Research and Theory for Nursing Practice最新文献

Background and Purpose: Quality of life (QoL) and self-care behaviors (SCB) are crucial for patients with heart failure, yet the uncertainty surrounding health outcomes can severely undermine these aspects, particularly in patients with heart failure with reduced ejection fraction (HFrEF). This study aimed to determine the collective impact of perceived uncertainty on both QoL and SCB in HFrEF patients. Methods: A cross-sectional study was conducted among 118 HFrEF patients recruited from cardiology clinics. Data were collected using the Mishel Uncertainty in Illness Scale-Community Form, the Left Ventricular Dysfunction Scale, and the European Heart Failure Self-Care Behavior Scale. The primary analysis, a one-way multivariate analysis of variance (MANOVA), assessed the relationship between uncertainty and the combined outcomes of QoL and SCB. Additional analyses, including a two-way MANOVA and multiple regression, examined predictors such as age, gender, body mass index, and New York Heart Association (NYHA) class. Results: Of the participants, 62.7% reported low uncertainty. Higher levels of uncertainty significantly predicted lower QoL and SCB scores (F = 15.795, p < .001, η² = .216). Other significant predictors included age, gender, body mass index, duration since diagnosis, and NYHA class. Implications for Practice: These findings highlight the pressing need for health care professionals to address uncertainty in HFrEF patients through tailored interventions. Reducing uncertainty can enhance both QoL and SCB, empowering patients to manage their condition more effectively. Future research should develop and evaluate interventions that reduce uncertainty, thereby fostering improved patient engagement, resilience, and long-term well-being.

Background and Purpose: The study investigates the effects of Orem's self-care model on balance and motor function in patients with Parkinson's disease (PD), aiming to enhance self-management abilities. Methods: Sixty-one PD patients were selected and divided into an experimental group (31 participants) receiving Orem's self-care interventions and a control group (30 participants) receiving standard care. The experimental group received Orem's self-care intervention, whereas the control group received standard care. The Berg Balance Scale (BBS) and the third part of the Unified Parkinson's Disease Rating Scale (UPDRS-III) scores were recorded and analyzed for both groups before and after the nursing intervention. Multiple linear regression was used to analyze the relationship between pre- and postintervention changes in BBS and UPDRS-III scores in the intervention group, considering factors, such as marital status, education level, place of residence, disease duration, and rehabilitation exercise participation. Results: After the intervention, the experimental group demonstrated significantly improved scores, with a BBS score of 34.81 ± 3.24 and a UPDRS-III score of 25.16 ± 5.49, compared with the control group, which had a BBS score of 29.54 ± 3.20 and a UPDRS-III score of 31.60 ± 7.69. The differences were statistically significant (t = 6.391, p < .001; t = 3.775, p < .001). Age and disease duration were negatively correlated with changes in BBS (ΔBBS) and UPDRS-III (ΔUPDRS-III), whereas education level showed a positive correlation with these changes. Implications for Practice: Incorporating Orem's self-care model into the nursing care of PD patients can lead to significant improvements in their balance and motor function.

Background: Transurethral resection of the prostate (TURP) is a common surgical procedure for benign prostatic hyperplasia. However, postoperative care often lacks continuity after hospital discharge, potentially leading to complications and reduced quality of life. Objective: The aim of the study was to develop and evaluate the effectiveness of a continuing care program based on Orem's Self-Care Model for patients after TURP. Methods: A quasi-experimental study was conducted with 97 patients with post-TURP. Participants were assigned to either the intervention group receiving the Orem-based continuing care program or the control group receiving standard care. The program included educational interventions, self-care skills training, and follow-up support. Outcomes were measured using the Self-Care Agency Scale, International Prostate Symptom Score (IPSS), and Quality of Life (QoL) scale at baseline, 1 month, and 3 months postdischarge. Results: The intervention group showed significant improvements in Self-Care Agency, IPSS scores, and QoL (WHOQOL-BREF Physical Health domain increase) compared with the control group at the 3-month follow-up (p < .001). The incidence of postoperative complications was lower in the intervention group without statistically significant differences. Conclusion: The continuing care program based on Orem's Self-Care Model effectively improved self-care abilities and quality of life in patients after TURP.

Background: Understanding ethics in health care research is necessary to solve moral conflicts that may arise during the research process. Guidelines have been proposed to ensure a standardized ethical approach. However, the use of proxy responses in research involving stroke survivors raises ethical debate due to the vulnerabilities of stroke survivors and the discrepancies observed between proxy and patient perspectives. Aim: This article aims to discuss the ramifications and ethical considerations associated with using proxy responses to examine the health-related quality of life of stroke survivors. Discussion: This article suggests a level of agreement on the ability to use proxy data with stroke survivors but with careful consideration of the nature of the data and how the result will be interpreted. The article also highlights the discrepancies between proxy and patient preferences. Strategies such as employing validated tools, integrating proxy data with patient observations, and providing proxy training are proposed to enhance data reliability. Conclusion: Proxy data serves as a feasible and ethical method to examine the health-related quality of life of stroke survivors when direct patient responses are unavailable. Addressing the discrepancies and ethical concerns through innovative approaches is essential to improve proxy-reported data in research and practice.

Background: Understanding and promoting healthy eating behaviors in young children is essential for their immediate and long-term health outcomes. However, these behaviors are influenced by an intricate network of factors that extend beyond individual choices, posing challenges for health practitioners seeking effective interventions. Purpose: This article aims to explore how the Social Ecological Model (SEM) can serve as a framework for understanding the multilevel determinants of young children's eating behaviors, and the seminal role that nursing plays in this dynamic. Discussion: The SEM encompasses five levels of influence: individual, interpersonal, community, organizational, and policy. At the individual level, factors include the child's biological predispositions and nutritional knowledge. The interpersonal level highlights the role of parents and caregivers in modeling and shaping dietary habits. Community influences focus on access to nutritious foods and social norms, while the organizational level emphasizes the importance of schools and health care settings in reinforcing healthy eating. The policy level addresses government regulations and public health initiatives that shape the food environment. Together, these interconnected layers provide a comprehensive understanding of the factors impacting children's eating behaviors. Implications for Nursing: By applying the SEM, nursing professionals can develop multilayered, culturally sensitive interventions that address these determinants, advocating for policies and practices that support healthy eating habits and promote holistic well-being in children.

Background and Purpose: Various nursing interventions can improve the treatment process of patients with heart failure. However, the effectiveness of these interventions can be different. Therefore, it is required to summarize these relationships. This systematic review and meta-analysis aimed to examine the effects of various types of nursing interventions on improving patients with heart failure. Methods: Two groups of keywords were searched in five databases. After removing irrelevant articles, the required information was extracted from the remaining papers. Also, the quality level of the papers was determined using the critical appraisal tools provided by the Joanna Briggs Institute. In addition to the descriptive findings, a case-control meta-analysis was also conducted on the values of compliance and satisfaction rates reported in some studies. Results: Forty-nine papers were included in the study. The results of all studies showed that various types of nursing can effectively influence the improvement of patients with heart failure. Among these interventions, comprehensive nursing, evidence-based nursing, and continuous nursing had the highest effectiveness. However, motivational interventions, telephone interventions, educational nursing interventions, and self-care interventions despite low cost could influence patient improvement. The results showed that nursing intervention in the case group compared with the control group could significantly decrease the complication rate (-11.22 [95% CI: -13.56, -8.87]) and increase the satisfaction rate (2.46 [95% CI: 1.79, 3.12]) in the patients. Implications for Practice: It is recommended that a set of nursing intervention measures can significantly improve the physical and mental conditions of patients with heart failure.

Background and Purpose: Chronic renal failure is a common public health problem worldwide, and hemodialysis has become the standard treatment. During this long and exhausting process, it is extremely important that individuals undergoing hemodialysis receive effective and high-quality nursing care so that accurate prognoses can be made and complications prevented. This study aimed to determine the effect of comfort theory-based nursing care on intolerance to uncertainty and comfort levels in hemodialysis patients. Methods: The sample of this randomized controlled study consisted of individuals receiving hemodialysis at a private dialysis center. The sample comprised a total of 60 patients, 30 in the experimental group and 30 in the control group. Patients in the experimental group received training during an 8-week dialysis period using nursing care interventions based on Katharine Kolcaba's comfort theory for health care needs. The training content covered holistic nursing care and consisted of physical, psychospiritual, sociocultural, and environmental dimensions in order to reduce uncertainty and increase comfort levels in the individuals receiving dialysis. This care was based on Kolcaba's comfort theory. A Personal Information Form including the individuals' descriptive, disease, and treatment characteristics, the Intolerance of Uncertainty Scale (IUS), and the General Comfort Questionnaire (GCQ) were used for data collection. Independent two-sample comparisons were performed using the χ² test for qualitative variables and the t test for quantitative variables. Results: In the comparison of the groups, there were significant results for the total GCQ and its subdimensions except for the relief subdimension (p < 0.05). The scores for the total IUS and its subdimensions were significant (p < 0.01). Implications for Practice: It was determined that comfort theory-based nursing care interventions were effective in reducing the level of intolerance of uncertainty and increasing the comfort level. It is recommended that comfort theory-based nursing care guidelines should be used to reduce the sense of uncertainty and increase the comfort levels of individuals receiving hemodialysis.

Purpose: The purpose of the study is to propose a new conceptual definition for cognitive health motivation and identify its attributes, antecedents, consequences, and empirical referents. Methods: Walker and Avant's method was used to analyze the concept of cognitive health motivation. The PubMed, Web of Science, Wiley Online Library, Embase, China National Knowledge Infrastructure, Wanfang Data, and CQVIP Chinese Journals Platform databases were searched. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 checklist was used. Results: Five attributes of the concept of cognitive health motivation were identified: cognitive health beliefs, cognitive health intentions, perception of cognitive health risks, perception of cognitive health benefits, and dynamically evolving. The antecedents are knowledge related to cognitive health, cognitive health assessment, and cognitive decline. The consequences are cognitive health behavior, cognitive health enhancement, and successful cognitive aging. Based on these attributes, a conceptual definition was proposed. Conclusion: In the context of aging, a clarified definition of cognitive health motivation will aid in understanding the concept, explaining the process of changes in cognitive health behavior, providing guidance for the implementation of cognitive health interventions, and improving cognitive health.

Purpose: This study aimed to identify and compare the chemotherapy-induced symptoms perceived as distressing by pediatric oncology patients and nurses, utilizing both patient-reported outcomes and proxy report outcomes frameworks. Methods: This cross-sectional, descriptive study was conducted in three university hospitals in Türkiye between January 2023 and December 2023. A total of 122 pediatric oncology patients and 139 pediatric oncology nurses participated. The Children's Memorial Symptom Assessment Scale was used to rank the perceived distress of symptoms. Results: Both pediatric oncology patients and nurses identified lack of energy, pain, nausea, feeling nervous, and feeling drowsy as the five most distressing symptoms. However, discrepancies were noted between the two groups: Pediatric oncology nurses reported higher distress rankings for symptoms such as nausea (p = .018), dry mouth (p = .027), cough (p = .030), mouth sores (p < .001), and difficulty swallowing (p = .003) compared with the patients. Conversely, pediatric oncology patients reported higher distress rankings for feeling nervous (p = .016), weight loss (p = .003), constipation (p = .014), and swelling of arms/legs (p < .001). Conclusions: The study revealed a general alignment in the ranking of distressing symptoms between pediatric oncology nurses and patients, with some notable differences. Practice Implications: Understanding the differences in symptom perception between patients and nurses is crucial to enhancing patient-centered care in pediatric oncology. Tailoring interventions to address the specific distress identified by patients and nurses can improve care outcomes and patient well-being.

Background and Purpose: A good understanding of nursing organizational well-being can allow nurse managers to monitor their work context, guide clinical practice, and improve care quality. Theoretical studies of nursing organizational well-being are limited, and this article proposes a situation-specific theory. Methods: The article's content explains the development of this situational theory of nursing organizational well-being following the integrative approach by Im and Meleis by checking assumptions for theorization, initiating theorization through multiple sources, reasoning through critical analyses, documenting theorization, and reporting and sharing theorization. Results: Eight theoretical propositions are conceptualized, emphasizing the interconnectedness of various professionals and work context factors with nursing organizational well-being and related outcomes. Nursing demands and nursing resources have been identified in this situational theory as crucial in determining nursing organizational well-being. Implications for Practice: This article discusses the implications of developing knowledge on nursing organizational well-being. Using this situational theory, researchers can understand the variables determining nursing organizational well-being, and the theory can guide their research study. Health care managers can also use this situational theory to evaluate the nursing work environment and the variables influencing it, subsequently improving outcomes for nurses, organizations, and patients.