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Effects of mindfulness-based interventions on reducing psychological distress among nurses: A systematic review and meta-analysis of randomized controlled trials 正念干预对减少护士心理困扰的影响:随机对照试验的系统回顾和荟萃分析。
IF 3.4 3区 医学 Q1 Nursing Pub Date : 2023-11-13 DOI: 10.1111/jnu.12941
Mestiana Karo DNSc, RN, Lindawati Simorangkir SKep, Ns, MKes, Ita Daryanti Saragih MSN, RN, Ira Suarilah PhD, RN, Huey-Ming Tzeng PhD, RN, FAAN

Purpose

Nurses increasingly use mindfulness as an effective mental health intervention to reduce psychological distress. The effectiveness of mindfulness-based interventions remains inconclusive, which may lead to implementation of interventions in an inefficient or ineffective manner. This study aimed to examine the effects of mindfulness-based interventions on reducing stress, anxiety, and depression among nurses.

Design

Systematic review and meta-analysis.

Methods

Randomized controlled trials (RCTs) were searched using six databases published through May 20, 2023, which evaluated the effects of mindfulness-based interventions on reducing psychological distress among nurses. To assess the quality of methodology included in the RCTs, version 2 of the Cochrane risk-of-bias instrument for RCTs with five domains was used. Standardized mean difference (SMD) with 95% confidence interval (CI) were calculated using the random–effects model in the meta-analyses. Publication bias was assessed using Egger's regression test. Further, the robustness effect size of the pooled analysis was assessed using leave-one-out sensitivity analysis.

Findings

A total of 16 RCTs were included in the final analysis. Overall, the modalities appeared to alleviate stress (pooled SMD: −0.50 [95% CI: −0.82 to −0.18]; p < 0.001) and depression (pooled SMD: −0.42 [95% CI: −0.78 to −0.06]; p = 0.02) among nurses.

Conclusion

Mindfulness-based interventions appear to alleviate stress and depression in nurses. Future research evaluating mindfulness-based interventions among working nurses with more rigorous methodological and larger sample size.

Clinical Relevance

Support for nurses' mental health must be included while implementing personal and professional development plans.

目的:护士越来越多地使用正念作为一种有效的心理健康干预来减少心理困扰。基于正念的干预措施的有效性仍然不确定,这可能导致以低效或无效的方式实施干预措施。本研究旨在探讨正念干预对减轻护士压力、焦虑和抑郁的影响。设计:系统回顾和荟萃分析。方法:检索截至2023年5月20日发表的6个数据库的随机对照试验(rct),评估基于正念的干预对减少护士心理困扰的效果。为了评估纳入随机对照试验的方法学质量,我们使用了Cochrane 5个领域随机对照试验的第2版偏倚风险评估工具。在meta分析中使用随机效应模型计算标准化平均差(SMD)和95%置信区间(CI)。采用Egger回归检验评估发表偏倚。此外,采用留一敏感性分析评估合并分析的稳健性效应大小。结果:最终分析共纳入16项rct。总的来说,这些方式似乎减轻了压力(综合SMD: -0.50 [95% CI: -0.82至-0.18];结论:正念干预可以缓解护士的压力和抑郁。未来的研究评估正念为基础的干预工作护士更严格的方法和更大的样本量。临床相关性:在实施个人和专业发展计划时,必须包括对护士心理健康的支持。
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引用次数: 0
Nurses' adherence to patient safety protocols and its relationship with adverse patient events 护士对患者安全协议的遵守情况及其与患者不良事件的关系。
IF 3.4 3区 医学 Q1 Nursing Pub Date : 2023-11-11 DOI: 10.1111/jnu.12942
Leodoro J. Labrague RN, DM, PhD, CNE

Introduction

Ensuring patient safety is a critical component of healthcare delivery, and nurses play a vital role in adhering to patient safety protocols to prevent adverse events. However, studies linking nurses' adherence to these protocols with patient outcomes is scarce. This study has two-fold purposes: (1) to examine determinants of nurses' adherence to patient safety protocols, and (2) to investigate the relationship between nurses' adherence to patient safety protocols and adverse patient events.

Design

A cross-sectional design.

Methods

A total of 343 clinical nurses from five hospitals in the Philippines were included in this study. Two standardized scales were used to collect data, including the Patient Safety Adherence Scale and the Adverse Patient Events Scale. Data collection took place from April 2022 to August 2022.

Results

Adherence to patient safety protocols was generally moderate to high (M = 4.483), while nurse-reported adverse events occurred at a lower frequency (M = 1.150). Lower adherence rates were identified in areas such as reporting safety errors (M = 3.950), conducting fall risk assessments (M = 4.299), and adhering to pressure ulcer prevention guidelines (M = 3.979). Patients' and their families' complaints (M = 2.129) and abuses (M = 1.475) were the most frequently reported adverse events. Increased adherence to safety protocols was associated with higher reporting of adverse patient events (β = 0.115, p < 0.001).

Conclusion

Higher adherence to patient safety protocols resulted in an increased reporting of adverse patient events. The factors identified that contributed to nurses' adherence to patient safety protocols can be utilized in the development of strategies aimed at improving compliance, especially in areas where adherence is currently low.

Clinical Relevance

Healthcare organizations should prioritize efforts to enhance adherence to patient safety protocols, particularly in areas with lower compliance rates, through relevant trainings, resource provision, and support systems. Promoting a culture of open communication and reporting can significantly contribute to reducing adverse events and improving patient safety.

引言:确保患者安全是医疗服务的关键组成部分,护士在遵守患者安全协议以预防不良事件方面发挥着至关重要的作用。然而,很少有研究将护士对这些协议的遵守与患者的结果联系起来。本研究有两个目的:(1)检查护士遵守患者安全协议的决定因素,以及(2)调查护士遵守患者安全协议与患者不良事件之间的关系。设计:横截面设计。方法:本研究共纳入来自菲律宾五家医院的343名临床护士。使用两种标准化量表来收集数据,包括患者安全依从性量表和患者不良事件量表。数据收集时间为2022年4月至2022年8月。结果:对患者安全协议的遵守程度一般为中度至高度(M = 4.483),而护士报告的不良事件发生频率较低(M = 1.150)。在报告安全错误(M = 3.950),进行跌倒风险评估(M = 4.299),并遵守压疮预防指南(M = 3.979)。患者及其家属的投诉(M = 2.129)和滥用(M = 1.475)是最常报告的不良事件。对安全性方案的依从性增加与不良患者事件的报告增加有关(β = 0.115,p 结论:对患者安全方案的更高依从性导致不良患者事件的报告增加。确定的有助于护士遵守患者安全协议的因素可用于制定旨在提高依从性的策略,特别是在目前依从性较低的领域。临床相关性:医疗保健组织应通过相关培训、资源提供和支持系统,优先努力加强对患者安全协议的遵守,特别是在合规率较低的领域。促进开放沟通和报告的文化可以大大有助于减少不良事件和提高患者安全性。
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引用次数: 0
Best practices for communication while wearing facemasks: A scoping review 戴口罩交流的最佳实践:范围界定综述。
IF 3.4 3区 医学 Q1 Nursing Pub Date : 2023-11-08 DOI: 10.1111/jnu.12939
Clarissa A. Shaw PhD, RN, Kyu Ri Lee MSN, RN, Alexander Williams BSN, RN, Nathan A. Shaw MD, Delaney Weeks BSN, RN, Lainie Jackson BSN, RN, Kristine N. Williams PhD, FNP-BC, RN, FGSA, FAAN

Introduction

Facemasks are an important piece of personal protective equipment (PPE) to mitigate the spread of respiratory illnesses, but they can impede communication between patients and healthcare providers. The purpose of this scoping review is to identify effective communication practices while wearing facemasks.

Design

Scoping review using a systematic search of articles from the PubMed, CINAHL, and Embase databases.

Methods

The PEO (population, exposure, outcome) methodology was selected for this systematic scoping review. The population of interest (P) includes humans of all ages (children, adults, and older adults); the exposure of interest (E) is PPE that covers the mouth (i.e., facemasks); and the outcome of interest (O) is successful or unsuccessful communication practices. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals appraisal guidelines were used to determine the level and quality of the research.

Results

Thirty-nine articles met the inclusion criteria. Seventeen of these were high- or good-quality research studies, and the remaining 22 were non-research articles included with separate analysis as part of the scoping review. The 17 articles encompassed 2656 participants. The highest quality evidence indicated that standard surgical masks have the least impact on speech perception compared to other non-transparent mask types, and that recognizing emotions is less accurate with facemasks, necessitating compensatory actions (i.e., reducing extraneous noise, using a microphone to amplify voice, and employing clear speech). Evidence was contradictory regarding the use of transparent masks. Evidence was of limited quality for other non-verbal and verbal communication strategies.

Conclusion

Awareness of communication challenges is crucial when wearing facemasks. More high-quality studies are needed to evaluate communication techniques when speakers are wearing facemasks. Basic strategies such as selecting an appropriate mask type, reducing extraneous noise, using microphones, verbalizing emotions, and employing clear speech appear to be beneficial.

Clinical Relevance

The findings of this sc

简介:口罩是一种重要的个人防护装备,可以缓解呼吸道疾病的传播,但它们会阻碍患者和医疗保健提供者之间的沟通。本范围审查的目的是确定戴口罩时的有效沟通做法。设计:通过系统检索PubMed、CINAHL和Embase数据库中的文章进行范围界定审查。方法:选择PEO(人群、暴露、结果)方法进行系统范围审查。感兴趣的人群(P)包括所有年龄段的人(儿童、成人和老年人);感兴趣的暴露(E)是覆盖口腔的PPE(即面罩);并且感兴趣的结果(O)是成功或不成功的通信实践。约翰斯·霍普金斯大学护士和医疗保健专业人员循证实践评估指南用于确定研究的水平和质量。结果:39篇文章符合入选标准。其中17篇是高质量或高质量的研究,其余22篇是非研究文章,作为范围审查的一部分,包含单独的分析。这17篇文章涉及2656名参与者。最高质量的证据表明,与其他不透明口罩类型相比,标准外科口罩对言语感知的影响最小,戴口罩识别情绪的准确性较低,因此需要采取补偿措施(即减少外来噪音、使用麦克风放大声音和使用清晰的语音)。关于使用透明口罩的证据是矛盾的。其他非言语和言语交流策略的证据质量有限。结论:戴口罩时,对沟通挑战的认识至关重要。需要更多高质量的研究来评估演讲者戴口罩时的沟通技巧。选择合适的口罩类型、减少外来噪音、使用麦克风、表达情感和使用清晰的语言等基本策略似乎是有益的。临床相关性:这项范围界定审查的结果强调了在医疗环境中戴口罩时考虑沟通挑战的重要性。该综述表明,选择合适的口罩类型、减少外来噪音、表达情绪和使用清晰的语言是一些可能有效减轻口罩对患者和医疗保健提供者之间沟通影响的策略。
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引用次数: 0
The importance of transparency: Declaring the use of generative artificial intelligence (AI) in academic writing 透明度的重要性:宣布在学术写作中使用生成人工智能。
IF 3.4 3区 医学 Q1 Nursing Pub Date : 2023-10-31 DOI: 10.1111/jnu.12938
Arthur Tang PhD, Kin-Kit Li PhD, Kin On Kwok PhD, Liujiao Cao MD, Stanley Luong PhD, Wilson Tam PhD

The integration of generative artificial intelligence (AI) into academic research writing has revolutionized the field, offering powerful tools like ChatGPT and Bard to aid researchers in content generation and idea enhancement. We explore the current state of transparency regarding generative AI use in nursing academic research journals, emphasizing the need for explicitly declaring the use of generative AI by authors in the manuscript. Out of 125 nursing studies journals, 37.6% required explicit statements about generative AI use in their authors' guidelines. No significant differences in impact factors or journal categories were found between journals with and without such requirement. A similar evaluation of medicine, general and internal journals showed a lower percentage (14.5%) including the information about generative AI usage. Declaring generative AI tool usage is crucial for maintaining the transparency and credibility in academic writing. Additionally, extending the requirement for AI usage declarations to journal reviewers can enhance the quality of peer review and combat predatory journals in the academic publishing landscape. Our study highlights the need for active participation from nursing researchers in discussions surrounding standardization of generative AI declaration in academic research writing.

生成人工智能(AI)与学术研究写作的结合彻底改变了该领域,提供了ChatGPT和Bard等强大的工具来帮助研究人员生成内容和增强想法。我们探讨了护理学术研究期刊中生成性人工智能使用的透明度现状,强调有必要在手稿中明确声明作者使用生成人工智能。在125份护理研究期刊中,37.6%的期刊要求在作者指南中明确说明生成性人工智能的使用。有和没有这一要求的期刊在影响因素或期刊类别方面没有发现显著差异。对医学、普通期刊和内部期刊的类似评估显示,包括生成性人工智能使用信息的比例较低(14.5%)。宣布生成性人工智能工具的使用对于保持学术写作的透明度和可信度至关重要。此外,将人工智能使用声明的要求扩展到期刊评审员,可以提高同行评审的质量,并在学术出版领域打击掠夺性期刊。我们的研究强调,护理研究人员需要积极参与围绕学术研究写作中生成性人工智能声明标准化的讨论。
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引用次数: 0
Health and care workers in long-term care facilities and their role in preventing emerging infectious diseases: A scoping review 长期护理机构中的卫生和护理工作者及其在预防新发传染病方面的作用:范围界定综述。
IF 3.4 3区 医学 Q1 Nursing Pub Date : 2023-10-19 DOI: 10.1111/jnu.12936
Po-Jen Kung, Ching-Ju Fang, Yi-Yuan Cheng, Ching-Min Chen

Background

The COVID-19 pandemic has had a tremendous impact on healthcare systems worldwide. In particular, long-term care facilities have proved more susceptible to infection as they care for vulnerable populations at high risk of chronic illness. How this impacts the role and core competencies of health and care workers in these facilities remains less understood.

Aim

Describe how health and care workers contribute to the prevention of emerging infectious diseases in long-term care facilities.

Design

A scoping review.

Methods

A systematic search of literature dating from 2002 to 2022 was conducted in the following databases: EMBASE, Medline (Ovid), Cochrane Library, CINAHL Plus with Full Text (EBSCOhost), Web of Science, and AgeLine. Studies were selected if they focused on health and care workers in long-term care facilities, offered a perspective on the prevention of emerging infectious diseases or infection prevention and control, and were original qualitative or quantitative studies in English. Data were extracted, cross-checked and analyzed by two researchers, and any difference in views regarding the appropriateness of literature would be resolved by consulting a third researcher. An inductive descriptive approach was applied for the analysis of results, and themes were established via consensus meetings.

Results

A total of fourteen studies from Asia, Europe, and the Americas were included. Three themes emerged from the review: “The roles of health and care workers evolve with the times”, “The core competencies of health and care workers are essential for preventing emerging infectious diseases in long-term care facilities” and “The key to successful prevention of emerging infectious diseases in long-term care facilities is through a systematic, comprehensive effort that mobilize health and care workers at all levels”. Health and care workers had to take on increasingly complex roles and rely on their core competencies to cope with epidemic changes, and facility resources, employee quality and management models were found to have significantly improved infection prevention and control outcomes.

Conclusions

The roles of health and care workers are evolving, and effective infection prevention within long-term care facilities depends on their ability

背景:新冠肺炎大流行对全球医疗系统产生了巨大影响。特别是,事实证明,长期护理机构更容易感染,因为它们照顾的是慢性病高危弱势人群。这如何影响这些设施中卫生和护理工作者的角色和核心能力,目前尚不清楚。目的:描述卫生和护理工作者如何在长期护理机构中为预防新发传染病做出贡献。设计:范围审查。方法:在以下数据库中对2002年至2022年的文献进行系统检索:EMBASE、Medline(Ovid)、Cochrane Library、CINAHL Plus with Full Text(EBSCOhost)、Web of Science和AgeLine。如果研究的重点是长期护理机构中的卫生和护理工作者,提供了预防新发传染病或感染预防和控制的视角,并且是英文的原始定性或定量研究,则选择这些研究。数据由两名研究人员提取、交叉检查和分析,关于文献适当性的任何意见分歧都将通过咨询第三名研究人员来解决。对结果的分析采用了归纳描述性方法,并通过协商一致会议确定了主题。结果:共纳入了来自亚洲、欧洲和美洲的14项研究。审查提出了三个主题:“卫生和护理工作者的角色随着时代的发展而演变”,“卫生和护理工作者的核心能力对于预防长期护理机构中新出现的传染病至关重要”和“成功预防长期护理设施中新出现传染病的关键是通过系统、全面的努力动员各级卫生和护理人员”。卫生和护理工作者必须承担越来越复杂的角色,并依靠他们的核心能力来应对疫情变化,设施资源、员工素质和管理模式被发现显著改善了感染预防和控制结果。结论:卫生和护理工作者的角色正在演变,长期护理机构中有效的感染预防取决于他们以技能和信心履行核心能力的能力。此外,迫切需要一个系统、全面的框架,本文为此提出了三项指导方针,以确保设施内的政策执行一致,并为卫生和护理工作者提供支持和获得资源。临床相关性:长期护理机构内的感染预防工作必须考虑到卫生和护理工作者不断变化的角色,重点是确保获得资源、培训和支持,帮助他们获得应对这些角色所需的核心能力。此外,迫切需要有助于评估这些能力并确定需要改进的领域的研究工具。
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引用次数: 0
Software-based interventions for low back pain management: A systematic review and meta-analysis 基于软件的腰痛管理干预措施:系统综述和荟萃分析。
IF 3.4 3区 医学 Q1 Nursing Pub Date : 2023-10-10 DOI: 10.1111/jnu.12937
Se Jin Hong PhD, RN, Jinkyung Park PhD, MPH, RN, Soyeon Park BSN student, Bright Eze PhDc, RN, Susan G. Dorsey PhD, RN, FAAN, Angela Starkweather PhD, ACNP-BC, FAANP, FAAN, Kyounghae Kim PhD, RN

Introduction

Using software for self-management interventions can improve health outcomes for individuals with low back pain, but there is a dearth of research to confirm its effectiveness. Additionally, no known research has evaluated the effective elements of software-based interventions for low back pain self-management components. This study aimed to synthesize the effectiveness of software-based interventions to promote self-management health outcomes among individuals with low back pain.

Design

A systematic review and meta-analysis was conducted.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, relevant studies up to July 2022 were searched via four electronic databases: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Web of Science.

Results

4908 adults with low back pain who participated in 23 studies were included. Software-based interventions were effective in reducing fear avoidance (mean difference [MD] = −0.95, 95% CI: −1.45 to −0.44), pain catastrophizing (MD = −1.31, 95% CI: −1.84 to −0.78), disability (MD = −8.21, 95% CI: −13.02 to −3.39), and pain intensity (MD = −0.86, 95% CI: −1.17 to −0.55). Specifically, interventions that included an exercise component were more effective in reducing pain and disability. Additionally, cognitive behavioral therapy (CBT) intervention significantly reduced fear avoidance and pain catastrophizing but had no noticeable impact on disability and pain compared to standard treatment. The certainty of the evidence in this review varied from very low to high across outcomes. The heterogeneity of the study results was significant, suggesting that future studies in this area could optimize the design, time points, measures, and outcomes to strengthen the evidence.

Conclusions

Low back pain self-management interventions delivered through software-based programs effectively reduce pain intensity, disability, fear avoidance, and pain catastrophizing.

Clinical Relevance

Low back pain is among the most common reasons for seeking healthcare visits. Combining exercise and counseling through soft-based programs may effectively address this issue and its associated suffering and disability.

引言:使用软件进行自我管理干预可以改善腰痛患者的健康状况,但缺乏研究来证实其有效性。此外,没有已知的研究评估基于软件的干预措施对腰痛自我管理组件的有效成分。本研究旨在综合基于软件的干预措施的有效性,以促进腰痛患者的自我管理健康结果。设计:进行系统回顾和荟萃分析。方法:根据系统评价和荟萃分析声明的首选报告项目,通过四个电子数据库搜索截至2022年7月的相关研究:PubMed、Embase、护理和相关健康文献累积索引和Web of Science。结果:4908名患有腰痛的成年人参与了23项研究。基于软件的干预措施在减少恐惧回避方面是有效的(平均差异[MD] = -0.95,95%置信区间:-1.45至-0.44),疼痛恶化(MD = -1.31,95%置信区间:-1.84至-0.78),残疾(MD = -8.21,95%置信区间:-13.02至-3.39)和疼痛强度(MD = -0.86,95%可信区间:-1.17至-0.55)。具体而言,包括运动成分在内的干预措施在减少疼痛和残疾方面更有效。此外,认知行为疗法(CBT)干预显著减少了恐惧回避和疼痛灾难,但与标准治疗相比,对残疾和疼痛没有明显影响。这篇综述中证据的确定性从很低到很高不等。研究结果的异质性是显著的,这表明该领域未来的研究可以优化设计、时间点、措施和结果,以加强证据。结论:通过基于软件的程序提供的腰痛自我管理干预有效地降低了疼痛强度、残疾、恐惧回避和疼痛灾难。临床相关性:腰痛是寻求医疗保健就诊的最常见原因之一。通过软性项目将锻炼和咨询相结合,可以有效地解决这个问题及其相关的痛苦和残疾。
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引用次数: 0
The future of open access, open science, and research dissemination 开放获取、开放科学和研究传播的未来。
IF 3.4 3区 医学 Q1 Nursing Pub Date : 2023-09-30 DOI: 10.1111/jnu.12935
Susan Gennaro, Jennifer Seward, Dustin Sullivan
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引用次数: 0
Nurse engagement in antibiotic time-outs: The collaborative process of leveraging design to disseminate research findings 护士参与抗生素停用:利用设计传播研究结果的协作过程。
IF 3.4 3区 医学 Q1 Nursing Pub Date : 2023-09-08 DOI: 10.1111/jnu.12931
Mary Lou Manning PhD, CRNP, CIC, FAAN, Maribeth Kradel-Weitzel BA, MFA

Introduction

Research findings and knowledge translation are typically disseminated via presentations at professional meetings and publication in peer-review journals. However, other opportunities to translate research evidence into practice exist, including the use of visual cues.

Aim

The aim of this paper is to describe the collaborative process of translating key research findings into a clear and compelling visual communication tool.

Design

As part of a multimodal research dissemination strategy, the researchers partnered with the University Health Communication Design Program faculty to develop a visual communication strategy to promote the use of antibiotic time-outs by nurses in a health system. An environmental poster was identified as an appropriate mode of communication for its potential to convey a message quickly, impactfully, and economically.

Methods

Five-step systematic approach, including feedback from end-users.

Results

To augment our research dissemination strategy, an action-oriented visual communication tool in the form of a 36x48 inch poster was created within four weeks and placed in the work environment. Unit nursing leaders and staff decided on poster locations for maximum nurse engagement with the message.

Conclusion

Creating visual communication to display scientific information is an important skill, but most nurse researchers never receive any formal training that encourages participation in collaborative development of visual communication tools. Our collaboration, was iterative, reflective, and provided a unique opportunity for shared learning. Partnering with health communication designers to expand research reach and impact is invaluable and should be considered as part of a dissemination strategy.

Clinical relevance

Clinical nurses' benefit from ‘seeing’ the science narrowed to a simple message in order to spark dialogue or remind them what they need to ‘do’.

引言:研究结果和知识翻译通常通过在专业会议上的演讲和在同行评审期刊上发表来传播。然而,还存在将研究证据转化为实践的其他机会,包括使用视觉线索。目的:本文的目的是描述将关键研究成果转化为清晰而引人注目的视觉交流工具的合作过程。设计:作为多模式研究传播策略的一部分,研究人员与大学健康传播设计项目的教员合作,制定了一项视觉传播策略,以促进护士在卫生系统中使用抗生素。环境海报被认为是一种合适的沟通方式,因为它有可能快速、有影响力、经济地传达信息。方法:五步系统方法,包括最终用户的反馈。结果:为了加强我们的研究传播策略,在四周内创建了一个36x48英寸海报形式的面向行动的视觉交流工具,并将其放置在工作环境中。单位护理领导和工作人员决定了海报的位置,以最大限度地提高护士的参与度。结论:创建视觉交流来显示科学信息是一项重要技能,但大多数护士研究人员从未接受过任何鼓励参与视觉交流工具合作开发的正式培训。我们的合作是反复的、反思性的,为共享学习提供了独特的机会。与健康传播设计师合作以扩大研究范围和影响是非常宝贵的,应该被视为传播战略的一部分。临床相关性:临床护士受益于“看到”科学被缩小到一个简单的信息,以引发对话或提醒他们需要“做什么”。
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引用次数: 0
Impact of home-visit nursing service use on costs in the last 3 months of life among older adults: A retrospective cohort study 老年人在生命最后 3 个月使用上门护理服务对成本的影响:一项回顾性队列研究。
IF 3.4 3区 医学 Q1 Nursing Pub Date : 2023-08-29 DOI: 10.1111/jnu.12934
Tomomi Sakano MSN, RN, Tatsuhiko Anzai PhD, Kunihiko Takahashi PhD, Sakiko Fukui PhD, RN

Introduction

Considering Japan's aging society, the number of older individuals who die at home is expected to increase. In Japan, there are challenges in utilizing and promoting home-visit nursing services at the end of life for community-dwelling older adults. We examined the use of home-visit nursing services at the end of patients' lives and the recommended use patterns of this service (utilization, timing of initiation, and continuity) that contribute to reducing the medical care and long-term care costs (total costs) in the last 3 months of life.

Design

This was a retrospective cohort study.

Methods

We examined 33 municipalities in Japan, including depopulated areas. The analysis included 22,927 people aged 75 or older who died between September 2016 and September 2018. We used monthly medical care and long-term care insurance claims data. Participants were classified into five groups based on their history of home-visit nursing service use: (1) early initiation/continuous use, (2) early initiation/discontinued or fragment use, (3) not-early initiation/continuous use, (4) not-early initiation/fragment use, and (5) no use. Univariate and multivariate linear regression analyses were performed to examine the association between total costs in the last 3 months of life and patterns of home-visit nursing service use.

Results

Overall, the median age was 85, and 12,217 participants were men (53.3%). In the last half year before death, 5424 (23.7%) older adults used home-visit nursing services. Multivariable linear regression analysis of the log10-transformed value of total costs revealed that compared with the no use group, the early initiation/continuous use group was estimated to have 0.88 times (95% confidence interval: 0.84, 0.93) the total costs in the last 3 months of life (p < 0.001).

Conclusion

Early initiation use of home-visit nursing services may contribute to reducing total costs in the last 3 months of life for Japanese people aged 75 years or older living at home as they approach the end of life.

Clinical relevance

When approaching the end of life, many older adults require daily life care and palliative care. Policymakers are strengthening end-of-life care for community-dwelling older adults in Japan. Although the current results do

导言:考虑到日本的老龄化社会,预计在家中去世的老年人数量将会增加。在日本,社区居住的老年人在临终时使用和推广家庭访问护理服务面临挑战。我们研究了患者生命末期家庭巡诊护理服务的使用情况,以及有助于降低生命最后 3 个月的医疗护理和长期护理成本(总成本)的建议使用模式(使用情况、开始时间和持续性):这是一项回顾性队列研究:我们调查了日本的 33 个城市,包括人口稀少地区。分析对象包括 2016 年 9 月至 2018 年 9 月期间死亡的 22927 名 75 岁或以上的老人。我们使用了每月的医疗护理和长期护理保险索赔数据。根据上门护理服务的使用历史,我们将参与者分为五组:(1)早期开始/持续使用;(2)早期开始/中断或片段使用;(3)非早期开始/持续使用;(4)非早期开始/片段使用;(5)未使用。我们进行了单变量和多变量线性回归分析,以研究生命最后 3 个月的总费用与上门护理服务使用模式之间的关联:总体而言,中位年龄为 85 岁,12217 名参与者为男性(53.3%)。在死亡前的最后半年,有 5424 名(23.7%)老年人使用了家庭上门护理服务。对总成本的 log10 变形值进行多变量线性回归分析后发现,与不使用组相比,早期开始/持续使用组在生命最后 3 个月的总成本估计是后者的 0.88 倍(95% 置信区间:0.84, 0.93)(P 结论:早期开始/持续使用组在生命最后 3 个月的总成本估计是后者的 0.88 倍(95% 置信区间:0.84, 0.93):对于 75 岁或以上的日本老年人来说,在生命即将结束时,尽早开始使用上门护理服务可能有助于降低他们在生命最后 3 个月的总费用:临近生命终点时,许多老年人需要日常生活护理和姑息治疗。日本的政策制定者正在加强对居住在社区的老年人的临终关怀。尽管目前的研究结果并不能证明上门护理服务的有效性,但却为评估上门护理服务的使用情况及其对老年人的影响提供了一个视角。这些研究结果有助于考虑如何在家庭护理环境中为那些希望在家度过最后时光的老年人提供护理服务。
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引用次数: 0
How the public perceives the “good nurse” in China: A content analysis of national newspapers 公众如何看待中国的 "好护士"?全国性报纸内容分析。
IF 3.4 3区 医学 Q1 Nursing Pub Date : 2023-08-22 DOI: 10.1111/jnu.12928
Xiao Chen, Yu Du, Zhiyun Shen, Wei Qin, Yuxia Zhang

Introduction

Newspapers are a predominant channel through which the Chinese public learns about nurses and the nursing profession. However, little nursing research has been performed in China to investigate the newspaper portrayal of nurses, and how the public perceives the role of nurses in the Chinese context is still an ambiguous phenomenon. This study aimed to clarify the public portrayals of nurses in China, and to analyze whether there are changes over time in news content related to nurses in the national newspapers.

Design

A content analysis of the newspaper articles citing nurses that have been published since each newspaper was established.

Method

We selected two national daily newspapers as sources to systematically search for articles about nurses from 1949 to 2022. A coding instrument was developed to quantitatively extract the contents of the articles identified. Then, using a mixed methods approach, we analyzed newspaper content to show the roles of nurses presented to the public by the media.

Results

A total of 317 articles were analyzed. Nurses have been depicted with heterogeneous images in both newspapers with positive wordings and up to 28 types of public images. More than half of the articles portrayed two, three, or more types of images. Among the images of nurses identified, “overworked” appeared the most frequently, followed by “dedicated,” “philanthropic and benevolent,” and “with a sense of responsibility,” and then “technically skilled.” By analyzing the image of nurses in both newspapers over time, we found that images related to virtue have largely increased with time, while images about professionalism have decreased.

Conclusion

Nursing continues to be depicted as a virtuous caregiving profession, often forgetting the wide need for knowledge, skill, and expertise required in the occupation. The public image of nurses portrayed in the national newspapers does not accurately match their actual roles.

Clinical Relevance

The public image of nurses portrayed in the national newspapers does not accurately match their actual roles. To actualize a professional role and increase social status of nurses, intentional image management is needed. Nursing schools, nursing associations, and nursing professionals should be more proactive in ov

引言报纸是中国公众了解护士和护士职业的主要渠道。然而,在中国,很少有护理研究对报纸上的护士形象进行调查,公众如何看待护士在中国环境中的角色仍然是一个模糊的现象。本研究旨在厘清中国公众对护士的印象,并分析全国性报纸中与护士相关的新闻内容是否随时间推移而发生变化:设计:对每份报纸创刊以来发表的引用护士的文章进行内容分析:我们选择了两份全国性日报作为资料来源,系统地搜索 1949 年至 2022 年间有关护士的文章。我们开发了一个编码工具,用于定量提取所识别文章的内容。然后,我们采用混合方法对报纸内容进行分析,以展示媒体向公众展示的护士角色:结果:共分析了 317 篇文章。在两份报纸中,护士的形象各不相同,有正面的措辞,也有多达 28 种的公众形象。一半以上的文章描绘了两种、三种或更多类型的形象。在确定的护士形象中,"超负荷工作 "出现的频率最高,其次是 "爱岗敬业"、"乐善好施 "和 "富有责任感",再次是 "技术精湛"。通过分析两份报纸中护士形象的变化,我们发现,随着时间的推移,与美德相关的形象在很大程度上有所增加,而与职业精神相关的形象则有所减少:结论:护士一直被描绘成一个高尚的护理职业,却往往忘记了这一职业对知识、技能和专业技术的广泛需求。全国性报纸对护士公众形象的描述与护士的实际角色并不相符:全国性报纸上的护士公众形象与护士的实际角色不符。为了实现护士的职业角色并提高其社会地位,需要有意识地进行形象管理。护理院校、护理协会和护理专业人员应更加积极主动地克服人们对他们的刻板印象,并利用新闻媒体作为工具,吸引公众对护理价值的关注并与公众进行对话,以重塑公众对专业护士在医疗保健中的专家角色的理解,并为护理工作创造一个全新的、更加专业的形象。
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引用次数: 0
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Journal of Nursing Scholarship
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