Asian Nursing Research最新文献

Purpose: This study aimed to develop and evaluate a dietary self-care promotion program for hemodialysis patients based on Hurley's self-efficacy model, utilizing an online community to enhance the dietary self-care behavior of patients undergoing hemodialysis.

Methods: The needs of hemodialysis patients were identified, and an online community-based dietary self-care promotion program was developed with expert evaluations. 44 hemodialysis patients were randomly assigned to an experimental group (n=22) and a control group (n=22). The program was applied to the experimental group for four weeks. Before and after the intervention, as well as four weeks after the intervention, dietary self-efficacy, dietary self-care behavior, interdialytic weight gain, serum phosphorus, and serum potassium were assessed in both groups.

Results: Significant differences over time and between groups were observed in dietary self-efficacy, interdialytic weight gain, serum phosphorus, and serum potassium. The interaction between time and group was also significant. While no significant differences were found over time in dietary self-care behavior, significant group differences and interaction effects between time and group were identified.

Conclusions: The results indicate that the dietary self-care promotion program using an online community for hemodialysis patients is more effective in enhancing dietary self-efficacy and dietary self-care behavior compared to conventional treatment. This suggests the clinical applicability of the proposed dietary self-care promotion program.

Trial registration: This study was registered in the Clinical Research Information Service system (No: KCT0007920).

Purpose: Infertility, a global health challenge, often leads to stigma for affected women. This stigma brings negative impacts to infertile women, and is influenced by several factors. Research to date treats infertile women as a homogeneous group based on their stigma. We attempted to identify subgroups based on their stigma and explored variables associated with subgroups.

Methods: A cross-sectional study design was utilized, involving 439 infertile women. General information questionnaire, Infertility Stigma Scale, Perceived Social Support Scale, and the Chinese version of the Infertility Self-Efficacy Scale were used. Latent profile analysis was performed to categorize potential stigma profiles in infertile women. Multinomial logistic regression analysis was employed to explore the influencing factors of stigma among infertile women in different latent profiles.

Results: 439 infertile women were divided into three stigma profiles: low stigma level-light public stigma group (41.5%), medium stigma level-light public stigma group (48.0%) and high stigma level-deep public stigma group (10.5%). Multinomial logistic regression showed that education level, per capita family income status, duration of infertility, duration of infertility treatments, perceived social support, and self-efficacy were the influencing factors of stigma in three latent profiles.

Conclusion: Stigma in infertile women can be divided into three potential profiles, which had obvious classification characteristics. In these different latent profiles, there are differences in education level, per capita family income, duration of infertility, duration of infertility treatments, perceived social support, and self-efficacy. Social withdrawal is a common and severe issue faced by infertile women. Additionally, infertile women with high stigma levels often suffer from more severe public stigma.

Purpose: This study aimed to investigate oncology nurses' compassion fatigue (CF) and whether emotional regulation mediates between stress load and CF.

Methods: Using convenience sampling, data of this cross-sectional study were collected from 471 oncology nurses from a cancer hospital. Self-administered questionnaires included socio-demographic factors, the Stress Overload Scale, the Nurse Emotional Management Scale, and the Chinese version of the Professional Quality of Life scale. Statistical analyses were performed using IBM SPSS Statistics for Windows (version 22.0). The hypothesized model was tested by the structural equation model using IBM SPSS AMOS (version 21.0).

Results: Burnout and secondary traumatic stress (STS) of CF in oncology nurses were 21.10±5.48 and 22.22±5.24 respectively. Stress load was positively correlated with burnout (r = .64, p < .01) and STS (r = .52, p < .01). Emotional regulation was negatively correlated with stress load (r = -.47, p < .01), burnout (r = -.57, p < .01) and STS (r = -.45, p < .01). The impact of stress load on CF is mediated by emotional regulation [β = .27, 95% CI of (.21∼.35)], with the mediation effect accounting for 34.62% of the total effect. This mediation model explains 80% of the variation in CF.

Conclusions: The stress load of oncology nurses directly positively impacted their CF, emotional regulation directly negatively impacted CF, while emotional regulation mediated between stress load and CF. This study suggests that nursing managers can prevent and alleviate oncology nurses' CF not only by relieving their stress load but also by promoting their ability of emotional regulation.

Purpose: In order to analyze the influencing factors of medication adherence in Chinese hypertensive patients, a nomogram of medication adherence in hypertensive patients was constructed in this paper, which may provide a foundation for the establishment of a simple method for predicting medication adherence in hypertensive patients.

Methods: We enrolled 297 hypertensive patients in a tertiary care hospital in Wuhu City. Medication adherence was assessed using the 4-item Medication Adherence Scale. Patients were categorized into Adherence group and poor medication adherence group based on their scores. We used logistic regression to identify factors influencing medication adherence. The predictors were analyzed by Nomogram method using R software. Its effectiveness was assessed by the area under the curve (AUC) of the receiver operating characteristic curve (ROC) and the calibration curve to evaluate its discriminatory power and accuracy.

Results: Of the 297 patients, 111 (37.4%) had good medication adherence, and 186 (62.6%) had poor medication adherence. In the group with good medication adherence, there were 52 (46.8%) males and 48 (43.3%) persons aged ≤65 years; in the group with poor medication adherence, there were 101 (54.3%) males and 92 (49.4%) persons aged 65-80 years. Place of residence, Acceptance of the disease, Satisfaction with family functioning, Frailty, and E-health literacy were factors influencing adherence to medication in hypertensive patients (p<.05); The predictors were incorporated into the R software to establish a Nomogram of medication adherence in hypertensive patients, and its test showed an AUC of .83 (95% CI: .79-.88);Hosmer-Lemeshow goodness-of-fit test showed χ²=4.78, p=.78, which indicated that the model had a high degree of differentiation and precision.

Conclusion: Overall, Chinese hypertensive patients had poor medication adherence. Medication adherence was better among hypertensive patients who lived in city, had higher disease acceptance, more satisfactory family functioning, were no physically frailty, and had higher e-health literacy. The established Nomogram has a good predictive value for medication adherence in hypertensive patients, reduces the medical burden on society and families, and provides a reference for clinical caregivers.

Purpose: This study aims to elucidate the clinical experiences of multicultural nursing students in South Korea.

Methods: Data was extracted from October 2022 to February 2023 through extensive interviews conducted in four sessions with three undergraduates with five months of clinical experience. Participants were three multicultural nursing students at D University who had clinical practice experience, whose parents were Russian or Filipino, and who could speak Korean. Data collection was conducted with interviews and observations, and the study quality was improved by reconfirming the interview content with the participants and seeking expert advice. The analysis method was classified to reflect the process in which the participants found their identity by telling their experiences through the collected stories according to Riessman's narrative inquiry verification criteria.

Results: The extracted stories are presented under the main themes: 'Overcoming differences and moving towards fusion', with four sub-themes: 'My identity felt in the clinical field in Korea', ' Nursing together and the role I found in it', ' Pride in being able to be a role model for foreign students, and 'Future nurses who overcome differences '.

Conclusion: In this study, positive cultural encounters alleviated the participants' fears and changed their identity in their lives. This was an opportunity for the participants to share their stories and understand each other, even though they had difficulties they had not planned in their clinical practice. Future research is suggested to explore the experiences of diverse multicultural nursing students.

Purpose: Previous research has explored the factors influencing frailty in older patients with chronic heart failure (CHF), but these studies have not revealed the potential network interactions among the related factors. This study aimed to construct a Bayesian network (BN) model of frailty in older patients with CHF, analyze the predictive factors and explore the internal relationships between these factors.

Methods: A total of 439 older patients with CHF were selected using a convenience sampling method from September 2023 to March 2024 at the cardiology department of a comprehensive tertiary hospital in Nanchang, Jiangxi, China. Multivariate logistic regression analysis was used to explore the influencing factors of frailty in older patients with CHF. The BN structure was learned using the max-min hill-climbing algorithm, with parameter estimation achieved through maximum likelihood estimation. Netica software was utilized for prediction and diagnosis. The effectiveness of the model was validated using the ROC curve.

Results: The prevalence of frailty in older patients with CHF was found to be 53.3%. After using a multivariate logistic regression analysis model screened the variables, the nutritional risk, physical activity, depression, multimorbidity, grip strength and left atrial diameter were included into the Bayesian network model. The Bayesian network model of frailty related factors in older CHF patients showed that nutritional risk, physical activity, depression, and multimorbidity were directly related to frailty, while grip strength and left atrial diameter were indirectly related.

Conclusion: The study results indicated that malnutrition risk, inactivity, depression, and multimorbidity were directly related to frailty, while lower grip strength and a wider left atrial diameter were indirectly related to frailty. Enhancing frailty assessment and implementing measures addressing disease, nutrition, exercise, and psychological well-being are crucial for delaying and potentially reversing the onset and progression of frailty.

Purpose: To explore the risk factors of delirium in patients with stroke and develop a nomogram model to predict the occurrence of delirium.

Methods: Convenience sampling was used to select 502 patients with stroke admitted to a tertiary hospital with a neurology specialty in Tianjin from December 2023 to June 2024, who were categorized into the delirium group (n=141) and the non-delirium group (n=361) using the ICU Patient Ambiguity of Consciousness Assessment Scale. We explored the independent risk factors for the occurrence of delirium through univariate and multifactorial logistic regression analyses, established a risk prediction model, developed a nomogram, and validated the model both internally and externally.

Results: Multifactorial logistic regression analysis revealed that age (OR=1.038), abnormal vision (OR=2.740), post stroke infection (OR=3.486), National Institute of Health Stroke Scale score (NIHSS) (OR=4.175),whether restrained (OR=3.440) were independent risk factors for the development of delirium. The consistency index of the nomogram model for the occurrence of delirium in stroke patients was 0.920, with a sensitivity of 83.00% and a specificity of 90.00%.

Conclusions: This study has developed and validated a predictive nomogram for identifying delirium in patients with stroke. It can help healthcare professionals quickly identify high-risk patients for post-stroke delirium, providing a basis for further developing personalized prevention strategies and intervention measures for post-stroke delirium.

Purpose: This study investigated the perceived importance and training of competencies during nursing clinical placements by examining the perspectives of nursing students and clinical nurses.

Methods: We conducted a cross-sectional study using an online survey of 351 nursing students and 247 clinical nurses. We utilized the Borich needs assessment model to identify the perceived importance and training of competencies during clinical placement. Students and nurses rated their perceived importance and training levels on 32 competency items regarding direct nursing care, indirect nursing care, decision-making and problem-solving, attitude, and nursing professionalism.

Results: Students and clinical nurses identified nursing handovers, nursing records, crisis coping abilities, clinical problem identification, clinical decision making, and priority setting in nursing as competencies of greater importance and with more significant discrepancies from training during clinical placements (Quadrant I in the locus for focus model). Clinical nurses reported examination, skin integrity management, and communication with medical staff as having higher importance and greater discrepancies from training (Quadrant I). In contrast, students recognized them as having lower importance and higher discrepancies (Quadrant II). For students, the perceived importance of all competence domains was significantly associated with the corresponding training (Spearman's rho = .30-.56, p < .01). For clinical nurses, only the perceived importance of nursing professionalism was associated with all training domains (Spearman's rho = approximately .14-.20, p < .05).

Conclusions: The disparities between students' and nurses' perceptions of the importance and training of competencies during clinical placements highlight the need to modify the clinical nursing education system.

Purpose: The health of older people, especially functional ability, has become a hot topic for scholars in various countries. There is insufficient research on the urban-rural disparity in the functional ability of older people. This study aimed to explore the urban-rural gap in the functional ability of older people and the related influencing factors.

Methods: The data analyzed in this study were collected through a cross-sectional survey conducted in China. Furthermore, binary logistic regression was utilized to assess the relationship between functional ability and the independent variables, and Oaxaca-blinder decomposition was used to explore urban-rural differences in functional ability among older people.

Results: The percentage of urban older people who were functionally robust was 65.9%, which was significantly higher than the rural 40.4%, and the difference was found to be statistically significant (χ² = 274.93, p < .001). Furthermore, our study identified factors affecting the functional ability of older people in urban areas, including age, BMI, education, social participation, and trust. In contrast, for older people in rural areas, in addition to these factors, gender, drinking, and social connection were also found to be factors affecting their functional ability. Moreover, the results of the Oaxaca-Blinder decomposition showed that the most critical factor influencing the urban-rural differences in functional ability among older people was social participation (26.5%). Besides, education (14.4%), living status (-10.8%), age (7.3%), and trust (-6.9%) likewise influence the urban-rural disparity.

Conclusions: A higher proportion of older people in rural areas have limited functional ability than in urban areas. Moreover, the disparity in social participation levels significantly contributed to the differences in functional ability observed between older adults in urban and rural settings. This study underscores the significance of enhancing the social engagement of older adults, particularly those living in rural communities.

Purpose: Although left ventricular assist devices (LVAD) are increasingly used as a standard treatment for end-stage heart failure, few studies have explored LVAD-related readmissions. This study investigated the factors associated with readmission and nursing documentation in patients with LVAD.

Methods: A retrospective analysis was conducted on electronic medical records of patients who underwent LVAD implantation at a tertiary hospital in South Korea (January 2015-April 2023). Baseline and clinical characteristics and nursing documentation were analyzed using χ² test, Fisher's exact test, t-test, and logistic regression.

Results: Of the 127 patients (mean age 61.31 ± 13.27 years, 81.1% male), 63.3% underwent LVAD implantation as a bridge to heart transplantation, and 85 (67.0%) were readmitted within 104 days. Bivariate analyses identified 17 variables significantly differing between readmission and non-readmission groups. The New York Heart Association (NYHA) class II (OR 7.29), NYHA Class III (OR 47.14), prothrombin time (OR 32.65), and presence of free-text nursing notes (OR 7.58) were significant factors of readmission.

Conclusion: Nurses play a vital role in managing patients and helping to reduce readmission rates. In addition to the NYHA class and prothrombin time this research highlights the critical importance of comprehensive nursing documentation. Specifically, 'free-text nursing notes' capture critical patient events and observations, such as non-sustained ventricular tachycardia, bleeding, and noncompliance, providing valuable insights for clinical decision-making and enhancing patient management to prevent unplanned readmissions. These findings highlight the importance of nursing roles in documentation, patient education, and personalized discharge planning to improve clinical outcomes for patients with LVAD.