Research in Nursing & Health最新文献

To evaluate the effects of social network-based health education on self-management, self-efficacy and HbA1c of older adults with type 2 diabetes mellitus (T2DM). A convenience sample of 64 elderly T2DM patients with poor glycemic control was randomly divided into two groups. The intervention group received social network-based health education with their nominated social network member for 12 weeks, while the control group received health education alone. The scores of Summary of Diabetes Self-Care Activities (SDSCA), Diabetes Self-Efficacy Scale (DSES), and HbA1c were compared between groups at the baseline and after 12 weeks by using RM-ANOVA. Sixty older adults with T2DM, 30 cases in each group, completed the study. The diet and blood glucose testing dimensions of C-SDSCA had an interaction effect on group-by-time (F were 4.700 and 4.752, respectively, p < 0.05). The mean diet dimension score increased by 1.55 in the intervention group, while 0.76 in the control group, and the score of blood glucose testing dimension increased by 3.5 in the intervention group, while 0.75 in the control group. No significant group-by-time differences were found in C-DSES (F = 1.667, p > 0.05) and HbA1c (F = 0.553, p > 0.05). Social network-based health education effectively promotes self-management in diet and blood glucose testing of the elderly T2DM patients with poor glycemic control. Trial Registration: China Clinical Trial Registration Center (ChiCTR2000038177).

Depressive symptoms in youth are influenced by psychosocial stressors and cognitive vulnerabilities. Perceived everyday discrimination (PED) is a common stressor linked to mental health issues, while dysfunctional attitudes (DAs), per Beck's cognitive theory of depression, may mediate these effects. Additionally, depressive symptoms have been associated with physical health outcomes, such as inflammation. We examined relationships between PED, DAs, depressive symptoms, and interleukin-6 (IL-6), a marker of inflammation, in a sample of 98 youth (13-16 years old; 36.4% female, 63.6% male) from diverse racial/ethnic backgrounds (41.4% Black/African American, 34.8% White/European American, 7.1% Multiracial, 2% Hispanic, 1% Native American, 1% Other). Measures included the Everyday Discrimination Scale, Dysfunctional Attitudes Scale, Center for Epidemiological Studies Depression Scale, and saliva samples. Our regression analyses demonstrated that PED was significantly associated with both DAs and depressive symptoms as well as that DAs were significantly associated with depressive symptoms and IL-6, while neither PED nor depressive symptoms were significantly associated with IL-6. Consistent with the regressions, our mediation analyses revealed no significant indirect effects of PED on IL-6 through DAs, depressive symptoms, or their sequential combination. Our findings support the role of PED as a stressor within Beck's cognitive theory and expand the theory's application by linking DAs to inflammatory processes. Given these connections, nurses can play a crucial role in implementing cognitive interventions to mitigate the effects of DAs and advocating for systemic change to reduce discrimination.

Artificial Intelligence (AI)-based applications have significant potential to differentiate between pressure injuries (PI) and incontinence-associated dermatitis (IAD), common challenges in nursing practice. Within the KIADEKU overall project, we are developing an AI-based application to aid in the nursing care of PI and IAD and to facilitate personalized, evidence-based nursing interventions. The KIADEKU clinical sub-study described in this study protocol is a controlled, non-randomized clinical pilot intervention study investigating the effects of the AI-based application, fully developed in the KIADEKU overall project, on the duration of wound assessment, dressing change and documentation, guideline adherence, and nurse task load. The study utilizes a pre-post design with two data collection periods. During the initial phase, we will observe and survey nurses in the control group as they provide conventional wound care without AI support to adult patients with PI or IAD in the pelvic area across eight wards at the LMU University Hospital. In the following intervention phase, the AI-based application will assist nurses in wound assessment and deliver guideline-based nursing interventions for documented wound types. Observations and surveys will be repeated. Measurements will include the duration of wound assessment, dressing changes, and documentation, adherence to wound care guidelines, and the accuracy of AI predictions in clinical settings, validated by an on-site expert assessment. The survey will assess nurses' task load and other covariates, such as professional experience, overall workload during the shift, and wound severity. Linear regression models will be used to analyze the effects of AI usage on the aforementioned aspects, taking into account these covariates. The accuracy of AI predictions regarding wound type and classification will be measured using the on-site expert's assessment as the ground truth. The usability of the AI-based application and standard clinical documentation systems will be evaluated further. The deployment of the AI application in clinical settings aims to reduce the duration of wound assessments, dressing changes, and documentation; decrease nurse task load; enhance guideline adherence in wound care; and promote AI utilization in nursing. German Clinical Trials Register (DRKS) (DRKS00031355). Registered on April 5th, 2023. TRIAL REGISTRATION: German Clinical Trials Register (DRKS) DRKS00031355. Registered on April 5^th 2023. PATIENT OR PUBLIC CONTRIBUTION: Patient representatives contributed to the development of the AI-based application through the use of Delphi methodology, as part of the KIADEKU qualitative sub-study.

Body mass index (BMI) is an inexpensive, easy-to-calculate, and noninvasive marker of malnutrition. Few studies have examined the longitudinal effects of BMI on the incidence of unfavorable physical health outcomes (UPHOs) among older adults receiving homecare nursing. Therefore, this prospective cohort study examined the longitudinal effects of low BMI on the occurrence of UPHOs at multiple time points (i.e., 1-, 3-, and 6-months) among older adults (≥ 75 years) receiving homecare nursing across Japan. Using an online questionnaire, homecare nurses reported clients' height and weight, as well as socio-demographic characteristics (e.g., age and gender) and health conditions (e.g., diagnosis and dependency level). The occurrence of seven UPHOs (urinary tract infection, respiratory infection, pressure ulcer or skin tear, dehydration, poor dyspnea control, poor pain control, and traumatic fall) was also reported. The longitudinal effects of low BMI on the total number of UPHOs at 1-, 3-, and 6-months follow-ups were examined using a Restricted Moment Model (RMM) with a log link function. Among 660 participants included in the analysis, 42.12% were males, 36.96% had dementia, and 44.09% had low BMI. Adjusting for client's characteristics and the number of UPHOs at the baseline, low BMI at the baseline could increase the incidence of UPHOs at 1-, 3- and 6-month follow-ups (incidence rate ratio [95% confidence interval]:1.59 [1.21, 2.07], 1.57 [1.18, 2.07], 1.35 [1.02, 1.79], respectively). Adequate management of low BMI among older adults receiving homecare nursing would have a favorable effect on reducing the occurrence of UPHOs, thereby reducing the deterioration of overall physical conditions.

Pain in neonates causes many negative effects, such as decreased oxygenation, deterioration in hemodynamics, and increased intracranial pressure. Mothers may experience anxiety while observing the infant experiencing pain. The aim of this study was to determine the effect of gentle human touch (GHT), applied by mothers, on the infant's physiological and pain responses during venipuncture, the mother's associated anxiety levels, and the correlation between infant pain and maternal anxiety. A randomized controlled study was conducted with 80 healthy preterm infants (40 GHT and 40 control) being seen in the neonatal follow-up clinic 24-48 h post discharge from the hospital in Turkiye. Infants were 32-37 weeks gestational age. Infant pain was rated with the Neonatal Infant Pain Scale (NIPS), oxygen saturation and heart rate (HR) were taken from clinic monitors, length of crying was measured in minutes with a stop watch, and maternal anxiety was assessed with the State-Trait Anxiety Inventory (STAI-I). Infants in the GHT group had higher oxygen saturation values, lower pain scores, and shorter crying duration, but higher peak heart rates. Their mothers had lower anxiety scores. Maternal anxiety was strongly correlated with infant pain levels. The GHT method applied by mothers during venipuncture was shown to be effective in reducing infant pain, regulating infant physiological parameters, and reducing maternal anxiety. Trial Registration: NCT05727631.

This narrative review aims to identify the role of public health nurses in rural areas and provide a comparative description of their roles and duties. The literature search was conducted in May 2024 using four electronic databases including PubMed, EMBASE, CINAHL, and COCHRANE. The review adhered to the Preferred Reporting System for Systematic Review and Meta-Analysis. Of the 2249 retrieved articles, 500 duplicates were removed. After title and abstract screening, 1734 were excluded, followed by two due to unavailable full text. Six more did not meet eligibility criteria, while two additional articles were identified through hand searching. Study quality was assessed using the Mixed Methods Appraisal Tool. Nine studies were selected, including four descriptive studies, one mixed-methods study, and four qualitative studies. In all nine studies, the nurse was a registered nurse; some studies also included practice nurses and advanced practice nurses. From the selected studies, eight distinct roles of rural public health nurses were identified: Assessment, Health Prevention and Promotion, Intervention, Care Coordination and Management, Communication, Community Solidarity, Education and Research, and Administration and Evaluation. Duties were matched according to these roles. This review highlights the essential roles and duties of rural public health nurses, providing foundational data for future research and practice, guiding the development of standardized role definitions, job descriptions, and training programs for rural public health nurses.

Application of qualitative enquiry is necessary to improve the understanding of patient experience during paramedic-led healthcare. Grounded Theory (GT) is acknowledged as a rigorous qualitative methodology useful for exploring social processes present during healthcare, particularly when little existing knowledge or theory exists. Despite wide use of GT in other health disciplines there are few studies that have used this methodology to guide research in paramedicine. This may be due to GT methods appearing complex and disorientating for both novice and experienced researchers. This methodological article provides a practical example of how Kathy Charmaz's "constructivist" approach to grounded theory (GTc) was applied during research that explored how patients experience paramedic-led healthcare during non-conveyance situations. It explains the fundamental tenets required of GTc research and describes how they were employed during the example research. The article aims to demystify the GTc process and improve the rigour of qualitative GTc research in paramedicine and health disciplines. How to apply Constructivist Grounded Theory methodology is described by providing a practical example of research into patient experience. This article informs researchers how to maintain trustworthiness and credibility when applying GTc methodology. This article describes research that explored how patients experience paramedic-led healthcare. The data was generated through individual interviews between the researcher and patients who had recent experiences of ambulance service healthcare that resulted in not being transported to a hospital ED. Patients or the public were not involved in the conceptualisation or research design of this article or the practical example provided.