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A cross-sectional study quantifies the independent contribution of nurses and midwives in child health outcomes 一项横断面研究量化了护士和助产士对儿童健康成果的独立贡献。
IF 3.4 3区 医学 Q1 Nursing
Journal of Nursing Scholarship
Pub Date : 2023-12-18 DOI: 10.1111/jnu.12951
Wenpeng You PhD, Frank Donnelly PhD

Introduction

As the largest profession within the healthcare industry, nursing and midwifery workforce (NMW) provides comprehensive healthcare to children and their families. This study quantified the independent role of NMW in reducing under-5 mortality rate (U5MR) worldwide.

Design

A retrospective, observational and correlational study to examine the independent role of NMW in protecting against U5MR.

Methods

Within 266 “countries”, the cross-sectional correlations between NMW and U5MR were examined with scatter plots, Pearson's r, nonparametric, partial correlation and multiple regression. The affluence, education and urban advantages were considered as the potential competing factors for the NMW–U5MR relationship. The NMW–U5MR correlations in both developing and developed countries were explored and compared.

Results

Bivariate correlations revealed that NMW negatively and significantly correlated to U5MR worldwide. When the contributing effects of economic affluence, urbanization and education were removed, the independent NMW role in reducing U5MR remained significant. NMW independently explained 9.36% U5MR variance. Multilinear regression selected NMW as a significant factor contributing an extra 3% of explanation to U5MR variance when NMW, affluence, education and urban advantage were incorporated as the predicting variables. NMW correlated with U5MR significantly more strongly in developing countries than in developed countries.

Conclusion

NMW, indexing nursing and midwifery service, was a significant factor for reducing U5MR worldwide. This beneficial effect explained 9.36% of U5MR variance which was independent of economic affluence, urbanization and education. The NMW may be a more significant risk factor for protecting children from dying under 5 years old in developing countries. As a strategic response to the advocacy of the United Nations to reduce child mortality, it is worthy for health authorities to consider a further extension of nurses and midwives' practice scope to enable communities to have more access to NMW healthcare services.

导言：作为医疗保健行业中最大的职业，护理和助产士队伍（NMW）为儿童及其家庭提供全面的医疗保健服务。本研究量化了 NMW 在降低全球 5 岁以下儿童死亡率（U5MR）方面的独立作用：设计：一项回顾性、观察性和相关性研究，旨在探讨 NMW 在降低 5 岁以下儿童死亡率方面的独立作用：方法：在 266 个 "国家 "中，使用散点图、皮尔逊 r、非参数、偏相关和多元回归等方法研究了 NMW 与五岁以下幼儿死亡率之间的横截面相关性。富裕程度、教育程度和城市优势被认为是影响 NMW-U5MR 关系的潜在竞争因素。对发展中国家和发达国家的 NMW-U5MR 相关性进行了探讨和比较：双变量相关性表明，在全球范围内，NMW 与 U5MR 呈显著负相关。在剔除经济富裕、城市化和教育的影响后，NMW 在降低五岁以下幼儿死亡率方面的独立作用仍然显著。NMW 可独立解释 9.36% 的五岁以下幼儿死亡率变异。当将 NMW、富裕程度、教育程度和城市优势作为预测变量时，多线性回归选择 NMW 作为一个重要因素，为五岁以下幼儿死亡率方差提供了额外 3% 的解释。发展中国家的 NMW 与五岁以下幼儿死亡率的相关性明显高于发达国家：结论：将护理和助产服务指数化的 NMW 是降低全球五岁以下幼儿死亡率的一个重要因素。这一有利影响解释了 9.36% 的五岁以下幼儿死亡率差异，与经济富裕程度、城市化和教育程度无关。在发展中国家，国家最低工资可能是保护 5 岁以下儿童免于死亡的更重要的风险因素。作为对联合国降低儿童死亡率倡议的战略回应，卫生当局值得考虑进一步扩大护士和助产士的执业范围，使社区有更多机会获得国家最低工资医疗保健服务。
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引用次数: 0
Editorial for the special issue about the health of transgender and gender diverse people 为有关变性人和性别多元化人群健康的特刊撰写社论。
IF 3.4 3区 医学 Q1 Nursing
Journal of Nursing Scholarship
Pub Date : 2023-12-15 DOI: 10.1111/jnu.12949
Laura Kelly she/her/hers PhD, PMHNP, Kasey Jackman he/him/his PhD, RN, PMHNP-BC, FAAN
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引用次数: 0
A longitudinal investigation of structural empowerment profiles among healthcare employees 医疗保健员工结构性赋权概况纵向调查
IF 3.4 3区 医学 Q1 Nursing
Journal of Nursing Scholarship
Pub Date : 2023-12-13 DOI: 10.1111/jnu.12950
Baptiste Cougot PhD, Nicolas Gillet PhD, Alexandre J. S. Morin PhD, Jules Gauvin MSc, Florian Ollierou MSc, Leïla Moret MD, PhD, Dominique Tripodi MD, PhD

Purpose

Research on structural empowerment has typically adopted a variable-centered perspective, which is not ideal to study the combined effects of structural empowerment components. This person-centered investigation aims to enhance our knowledge about the configurations, or profiles, of healthcare employees' perceptions of the structural empowerment dimensions present in their workplace (opportunity, information, support, and resources). Furthermore, this study considers the replicability and stability of these profiles over a period of 2 years, and their outcomes (perceived quality of care, and positive and negative affect).

Design

Participants completed the same self-reported questionnaires twice, 2 years apart.

Methods

A sample of 633 healthcare employees (including a majority of nurses and nursing assistants) participated. Latent transition analyses were performed.

Results

Five profiles were identified: Low Empowerment, High Information, Normative, Moderately High Empowerment, and High Empowerment. Membership into the Normative and Moderately High Empowerment profiles demonstrated a high level of stability over time (79.1% to 83.2%). Membership in the other profiles was either moderately stable (43.5% for the High Empowerment profile) or relatively unstable (19.7% to 20.4% for the Low Empowerment and High Information profiles) over time. More desirable outcomes (i.e., higher positive affect and quality of care, and lower negative affect) were observed in the High Empowerment profile.

Conclusions

These results highlight the benefits of high structural empowerment, in line with prior studies suggesting that structural empowerment can act as a strong organizational resource capable of enhancing the functioning of healthcare professionals. These findings additionally demonstrate that profiles characterized by the highest or lowest levels of structural empowerment were less stable over time than those characterized by more moderate levels.

Clinical Relevance

From an intervention perspective, organizations and managers should pay special attention to employees perceiving low levels of structural empowerment, as they experience the

有关结构性赋权的研究通常采用以变量为中心的视角，这对于研究结构性赋权各组成部分的综合效应并不理想。这项以人为中心的调查旨在增进我们对医疗保健员工对其工作场所中存在的结构性赋权维度（机会、信息、支持和资源）的认知配置或概况的了解。此外，本研究还考虑了这些特征在两年内的可复制性和稳定性，以及它们的结果（感知到的护理质量、积极和消极情绪）。
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引用次数: 0
Correction to “The effect of a lifestyle intervention program using a mobile application versus the effect of a program using a booklet for adults with metabolic syndrome: A three-arm randomized controlled trial” 更正“使用移动应用程序的生活方式干预计划与使用小册子的计划对代谢综合征成人的影响:一项三组随机对照试验”。
IF 3.4 3区 医学 Q1 Nursing
Journal of Nursing Scholarship
Pub Date : 2023-12-07 DOI: 10.1111/jnu.12948

Wong EML, Leung DYP, Wang Q, Leung AYM, Cheung ASP. The effect of a lifestyle intervention program using a mobile application versus the effect of a program using a booklet for adults with metabolic syndrome: A three-arm randomized controlled trial. J Nurs Scheme 2023;55:936-948.

In the Funding Information section, the text “This research is supported by the Health and Medical Research Fund (No. 10110301), Food and Health Bureau, Hong Kong SAR.” was incorrect. This should have read “This research is supported by the Health and Medical Research Fund (No. 16172411), Food and Health Bureau, Hong Kong SAR.”

We apologize for this error.

Wong EML, Leung DYP, Wang Q, Leung AYM, Cheung ASP.针对成人代谢综合征患者的移动应用程序生活方式干预计划与手册计划的效果对比：三臂随机对照试验》。J Nurs Scheme 2023;55:936-948.In the Funding Information section, the text "This research is supported by the Health and Medical Research Fund (No. 10110301), Food and Health Bureau, Hong Kong SAR." was incorrect.我们对此表示歉意。
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引用次数: 0
Parental supporter in pediatric resuscitation: A mixed-method study with Delphi and analytic hierarchy process 儿童复苏中的父母支持:采用德尔菲法和层次分析法的混合方法研究。
IF 3.4 3区 医学 Q1 Nursing
Journal of Nursing Scholarship
Pub Date : 2023-11-29 DOI: 10.1111/jnu.12947
Arezoo Ghavi, Hadi Hassankhani, Kathleen L. Meert

Introduction

Providing support to parents is an evidence-based practice and a crucial part of family-centered nursing care. However, it is not clear who and how to provide the best support to parents during and after their child's resuscitation attempts.

Purpose

This study was conducted to explore the characteristics and roles of parental supporters responsible for caring for parents during and after their child's resuscitation.

Methods

This is a mixed-method study combining the Delphi technique and the Analytic Hierarchy Process. A list of potentially important items describing the characteristics and roles of parental supporters caring for parents during and after pediatric resuscitation was developed through qualitative interviews with parents and members of the resuscitation team, and a thorough literature search. Then, the Delphi round was conducted with key experts. In the final step, the Analytic Hierarchy Process was used for ranking items in the order of their importance.

Results

A list with 69 items describing the characteristics and roles of parental supporters was developed. 15 items (21.74%) were related to the “Characteristics of parental supporter” category; 8 items (11.59%) were related to the “Roles of a parental supporter during resuscitation” category; 13 items (18.84%) were related to the “Roles of a parental supporter after successful resuscitation” category; 23 items (33.34%) were related to the “Roles of a parental supporter after unsuccessful resuscitation” category; and 10 items (14.49%) were related to the “Roles of a parental supporter after unsuccessful resuscitation with help of other staff of the hospital” category.

Conclusion

The findings of this study can be used to develop guidelines that include parental supporter characteristics and roles to support parents during and after their child's resuscitation according to family-centered care practices in pediatric settings.

Clinical Relevance

Study findings indicate the need for the presence of a parental supporter during and after pediatric resuscitation, whether witnessed by the parents or not. Knowledge regarding the characteristics and roles of parental supporters can be used in practice to uphold family-centered nursing care during critical situations.

为父母提供支持是一种循证实践，也是以家庭为中心的护理的重要组成部分。然而，目前尚不清楚谁以及如何在孩子复苏期间和之后为父母提供最好的支持。目的:本研究旨在探讨在儿童复苏期间和复苏后负责照顾父母的父母支持者的特点和角色。方法:采用德尔菲法和层次分析法相结合的混合方法进行研究。通过对父母和复苏团队成员的定性访谈，以及全面的文献检索，制定了一份描述在儿科复苏期间和之后照顾父母的父母支持者的特征和角色的潜在重要项目清单。然后，与关键专家进行了德尔菲回合。在最后一步中，使用层次分析法对项目的重要性进行排序。结果:编制了一份包含69个条目的表，描述了父母支持者的特征和角色。15项(21.74%)与“父母赡养者特征”相关;8项(11.59%)与“复苏过程中父母赡养者的角色”相关;13项(18.84%)与“成功复苏后父母赡养者的角色”相关;与“复苏失败后父母支持者的角色”相关的题项有23项(33.34%);10项(14.49%)与“在医院其他工作人员帮助下复苏失败后父母支持者的角色”相关。结论:本研究的发现可用于制定指南，包括父母支持者的特征和角色，以支持父母在儿童复苏期间和之后，根据家庭为中心的护理实践。临床相关性:研究结果表明，在儿童复苏期间和之后，无论父母是否在场，都需要父母的支持。关于父母支持者的特征和角色的知识可以在实践中使用，在危急情况下维护以家庭为中心的护理。
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引用次数: 0
Comprehensive lifestyle modification interventions for metabolic syndrome: A systematic review and meta-analysis 综合生活方式改变干预代谢综合征:系统回顾和荟萃分析。
IF 3.4 3区 医学 Q1 Nursing
Journal of Nursing Scholarship
Pub Date : 2023-11-27 DOI: 10.1111/jnu.12946
Sungwon Park PhD, RN, Jiwon Lee PhD, RN, Jo Woon Seok PhD, RN, Chang Gi Park PhD, Jin Jun PhD, RN

Introduction

Previous systematic reviews and meta-analyses have mainly focused on improvements in the number of metabolic syndrome risk factors and individual changes in each risk factor, making it challenging to examine the impact of comprehensive lifestyle modification interventions on adherence to recommended health behaviors. To address this gap, we conducted a systematic and meta-analysis aimed at identifying clinical parameter levels associated with lifestyle modification outcomes and adherence to recommended health behaviors for individuals with metabolic syndrome.

Methods

A total of seven studies retrieved from four databases (CINAHL, Medline via PubMed, American Psychological Association PsycINFO, and Embase) were included in the review. The selected studies, which demonstrated improvements in health behaviors, all included diet and exercise as main factors of comprehensive lifestyle modification in home settings.

Results

Our findings suggest that a 6-month comprehensive intervention including diet and exercise can be effective in decreasing glucose levels and systolic blood pressure. However, given the limited available data, further studies investigating the efficacy of interventions of varying durations are needed.

Discussion

Although our review included a small number of studies, comprehensive lifestyle modifications consisting of at least two components (primarily diet and exercise) can improve health behaviors and some clinical parameters among individuals with metabolic syndrome. Future studies are needed to investigate the long-term effects of lifestyle modifications on health behavior adherence and explore effective interventions to address certain clinical parameters, such as high-density lipoprotein levels. Also, we recommend using objective and quantifiable measure to compare adherence to recommended lifestyle modifications across studies.

Clinical Relevance

This research provides empirical evidence of the effectiveness of comprehensive lifestyle modification and emphasizes the need to develop long-term nursing strategies in public health that can be used to effectively manage metabolic syndrome.

先前的系统综述和荟萃分析主要集中在代谢综合征危险因素数量的改善和每个危险因素的个体变化上，这使得研究综合生活方式改变干预对坚持推荐健康行为的影响具有挑战性。为了解决这一差距，我们进行了一项系统和荟萃分析，旨在确定与代谢综合征患者生活方式改变结果和坚持推荐健康行为相关的临床参数水平。方法:从四个数据库(CINAHL, Medline via PubMed, American Psychological Association PsycINFO和Embase)中检索到的7项研究被纳入本综述。所选的研究证明了健康行为的改善，所有这些研究都将饮食和运动作为家庭环境中全面改变生活方式的主要因素。结果:我们的研究结果表明，6个月的综合干预包括饮食和运动可以有效地降低血糖水平和收缩压。然而，鉴于现有数据有限，需要进一步研究不同持续时间的干预措施的有效性。讨论:尽管我们的综述只包括少量的研究，但至少由两部分组成的全面生活方式改变(主要是饮食和运动)可以改善代谢综合征患者的健康行为和一些临床参数。未来的研究需要调查生活方式改变对健康行为依从性的长期影响，并探索有效的干预措施来解决某些临床参数，如高密度脂蛋白水平。此外，我们建议使用客观和可量化的措施来比较研究中推荐的生活方式改变的依从性。临床意义:本研究为全面改变生活方式的有效性提供了经验证据，并强调了在公共卫生领域制定可用于有效管理代谢综合征的长期护理策略的必要性。
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引用次数: 0
Relations between concussion symptoms and depression among patients with mild traumatic brain injury: A moderated mediation model 轻度创伤性脑损伤患者脑震荡症状与抑郁的关系:一个有调节的中介模型
IF 3.4 3区 医学 Q1 Nursing
Journal of Nursing Scholarship
Pub Date : 2023-11-22 DOI: 10.1111/jnu.12944
Ching-Yuan Ma MSN, Ya-Wen Hsiao MSN, Hsin-Ya Tzeng MSN, Dueng-Yuan Hueng MD, PhD, Hui-Hsun Chiang PhD, RN

Introduction

Concussion symptoms following a traumatic accident are both common and known to adversely affect mental health and recovery in patients with traumatic brain injury. Depression, highly prevalent among patients with traumatic brain injury, is also associated with the important factors of sleep quality and resilience. However, the mediator and moderator roles of depression following concussion in patients with traumatic brain injury have been underexplored. The aims of this study were to investigate the mediating role of sleep quality in the relation between concussion symptoms and depression and to examine the moderating effect of resilience on this mediated model.

Design

Cross-sectional pretest data analysis of a randomized controlled trial.

Methods

A total of 249 adult patients with mild traumatic brain injury (Glasgow Coma Scale 13–15) at admission following brain injury were surveyed at a medical center in Taipei, Taiwan. The outcome variables were concussion symptoms (Rivermead Post-Concussion Symptom Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), resilience (Resilience Scale for Adults), and depression (Beck Depression Inventory II). These data were analyzed using moderated mediation regressions with the SPSS PROCESS macro.

Results

In patients with mild traumatic brain injury, there was a significant positive relation between concussion symptoms and depression, of which sleep quality was a significant mediator. Additionally, resilience had a negative moderating effect on the relations between sleep quality and depression. Patients with less resilience showed a stronger negative effect of sleep quality on depression.

Conclusion

Our findings suggest that ameliorating both concussion symptoms and sleep disturbance is important for reducing the risk of depression in patients with mild traumatic brain injury, especially in those patients with less resilience.

Clinical Relevance

It is essential for clinical nurses to develop interventions for patients with mild traumatic brain injury that will improve their sleep quality, while strengthening their resilience, to alleviate depression.

简介:创伤性事故后的脑震荡症状既常见又已知会对创伤性脑损伤患者的心理健康和康复产生不利影响。抑郁症在创伤性脑损伤患者中非常普遍，它也与睡眠质量和恢复力等重要因素有关。然而，创伤性脑损伤患者脑震荡后抑郁的调节和调节作用尚未得到充分的探讨。本研究旨在探讨睡眠质量在脑震荡症状与抑郁关系中的中介作用，并探讨心理弹性在这一中介模型中的调节作用。设计:随机对照试验的横断面测前数据分析。方法:对台湾省台北市某医疗中心收治的249例轻度外伤性脑损伤(格拉斯哥昏迷量表13-15分)患者进行调查。结果变量为脑震荡症状(Rivermead脑震荡后症状问卷)、睡眠质量(匹兹堡睡眠质量指数)、心理弹性(成人心理弹性量表)和抑郁(贝克抑郁量表II)。这些数据使用SPSS PROCESS宏进行有调节的中介回归分析。结果:在轻度颅脑损伤患者中，脑震荡症状与抑郁呈显著正相关，其中睡眠质量是显著中介。此外，弹性对睡眠质量和抑郁之间的关系有负向调节作用。韧性较差的患者睡眠质量对抑郁症的负面影响更大。结论:我们的研究结果表明，改善脑震荡症状和睡眠障碍对降低轻度创伤性脑损伤患者的抑郁风险很重要，特别是对那些恢复能力较差的患者。临床意义:临床护理人员有必要针对轻度创伤性脑损伤患者制定干预措施，改善其睡眠质量，同时增强其适应能力，以减轻抑郁。
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引用次数: 0
Incorporating co-design principles and social media strategies to enhance cross-sectional online survey participation: The Birth Experience Study 结合共同设计原则和社会媒体策略，提高横断面在线调查参与:出生经验研究。
IF 3.4 3区 医学 Q1 Nursing
Journal of Nursing Scholarship
Pub Date : 2023-11-20 DOI: 10.1111/jnu.12945
Hazel Keedle PhD, RN RM, Hannah G. Dahlen PhD RM

Aim

To use co-design principles to design a nationwide maternity experiences survey and to distribute the survey through social media.

Design

A co-designed, cross sectional, and national online survey.

Methods

Using co-design principles from study design and throughout the research process a cross-sectional, online, national survey of Australian women's experiences of maternity care was designed. Four validated survey instruments were included in the survey design.

Results

An extensive social media strategy was utilized, which included paid advertising, resulting in 8804 surveys for analysis and 54,896 comments responding to open text questions.

Discussion

The inclusion of co-design principles contributed to a well-designed survey and consumer involvement in distribution and support of the online survey. The social media distribution strategy contributed to high participation rates with overall low marketing costs.

Clinical Relevance

Maternity services should be designed to provide woman-centered, individualized care. This survey was co-designed with maternity users and maternity organizations to explore women's recent experiences of maternity care in Australia. The outcomes of this study will highlight the factors that contribute to positive and negative experiences in maternity services.

Patient or Public Contribution

As a co-designed study, there was consumer engagement from the design of the study, throughout the research process.

目的:运用协同设计原理设计一项全国性的产妇体验调查，并通过社交媒体进行分发。设计:一个共同设计的，横断面的，全国性的在线调查。方法:采用研究设计的共同设计原则，在整个研究过程中，设计了一项横断面、在线、澳大利亚妇女产妇护理经历的全国调查。调查设计中包括四种有效的调查工具。结果:使用了广泛的社交媒体策略，其中包括付费广告，产生了8804项调查分析和54,896条回复开放文本问题的评论。讨论:包含协同设计原则有助于设计良好的调查和消费者参与在线调查的分发和支持。社交媒体分销策略有助于以较低的整体营销成本提高参与率。临床相关性:产科服务应设计为提供以妇女为中心的个性化护理。这项调查是与产妇用户和产妇组织共同设计的，旨在探索澳大利亚妇女最近的产妇护理经历。这项研究的结果将突出在产妇服务中产生积极和消极经验的因素。患者或公众贡献:作为一项共同设计的研究，从研究设计到整个研究过程都有消费者的参与。
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引用次数: 0
Key stakeholders' perspectives: A gap analysis of hospital-acquired pressure injuries 关键利益相关者的观点:医院获得性压力伤害的差距分析。
IF 3.4 3区 医学 Q1 Nursing
Journal of Nursing Scholarship
Pub Date : 2023-11-20 DOI: 10.1111/jnu.12940
Bettina H. Riley PhD, RN, FAAS, Joyce Pittman PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, Jo Ann A. Otts DNP, RN, NEA-BC, CENP, Madhuri S. Mulekar PhD

Introduction

Hospital-acquired pressure injuries (HAPIs) are a global high-stakes patient safety issue. Key stakeholder perspectives regarding their role and experiences with pressure injuries is critical as part of the solution to minimizing HAPI occurrence and attain sustainability.

Design

A qualitative, descriptive approach provided multiple perspectives of key stakeholders to support the complexity of HAPI care. The qualitative data are a part of a mixed method convergent research study examining pressure injury prevention and management practices.

Methods

Nursing system theory, mixed method convergent design, and participatory action research methodologies were chosen to address both the gap analysis development and results, achieve collaborative comprehensiveness, and enable key stakeholder involvement throughout this HAPI prevention and management initiative. Participants were recruited and enrolled from a large Level I trauma hospital and the key stakeholders. Demographic information were collected prior to the individual interview. Focused interviews were conducted virtually using zoom technology. Qualitative data were analyzed using NVivo software and thematic analysis was confirmed across the co-investigators for congruence and applicability to the research questions.

Results

Qualitative interviews with 26 key stakeholders provided data to support and integrate a link with gap analysis results on the complex health issue of HAPIs. Specific barrier and recommendation themes identified interventions that could be prioritized. The 52 barrier and 52 recommendation themes/sub-theme(s) respectively were organized by Donabedian (structure, process, and outcome) with structure elements the majority. The top three structure barrier themes involved equipment and standards for use, staff prevention education, and specialized health professionals. The top three structure recommendation themes involved specialized health professionals, equipment and standards for use, and an educational plan for those at risk or with HAPIs.

Conclusion

The article provides findings from the qualitative portion of a mixed method study related to HAPIs. The qualitative findings associated with the gap analysis quantitative results, achieved the goal of the participatory action research key stakeholders' input into HAPI care and can be replicated internationally.

医院获得性压力损伤(HAPIs)是一个全球性的高风险患者安全问题。关键利益相关者关于他们在压力伤害中的作用和经验的观点是减少HAPI发生和实现可持续性解决方案的重要组成部分。设计:一种定性的、描述性的方法提供了关键利益相关者的多个视角，以支持HAPI护理的复杂性。定性数据是一项混合方法的研究研究的一部分，研究了压力伤害的预防和管理实践。方法:选择护理系统理论、混合方法趋同设计和参与式行动研究方法来解决差距分析的发展和结果，实现协作全面性，并使关键利益相关者参与整个HAPI预防和管理计划。参与者是从一家大型一级创伤医院和主要利益攸关方招募和登记的。在个人访谈之前收集了人口统计信息。重点访谈采用虚拟变焦技术进行。使用NVivo软件对定性数据进行分析，并在共同调查者之间确认主题分析，以确定研究问题的一致性和适用性。结果:对26个关键利益攸关方的定性访谈提供了数据，以支持并整合了关于HAPIs复杂健康问题的差距分析结果的联系。具体的障碍和建议主题确定了可以优先考虑的干预措施。Donabedian分别组织了52个障碍和52个推荐主题/子主题(结构、过程和结果)，其中结构元素占多数。排在前三位的结构障碍主题涉及设备和使用标准、工作人员预防教育和专门的卫生专业人员。排名前三位的结构建议主题涉及专门的保健专业人员、使用的设备和标准，以及针对有风险或患有hapi者的教育计划。结论:本文提供了与HAPIs相关的混合方法研究的定性部分的结果。定性发现与差距分析定量结果相关联，实现了参与性行动研究关键利益相关者对HAPI护理投入的目标，并可在国际上复制。临床相关性:关键利益相关者参与解决临床问题的好处是可持续性。定量方法和整合定性利益相关者的观点提供了一个深入的解决方案，将在全球层面上推进护理能力，实现卫生保健提供和HAPI护理科学和政策制定。
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引用次数: 0
Randomized controlled trials in nursing conducted by Latin American research teams: A scoping review 拉丁美洲研究小组进行的护理随机对照试验:范围综述。
IF 3.4 3区 医学 Q1 Nursing
Journal of Nursing Scholarship
Pub Date : 2023-11-15 DOI: 10.1111/jnu.12943
Melixa Medina-Aedo RN, MSc, Cristian Segura-Carrillo MSW, PhD, Elena Torralba-Martinez RN, MSc, Diana Buitrago-García RN, MSc, Ivan Solà BSc, Hector Pardo-Hernandez BA, MPH, PhD, Xavier Bonfill MD, MPH, PhD

Introduction

Randomized controlled trials (RCTs) are the cornerstone of systematic reviews and other evidence synthesis. RCT identification remains challenging because of limitations in their indexation in major databases and potential language bias. Scientific production in Latin American nursing is steadily increasing, but little is known about its design or main features. We aimed to identify the extent of evidence from RCTs in nursing conducted by Latin American research teams and evaluate their main characteristics, including potential risk of bias.

Design

Scoping review with risk of bias assessment.

Methods

We conducted a scoping review including a comprehensive electronic search in five relevant databases. We completed a descriptive data analysis and a risk of bias assessment of eligible studies using Cochrane's guidance.

Results

We identified 1784 references of which 47 were RCTs published in 40 journals. Twenty (42.6%) RCTs were published in journals in English. Chronic diseases were the most common health conditions studied (29.7%). Fifteen (31.9%) RCTs had a high risk of bias. Thirty (75%) journals were included in the Journal Citation Report (JCR) catalog and 5 (16.7%) were journals classified under nursing category. Twenty-one (52.5%) journals explicitly required CONSORT checklist recommendations for RCTs reporting.

Conclusion

Publication of RCTs in nursing by Latin American authors has increased. Most journals where RCTs are published are in English and not specific to nursing. Searches in journals of other disciplines may be necessary to facilitate identification of RCTs in nursing. CONSORT statements need to be actively promoted to facilitate rigorous methodology and reporting of RCTs.

Clinical Relevance Statement

This study highlights the need for an increased research focus on RCTs in nursing in Latin America, and the importance of enhancing the reporting quality of these studies to support evidence-based nursing practice.

随机对照试验(RCTs)是系统评价和其他证据合成的基础。由于在主要数据库中索引的局限性和潜在的语言偏倚，RCT鉴定仍然具有挑战性。拉丁美洲护理领域的科学成果正在稳步增长，但人们对其设计或主要特征知之甚少。我们的目的是确定拉丁美洲研究团队在护理方面进行的随机对照试验的证据程度，并评估其主要特征，包括潜在的偏倚风险。设计:范围评估和偏倚风险评估。方法:我们进行了范围综述，包括在五个相关数据库中进行全面的电子检索。我们在Cochrane的指导下完成了描述性数据分析和对符合条件的研究的偏倚风险评估。结果:共检索到文献1784篇，其中47篇为随机对照试验。20例(42.6%)随机对照试验发表在英文期刊上。慢性病是最常见的健康状况(29.7%)。15项(31.9%)随机对照试验存在高偏倚风险。30种(75%)期刊被纳入期刊引文报告(JCR)目录，5种(16.7%)期刊被归入护理类。21份(52.5%)期刊明确要求CONSORT清单推荐RCTs报告。结论:拉丁美洲作者发表的关于护理的随机对照试验有所增加。发表随机对照试验的大多数期刊都是英文的，并不是专门针对护理的。在其他学科的期刊中搜索可能是必要的，以便于识别护理方面的随机对照试验。需要积极推广CONSORT声明，以促进严格的随机对照试验方法和报告。临床相关性声明:本研究强调了对拉丁美洲护理领域的随机对照试验进行更多研究的必要性，以及提高这些研究报告质量以支持循证护理实践的重要性。
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