Competence, Solidarity and Kindness: Nursing's Best Weapons 能力、团结和仁慈：护理工作的最佳武器。

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2025-03-25 DOI: 10.1111/jnu.70009

Miriam J. Hirschfeld

引用次数: 0

Does Grit Matter? The Relationship Between Grit and Drinking Behavior Among Adolescents: A Cross-Sectional Study of a Nationally Representative Sample of Korean Adolescents 勇气重要吗？坚毅与青少年饮酒行为的关系：韩国青少年全国代表性样本的横断面研究。

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2025-03-22 DOI: 10.1111/jnu.70007

Yunji Han, Yeji Hwang

Introduction

Drinking is the most problematic health behavior among adolescents. Adolescent drinking behavior is likely to continue into adulthood and can lead to various social problems, development of multiple diseases, and even death. Grit is defined as the ability to persist in the face of a struggle. While grit can be a protective factor against risky health behaviors, there is a lack of information on how grit is related to adolescent drinking behavior. Based on the integrative model of adolescent health risk behavior, this study aimed to examine how intrapersonal, interpersonal, and cultural/environmental factors were related to adolescent drinking behaviors. Especially, this study aimed to examine the relationship between grit and adolescent drinking behavior by adding grit as a psychosocial maturity factor.

Design

A cross-sectional study using a nationally representative sample of Korean adolescents.

Methods

A secondary data analysis of the 5th wave of the Korean children and youth panel survey (N = 2252) was conducted. The study sample comprised 11th-grade high school students. Descriptive statistics and logistic regression analyses were performed

Results

Model 1 included intrapersonal, interpersonal, and cultural/environmental factors associated with adolescent drinking behavior. Model 2 added grit to the factors in model 1 to examine how grit is related to adolescent drinking behavior. After controlling for intrapersonal, interpersonal, and cultural/environmental factors, a higher level of grit was associated with lower odds of drinking behavior among adolescents (OR = 0.413, 95% CI = 0.257–0.662, p < 0.001)

Conclusion

A higher level of grit was associated with lower odds of drinking behavior among adolescents after adjusting for intrapersonal, interpersonal, and cultural/environmental factors

Clinical Relevance

As grit can help deter risky health behaviors, guardians, teachers, and school nurses should focus on fostering grit among adolescents through education, mentorship, and intervention programs

饮酒是青少年中最具问题的健康行为。青少年的饮酒行为很可能会持续到成年，并可能导致各种社会问题，多种疾病的发展，甚至死亡。毅力被定义为面对斗争坚持不懈的能力。虽然勇气是防止危险健康行为的保护因素，但缺乏关于勇气与青少年饮酒行为之间关系的信息。基于青少年健康风险行为的综合模型，本研究旨在探讨内省因素、人际因素和文化/环境因素对青少年饮酒行为的影响。特别是，本研究旨在通过将坚毅作为心理社会成熟度因素来研究坚毅与青少年饮酒行为之间的关系。设计：采用具有全国代表性的韩国青少年样本进行横断面研究。方法：对韩国第五次儿童青少年小组调查（N = 2252）的二次资料进行分析。研究样本包括11年级的高中生。结果：模型1包括与青少年饮酒行为相关的个人、人际和文化/环境因素。模型2将砂砾添加到模型1的因素中，以检验砂砾与青少年饮酒行为的关系。在控制了个人、人际关系和文化/环境因素后，较高水平的砂砾与青少年较低的饮酒行为几率相关(OR = 0.413, 95% CI = 0.257-0.662, p

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引用次数: 0

Supporting Nurse Leaders to Recognize and Intervene in Team Members' Suicidality 支持护士长认识和干预团队成员的自杀倾向。

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2025-03-21 DOI: 10.1111/jnu.70006

Kristina E. James, Julia Rogers, Rachael Accardi, Gokarna Aryal, Patti Ludwig-Beymer, Judy E. Davidson

<div> <section> <h3> Introduction</h3> <p>Nurses and healthcare support staff have a higher suicide risk than the public. This elevated risk calls for increased efforts to support mental health. Additionally, nursing leaders' education on employee-specific suicide prevention is lacking.</p> </section> <section> <h3> Design</h3> <p>An evidence-based project was implemented using the PICO question: Among nurse leaders at an academic healthcare system in California, does the provision of an educational program using role-playing practice and the creation of a suicide prevention toolkit versus no standard education or training improve self-efficacy and knowledge on how to take action with a team member who is suspected of being suicidal or voicing suicidal ideation?</p> </section> <section> <h3> Methods</h3> <p>Education sessions were planned based on the literature, with surveys collected preintervention, immediately posteducation, and 1-month postintervention to assess suicide prevention self-efficacy and knowledge. Knowledge was measured using a researcher-constructed questionnaire validated by six suicide prevention experts. The General Self-Efficacy Scale (range: 10–40) was used.</p> </section> <section> <h3> Results</h3> <p>Sixty participants attended one of 11 scheduled remote-learning sessions. Mean self-efficacy significantly improved (pre: 31.3 [<i>n</i> = 46, min: 18, max: 40]; immediate post: 33.49 [<i>n</i> = 37, min: 24, max: 40]; 1-month post: 33.77 [<i>n</i> = 31, min: 28, max: 40]) (<i>X</i> <sup>2</sup> = 8.0184, df = 2, <i>p</i> = 0.01815). The proportion of incorrect knowledge questions was significantly lower postintervention (mean pre: 24.5%, immediate post: 11.5%, 1-month post: 10.7<i>%, X</i> <sup>2</sup> = 23.195, df = 2, <i>p</i> = 0.000001). All participants (100%, <i>n</i> = 55) recommended the program. Leaders reported feeling better prepared to support suicidal employees.</p> </section> <section> <h3> Conclusion</h3> <p>Project results demonstrate the need to provide suicide prevention training for leaders. The authors recommend requiring training/return demonstration competency as a component of new leaders' onboarding. This program can easily be modified for nurses from prelicensure through senior leadership.</p> </section> <section> <h3> Clinical Relevance</h3> <p>Suicide rates in hea

导言：护士和卫生保健支持人员比公众有更高的自杀风险。这种风险的增加要求加大对精神卫生的支持力度。此外，护理领导缺乏针对员工的自杀预防教育。设计：一个基于证据的项目使用PICO问题来实施：在加利福尼亚的一个学术医疗保健系统的护士领导中，提供一个使用角色扮演实践的教育项目和创建自杀预防工具包，与没有标准的教育或培训相比，是否提高了自我效能感和如何对怀疑有自杀倾向或表达自杀想法的团队成员采取行动的知识？方法：根据文献规划教育课程，在干预前、干预后立即和干预后1个月收集问卷，评估自杀预防自我效能感和知识。知识是通过研究人员构建的问卷来测量的，该问卷由六名自杀预防专家验证。采用一般自我效能量表（范围：10-40）。结果：60名参与者参加了11次预定的远程学习会议之一。平均自我效能显著提高(pre: 31.3 [n = 46, min: 18, max: 40]；即时发帖：33.49 [n = 37, min: 24, max: 40]；个月后:33.77 (n = 31日分钟:28日,马克斯:40))(X2 = 8.0184, df = 2, p = 0.01815)。干预后知识题错误率显著降低（干预前平均24.5%，干预后立即平均11.5%，干预后1个月平均10.7%,X2 = 23.195, df = 2, p = 0.000001）。所有参与者（100%,n = 55）都推荐了该方案。领导们报告说，他们在支持有自杀倾向的员工方面做了更好的准备。结论：项目结果表明有必要为领导提供自杀预防培训。作者建议将培训/回报展示能力作为新领导者入职的一个组成部分。这个程序可以很容易地修改护士从执照预审到高级领导。临床相关性：医疗保健人员的自杀率高于一般人群。自杀预防计划可以帮助护理领导更好地准备支持和连接有风险的医护人员与资源。

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引用次数: 0

What Is a Good Death in South Asia? A Systematic Review and Narrative Synthesis 在南亚什么是善死？系统回顾与叙事综合。

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2025-03-18 DOI: 10.1111/jnu.70002

Lihini Wijeyaratne, Odette Spruijt, Saroj Jayasinghe, Sumit Kane, Udayangani Ramadasa, Jennifer Philip

<div> <section> <h3> Introduction</h3> <p>To deliver palliative care, it is important to understand what a “good death” means to the relevant people. Such studies have mostly occurred in high-income settings that usually live by Western ideals. What matters to people is likely to vary across different regions of the world, influenced by multiple factors. Although there is a great need for palliative care in South Asia, there is a lack of comprehensive understanding of what a good death means in this setting. This study aimed to increase understanding of what is considered a good death in South Asia.</p> </section> <section> <h3> Design</h3> <p>Systematic review and narrative synthesis.</p> </section> <section> <h3> Method</h3> <p>A systematic search was conducted across eight databases, an Advanced Google search, and a bibliography search of selected articles. A data-based convergent synthesis was performed, along with quality appraisal.</p> </section> <section> <h3> Results</h3> <p>Twenty-five empirical studies were selected for analysis from India, Pakistan, Bangladesh, Sri Lanka, and Bhutan. Four themes emerged. <i>Mutual care and connection support a continued sense of self</i>: contributing to others, while receiving connection through relationships and spiritual practices, was important for patients and supported by families and healthcare workers. <i>Freedom to choose—privilege or burden</i>?: the choice to participate in care was necessary for some patients but a burden for others, who preferred the family to lead their care. Severe uncontrolled pain and financial distress precluded choice for some patients, who felt death was the only option. Decisions regarding artificial prolongation of life were complex for patients and healthcare workers. <i>Opportunities in the last days</i>: when actively dying, there was general agreement on the importance of being pain-free, feeling safe, and having family present. Home was not always the preferred place of death. For family, it was critical to perform last rites. <i>After death matters</i>: What happens after death—influenced by leaving a legacy and religious beliefs—affected all parties before, during, and post-death.</p> </section> <section> <h3> Conclusions</h3> <p>To our knowledge, this is the first review of what a good death means in South Asia. There is a dearth of research from most South Asian countries. Although the South Asian perspective has similarities with the Western perspective, w

导言：为了提供姑息治疗，重要的是要了解“善终”对相关人员意味着什么。这类研究大多发生在通常按照西方理想生活的高收入国家。受多种因素影响，世界不同地区对人们重要的事情可能有所不同。尽管南亚非常需要姑息治疗，但在这种情况下，人们对善终的含义缺乏全面的了解。这项研究的目的是增加对在南亚被认为是善死的理解。设计：系统回顾和叙事综合。方法：对8个数据库进行系统检索，进行高级谷歌检索，并对选定的文章进行书目检索。进行了基于数据的收敛综合，并进行了质量评价。结果：选取了来自印度、巴基斯坦、孟加拉国、斯里兰卡和不丹的25项实证研究进行分析。出现了四个主题。相互照顾和联系支持持续的自我意识：为他人做出贡献，同时通过关系和精神实践获得联系，这对患者很重要，并得到家庭和保健工作者的支持。选择的自由——特权还是负担？：参与护理的选择对一些病人来说是必要的，但对另一些病人来说是一种负担，他们更喜欢家庭来领导他们的护理。严重的无法控制的疼痛和经济困难使一些患者无法选择，他们认为死亡是唯一的选择。关于人工延长生命的决定对患者和医护人员来说是复杂的。最后几天的机会：当积极死亡时，人们普遍认为没有痛苦、感觉安全、有家人陪伴是很重要的。家并不总是首选的死亡地点。对家人来说，举行最后的仪式至关重要。死后问题：死后发生的事情——受到遗产和宗教信仰的影响——在死前、死中和死后都会影响到各方。结论：据我们所知，这是第一次对南亚“善死”的意义进行回顾。大多数南亚国家缺乏相关研究。尽管南亚人的观点与西方的观点有相似之处，但我们注意到在决策、延长寿命、预测意识和想要结束生命方面的重要细微差别，这些细微差别受到文化、宗教和贫困的影响。我们支持能够解释这些变化的政策。需要持续开展工作以提供良好的症状管理，从而增加患者参与护理的机会。需要在南亚临终时的伦理和宗教领域进行进一步的研究。

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引用次数: 0

Artificial Intelligence and Peer Review 人工智能与同行评议。

IF 2.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2025-03-16 DOI: 10.1111/jnu.70004

Susan Gennaro

引用次数: 0