The assessment indicators of postpartum hemorrhage (PPH) were systematically reviewed to explore their relationship with blood loss as an early warning sign to identify potential PPH for prompt intervention.
A systematic literature search of 9 databases was conducted according to inclusion and exclusion criteria using a comprehensive strategy. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) strategy was chosen as the tool for quality assessment of included studies, and data concerning the basic study characteristics and assessment indicators were extracted.
Eleven studies were included in this review. The assessment indicators in different reports covered heart rate, blood pressure, placental and birth canal check, hemoglobin (Hb), hematocrit (HCT), coagulation function tests, hemodynamic parameters and arterial blood gas, but no data on the assessment of postpartum uterine contraction were found. The relationship between indicators and blood loss varies. The overall quality of 9 manuscripts was comparatively high or moderate, and 2 were rated as low.
The association between blood loss and clinical symptoms is not conclusive based on the present studies, and specific cut-off points could not be formulated to determine the approximate amount of blood loss. However, some cut-off points can be considered warning signs for the need of advanced interventions, such as heart rate, prothrombin time, and placental implantation. Further research on comprehensive assessment and cut-off points should be performed such that birth attendants can distinguish PPH as early as possible.
Breast cancer survivors face many challenges (particularly changes in body image) on their road to restoring physical and psychosocial health following diagnosis. Perceived health-related stigma (PHS) refers to the attachment of negative connotations to some types of disease diagnoses. PHS is common among patients with breast cancer and is associated with adverse emotions, attitudes and behaviors. This article summarizes the latest advances and new perspectives on PHS of breast cancer patients and approaches to block this deleterious process. Effects of PHS on patients with breast cancer, in this paper, and measures, predictors and interventions of PHS have been discussed in depth. Future studies should continue to develop more effective instruments that are specialized for measuring PHS of breast cancer patients, explore the predictors of PHS, and discuss effective interventions on the basis of the predictors.
In current clinical settings, effective clinical leadership ensures a high-quality health care system that consistently provides safe and efficient care. It is useful, then, for health care professionals to be able to identify the leadership styles and theories relevant to their nursing practice. Being adept in recognizing these styles not only enables nurses to develop their skills to become better leaders but also improves relationships with colleagues and leaders who have previously been challenging to work with. This article aims to use different leadership theories to interpret a common scenario in clinical settings in order to improve leadership effectiveness. Ultimately, it is found that different leadership styles are needed for different situations, and leaders should know which approach is most effective in a given scenario to achieve the organization's goals.
The flipped classroom has generated considerable interest in nursing education in the last few years, especially in higher education in China. However, research to date has been insufficient to confirm the effectiveness of the flipped classroom approach. Since most of the Chinese studies are published in Chinese journals, they may not be easily accessible to international researchers. Therefore, this meta-analysis aimed to review the effectiveness of a flipped classroom in nursing education both in English and Chinese databases.
The aim of the present study was to identify the robust available evidence about the effectiveness of flipped classrooms in nursing education through a systematic review and meta-analysis.
A systematic search of English databases, including PubMed, EMBASE, Science Director, CINAHL and Google Scholar, and Chinese databases, including Chinese National Knowledge Infrastructure (CNKI), WanFang Data, VIP Information and Chinese Biomedical Literature (CMB), were conducted to identify peer-reviewed studies that met the inclusion criteria. Two reviewers independently performed study identification with Endnote X7 software and used Excel to extract data. The risk of bias in the included studies was assessed with Cochrane Collaboration's risk of bias tool, and a meta-analysis was conducted using RevMan 5.3 software following the guidelines proposed by PRISMA reporting standards with the protocol register No. CRD42016041826.
A total of 29 studies were included in systematic review. There was a significant post-intervention improvement in academic performance both in knowledge with a pooled random-effects standardized mean difference of 1.13 and skills with a pooled random-effects standardized mean difference (SMD) of 1.68. Students' self-learning abilities were also improved with a pooled random-effects SMD of 1.51 compared with traditional lecture. In the subgroup analysis, we found that the effect sizes had high fidelity in terms of nursing degrees and research settings. There was a high rating of flipped classroom pedagogy from teaching evaluations, study satisfaction, study attitude and improvement in critical thinking and problem-solving skills.
These results indicated that a flipped classroom might help nursing students improve in knowledge, skills, attitudes, self-learning, study satisfaction, critical thinking and problem-solving skills. We recommend adopting this approach for nursing education reform. There is a call for robust empirical research and unification of appraisal standards for further support of the effectiveness of the flipped classroom. Furthermore, a meta-regression analysis is also recommended to explore the sources of heterogeneity in included studies.
Home therapy for hemophilia reduces pain, deformity and incidence of complication-induced hospitalizations. Therefore, it is an important component of comprehensive hemophilia care. Unfortunately, most hemophilic families in Shanxi province, China do not continue home therapy.
To analyze the reasons that hemophilic families do not continue home therapy and to provide a foundation for formulating targeted interventions by the Hemophilia Treatment Center (HTC) in Shanxi Province.
A qualitative phenomenological approach using purposeful sampling of 17 hemophilic families, two physicians, and one nurse from 11 branches across 11 cities in Shanxi Province. Interviews were recorded, transcribed verbatim and analyzed using qualitative content analysis.
Four themes were identified: (1) home therapy was generally positively evaluated; (2) concerns about the safety of home therapy; (3) an imperfect social medical security system; and (4) inadequate continuous nursing of hemophilia.
Home therapy for hemophilia remains in a preliminary stage in Shanxi Province, and inadequate family and social support systems have obstructed the implementation of home therapy. It is necessary to develop a home therapy model suitable for hemophilic families in Shanxi Province as soon as possible. Such a model would improve the community and home care medical systems for hemophilia and guarantee home therapy throughout the entire medical care system, thus enabling more hemophilic families to carry out home therapy. Achieving these goals requires urgent research and attention from medical staff.
This study focuses on how a collective leadership style could influence the implementation of change in health care.
Kotter's 8-step process and leadership can guide the implementation of change. Collective leadership can highlight all levels of staff engagement, establish an organizational culture of learning and trust, and create continuous improvement. At the same time, it can formulate a well-designed plan; develop efficient strategies; communicate and empower the staff; assess the performance; and integrate the improvement.
Collective leadership can establish vision and trust, highlight all levels of staff engagement, establish an organizational culture of learning and trust, create continuous improvement, communicate and empower the staff and integrate the improvement.
Collective leadership can be a powerful way to overcome the barrier and create an effective environment of adaptation of changes by analyzing Kotter's eight stage process.
This study was conducted to understand the trends and research hotspots of clinical nursing in China and abroad, thereby to provide guidance for nursing practice and studies.
We retrieved clinical nursing literature (excluding literature related to psychological nursing and traditional Chinese medicine nursing) cited in Wanfang Data (www.wanfangdata.com.cn) and PubMed between 2007 and 2015 and subsequently performed bibliometric analyses on article volume, journal, clustering of high-frequency keywords, and co-occurrence of keywords.
A total of 10374 publications, excluding those related to psychological nursing, were retrieved via a PubMed search. The literature displayed a rising trend in terms of annual publication volume. The journal distribution of clinical nursing publications overall was consistent with Bradford's Law. The main contents of clinical nursing literature between 2007 and 2009 included: (1) studies on effects of the midwife and midwifery methods for natural childbirth; (2) studies on emergency nursing care; (3) studies on dementia care; (4) studies on bandage dressing in trauma nursing; and (5) studies on quality of life in cancer patients nursing. The main contents of clinical nursing literature between 2010 and 2012 included: (1) studies on obstetric nurse–patient relationships; (2) studies on patients' medical team in stroke nursing; (3) studies on cancer nursing methods; (4) studies on nursing patients with trauma related to urinary incontinence; and (5) studies on the quality of life of caregivers of dementia patients. The main contents of clinical nursing literature between 2013 and 2015 included (1) studies on skin care and bandaging in trauma nursing; (2) studies on evidence-based nursing in AIDS care; (3) studies on nurses' role in obstetric nurse–patient relationships; studies on cancer nursing methods; (4) studies on nursing for Alzheimer's disease and dementia; and (5) studies on caregivers and nursing of stroke patients. A Wanfang Data search retrieved a total of 85570 publications, whose volume also exhibited an annual rising trend, in particular with regard to those in core journals. However, percentage of total publication volume, mean cited frequency per article, and total ranking of clinical nursing publications overall displayed a decreasing trend. The main contents of clinical nursing literature between 2007 and 2009 included: (1) diabetes nursing; (2) nursing for cancer; (3) nursing for senility-related diseases; (4) nursing in the event of complications; (5) nursing for hypertension; (6) studies on quality of life after nursing interventions; (7) chemotherapy nursing; (8) studies on compliance after nursing interventions; (9) constipation nursing; and (10) nursing for stroke patients. The main contents of clinical nursing literature between 2010 and 2012 included: (1) diabetes nu
To investigate the research hotspots and development trends of Chinese geriatric medicine by analyzing the high-frequency keywords, core authors, research institutions and their collaborations in papers published in the Chinese Journal of Geriatrics.
Bibliometric methods and information visualization software (CiteSpace III) were used to analyze the following 3 aspects: keywords, institutions and authors.
Overall, the number of papers published in the Chinese Journal of Geriatrics grew between 1994 and 2015. The top 3 institutions with the greatest numbers of published papers were Beijing Hospital, People's Liberation Army General Hospital and the Second Xiangya Hospital of Central South University. The authors with high productivity were Pulin Yu, Jianye Wang and Xiaoying Li. The terms “Diabetes”, “hypertension” and “myocardial infarction” were hotspot words that drew sustained attention in this field.
Research on geriatric medicine is growing steadily in China. Hospitals and teaching hospitals are major contributors to publications. The collaboration of authors is more common within the same institutions or in the same regions. Clinical research is still the focus of current research. In the future, basic research should be strengthened, and collaborations between different institutions and regions should be promoted to achieve coordinated and integrated development in Chinese geriatric medicine.
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