Asian Nursing Research最新文献_第8页

Validity and Reliability of the Korean Version of the Paternal Postnatal Attachment Scale 韩国版父亲产后依恋量表的效度与信度

IF 2.2 3区医学 Q1 Nursing

Asian Nursing Research

Pub Date : 2023-05-01 DOI: 10.1016/j.anr.2023.03.003

Yookyung Choi, Suk-Sun Kim

Purpose

The study aimed to translate the Paternal Postnatal Attachment Scale (PPAS) into Korean and to evaluate the validity and reliability of the Korean version of the PPAS (K-PPAS).

Methods

The PPAS was translated, back-translated, and reviewed by 12 experts and 5 fathers following the World Health Organization's guideline. A convenience sample of 396 fathers with infants in their first 12 months participated in this study. For construct validity, an underlying factor structure and model fit was assessed with an exploratory and confirmatory factor analysis. Convergent and discriminant validity and reliability of the K-PPAS were evaluated.

Results

The construct validity of the K-PPAS with 11 items was identified by two-factor structures: healthy attachment relationship, and patience and tolerance. The final model fit was shown acceptable with the normed chi-square = 1.94, comparative fit index = .94, Tucker–Lewis index = .92, root mean square error of approximation = .07, and standardized root mean square residual = .06. This model had acceptable convergent and discriminant validity for each construct with the values of the composite reliability and heterotrait–monotrait ratio at a satisfactory level. Discriminant validity with known groups showed that fathers with no postnatal depression had significantly higher scores on the K-PPAS than those with postnatal depression. Cronbach's α and McDonald's omega coefficient of the K-PPAS was .84 and .83.

Conclusions

The K-PPAS would be beneficial to measure postnatal attachment among fathers with infants aged 12 months or younger in Korea. However, further studies are suggested to evaluate the applicability of the scale considering the various family structures, such as single or foster parents and multicultural families that exist within the Korean population.

目的本研究旨在将产后依恋量表（PPAS）翻译成韩语，并评估韩国版产后依恋量量表（K-PPAS）的有效性和可靠性。396名前12个月有婴儿的父亲参加了这项研究。对于结构有效性，通过探索性和验证性因素分析来评估潜在因素结构和模型拟合。评估了K-PPAS的收敛性和判别性的有效性和可靠性。结果K-PPAS的11个项目的结构有效性由两个因素结构确定：健康依恋关系、耐心和容忍。最终模型拟合被证明是可接受的，赋范卡方=1.94，比较拟合指数=.94，Tucker–Lewis指数=.92，近似均方根误差=.07，标准化均方根残差=.06。该模型对每个结构都具有可接受的收敛性和判别有效性，复合信度和异特异性-单性状比值均处于令人满意的水平。已知组的判别有效性表明，没有产后抑郁症的父亲在K-PPAS上的得分明显高于有产后抑郁症的爸爸。K-PPAS的Cronbachα和McDonald’s omega系数分别为.84和.83。结论K-PPAS有利于测量韩国12个月及以下婴儿父亲的产后依恋。然而，建议进行进一步的研究，以评估该量表的适用性，考虑到韩国人口中存在的各种家庭结构，如单亲或养父母以及多元文化家庭。

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引用次数: 1

Relationship Between Trunk Control Ability and Respiratory Function in Stroke Patients: A Scoping Review and Meta-Analysis 脑卒中患者躯干控制能力与呼吸功能的关系:一项范围回顾和meta分析

IF 2.2 3区医学 Q1 Nursing

Asian Nursing Research

Pub Date : 2023-05-01 DOI: 10.1016/j.anr.2023.04.001

Hsiang-Chu Pai , Chia-Chi Li

Purpose

Hemiparesis in stroke survivors has been reported to affect respiratory function. The relationship between trunk control and respiratory function, however, is not well understood. We aimed to map the state of the association between the trunk and respiratory function as well as evaluate the effect of a respiratory function training intervention on trunk control for stroke survivors.

Methods

A scoping review and meta-analysis of observational and interventional studies were performed. Cochrane Library, CINAHL with Full Text (EBSCO), Medline (Ovid), and PubMed were searched using the terms stroke, respiratory, and trunk control. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist was used to examine the sections of each report.

Results

A total of 102 studies were identified, of which 12, published between 2011 and 2022, were included in the meta-analysis or narrative synthesis. Three studies were included in the meta-analysis of the correlation between trunk control and respiratory function parameters (forced vital capacity [FVC], forced expiratory volume during the first breath [FEV₁], maximal inspiratory pressure [MIP], and maximal expiratory pressure [MEP]) with effect sizes (Fisher's z) for all outcomes, which ranged from small to intermediate (between 0.21 and 0.39). Furthermore, five studies were included in the meta-analysis of the effect of respiratory function training intervention on trunk control. An overall effect size (Cohen's d) of 1.47 corresponds to a large effect. We also found significant improvements in MIP and MEP but not in FVC and FEV₁ for stroke survivors with the interventions.

Conclusions

Respiratory training, use of diaphragmatic resistance exercise or abdominal breathing, use of a pressure threshold-loading device, and the performance of functional strengthening exercises for the trunk muscles were found to increase patients’ trunk control and improve their respiratory muscle strength.

目的据报道，中风幸存者的偏瘫会影响呼吸功能。然而，躯干控制和呼吸功能之间的关系尚不清楚。我们旨在绘制躯干和呼吸功能之间的关联状态，并评估呼吸功能训练干预对中风幸存者躯干控制的影响。方法对观察性和介入性研究进行范围界定和荟萃分析。使用中风、呼吸和躯干控制等术语搜索Cochrane Library、CINAHL with Full Text（EBSCO）、Medline（Ovid）和PubMed。系统评价的首选报告项目和范围界定评价的荟萃分析扩展（PRISMA ScR）检查表用于检查每份报告的章节。结果共确定了102项研究，其中12项发表于2011年至2022年间，被纳入荟萃分析或叙事综合。三项研究纳入了躯干控制和呼吸功能参数（用力肺活量[FVC]、第一次呼吸时用力呼气量[FEV1]、最大吸气压力[MIP]和最大呼气压力[MEP]）与所有结果的效应大小（Fisher’s z）之间相关性的荟萃分析，其范围从小到中等（0.21到0.39）。此外，呼吸功能训练干预对躯干控制影响的荟萃分析中包括了五项研究。1.47的总体效应大小（Cohen’s d）对应于大的效应。我们还发现，通过干预，中风幸存者的MIP和MEP有显著改善，但FVC和FEV1没有改善。结论呼吸训练、膈肌阻力运动或腹式呼吸、压力阈值加载装置的使用以及躯干肌肉功能强化运动的表现可以增强患者的躯干控制能力，提高呼吸肌肉力量。

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引用次数: 0

Incidence and Risk Factors for Radiotherapy-Induced Oral Mucositis Among Patients With Nasopharyngeal Carcinoma: A Meta-Analysis 鼻咽癌患者放疗所致口腔黏膜炎的发病率及危险因素:一项荟萃分析

IF 2.2 3区医学 Q1 Nursing

Asian Nursing Research

Pub Date : 2023-05-01 DOI: 10.1016/j.anr.2023.04.002

Juejin Li , Chuanmei Zhu , Yun Zhang , Chang Guan , Qi Wang , Yuxin Ding , Xiaolin Hu

Purpose

To evaluate the incidence and identify the risk factors for radiotherapy-induced oral mucositis among patients with nasopharyngeal carcinoma.

Methods

A meta-analysis was conducted. Eight electronic databases (Medline, Embase, Cochrane Library, CINAHL Plus with Full Text, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and Chinese Scientific Journals Database) were systematically searched from inception to 4 March 2023 for relevant studies. Study selection and data extraction were conducted by two independent authors. The Newcastle‒Ottawa scale was used for quality assessment among the included studies. Data synthesis and analyses were performed in R software package version 4.1.3 and Review Manager Software 5.4. The pooled incidence was calculated using proportions with 95% confidence intervals (CIs), and the risk factors were evaluated using the odds ratio (OR) with 95% CIs. Sensitivity analysis and predesigned subgroup analyses were also conducted.

Results

A total of 22 studies published from 2005 to 2023 were included. The results of the meta-analysis showed that the incidence of radiotherapy-induced oral mucositis was 99.0% among nasopharyngeal carcinoma patients, and the incidence of severe radiotherapy-induced oral mucositis was 52.0%. Poor oral hygiene, overweight before radiotherapy, oral pH < 7.0, the use of oral mucosal protective agents, smoking, drinking, combined chemotherapy, and the use of antibiotics at early treatment stage are risk factors for severe radiotherapy-induced oral mucositis. Sensitivity analysis and subgroup analyses also revealed that our results are stable and reliable.

Conclusions

Almost all patients with nasopharyngeal carcinoma have suffered from radiotherapy-induced oral mucositis, and more than half of patients have experienced severe oral mucositis. Facilitating oral health might be the key focus of reducing the incidence and severity of radiotherapy-induced oral mucositis among nasopharyngeal carcinoma patients.

Registration number

CRD42022322035.

目的评估鼻咽癌患者放疗诱发口腔粘膜炎的发生率并确定危险因素。方法进行荟萃分析。从成立到2023年3月4日，系统检索了8个电子数据库（Medline、Embase、Cochrane Library、CINAHL Plus with Full Text、Web of Science、中国国家知识基础设施、万方数据库和中国科学期刊数据库）进行相关研究。研究选择和数据提取由两位独立作者进行。纽卡斯尔-渥太华量表用于纳入研究的质量评估。数据合成和分析在R软件包版本4.1.3和Review Manager软件5.4中进行。合并发病率使用95%置信区间（CI）的比例进行计算，风险因素使用95%CI的比值比（OR）进行评估。还进行了敏感性分析和预先设计的亚组分析。结果纳入2005年至2023年发表的22项研究。荟萃分析结果显示，鼻咽癌患者放疗诱发口腔粘膜炎的发生率为99.0%，严重放疗诱发口腔黏膜炎的发生率52.0%；7.0、使用口腔黏膜保护剂、吸烟、饮酒、联合化疗以及在早期治疗阶段使用抗生素是严重放疗诱导的口腔粘膜炎的危险因素。敏感性分析和亚组分析也表明我们的结果是稳定可靠的。结论鼻咽癌患者大多有放疗引起的口腔粘膜炎，超过一半的患者有严重口腔粘膜炎。促进口腔健康可能是降低鼻咽癌患者放疗诱发口腔粘膜炎发生率和严重程度的关键。注册号CRD42022322035。

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引用次数: 0

Fatigue and Quality of Life Among Patients with Diabetes and Non-diabetes Receiving Primary Percutaneous Coronary Interventions 原发性经皮冠状动脉介入治疗的糖尿病和非糖尿病患者的疲劳和生活质量

IF 2.2 3区医学 Q1 Nursing

Asian Nursing Research

Pub Date : 2023-05-01 DOI: 10.1016/j.anr.2023.02.001

Shu-Fen Su , Wen-Ting Yeh

Purpose

Few studies have examined the effect of diabetes mellitus (DM) on patients with coronary artery disease. The relationships between quality of life (QoL), risk factors, and DM of patients receiving percutaneous coronary interventions (PCIs) are poorly understood. We investigated the influence of DM on fatigue and QoL over time among patients receiving PCIs.

Methods

An observational cohort study with a longitudinal, repeated-measures design was used to investigate fatigue and QoL among 161 Taiwanese patients with coronary artery disease with/without DM who received primary PCIs between February and December 2018. Participants provided demographic information and their Dutch Exertion Fatigue Scale and the 12-Item Short-Form Health Survey scores before the PCI and two weeks, three months, and six months post-discharge.

Results

Seventy-seven PCI patients were in the DM group (47.8%; mean age = 67.7 [SD = 10.4] years). The mean scores of fatigue, physical component scale (PCS), and mental component scale (MCS) were 7.88 (SD = 6.74), 40.74 (SD = 10.05), and 49.44 (SD = 10.57), respectively. DM did not affect the magnitude of change in fatigue or QoL over time. Patients with DM perceived similar fatigue as those without DM before PCI and two weeks, three and six months post-discharge. Patients with DM perceived lower psychological QoL than those without DM two weeks post-discharge. Compared to pre-surgery scores, patients without DM perceived lower fatigue at two weeks, three months, and six months post-discharge, and higher physical QoL at three- and six-months post-discharge.

Conclusions

Compared with DM patients, patients without DM had higher pre-intervention QoL and better psychological QoL two weeks post-discharge, and DM did not influence fatigue or QoL of patients receiving PCIs over six months. DM may affect patients in the long term; therefore, nurses should educate patients to regularly take medication, maintain proper habits, notice comorbidities, and follow rehabilitation regimes after PCIs to improve prognosis.

目的很少有研究检测糖尿病（DM）对冠状动脉疾病患者的影响。接受经皮冠状动脉介入治疗（PCI）的患者的生活质量（QoL）、危险因素和糖尿病之间的关系尚不清楚。我们研究了糖尿病对PCI患者疲劳和生活质量的影响。方法采用纵向重复测量设计的观察性队列研究，对2018年2月至12月期间接受原发PCI的161名患有/不患有糖尿病的台湾冠状动脉疾病患者的疲劳和生活水平进行了调查。参与者在PCI前和出院后两周、三个月和六个月提供了人口统计信息、荷兰运动疲劳量表和12项简式健康调查得分。结果共有7名PCI患者属于DM组（47.8%；平均年龄=67.7[SD=10.4]岁）。疲劳、身体成分量表和心理成分量表的平均得分分别为7.88（SD=6.74）、40.74（SD=10.05）和49.44（SD=10.57）。DM不影响疲劳或生活质量随时间变化的幅度。糖尿病患者在PCI前和出院后两周、三个月和六个月感觉到与无糖尿病患者相似的疲劳。出院两周后，糖尿病患者的心理生活质量低于无糖尿病患者。与术前评分相比，无DM患者在出院后两周、三个月和六个月的疲劳程度较低，出院后三个月、六个月身体生活质量较高。结论与DM患者相比，无糖尿病患者在干预前生活质量较高，出院后两周心理生活质量较好，DM对PCI患者6个月以上的疲劳和生活质量没有影响。DM可能会长期影响患者；因此，护士应教育患者定期服药，保持适当的习惯，注意合并症，并遵循PCI后的康复制度，以改善预后。

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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 Q1 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 Q1 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

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 Q1 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

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 Q1 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 Q1 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 Q1 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