Asian Nursing Research最新文献_第7页

Volume Management in Nursing for Patients With Heart Failure: A Concept Analysis Using Rodgers’ Evolutionary Approach 心衰患者护理中的容积管理：运用罗杰斯进化方法的概念分析。

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-08-01 DOI: 10.1016/j.anr.2025.03.004

Hua Chen , Xiaoyun Xiong , Si Liu , Mengdie Liu , Lu Chen , Yingjie Li , Rui Wu , Huiwen Wang

Purpose

This study aims to analyze the concept of volume management in nursing for patients with heart failure.

Methods

We employed Rodgers’ evolutionary concept analysis method to identify related concepts, attributes, antecedents, and consequences of volume management in nursing for patients with heart failure. Articles on volume management for patients with heart failure, published between 2010 and 2024, were searched in reliable academic research databases. The inclusion criteria for the full-text articles were based on the characteristics, antecedents, and consequences of volume management for patients with heart failure.

Results

A total of 17 eligible articles were thoroughly reviewed, with findings categorized into antecedents, attributes, and consequences. The antecedents of volume management were classified into three categories: personal factors (including patients' health status and lifestyle factors), healthcare system and provider factors, and family nursing. Consequences were categorized into three groups: patient-related, family/caregiver-related, and hospital-related consequences. Volume management for patients with heart failure was summarized into three general characteristics: patient-centered individualized care, holistic and integrated care, and early-start and continuous care.

Conclusions

This study on volume management in nursing for patients with heart failure aims to advance understanding through a comprehensive analysis of its characteristics, providing a systematic theoretical foundation for researchers in the field of nursing.

Trial Registration

The trial was registered at the Chinese Clinical Trial Registry under the identifier ChiCTR2400089084 on September 2, 2024.

目的：探讨容积管理在心力衰竭患者护理中的概念。方法：采用Rodgers的进化概念分析方法，识别心力衰竭患者护理中容积管理的相关概念、属性、前因和后果。在可靠的学术研究数据库中检索了2010年至2024年间发表的关于心力衰竭患者容量管理的文章。全文文章的纳入标准是基于心力衰竭患者容积管理的特征、前因和后果。结果：总共17篇符合条件的文章被彻底审查，发现分为前因式、属性式和后果式。将容积管理的影响因素分为个人因素（包括患者健康状况和生活方式因素）、卫生保健制度和提供者因素、家庭护理等三类。结果分为三组：与患者相关、与家庭/护理人员相关和与医院相关的后果。心力衰竭患者的容积管理可归纳为三个总体特征：以患者为中心的个体化护理、整体和综合护理、早期开始和持续护理。结论：本研究旨在通过对心力衰竭患者护理中的容积管理特点的全面分析，增进对其的认识，为护理领域的研究者提供系统的理论基础。试验注册：该试验于2024年9月2日在中国临床试验注册中心注册，编号为ChiCTR2400089084。

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引用次数: 0

Nursing Leadership in Times of Doctor's Strike: Korea's Path to Research Excellence 医生罢工时代的护理领导：韩国的卓越研究之路

IF 2.3 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-08-01 DOI: 10.1016/j.anr.2025.07.001

Eunyoung E. Suh PhD, FNP, RN

引用次数: 0

School-Based Intervention of Smoking Media Literacy Among South Korean Adolescents: A Cluster Randomized Trial. 韩国青少年吸烟媒体素养的学校干预：一项聚类随机试验。

IF 2.1 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-05-20 DOI: 10.1016/j.anr.2025.03.001

Sunhee Park, Haein Lee

Purpose: Western literature has well established that (a) exposure to pro-smoking media messages is positively associated with adolescent smoking, and (b) an increase in smoking media literacy (SML) can mitigate the harmful effects of pro-smoking advertisements on adolescent smoking behavior. However, little is currently known about this phenomenon in South Korea. Thus, we aimed to investigate the effects of a SML intervention on SML, smoking attitudes, and smoking norms among Korean adolescents.

Methods: Based on the media literacy framework, we developed a five-lesson SML education program. We conducted a cluster randomized trial in one male high school to investigate the effects of the intervention. We randomly allocated ten classes in a one-to-one ratio to either the intervention or control group (N = 250, 10th graders). The intervention group participated in the SML program; the control group participated in a traditional anti-smoking program. We assessed the three outcomes (i.e., SML, smoking attitudes, and norms) at 1-week and 3-month follow-ups. We analyzed data obtained from 249 students after excluding one participant who did not complete the baseline test. Specifically, we conducted a mixed-model regression analysis three times after accounting for intraclass correlations.

Results: SML, smoking attitudes, and norms assessed in a pre-test before the intervention did not significantly differ between the intervention and control groups. After the intervention, we found a significant increase in SML at both 1-week (coefficient = 0.91) and 3-month follow-ups (coefficient = 0.73), although we did not find important intervention effects on smoking attitudes and norms at both follow-ups.

Conclusions: We found the strong effect of the SML education on an increase in SML, which could mitigate the negative effects of pro-smoking advertisements. Thus, health professionals need to actively incorporate strategies that enhance SML, developed based on the multidimensional core concepts of media literacy, into traditional anti-smoking programs.

Trial registration: Clinical Research Information Service, KCT0009514.

目的：西方文献已经很好地确立了(a)接触吸烟的媒体信息与青少年吸烟呈正相关，(b)增加吸烟媒体素养（SML）可以减轻吸烟广告对青少年吸烟行为的有害影响。然而，目前对韩国的这种现象知之甚少。因此，我们的目的是调查SML干预对韩国青少年SML、吸烟态度和吸烟规范的影响。方法：基于媒介素养框架，我们开发了一个五课的SML教育计划。我们在一所男子高中进行了一项随机分组试验，以调查干预的效果。我们以一对一的比例随机分配了10个班级给干预组或对照组（N = 250, 10年级学生）。干预组参与SML项目；对照组参加了传统的禁烟计划。我们在1周和3个月的随访中评估了三个结果（即SML、吸烟态度和规范）。在排除了一名未完成基线测试的参与者后，我们分析了来自249名学生的数据。具体来说，在考虑了类内相关性后，我们进行了三次混合模型回归分析。结果：在干预前的预测试中评估的SML，吸烟态度和规范在干预组和对照组之间没有显着差异。干预后，我们发现SML在1周（系数= 0.91）和3个月随访时（系数= 0.73）均显著增加，尽管我们在两次随访中均未发现干预对吸烟态度和规范的重要影响。结论：我们发现SML教育对SML的增加有很强的作用，可以减轻吸烟广告的负面影响。因此，卫生专业人员需要积极地将加强基于媒体素养多维核心概念的SML战略纳入传统的反吸烟方案。试验注册：临床研究信息服务中心，KCT0009514。

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引用次数: 0

Comparative Analysis of Differences in Functional Ability Among Older People Between Urban and Rural Areas: A Cross-sectional Study From China 城乡老年人功能能力差异的比较分析：来自中国的横断面研究。

IF 2.1 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-05-01 DOI: 10.1016/j.anr.2025.01.004

Zixuan Hong, Ying Guo, Wenwen Cao, Chenglin Cao, Wenjin Song, Jiawei Huang, Ren Chen, Zhongliang Bai

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%. Furthermore, our study identified factors affecting the functional ability of older people in urban areas, including age, body mass index, 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.

Conclusion

A higher proportion of older people in rural areas have limited functional ability than those 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.

目的：老年人的健康，尤其是功能能力，已经成为各国学者关注的热点。对老年人功能能力的城乡差异研究不足。本研究旨在探讨老年人功能能力的城乡差距及其影响因素。方法：本研究分析的数据是通过在中国进行的横断面调查收集的。采用二元logistic回归分析功能能力与自变量之间的关系，采用Oaxaca-blinder分解分析老年人功能能力的城乡差异。结果：城市老年人功能健全率为65.9%，显著高于农村老年人的40.4%，差异有统计学意义（χ2 = 274.93, p < 0.001）。此外，我们的研究确定了影响城市地区老年人功能能力的因素，包括年龄、BMI、教育、社会参与和信任。相比之下，对于农村地区的老年人，除了这些因素外，性别、饮酒和社会关系也被发现是影响其功能能力的因素。此外，Oaxaca-Blinder分解结果显示，影响老年人功能能力城乡差异的最关键因素是社会参与（26.5%）。此外，教育（14.4%）、生活状况（-10.8%）、年龄（7.3%）和信任（-6.9%）同样影响城乡差距。结论：农村老年人功能能力受限的比例高于城市老年人。此外，社会参与水平的差异显著影响了城市和农村老年人的功能能力差异。这项研究强调了加强老年人，特别是生活在农村社区的老年人的社会参与的重要性。

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引用次数: 0

Navigating Disparities: An In-depth Analysis of Perceived Competency Importance and Training Discrepancies in Clinical Placements Among Students and Clinical Nurses 导航差异：深入分析学生和临床护士在临床实习中的感知能力重要性和培训差异。

IF 2.1 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-05-01 DOI: 10.1016/j.anr.2025.01.003

Su Hyun Kim , Dayeong Kim , Sunyoung Lee , Sojeong Lee , Hyunjee Lee , Hyewon Jeon , Geun-Hee Kim

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 ≈ .14.20, p < .05).

Conclusion

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.

目的：本研究通过观察护生和临床护士的观点，探讨护理临床实习中能力的重要性和培训。方法：采用横断面调查方法，对351名护生和247名临床护士进行在线调查。我们利用Borich需求评估模型来确定临床实习期间能力的感知重要性和培训。学生和护士对直接护理、间接护理、决策和解决问题、态度和护理专业等32个能力项目的感知重要性和培训水平进行了评分。结果：学生和临床护士认为护理移交、护理记录、危机应对能力、临床问题识别、临床决策和护理优先级设置是更重要的能力，并且与临床实习期间的培训有更显著的差异（焦点轨迹模型象限I）。临床护士认为检查、皮肤完整性管理和与医务人员的沟通具有较高的重要性，并且与培训有较大的差异（象限I）。相反，学生认为它们具有较低的重要性和较高的差异（象限II）。对于学生来说，所有能力领域的感知重要性与相应的培训显著相关（Spearman's rho = .30-）。56, p < 0.01)。对于临床护士来说，只有护理专业的感知重要性与所有培训领域相关（斯皮尔曼的rho =约0.14 -）。20, p < 0.05)。结论：在临床实习期间，学生和护士对能力培训的重要性的认识存在差异，这表明需要修改临床护理教育体系。

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引用次数: 0

Influencing Factors of Frailty in Older Patients With Chronic Heart Failure: Based on Bayesian Network 老年慢性心力衰竭患者衰弱的影响因素：基于贝叶斯网络。

IF 2.1 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-05-01 DOI: 10.1016/j.anr.2025.01.005

Si Liu , Xiao-yun Xiong , Mei-jun Zhang , Qin Xiang , Ting Guo , Yu-jie Song

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 Receiver Operating Characteristic (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 that 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.

目的：以往的研究探讨了老年慢性心力衰竭（CHF）患者衰弱的影响因素，但这些研究并未揭示相关因素之间潜在的网络相互作用。本研究旨在构建老年CHF患者衰弱的贝叶斯网络（BN）模型，分析其预测因素，并探讨各因素之间的内在关系。方法：采用方便抽样方法，选取2023年9月至2024年3月在中国江西省南昌市某综合性三级医院心内科就诊的老年CHF患者439例。采用多因素logistic回归分析探讨老年CHF患者衰弱的影响因素。采用最大-最小爬坡算法学习BN结构，通过最大似然估计实现参数估计。采用Netica软件进行预测和诊断。采用ROC曲线验证模型的有效性。结果：老年CHF患者虚弱患病率为53.3%。采用多元logistic回归分析模型筛选变量后，将营养风险、体力活动、抑郁、多病、握力和左房内径纳入贝叶斯网络模型。老年CHF患者衰弱相关因素贝叶斯网络模型显示，营养风险、体力活动、抑郁、多发病与衰弱直接相关，握力、左房内径与衰弱间接相关。结论：研究结果表明，营养不良风险、缺乏运动、抑郁、多发病与虚弱有直接关系，握力较低、左房内径较宽与虚弱有间接关系。加强虚弱评估和实施针对疾病、营养、运动和心理健康的措施，对于延缓和可能逆转虚弱的发生和发展至关重要。

{"title":"Influencing Factors of Frailty in Older Patients With Chronic Heart Failure: Based on Bayesian Network","authors":"Si Liu , Xiao-yun Xiong , Mei-jun Zhang , Qin Xiang , Ting Guo , Yu-jie Song","doi":"10.1016/j.anr.2025.01.005","DOIUrl":"10.1016/j.anr.2025.01.005","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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 Receiver Operating Characteristic (ROC) curve.</div></div><div><h3>Results</h3><div>The prevalence of frailty in older patients with CHF was found to be 53.3%. After using a multivariate logistic regression analysis model that 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":55450,"journal":{"name":"Asian Nursing Research","volume":"19 2","pages":"Pages 152-160"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors Associated With Readmission in Patients With Left Ventricular Assist Devices in South Korea 韩国左心室辅助装置患者再入院的相关因素

IF 2.1 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-05-01 DOI: 10.1016/j.anr.2024.12.009

Hyeonji Kang , Mona Choi

Purpose

Although left ventricular assist devices (LVADs) 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 LVADs.

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% men), 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 nonreadmission groups. New York Heart Association (NYHA) class II [odds ratio (OR): 7.29], NYHA Class III (OR: 47.14), prothrombin time (OR: 32.65), and the 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 nonsustained 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 LVADs.

目的：尽管左心室辅助装置（LVAD）越来越多地被用作终末期心力衰竭的标准治疗方法，但很少有研究探讨LVAD相关的再入院情况。本研究调查了LVAD患者再入院的相关因素和护理记录。方法：回顾性分析韩国某三级医院2015年1月- 2023年4月LVAD植入患者的电子病历。采用χ2检验、Fisher精确检验、t检验和logistic回归分析基线、临床特征和护理资料。结果：127例患者（平均年龄61.31±13.27岁，男性81.1%）中，63.3%的患者接受了LVAD植入作为心脏移植的桥梁，85例（67.0%）在104天内再次入院。双变量分析确定了再入院组和非再入院组之间显着差异的17个变量。纽约心脏协会（NYHA） II级（OR 7.29）、NYHA III级（OR 47.14）、凝血酶原时间（OR 32.65）和自由文本护理笔记的存在（OR 7.58）是再入院的重要因素。结论：护士在管理患者和降低再入院率中起着至关重要的作用。除了NYHA类和凝血酶原时间，这项研究强调了全面的护理文件的重要性。具体而言，“自由文本护理笔记”记录了关键的患者事件和观察结果，如非持续性室性心动过速、出血和不依从性，为临床决策提供了有价值的见解，并加强了患者管理，以防止意外再入院。这些发现强调了护理在文献记录、患者教育和个性化出院计划方面的重要性，以改善LVAD患者的临床结果。

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引用次数: 0

Development and Validation of a Nomogram for Predicting Model for Delirium After Stroke 脑卒中后谵妄的nomogram预测模型的建立与验证。

IF 2.1 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-05-01 DOI: 10.1016/j.anr.2025.01.001

Chuyun Cui, Guoqing Han, Yandi Wang, Baojuan Zhao, Qingguo Li

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 = 1.04), abnormal vision (OR = 2.74), post stroke infection (OR = 3.49), National Institute of Health Stroke Scale score (NIHSS) (OR = 4.18), whether restrained (OR = 3.44) 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 0.92, with a sensitivity of 83.0% and a specificity of 90.0%.

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.

目的：探讨脑卒中患者谵妄的危险因素，建立预测谵妄发生的nomogram模型。方法：采用方便抽样的方法，选取2023年12月至2024年6月在天津市某神经内科三级医院住院的502例脑卒中患者，采用ICU患者意识模糊度评定量表分为谵妄组（n=141）和非谵妄组（n=361）。通过单因素和多因素logistic回归分析，探讨谵妄发生的独立危险因素，建立风险预测模型，绘制nomogram，并对模型进行内外验证。结果：多因素logistic回归分析显示，年龄（OR=1.038）、视力异常（OR=2.740）、卒中后感染（OR=3.486）、国立卫生研究院卒中量表评分（NIHSS）（OR=4.175）、是否约束（OR=3.440）是谵妄发生的独立危险因素。脑卒中患者出现谵妄的nomogram模型一致性指数为0.920，敏感性为83.00%，特异性为90.00%。结论：这项研究已经开发并验证了一种用于识别脑卒中患者谵妄的预测图。可以帮助医护人员快速识别脑卒中后谵妄的高危患者，为进一步制定个性化的脑卒中后谵妄预防策略和干预措施提供依据。

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引用次数: 0

Identifying and Prioritizing the Moral Virtue Indicators for Undergraduate Nursing Students: Measurement Invariance Testing Across Class Levels 本科护生道德美德指标的识别与优先排序：班级水平的测量不变性检验。

IF 2.1 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-05-01 DOI: 10.1016/j.anr.2025.01.006

Pisamai Orathai , Benchaporn Chuengkriangkrai , Kesinee Chaimo

Purpose

This study aimed to identify and prioritize the importance of the moral virtue indicators for undergraduate nursing students and to test the noninvariant indicators across class levels.

Methods

Secondary data from a sample of 1,000 Thai undergraduate nursing students from two nursing education institutes (one university nursing school and one nursing college of the Ministry of Public Health) were split into the first-, second-, third-, and fourth-year student groups (n = 247, 229, 246, and 278, respectively). A confirmatory factor analysis was conducted to identify and prioritize the importance of the moral virtue indicators in four student groups separately. The noninvariant indicators testing across the four class levels was used using multiple-group analysis.

Results

The 10 indicators were crucial for nursing students' moral virtue across the first to fourth years. The most important indicator for the first- and second-year student nurses was cooperation, while honesty was the most crucial indicator for the third-year student nurses, and caring was the most dominant indicator for the fourth-year student nurses. The testing of noninvariant indicators confirmed that each indicator contributed differently to the moral virtue of junior and senior students.

Conclusion

The findings spotlight the importance of the 10 moral virtue indicators for undergraduate nursing students. Besides, the junior and senior student nurses prioritized the importance of the 10 indicators measuring moral virtue differently. Therefore, administrators and nurse educators should provide the ethical scenarios and issues for classroom discussion and implement clinically authentic case-based simulations with timely feedback in laboratories for junior students. A regulatory process on moral virtues, using critical reflection, assessment criteria, and multirater assessors, should be deliberated in clinical training for senior students so that they adhere to moral virtues. These tailored strategies may help student nurses recognize their ethical behavior and gain personal and professional development as future nurses.

目的：本研究旨在确定本科护生道德美德指标的重要性并对其进行排序，并对非不变指标进行跨班级水平的检验。方法：来自泰国两所护理教育机构（一所大学护理学校和一所公共卫生部护理学院）的1000名本科护理学生样本的二级数据被分为一年级、二年级、三年级和四年级学生组（n = 247、229、246和278）。通过验证性因子分析，分别确定四个学生群体道德美德指标的重要性并进行排序。采用多组分析对四个类水平的非不变指标进行检验。结果：10项指标对护生一至四年级的道德品质具有重要影响。一、二年级护生最重要的指标是合作，三年级护生最重要的指标是诚实，四年级护生最主要的指标是关怀。非不变指标的检验证实，各指标对初高中学生道德品质的贡献是不同的。结论：本研究结果突出了护理本科学生十项道德美德指标的重要性。此外，大三护生和大四护生对衡量品德的十个指标的重要性排序也存在差异。因此，管理者和护士教育者应该为课堂讨论提供伦理场景和问题，并在实验室中为初中生实施临床真实的基于案例的模拟，并及时反馈。在高年级学生临床培养过程中，应探讨运用批判性反思、评价标准和多重评价指标的道德规范过程，使高年级学生坚持道德。这些量身定制的策略可以帮助学生护士认识到他们的道德行为，并获得作为未来护士的个人和专业发展。

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引用次数: 0

Latent Profile Analysis of Stigma in Infertile Women and its Influencing Factors 不孕症妇女病耻感的潜在特征分析及其影响因素。

IF 2.1 3区医学 Q2 NURSING

Asian Nursing Research

Pub Date : 2025-05-01 DOI: 10.1016/j.anr.2025.01.010

Hui Wang , Yanxia Chen , Congjing Song , Huan Jiang , Hongyan Chen , Lizhen Zhang , Xiaolu Xia , Shiyi Zhang , Fengxiang Wei , Weiqiang Chen

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

Four hundred thirty-nine 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.

目的：不孕症是一项全球健康挑战，常常导致受影响妇女蒙受耻辱。这种耻辱给不孕妇女带来了负面影响，并受到几个因素的影响。迄今为止的研究将不育妇女视为一个同质群体，基于她们的耻辱。我们试图根据他们的病耻感来确定亚群，并探索与亚群相关的变量。方法：采用横断面研究设计，纳入439名不孕妇女。采用一般信息问卷、不孕症耻感量表、感知社会支持量表和中文版不孕症自我效能感量表。对不孕症妇女的潜在柱头特征进行了潜在分析。采用多项logistic回归分析探讨不同潜伏型不孕症妇女耻辱感的影响因素。结果：439名不孕症妇女被分为低污名-轻度公开污名组（41.5%）、中污名-轻度公开污名组（48.0%）和高污名-重度公开污名组（10.5%）。多元logistic回归结果显示，教育程度、家庭人均收入状况、不孕持续时间、不孕治疗持续时间、感知到的社会支持和自我效能感是耻辱感的影响因素。结论：不孕症妇女耻感可分为三种潜在的特征，具有明显的分类特征。在这些不同的潜在特征中，存在教育水平、家庭人均收入、不孕持续时间、不孕治疗持续时间、感知社会支持和自我效能感的差异。社会退缩是不孕妇女面临的一个普遍而严重的问题。此外，耻辱程度高的不育妇女往往遭受更严重的公众耻辱。

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