Asian Nursing Research最新文献_第10页

What Frequency of Ankle Pump Exercise is Optimal to Improve Lower Limb Hemodynamics? A Systematic Review and Network Meta-analysis 踝关节泵运动的频率对改善下肢血流动力学是最佳的?系统回顾与网络元分析

IF 2.2 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2023-05-01 DOI: 10.1016/j.anr.2023.03.001

Xin Wang , Rongsong Tang , Heli Zhang , Fan Li , Jing Wang , Baohua Li

Purpose

Ankle pump exercises (APE) have been widely used in clinical practice. However, best practices for APE have not been established. Recognize the most effective frequency of APE for improving lower extremity hemodynamics and establish recommendations in clinical practice.

Methods

Therefore, a systematic review and network meta-analysis (NMA) was performed according to PRISMA-NMA. Six English databases (Pubmed, Medline, CINAHL, Embase, the Cochrane library and ProQuest) and four Chinese databases (CNKI, Wanfang, VIP and Sinomed) were searched. Randomized controlled trials (RCTs) and quasi-experimental studies investigating the effects of different frequencies of APE on lower limb hemodynamics published before July 2022 were included. The reference list was also searched. Seven studies (one RCTs and six quasi-experimental studies) were included in the systematic review and five studies (one RCTs and four quasi-experimental studies) were included in the NMA. The risk of bias was assessed using the Cochrane and Joanna Briggs Institute tools. The NMA was performed using the R software (version 4.2.1) and OpenBUGS (version 3.2.3).

Results

The results of the NMA showed that a frequency of every 3–4 s the most effective in improving lower extremity hemodynamics (P =.85), followed by every 1–2 s (P = .81), every 5–6 s (P=.32) and less than every 10 s (P =.02). Subgroup analysis failed to find a difference between healthy participants and those with unilateral total hip arthroplasty or fracture (MD = −0.23, 95% CI-5.92 to 4.61).

Conclusions

Consequencely, for adult patients, with or without lower extremity disease, a frequency of every 3–4 s can be recommended as the optimal frequency of APE in clinical care practice.

Registered number on PROSPERO

CRD42022349365. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349365.

目的踝关节泵运动（APE）在临床上得到了广泛的应用。然而，APE的最佳实践尚未确立。认识APE改善下肢血流动力学的最有效频率，并在临床实践中提出建议。方法根据PRISMA-NMA进行系统回顾和网络荟萃分析（NMA）。检索了6个英文数据库（Pubmed、Medline、CINAHL、Embase、Cochrane library和ProQuest）和4个中文数据库（CNKI、Wanfang、VIP和Sinomed）。包括2022年7月之前发表的随机对照试验（RCT）和准实验研究，研究不同频率的APE对下肢血流动力学的影响。还搜索了参考名单。系统综述中包括7项研究（1项随机对照试验和6项准实验研究），NMA中包括5项研究（一项随机对照研究和4项准实验性研究）。使用Cochrane和Joanna Briggs研究所的工具评估了偏倚的风险。使用R软件（4.2.1版）和OpenBUGS（3.2.3版）进行NMA。结果NMA的结果显示，每3-4秒的频率对改善下肢血流动力学最有效（P=.85），其次是每1-2秒（P=.81），每5-6秒（P=.32）和少于每10秒（P=.02）。亚组分析未能发现健康参与者与单侧全髋关节置换术或骨折参与者之间的差异（MD=-0.23，95%CI-5.92至4.61）。结论因此，对于患有或不患有下肢疾病的成年患者，在临床护理实践中，每3-4秒的频率可以被推荐为APE的最佳频率。PROSPEROCRD42022349365上的注册号。https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349365.

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引用次数: 0

Performance of Early Warning Scoring Systems Regarding Adverse Events of Unanticipated Clinical Deterioration in Complementary and Alternative Medicine Hospitals 补充和替代医学医院非预期临床恶化不良事件预警评分系统的性能

IF 2.2 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2023-05-01 DOI: 10.1016/j.anr.2023.04.003

Jee-In Hwang , Jae-Woo Park , Jinsung Kim , Na-Yeon Ha

Purpose

This study aims to examine the performance of early warning scoring systems regarding adverse events of unanticipated clinical deterioration in complementary and alternative medicine hospitals.

Methods

A medical record review of 500 patients from 5-year patient data in two traditional Korean medicine hospitals was conducted. Unanticipated clinical deterioration events included unexpected in-hospital mortality, cardiac arrest, and unplanned transfers to acute-care conventional medicine hospitals. Scores of the Modified Early Warning Score (MEWS), National Early Warning Score (NEWS), and National Early Warning Score 2 (NEWS2) were calculated. Their performance was evaluated by calculating areas under the receiver-operating characteristic curve for the event occurrence. Multiple logistic regression analyses were performed to determine the factors associated with event occurrence.

Results

The incidence of unanticipated clinical deterioration events was 1.1% (225/21101). The area under the curve of MEWS, NEWS, and NEWS2 was .68, .72, and .72 at 24 hours before the events, respectively. NEWS and NEWS2, with almost the same performance, were superior to MEWS (p = .009). After adjusting for other variables, patients at low-medium risk (OR = 3.28; 95% CI = 1.02–10.55) and those at medium and high risk (OR = 25.03; 95% CI = 2.78–225.46) on NEWS2 scores were more likely to experience unanticipated clinical deterioration than those at low risk. Other factors associated with the event occurrence included frailty risk scores, clinical worry scores, primary medical diagnosis, prescribed medicine administration, acupuncture treatment, and clinical department.

Conclusions

The three early warning scores demonstrated moderate-to-fair performance for clinical deterioration events. NEWS2 can be used for early identification of patients at high risk of deterioration in complementary and alternative medicine hospitals. Additionally, patient, care, and system factors need to be considered to improve patient safety.

目的本研究旨在检验补充医学医院和替代医学医院对非预期临床恶化不良事件的预警评分系统的性能。方法对两所韩国传统医学医院的500例5年住院患者的病历资料进行回顾性分析。意外的临床恶化事件包括意外的住院死亡率、心脏骤停和意外转移到急诊常规医学医院。计算修正预警分数（MEWS）、国家预警分数（NEWS）和国家预警分数2（NEWS2）的分数。通过计算事件发生时接收器工作特性曲线下的面积来评估它们的性能。进行多元逻辑回归分析，以确定与事件发生相关的因素。结果非预期临床恶化事件发生率为1.1%（225/21101）。在事件发生前24小时，MEWS、NEWS和NEWS2的曲线下面积分别为.68、.72和.72。NEWS和NEWS2表现几乎相同，优于MEWS（p=0.009）。在调整其他变量后，NEWS2评分中处于中低风险（OR=3.28；95%CI=1.02–10.55）和中高风险（OR=25.03；95%CI=2.78–225.46）的患者比处于低风险的患者更有可能出现意外的临床恶化。与事件发生相关的其他因素包括虚弱风险评分、临床担忧评分、初级医学诊断、处方药管理、针灸治疗和临床科室。结论三个早期预警评分对临床恶化事件表现为中度至中度。NEWS2可用于辅助和替代医学医院中病情恶化风险高的患者的早期识别。此外，需要考虑患者、护理和系统因素，以提高患者安全性。

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引用次数: 1

Advanced Practice Nurses' Organization Commitment: Impact of Job Environment, Job Satisfaction, and Person-Organization Fit 高级执业护士组织承诺:工作环境、工作满意度和个人与组织契合度的影响

IF 2.2 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2023-05-01 DOI: 10.1016/j.anr.2023.03.002

Yeon Hee Kim , Soo Il Shin , Hye-Kyung Kim , Myunghee Jun , Michael Wreen

Purpose

The demand for advanced practice nurses (APNs) has increased globally due to a shortage of physicians and an increased demand for high-quality healthcare. Research is needed on the enhancement of advanced practice nurses' organization commitment. Organization commitment (OC) directly impacts the retention of APNs. This study aims to identify the key factors affecting the OC of advanced practice nurses.

Method

A cross-sectional survey was conducted at the largest hospital in South Korea. A total of 189 APNs answered survey questions. A partial least squares-structural equation modeling method was employed to analyze the survey responses.

Results

A pay scale of APNs is positively associated with person-organization fit (POF). However, the effect of job location and computer self-efficacy on POF is not significant. Job satisfaction plays a salient direct role in supervision and POF. Job satisfaction is also a significant moderator in the relationship between supervision and POF. POF is significantly associated with both OC and supervision. Supervision has a positive effect on organization commitment.

Conclusions

Pay scale, job satisfaction, supervision, and POF are significant factors affecting organization commitment. Establishing an intra-organization entity, such as APN steering committee, to ensure mutual consensus and transparent communication between administrators and APNs would enhance POF, the rating of supervision, and organization commitment.

目的由于医生短缺和对高质量医疗保健的需求增加，全球对高级执业护士（APN）的需求增加。需要研究如何增强高级实习护士的组织承诺。组织承诺（OC）直接影响APN的保留。本研究旨在找出影响高级实习护士OC的关键因素。方法在韩国最大的医院进行横断面调查。共有189个APN回答了调查问题。采用偏最小二乘结构方程建模方法对调查响应进行分析。结果APN的薪酬水平与人-组织匹配度呈正相关。然而，工作地点和计算机自我效能感对POF的影响并不显著。工作满意度在监督和POF中起着显著的直接作用。工作满意度也是监督和POF之间关系的重要调节因素。POF与OC和监督密切相关。监督对组织承诺有积极影响。结论支付量表、工作满意度、监督和POF是影响组织承诺的重要因素。建立一个组织内实体，如APN指导委员会，以确保管理员和APN之间的相互共识和透明沟通，将增强POF、监督评级和组织承诺。

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引用次数: 5

Early Sedation Depth and Clinical Outcomes in Mechanically Ventilated Patients in a Hospital: Retrospective Cohort Study 医院机械通气患者的早期镇静深度和临床结果：回顾性队列研究

IF 2.2 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2023-02-01 DOI: 10.1016/j.anr.2022.12.002

Jeong Mi Hwang , Su Jung Choi

Purpose

This study aimed to identify the early sedation depth in the first 48 hours of mechanical ventilation and its relationship to clinical outcomes to promote the transition to light sedation.

Methods

This retrospective single-center cohort study was conducted in two medical intensive care units (MICUs) at a general tertiary hospital, using a standardized sedation protocol. To investigate the early sedation depth, the Sedation Index was used, which can indicate changes over the first 48 hours. Patients were divided into three groups based on tertiles of Sedation Index. The primary outcome was mortality at 30, 90, and 180 days. The secondary outcomes included length of stay in the ICU and ventilator-free days. Kaplan-Meier analysis and multivariable Cox regression were conducted to compare factors influencing mortality.

Results

This study included 394 patients. The deepest sedation group showed more severe illness, delirium, and deeper sedation at admission (p < .001). The survival curve decreased as sedation increased, even within the light sedation levels. In the deepest sedation group, 30-day mortality (hazard ratio [HR] 2.11, 95% confidence interval [CI] 1.33–3.34), 90-day mortality (HR 2.00, 95% CI 1.31–3.06), and 180-day mortality (HR 1.77, 95% CI 1.17–2.67) increased. The length of stay in the ICU and ventilator-free days did not show statistical differences.

Conclusions

These results indicate that early deep sedation is a modifiable factor that can potentially affect mortality. The protocol for inducing the transition into light sedation must comply with recommendations to improve clinical outcomes.

目的本研究旨在确定机械通气前48小时的早期镇静深度及其与临床结果的关系，以促进向轻度镇静的过渡。方法采用标准化镇静方案，在一家综合性三级医院的两个医疗重症监护室（MICU）进行回顾性单中心队列研究。为了研究早期镇静深度，使用了镇静指数，该指数可以指示前48小时的变化。根据镇静指数的三分位数将患者分为三组。主要结果是30、90和180天的死亡率。次要结果包括ICU住院时间和无呼吸机天数。采用Kaplan-Meier分析和多变量Cox回归对影响死亡率的因素进行比较。结果本研究共纳入394例患者。最深镇静组在入院时表现出更严重的疾病、谵妄和更深的镇静（p<；.001）。生存曲线随着镇静程度的增加而下降，即使在轻度镇静水平内也是如此。在深度镇静组中，30天死亡率（危险比[HR]2.11，95%置信区间[CI]1.33-3.34）、90天死亡率（HR 2.00，95%CI 1.31-3.06）和180天死亡率（HR1.77，95%CI 1.17-2.67）增加。ICU的住院时间和无呼吸机天数没有显示出统计学差异。结论早期深度镇静是一个可能影响死亡率的可改变因素。诱导过渡到轻度镇静的方案必须符合改善临床结果的建议。

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引用次数: 0

Relationship between Unit-Level Nurses' Expectations from Nursing Assistant Roles and Individual Nursing Assistants’ Information-Sharing Behaviors: A Multilevel Mediation Analysis 单位级护士对护理助理角色的期望与个体护理助理信息共享行为的关系：多层次中介分析

IF 2.2 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2023-02-01 DOI: 10.1016/j.anr.2022.11.003

Masatoshi Saiki , Yukie Takemura , Keiko Kunie

Purpose

This study aimed to investigate the relationship between the expectations of unit-level nurses from nursing assistants (NAs), frequency of individual NAs' information-sharing behaviors with nurses, and the effect of NAs’ self-perceived roles on this relationship. NAs provide patient care along with nurses, and their information-sharing behaviors with nurses may be influenced by the expectations of the nurses.

Methods

Nurses and NAs from 104 integrated community care (sub- and postacute) units were included in this Japanese cross-sectional study conducted from July to September 2018. Nurses' expectations from NAs and the NAs' self-perceived roles and information-sharing frequency were measured. Multilevel mediation analysis was performed for NAs’ information-sharing behaviors, such as expressing, asking, providing linguistic responses, and providing feedback.

Results

Unit-level nurses' expectations from NAs were associated with the frequency of NAs' asking and responding behaviors with nurses (p < .05), mediated by the NAs' self-perceived roles. The frequency of NAs’ expressing behaviors and feedback were also associated with their self-perceived roles (p < .001).

Conclusions

High expectations of unit-level nurses from NAs led to better perception by NAs of their roles and led to better information-sharing behaviors. Educating nurses on NAs’ roles may improve information-sharing between nurses and NAs that leads to safe and appropriate care to patients.

目的本研究旨在探讨单位级护士对护理助理（NAs）的期望、个体NAs与护士信息共享行为的频率以及NAs的自我感知角色对这种关系的影响之间的关系。NAs与护士一起提供患者护理，他们与护士的信息共享行为可能会受到护士期望的影响。方法将来自104个综合社区护理（亚急性期和急性期后）单位的护士和NAs纳入2018年7月至9月进行的日本横断面研究。测量护士对NAs的期望以及NAs的自我感知角色和信息共享频率。对NA的信息共享行为进行了多层次中介分析，如表达、询问、提供语言反应和提供反馈。结果单位级护士对NAs的期望与NAs对护士的询问和回应行为的频率相关（p<；.05），由NAs的自我感知角色介导。NAs表达行为和反馈的频率也与他们的自我感知角色有关（p<；.001）。结论单位级护士对NAs的高期望导致NAs更好地感知他们的角色，并导致更好的信息共享行为。对护士进行NAs角色教育可以改善护士和NAs之间的信息共享，从而为患者提供安全和适当的护理。

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引用次数: 1

Effect of Animal-Assisted Therapy (AAT) on Social Interaction and Quality of Life in Patients with Schizophrenia during the COVID-19 Pandemic: An Experimental Study 新冠肺炎大流行期间动物辅助治疗对精神分裂症患者社会交往和生活质量的影响：一项实验研究

IF 2.2 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2023-02-01 DOI: 10.1016/j.anr.2023.01.002

Chieh-An Shih , Man-Hua Yang

Purpose

Most patients with schizophrenia exhibit low willingness to return to society because of negative social experiences. The COVID-19 pandemic led to severe social isolation for schizophrenia patients. However, animal-assisted therapy (AAT) can improve individuals' empathy, social functions, and quality of life. The study aimed to evaluate the effectiveness of AAT in improving social interactions and quality of life in patients with chronic schizophrenia during the COVID-19 pandemic.

Methods

An experimental study was conducted, with six institutions for psychiatric rehabilitation in Taiwan as the case institutions. Patients in these institutions were randomly allocated to the experimental group, which received 60 minutes of AAT once a week for 12 weeks, or the control group, which engaged in routine discussion groups and watched short films about animals. Comparisons between the two groups were made before and after the intervention on social function, social adaptive function, and quality of life. Data were collected before the intervention (T1), immediately after the intervention (T2), and 3 months after the intervention (T3).

Results

Comparison between groups showed that social functioning was significantly higher in the experimental group than in the control group at T2. However, there was no sign of improvement in social adaptive functions of the experimental group. The experimental group exhibited significantly higher quality of life than the control group at T2 and T3.

Conclusions

There was an impact of COVID-19 on the studied effects. AAT improved social functioning and quality of life in patients with chronic schizophrenia. The effect on quality of life lasted only up to 3 months after the intervention. AAT should be promoted for use as a community-based rehabilitation tool in patients with chronic schizophrenia.

Trial registration

Chinese Clinical Trial Registry, ChiCTR2200061715. https://www.chictr.org.cn.

目的大多数精神分裂症患者由于消极的社会经历而表现出较低的重返社会意愿。新冠肺炎大流行导致精神分裂症患者严重的社会隔离。然而，动物辅助治疗（AAT）可以提高个体的同理心、社会功能和生活质量。该研究旨在评估AAT在新冠肺炎大流行期间改善慢性精神分裂症患者社交互动和生活质量的有效性。方法以台湾六所精神病康复机构为个案进行实验研究。这些机构的患者被随机分配到实验组和对照组，实验组每周接受一次60分钟的AAT，持续12周，对照组参加常规讨论小组并观看关于动物的短片。比较两组干预前后的社会功能、社会适应功能和生活质量。在干预前（T1）、干预后立即（T2）和干预后3个月（T3）收集数据。结果组间比较显示，T2时实验组的社会功能显著高于对照组。然而，实验组的社会适应功能没有改善的迹象。在T2和T3，实验组的生活质量显著高于对照组。结论新冠肺炎对研究效果有影响。AAT改善了慢性精神分裂症患者的社会功能和生活质量。干预后对生活质量的影响仅持续了3个月。应推广AAT作为慢性精神分裂症患者的社区康复工具。试验注册中国临床试验注册中心，ChiCTR220061715。https://www.chictr.org.cn.

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引用次数: 4

Dignity and Related Factors in Patients with Cancer: A Cross-Sectional Study 癌症患者的尊严及其相关因素:一项横断面研究

IF 2.2 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2023-02-01 DOI: 10.1016/j.anr.2022.12.001

Yu-Chi Li , Yin-Hsun Feng , Shu-Ching Ma , Hsiu-Hung Wang

Purpose

Dignity is a basic human right that is related to psychological distress factors in patients with cancer such as depression and demoralization. Hence, the dignity issue is of great importance to healthcare professionals. The present study aimed to advise healthcare professionals regarding the related distress factors of dignity in patients with cancer by investigating its relationship with patients’ demographics, disease characteristics, and psychological distress.

Methods

This was a cross-sectional study design. A convenience sample of 267 patients with cancer from a medical center was recruited into this study. Each patient completed demographics and disease characteristics questionnaires, the Patient Dignity Inventory Mandarin Version, the Demoralization Scale Mandarin Version (DS-MV), and the Patient Health Questionnaire-9 (PHQ-9). Data were analyzed with SPSS 22.0 software.

Results

Dignity was significantly correlated with age, demoralization, and depression. Cancer patients aged 65 or above were more likely to have a lower sense of dignity. In the present study, the sensitivity and specificity of the Patient Dignity Inventory Mandarin Version for demoralization (DS-MV≥30) were 84.8% and 79.1% and for depression (PHQ-9≥10) were 73.8% and 70.9% in patients with cancer with an aggregate score of 35 or above.

Conclusions

Dignity is significantly correlated with personal demographic characteristics and psychological distress in patients with cancer. The results provide reference data for healthcare professionals to understand and enable dignity in patients with cancer and aid in the development of methods that promote their dignity.

目的尊严是癌症患者的一项基本人权，它与抑郁、沮丧等心理困扰因素有关。因此，尊严问题对医疗专业人员来说非常重要。本研究旨在通过调查癌症患者的人口统计学、疾病特征和心理困扰的关系，向医疗保健专业人员提供有关尊严的相关困扰因素的建议。方法采用横断面研究设计。这项研究招募了来自医疗中心的267名癌症患者作为方便样本。每个患者都完成了人口统计和疾病特征问卷、患者尊严量表普通话版、降级量表普通话版本（DS-MV）和患者健康问卷-9（PHQ-9）。数据采用SPSS 22.0软件进行统计分析。结果尊严与年龄、士气低落和抑郁情绪显著相关。65岁或以上的癌症患者更有可能有较低的尊严感。在本研究中，在总分为35分或以上的癌症患者中，患者尊严量表普通话版对士气低落（DS-MV≥30）的敏感性和特异性分别为84.8%和79.1%，对抑郁症（PHQ-9≥10）的敏感性为73.8%和70.9%。结论癌症患者的抑郁程度与个体人口学特征和心理压力显著相关。研究结果为医疗保健专业人员了解和提高癌症患者的尊严提供了参考数据，并有助于开发促进他们尊严的方法。

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引用次数: 2

Personal Factors and Clinical Learning Environment as Predictors of Nursing Students' Readiness for Practice: A Structural Equation Modeling Analysis 个人因素和临床学习环境对护生实习准备程度的预测：结构方程模型分析

IF 2.2 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2023-02-01 DOI: 10.1016/j.anr.2023.01.003

Taewha Lee , Su Jeong Lee , Yea Seul Yoon , Hyunju Ji , Sookhee Yoon , SangA Lee , Yoonjung Ji

Purpose

It is essential to ensure the readiness for practice among undergraduate nursing students since the purpose of such education is to cultivate competent nurses who deliver high-quality and safe nursing. Astin's theory of student involvement suggests that this is affected by their personal factors and learning environment.

Methods

We conducted a cross-sectional study between November 16, 2020 and December 21, 2020 which examined personal factors and aspects of the clinical learning environment among senior nursing students (n = 838) enrolled across 54 nursing schools in Korea. The participants were asked to fill out a self-administered online survey, which assessed demographic characteristics, self-esteem, depression, work-life balance, clinical learning environment, anxiety during clinical practicum, and readiness for practice. Readiness for practice was measured using the Casey-Fink Readiness for practice survey. We used structural equational modeling to test our hypothetical model.

Results

The nursing students' readiness for practice was significantly affected by their self-esteem, work-life balance satisfaction, and clinical learning environment. Anxiety during clinical practicum directly influenced their readiness for practice.

Conclusion

Increasing self-esteem and work-life balance satisfaction, and improving their clinical learning environment by providing sufficient educational and clinical support, could help facilitate the transition from nursing schools to real-world practice for nursing students.

目的确保护理本科生做好实习准备是至关重要的，因为这种教育的目的是培养能够提供高质量和安全护理的合格护士。Astin的学生参与理论表明，这受到他们个人因素和学习环境的影响。方法我们在2020年11月16日至2020年12月21日期间进行了一项横断面研究，调查了韩国54所护理学校的高级护理学生（n=838）的个人因素和临床学习环境。参与者被要求填写一份自我管理的在线调查，该调查评估了人口统计学特征、自尊、抑郁、工作与生活平衡、临床学习环境、临床实习期间的焦虑以及实习准备情况。使用Casey Fink练习准备情况调查来衡量练习准备情况。我们使用结构方程模型来测试我们的假设模型。结果护生实习意愿受自尊、工作生活平衡满意度、临床学习环境等因素影响显著。临床实习期间的焦虑直接影响了他们的实习准备。结论通过提供足够的教育和临床支持，提高自尊和工作与生活平衡的满意度，改善临床学习环境，有助于护理专业学生从护理学校向现实世界的实践过渡。

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引用次数: 0

Patient Safety Culture and Speaking Up Among Health Care Workers 患者安全文化与卫生保健工作者的直言不讳

IF 2.2 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2023-02-01 DOI: 10.1016/j.anr.2023.01.001

Seung Eun Lee , V. Susan Dahinten , Ja-Kyung Seo , InYoung Park , Mi Young Lee , Hye Sung Han

Purpose

Although previous research showed the importance of safety culture on health care workers' speaking up behaviors, it is not clear how particular safety culture domains are associated with the speaking up behaviors of hospital staff. Also, researchers have suggested that health care workers’ speaking up behaviors vary by profession, but there has been limited research into such differences. Thus, this study examined differences in perceptions of patient safety culture and the promotive and prohibitive speaking up behaviors of health care workers by profession and investigated the relationships between patient safety culture and the two types of speaking up behaviors.

Methods

A descriptive correlational study was conducted using secondary data collected through an online survey of health care workers at a private, nonprofit, tertiary-level teaching hospital in South Korea. The sample (N = 831) consisted of nurses (54.0%), physicians (13.0%), and other licensed and unlicensed hospital personnel (33.0%). Analyses of variance were conducted to examine differences in study variables by profession. Hierarchical regression analyses were conducted to evaluate the effects of the seven patient safety culture factors on promotive and prohibitive voice after controlling for tenure and profession.

Results

Perceptions of safety culture and promotive voice behaviors were higher for physicians compared with nurses. Communication openness, reporting patient adverse events, and unit supervisors' and hospital managements’ support for patient safety were significant predictors of both types of voice behaviors.

Conclusion

Hospital administrators and unit managers should create a supportive environment where staff feel free to voice their concerns and suggestions. They should also pay attention to the varying perspectives held by different groups of hospital workers and their different voice behaviors. Knowing which dimensions of patient safety culture are most strongly related to health care workers’ voice behaviors can guide patient safety improvement activities in health care organizations.

目的尽管先前的研究表明了安全文化对医护人员发声行为的重要性，但尚不清楚特定的安全文化领域与医院工作人员的发声行为有何关联。此外，研究人员表示，医护人员的发声行为因职业而异，但对这种差异的研究有限。因此，本研究考察了医护人员对患者安全文化的认知差异以及职业上的促进性和禁止性发声行为，并调查了患者安全文化与这两种发声行为之间的关系。方法采用二次数据进行描述性相关研究，二次数据是通过对韩国一家私立、非营利、三级教学医院的医护人员的在线调查收集的。样本（N=831）由护士（54.0%）、医生（13.0%）和其他有执照和无执照的医院人员（33.0%）组成。进行方差分析以检验不同职业的研究变量的差异。在对任期和职业进行控制后，采用层次回归分析来评估七个患者安全文化因素对晋升和禁止性话语的影响。结果与护士相比，医生对安全文化和促进性话语行为的认知程度更高。沟通开放性、报告患者不良事件以及单位主管和医院管理层对患者安全的支持是这两种声音行为的重要预测因素。结论医院管理者和单位管理者应创造一个支持性的环境，让员工可以自由地表达他们的担忧和建议。他们还应该关注不同群体的医院工作人员持有的不同观点以及他们不同的声音行为。了解患者安全文化的哪些维度与卫生保健工作者的声音行为最密切相关，可以指导卫生保健组织中的患者安全改进活动。

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引用次数: 2

The Moderated Mediating Effects of Nutrition and Physical Activity Between Fatigue and Quality of Life in Childhood Cancer Survivors 营养和体育活动对癌症儿童生存期疲劳与生活质量的中介作用

IF 2.2 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2023-02-01 DOI: 10.1016/j.anr.2022.12.003

Wei-Wen Wu , Cheng-Shi Shiu , Chia-Chun Tang , Shiann-Tang Jou , Huey-Ling Chen

Purpose

The aim of this study was to investigate the associations between nutrition, physical activity, fatigue, and quality of life (QoL) among childhood cancer survivors. The specific purpose was to examine whether nutrition mediated and physical activity moderated the relationship between fatigue and QoL in this population.

Methods

A pooled sample of 120 childhood cancer survivors was recruited at pediatric oncology wards and ambulatory settings between August 2020 and May 2021. We collected data on participants’ demographic characteristics, fatigue, nutritional status, physical activity, and QoL. We then adapted Hayes Process Macro to examine the mediating and moderating effects of nutrition and physical activity on the relationship between fatigue and QoL.

Results

In models adjusted for age and sex, (1) the simple mediation analysis identified the mediating effect of nutrition on the relationship between fatigue and QoL; and (2) the mediation and moderation analysis identified that the direct effect of nutrition between fatigue and QoL was significant when adding (a) physical activity and (b) fatigue × physical activity. There were significantly decreasing trends in physical activity at 1 standard deviation below the mean and at the mean, but not at 1 standard deviation above the mean.

Conclusions

Our findings demonstrate that nutrition mediated and physical activity moderated the relationship between fatigue and QoL. This highlights an opportunity to enhance QoL among childhood cancer survivors through healthy lifestyle interventions. To ensure that future interventions address children's needs and promote the greatest impact, such interventions should include nutrition and physical activity components that involve nurses, pediatric oncology physicians, nutritionists, and physical therapists.

目的本研究旨在探讨癌症儿童幸存者的营养、体力活动、疲劳和生活质量（QoL）之间的关系。具体目的是研究营养介导和体育活动是否调节了该人群疲劳和生活质量之间的关系。方法在2020年8月至2021年5月期间，在儿科肿瘤病房和流动环境中招募120名癌症儿童幸存者的汇总样本。我们收集了参与者的人口统计学特征、疲劳、营养状况、体育活动和生活质量的数据。然后，我们采用Hayes过程宏来检验营养和体育活动对疲劳和生活质量之间关系的中介和调节作用。结果在经年龄和性别调整的模型中，（1）简单中介分析确定了营养对疲劳与生活质量关系的中介作用；（2）中介和适度分析表明，当增加（a）体力活动和（b）疲劳×体力活动时，营养对疲劳和生活质量的直接影响显著。在低于平均值1个标准偏差和平均值时，体力活动有显著下降的趋势，但在高于平均值1标准偏差时没有。结论我们的研究结果表明，营养介导和体育活动调节了疲劳与生活质量之间的关系。这突出了通过健康的生活方式干预提高癌症儿童幸存者生活质量的机会。为了确保未来的干预措施能够满足儿童的需求并产生最大的影响，此类干预措施应包括营养和体育活动部分，包括护士、儿科肿瘤学医生、营养学家和物理治疗师。

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引用次数: 1