Research in Nursing & Health最新文献

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.

To explore the incidence and risk factors for medical adhesive-related skin injury (MARSI) in cancer patients in China, and to provide a basic framework for approaches designed to reduce the occurrence of MARSI and improve the management of its risk factors. PubMed, Web of Science, The Cochrane Library, EmBase, CNKI, VIP, Wanfang, and CBM were searched from database inception to October 2024. The Agency for Healthcare Research and Quality and the Newcastle-Ottawa Scale were used to assess the quality of the included studies, and a random-effects model with Stata 15.0 software was utilized for calculating the pooled incidence and risk factor for MARSI in cancer patients. A total of 18 studies were included, with 11,393 patients. Meta-analysis showed that the pooled incidence of MARSI in Chinese cancer patients was 24%. In subgroup analyses, dermatitis demonstrated the highest incidence rate (10%). MARSI history, allergy history, dressing type (3M), puncture site (upper arm), gender (female), BMI > 25 kg/m², moist skin, and age (≥ 50 years) were risk factors for MARSI in cancer patients. The incidence of MARSI in Chinese cancer patients is high, and MARSI history, allergy history, dressing type (3M), puncture site, gender (female), BMI > 25 kg/m², moist skin, and age (≥ 50 years) were risk factors for the occurrence of MARSI in Chinese cancer patients, suggesting that early identification and protection of high-risk patients, and timely targeted preventive measures are important to reduce the incidence of MARSI in cancer patients.

This study aimed to examine the effect of work environment and work-related characteristics of front-line nurse managers on their perceived individual work performance. It was conducted between March and May of 2022 with 219 front-line nurse managers working in a private chain hospital group in Türkiye. The Nurse Manager Practice Environment Scale and the Individual Work Performance Questionnaire were used for data collection. Descriptive statistics, Spearman correlation analysis, and generalized linear model regression analysis were used in data analysis. A positive correlation was found between the scores obtained from the two scales (r = 0.453; p < 0.001). Regression analysis revealed that two independent variables-nurse manager's work environment and duration of managerial experience-predicted nurse managers' perceived individual work performance level, with these variables explaining 28.1% of the total variance. Results showed that a favorable work environment and four or more years of managerial experience enhanced the perceived individual performance of front-line nurse managers. These findings suggest that to improve the individual work performance of front-line nurse managers, their work environment must also be improved. In addition, retention strategies that target experienced front-line nurse managers are critical to maintaining high levels of performance.

The ongoing regional nursing shortages in the United States, exacerbated by the COVID-19 pandemic, compromise patient safety and quality. Additionally, an aging workforce coupled with an aging population requiring more nursing care services limits organizations' ability to adequately staff their facilities. Nurses' turnover from the profession has been studied less than organizational turnover, thus, the purpose of this integrative review is to identify factors associated with intention to leave the nursing profession in the United States. Using Whittemore and Knafl's (2005) guidelines for integrative review methods, we conducted systematic searches in CINAHL, PubMed, and Web of Science in July 2024. There were 39 peer-reviewed studies that met inclusion criteria. Synthesis of findings resulted in four individual and four work-level themes associated with intent to leave the nursing profession. Individual themes included individual beliefs, health and wellbeing, individual work experiences, and career stability. Work-level themes included job characteristics, job demands/workload, resources and support, and work environment. Notably, job-level factors (i.e., workload, work environment, and support) were associated with professional turnover intention, which suggests that nurses do not believe their experiences will improve at another nursing job. Gaps in the literature include studies with nationally representative samples, studies using validated measures of health, and qualitative studies conducted with the aim of understanding why nurses want to leave the profession. To promote retention of nurses at the professional and organizational level, organizations should measure and modify relevant job-level factors, and the protection of nurses' wellness should be a top organizational priority.

Despite negative outcomes, being diagnosed with Crohn's disease, a chronic lifelong condition, may prompt individuals to undergo positive psychological and emotional growth. However, understanding the dynamic process of posttraumatic growth in Chinese patients with Crohn's disease remains unknown. Therefore, this study aims to longitudinally explore the posttraumatic growth process in newly diagnosed Chinese patients with Crohn's disease. Semi-structured interviews were conducted at 3, 6, and 12 months post-diagnosis in 16 patients. Conventional content analysis revealed a four-stage trajectory of posttraumatic growth: enduring hardships, accepting illness, living with illness, and achieving personal growth. Generally, disease-related suffering diminished, and acceptance of the disease by patients improved over time. Additionally, the capacity of patients to self-manage disease enhanced and their manifestations of posttraumatic growth increased. Overall, patients transitioned from a state of severe trauma coupled with nascent personal growth to a state of reduced trauma and profound personal growth. However, challenges persist throughout this process. Moreover, patients with Crohn's disease may continue to struggle with perceived limitations in their development and find it difficult to accept their illness, especially during relapses and complications. They may also experience reduced vigilance in managing their condition. Healthcare staff could provide targeted guidance based on the characteristics of different stages to help patients with Crohn's disease tap into their inner resources and foster psychological growth.

The literature has documented that many women with disability (WWD) report barriers to obtaining reproductive health care as well as poor experiences with providers when care is received. This project sought to compare barriers and experiences in reproductive health care for WWD to those of women without disability in the United States. Using representative data from the National Survey of Family Growth (2017-2019), we present weighted estimates of poor or fair experiences with providers by disability status, as well as weighted estimates of the proportion of women reporting types of barriers to services by disability status, among individuals identifying as women between the ages of 15 and 49. We then used weighted logistic regressions to compare barriers and experiences with providers by disability status. After controlling for potential confounders, women with any disability had 2.6 times higher odds as women without disability to rate their providers' respect for them as "poor" or "fair" (95% CI: 1.1-6.2). WWD did not significantly differ from women without disability in whether they reported more than one type of barrier (AOR = 1.3, 95% CI: 0.8-2.1), yet WWD had higher odds of reporting financial barriers compared to women without disability (AOR = 1.5, 95% CI: 1.02-2.2). While access to reproductive health care and experience with providers needs to be improved for all, these findings suggest that targeted efforts are needed to eliminate inequities for WWD in the reproductive health care system.

Minimal progress has been made in narrowing disparities between patients with and without limited English proficiency (LEP). Using 2016 data from RN4CAST-US, New Jersey Discharge Data Collection System, and AHA Annual Hospital Survey, multivariable logistic regression models were employed to examine whether and to what extent the hospital nurse work environment, defined as the conditions that nurses work in, is associated with decreased disparities in 7-day hospital readmissions between patients with and without LEP. Existing literature has established associations between nurse work environments and outcomes disparities of various minoritized populations; however, no literature has examined this relationship in the context of hospitalized patients with LEP. In a sample of 424,745 hospitalized adults (n = 38,906 with LEP), patients with LEP, compared to those without LEP, were younger (63.4 vs 64 years old, p < 0.001), more likely to be insured by Medicaid (8.9% vs 5.5%) or uninsured (7.5% vs 2%, p < 0.001), and readmitted (4.5% vs 3.9%, p < 0.001). Adjusting for patient and hospital characteristics, LEP patients had 33% higher odds of a 7-day readmission, as compared to patients without LEP (OR 1.33, 95% CI [1.19-1.47]). A significant interaction was found between patients' LEP status and the nurse work environment (OR 0.83, 95% CI [0.70-0.99]), such that patients with LEP experienced lower odds of 7-day readmission in more favorable nurse work environments, compared to patients without LEP. Hospitals dedicated to providing equitable healthcare may consider enhancing nurses' working conditions as a potential way to reduce disparities in readmission rates.