Research in Nursing & Health最新文献

Type 2 diabetes mellitus (T2DM) affects the patient's quality of life. Currently, hypoglycemic drugs are mainly used for the standard care for T2DM, but they appear to cause many adverse reactions. As a traditional therapy, acupuncture has been gradually applied to the treatment of T2DM. However, the best acupuncture regimen is still uncertain. Therefore, we evaluated the clinical efficacy of various acupuncture therapies in the treatment of T2DM. Up to December 2nd, 2024, eight databases were searched. The data were analyzed using Stata 15.1 and R 4.2.1 software. The included studies were assessed for bias using the Cochrane risk of bias tool (RoB2.0). A total of 139 randomized controlled trials were included, involving 12,231 patients with T2DM. The results showed that compared with conventional treatment (CT), body acupuncture + CT had the best effect on improving fasting blood glucose (FBG) (MD = -0.84, 95% CI: -1.01, -0.67; SUCRA = 84.44%) and HbA1c (MD = -1.08, 95% CI: -1.42, -0.76; SUCRA = 87.44%); auricular acupuncture + CT had the best effect on improving 2 h postprandial blood glucose (2hBG) (MD = -1.56, 95% CI: -2.05, -1.06: SUCRA = 82.10%), and laser acupuncture + CT had the best effect on improving homeostasis model assessment for insulin resistance (HOMA-IR) (MD = -2.46, 95% CI: -5.85, 0.96; SUCRA = 83.95%), fasting insulin (FINS) (MD = -7.21, 95% CI: -19, 4.54; SUCRA = 82.00%) and overall response rate (RR = 1.45, 95% CI: 0.97, 2.31; SUCRA = 84.00%) Acupuncture can effectively improve diabetes related indicators. Body acupuncture, auricular acupuncture, and laser acupuncture appear to be the most advantageous options for managing T2DM. However, due to the low quality of the included studies, more evidence may be needed to verify the conclusions.

Understanding how older adults make decisions about their self-care is essential for designing tailored interventions that promote autonomy and well-being. However, no instrument currently exists to specifically measure self-care decision-making styles in this population. The study aimed to develop and test the psychometric properties of the Self-Care Decision-Making Styles of Older Adult (DECIDE) Inventory, a new instrument designed to assess styles of self-care decision-making among older adults. A three-phase process was undertaken: (i) instrument development based on theory and previous studies; (ii) content validity evaluation with 10 experts and cognitive interviews with 10 older adults; and (iii) psychometric testing, including assessment of structural and construct validity, internal consistency, and test-retest reliability. A convenience sample of 350 older adults from various Italian regions participated in the validation phase. The study followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) reporting guidelines. Following content validation, an instrument was finalized, assessing four decision-making styles-independent, responsible, self-neglected, and guided-, with five items per scale. Confirmatory factor analyses supported the structural validity of the four-scale model. Construct validity was confirmed through hypothesis testing. Reliability indicators, including Omega coefficients, factor score determinacy, item-total correlations, and intraclass correlation coefficients, ranged from adequate to optimal across all scales. The Self-Care Decision-Making Styles of Older Adult Inventory demonstrated good validity and adequate reliability for assessing self-care decision-making styles in older adults. Further refinement and cross-cultural validation are recommended before its use in clinical practice.

This study aimed to develop and validate the Traditional Chinese version of the Interprofessional Collaborative Competency Attainment Survey (TC-ICCAS), a culturally sensitive tool for assessing interprofessional education (IPE) competencies in Taiwan's hierarchical healthcare system. Conducted from 2022 to 2023 at a tertiary medical center and guided by the COSMIN framework, this psychometric validation study involved 324 early-career healthcare professionals. A three-phase process was employed: (1) translation and cultural adaptation with expert review; (2) pilot testing with 30 professionals to ensure cultural relevance; and (3) field testing using post-IPE program surveys. Confirmatory factor analysis (CFA) of the field test data confirmed the instrument's six-domain structure (communication, collaboration, roles and responsibilities, patient-centered care, conflict management, and team functioning) and established its construct validity. All subscales demonstrated high internal consistency (Cronbach's α = 0.86-0.93). Notably, the limited discriminant validity of the "roles and responsibilities" domain was interpreted not as a flaw, but as evidence of the tool's cultural sensitivity, reflecting the authentic role overlap common in Confucian-influenced contexts. The TC-ICCAS provides a reliable and valid tool for evaluating IPE outcomes, filling a critical gap in culturally appropriate instruments for hierarchical settings. Its use can enhance interprofessional training and holds the potential to improve teamwork and patient safety in Taiwan and similar Asian healthcare contexts. No patient or public contribution was included as the study focused on professional competencies.

To estimate the pooled prevalence of feeding difficulties among persons with dementia and to explore heterogeneity, including regional differences and study characteristics. Feeding difficulties, including impaired ability to feed oneself, swallowing problems, reduced appetite, and behavioral resistance to eating, are common among individuals with dementia, leading to malnutrition, and caregiver burden. Evidence on the prevalence of feeding difficulties is fragmented, with no prior meta-analysis available. Six databases were searched until April 2025 for observational studies. This systematic review and meta-analysis followed MOOSE and PRISMA guidelines with PROSPERO registration (CRD420251024333). Studies were included if they reported feeding difficulty prevalence in dementia using validated instruments or clinical observation. Two reviewers independently screened studies, extracted data, and assessed quality using the Newcastle-Ottawa Scale. Pooled prevalence and 95% prediction intervals were calculated using a random-effects model with Freeman-Tukey double arcsine transformation. Subgroup analyses and meta-regression explored heterogeneity. Fifteen studies involving 3175 participants were included. The pooled prevalence of feeding difficulties among persons with dementia was 48% (95% PI: 38%-59%), with significant heterogeneity (I² = 97%). Prevalence was notably higher in studies conducted in Asia (59%) compared to non-Asian regions (32%). Neither publication year nor mean participant age significantly moderated prevalence estimates. Nearly half of individuals with dementia experience feeding difficulties, with particularly high prevalence in Asia. This regional disparity stresses the importance of routine assessment. High heterogeneity and inconsistent disease staging reporting call for standardized assessments and further research across dementia stages to improve care globally.

Timely and adequate prenatal care (PNC) is essential for optimizing maternal and infant health outcomes. However, persistent disparities in PNC utilization exist in the United States, particularly among ethnic/racial minority populations. While discrimination has been recognized as a barrier, its multifaceted influence across social and structural contexts remains underexplored. This systematic review, guided by the Social-Ecological Model, synthesizes evidence on how various forms of discrimination affect PNC utilization. We conducted comprehensive searches in PubMed, Web of Science, and CINAHL for peer-reviewed studies published in the United States between 2010 and 2024. After screening 342 records, 11 studies met the inclusion criteria. Five studies employed qualitative methods, five used quantitative methods, and one utilized a mixed-methods approach. Findings revealed that structural discrimination, such as language barriers and institutional policies, was associated with delayed or insufficient PNC utilization. Interpersonal dynamics, including negative patient-provider interactions and implicit bias, discouraged engagement with care. Additionally, intrapersonal factors, like internalized discrimination, shaped perceptions of care quality and trust in healthcare systems. The review highlights how discrimination operates across multiple levels to influence PNC behaviors and outcomes. Addressing discrimination requires culturally responsive care models, provider training in cultural humility, and institutional reforms aimed at equity. Future research should explore protective factors, such as social support and resilience, that may buffer the negative effects of discrimination. Understanding these dynamics is crucial for developing interventions that promote equitable and effective PNC utilization.

Increasing reliance on Internationally Educated Nurses (IENs) in the U.S. healthcare system, particularly in Long-Term Care (LTC) settings, necessitates an in-depth exploration of their transition experiences. The primary purpose of this qualitative study was to understand how IENs describe their experiences transitioning to work with older adults in LTC settings in the United States and the policies and practices that contribute to the successful integration of IENs. A qualitative descriptive design was used, including one-time individual interviews with 22 IENs working in various LTC settings across the United States via Zoom using a semi-structured interview guide. Demographic data were analyzed using descriptive statistics, while NVivo 14 software was utilized to organize the data; verified verbatim transcripts were subjected to thematic analysis. Three key themes were identified: Systemic and Practice-Based Barriers to IEN Integration, Structural and Social Enablers of IEN Integration, and Role of Structured Support Systems in the IENs' Transition. This study highlighted the critical challenges and facilitators that influence IENs during their integration into LTC settings in the United States. Participants reported concerns, specifically noting experiences of racial discrimination and xenophobia perpetrated by co-workers, patients, and patients' families. These experiences highlight the complex interpersonal dynamics faced by IENs, underscoring the need for proactive strategies to mitigate discriminatory practices and provide culturally sensitive orientation and mentorship programs to support the smooth integration of IENs into LTC settings. Addressing these challenges can have profound implications for strengthening inclusivity and enhancing the overall resilience of the U.S. nursing workforce, particularly within LTC environments.

Type 2 diabetes (T2D) is a growing global health concern, including in Israel. Effective Diabetes self-management (DSM) is critical for achieving glycemic targets and preventing complications. While several tools exist to assess DSM, none have been translated for Hebrew-speaking populations. This study aimed to translate the Diabetes Self-Management Questionnaire (DSMQ) into Hebrew (H-DSMQ) and evaluate its psychometric properties. The DSMQ was translated into Hebrew using a standard forward-backward translation procedure. A convenience sample of 220 community-dwelling adults with T2D in Israel was recruited via PANEL4ALL. Internal consistency was tested with Cronbach's α. Construct validity was examined via Confirmatory Factor Analysis and known-groups validity, and criterion validity through correlations between H-DSMQ scores, HbA1c, and BMI. The H-DSMQ construct validity was supported by CFA. In addition, known-groups validity was established, with participants with less than 7% reporting significantly higher self-management in glucose monitoring, dietary control/nutrition management, and healthcare use compared to those with above 7.1% HbA1c levels. Criterion validity was demonstrated by significant negative correlations between HbA1c and healthcare use/glucose monitoring, and between BMI and nutrition management/physical activity. The reliability of the H-DSMQ subscales ranged from poor (healthcare use, α = 0.461) to good (physical activity, α = 0.83). The H-DSMQ is a reliable and valid tool for clinical and research purposes to assess self-care behaviors related to blood glucose management in Hebrew-speaking adults with T2D. The H-DSMQ may support nurses by encouraging constructive and comprehensive dialog for assessing DSM.

Pain and pain-related functional limitations are common in fibromyalgia patients. In this regard, attempts to cope with pain and related symptoms are important. This study was conducted to investigate the effect of progressive muscle relaxation exercises on pain, kinesiophobia and functional status in fibromyalgia patients. This randomized controlled study has been conducted with 85 individuals diagnosed with fibromyalgia between November 2022 and June 2023. The study consisted of experimental and control groups. Progressive relaxation exercise was applied to the experimental group 2 days a week for 8 weeks. Data have been collected with Descriptive Information Form, Visual Analogue Scale, Tampa Scale of Kinesiophobia, and Revised Fibromyalgia Impact Questionnaire. In this study, it has been determined that Visual Analogue Scale, Tampa Scale of Kinesiophobia and Fibromyalgia Impact Questionnaire total mean scores of the progressive muscle relaxation exercise group have decreased significantly compared to the control group (p < 0.01). This study has shown that progressive muscle relaxation exercises improve pain, kinesiophobia and functional status in fibromyalgia patients. It is recommended to be applied by individuals with chronic pain and in clinics. Trial Registration: This study is registered in the Clinical Trial Registry (registration number NCT05695274).