The journal of nursing research : JNR最新文献

Background: Students must be able to accept the unrealistic aspects of clinical simulations to ensure these simulations are effective learning tools. As the flow during simulation must be measured to determine simulation learning effectiveness, a reliable measurement tool is needed.

Purpose: This study was carried out to translate the Learning Flow in Clinical Simulation Scale (LFCSS) into Turkish and then to validate it on a sample of nurses in Turkey.

Methods: A methodological research approach was used, and 135 nursing students with prior experience engaging with clinical simulations were recruited and enrolled as participants. The data were collected using two forms, i.e., the Student Information Form, LFCSS (Turkish version) and The Simulation Effectiveness Tool-Modified. Content validity was evaluated using a content validity index (CVI) based on expert opinions. The correlation between the two forms was calculated using the equivalent (parallel) forms method, and reliability and internal consistency were examined using the Cronbach alpha coefficient and item analysis. The construct validity of the scale was determined using factor analysis with varimax rotation.

Results: The Cronbach alpha coefficient was .93 for the entire LFCSS, with item-total score correlations ranging between .922 and .745. In terms of equivalent (parallel) forms reliability, a low correlation (r = .389) was found with the Flow Scale in Clinical Simulation and Prebriefing subdimension of the Simulation Effectiveness Tool-Modified, and a moderate correlation (r = .467, r = .584, r = .447) was found with the Learning, Confidence, and Debriefing subdimensions of the same. The factor analysis showed a four-factor structure explaining 74.13% of the total variance, which is similar to the original scale. The Kaiser-Meyer-Olkin value was .890 and the Bartlett's test chi-square value was 1455.35 with a p < .001 significance level.

Conclusions: The findings indicate the Turkish version of the LFCSS is a reliable and valid tool for assessing level of student/participant flow in clinical simulation.

Background: Metabolic syndrome (MetS) is a complex condition that captures several markers of dysregulation, including obesity, elevated blood glucose levels, dyslipidemia and hypertension. Using an approach to early prediction of MetS risk in hospital employees that takes into account the differing effects of gender may be expected to improve cardiovascular disease-related health outcomes.

Purpose: In this study, machine learning techniques were applied to construct an optimized MetS prediction model for use on hospital employees.

Methods: This population-based study survey included 3,537 participants aged 20 to 65 years old. Participant demographic, anthropometric data, medical history, lifestyle-related factor, and biochemical data were collected from the hospital's Health Management Information System from 2018 to 2020. MetS prediction and the investigation of gender differences were performed using six machine learning models based on the following algorithms: K-nearest neighbor, random forest, logistic regression, support vector machine, neural network, and Naïve Bayes. All analyses were performed by sequentially inputting the features in three steps according to their characteristics.

Results: MetS was detected in 8.91% of the participants. Among the MetS prediction models, Naïve Bayes showed the best performance, with a sensitivity of 0.825, an accuracy of 0.859 and an area under the receiver operating characteristic curve of 0.936. Body mass index and alanine transaminase were identified as important predictive factors for MetS in participants of both genders. Age, uric acid, and aspartate transaminase were identified as important predictive factors in men, while chronic disease and phosphorous were identified as important predictive factors in women.

Conclusions: The results indicate Naïve Bayes model to be useful and accurate in identifying MetS in hospital employees independent of gender. The early prediction of MetS using a model that accounts for gender differences is an important part of routine health screening and requires a multidimensional approach, including self-administered questionnaires and anthropometric and biochemical measurements.

Background: Nursing is a highly demanding profession involving shift-work schedules around the clock. Rest time between shifts is an issue that has gained increasing research attention in recent years, with brief rest periods (< 11 hours) between shifts coined "quick-return." Quick-return work schedules have been linked to negative health outcomes such as poor sleep quality and stress, which may create a vicious cycle that can contribute to work-family conflict.

Purpose: This study aimed to investigate mediation models exploring the role of sleep quality in mediating the relationship between quick-return work shift schedules and work-family conflict among female nurses with children.

Methods: A cross-sectional approach was used, and data were collected from 131 female nurses with children under the age of 18 years between October 2020 and February 2021 in three hospitals. The participants completed a set of questionnaires to evaluate quick-return frequency within the past week, sleep quality between different types of shifts (morning [07:00-15:00]-night [23:00-07:00], evening [15:00-23:00]-morning, night-evening, morning-morning, evening-evening, night-night, and 2 days off), work-family conflict, workload, and sociodemographic factors. Seven mediation models were conducted using the SPSS PROCESS macro.

Results: Only one mediation model was supported. In the supported model, sleep quality between morning-night shifts mediates the relationship between quick-returns within the past week and work-family conflict. Specifically, shift-work schedules with higher numbers of quick-returns within the past week were significantly associated with poorer sleep quality between morning-night shifts ( B = 1.047, SE = 0.457, 95% CI [0.142, 1.952]), which was in turn significantly associated with higher work-family conflict ( B = -0.548, SE = 0.205, 95% CI [-0.953, -0.143]). Notably, whereas the indirect effect between quick-returns within the past week and work-family conflict was significant ( B = -0.574, SE = 0.311, 95% CI [-1.301, 0.079]), the direct effect was not ( p = .169).

Conclusions: The findings of this study show the potentially negative effects of a specific type of quick-return work schedule on sleep quality in nurses, which in turn has a significant impact on nurses' personal and family lives. Because sleep is a modifiable behavior, optimizing this behavior may result in better recovery between shifts. Furthermore, nurse managers should ensure their staff are not assigned work schedules that require quick-returns to work between morning and night shifts.

Background: Prolonged depressive symptoms in individuals with schizophrenia not only diminish their quality of life but also significantly increase their risk of suicide. This, in turn, may lead to a lower average life expectancy among people with schizophrenia compared to the general population.

Purpose: This study was designed to examine the effectiveness of rumination-focused cognitive behavior therapy (RFCBT) on depressive symptoms in individuals with schizophrenia.

Methods: This study was conducted between July 2019 and March 2020. Seventy-seven participants, all of whom had been diagnosed with schizophrenia, were randomly divided into the experimental group ( n = 38) and control group ( n = 39). The experimental group underwent a 12-week, six-session RFCBT regimen, whereas the control group received six sessions of psychosocial education. Outcomes were measured using the Beck Depression Inventory-II and the revised short form of the Chinese Response Style Questionnaire at three time points: baseline, postintervention, and at the 3-month follow-up. Statistical analyses were conducted using chi-square tests, independent t tests, and generalized estimating equations, with the generalized estimating equations model assessing between-group differences over time after adjusting for 13 covariates.

Results: No effect on depressive symptoms was observed immediately following RFCBT. However, at the 3-month follow-up, the mean Beck Depression Inventory-II score had reduced significantly in the experimental group (from 17.24 to 15.56) and increased in the control group (from 17.59 to 23.03; p = .016). Chinese Response Style Questionnaire-10 scores, which are used to represent ruminative responses, did not differ significantly between the groups at any of the three time points.

Conclusions/implications for practice: These findings offer compelling preliminary evidence in support of RFCBT as a potentially effective treatment strategy for alleviating depressive symptoms in patients with schizophrenia. The efficacy of RFCBT was demonstrated in terms of preventing the exacerbation of depressive symptoms. The findings have notable implications for clinicians, researchers, and policymakers with regard to developing more effective treatment strategies and enhancing outcomes for individuals with schizophrenia.

Background: The current focus of cardiac rehabilitation is on adults, with no standard nursing plan available for children with congenital heart disease. Therefore, it is very necessary to develop a standardized early rehabilitation nursing model for children with congenital heart disease to promote the recovery of bodily functions and improve quality of life in this population.

Purpose: This study was designed to explore the feasibility of an early graded rehabilitation nursing model for postoperative children with congenital heart disease and evaluate its clinical effect to promote the standardization of postoperative rehabilitation nursing care.

Methods: One hundred and sixteen postoperative children with congenital heart disease treated at a medical university hospital between August 2022 and January 2023 enrolled as participants in this study, with 58 assigned to the control (routine rehabilitation nursing) group and 58 assigned to the intervention (graded rehabilitation nursing) group. The outcome indicators of the two groups were assessed at the time the participants transferred out of the pediatric intensive care unit (PICU) and at discharge, and then analyzed and compared. The Strengthening the Reporting of Observational Studies in Epidemiology Checklist (case-control studies) was used in this study.

Results: No statistical differences were found between the two groups at baseline. After implementation of the model, more intervention group participants succeeded in achieving difficult target functions when they were transferred out of the PICU and at discharge. At discharge, intervention group participants aged 3 months to 3 years showed higher gross motor quotient (95.36 ± 7.46 vs. 86.77 ± 12.34), fine motor quotient (94.79 ± 4.59 vs. 88.73 ± 14.04), and total motor quotient (95.57 ± 5.49 vs. 86.27 ± 13.08) than their peers in the control group. Also, the average 6-minute walk test (6MWT) duration for intervention group participants older than 3 years was longer than that for their control group peers. Furthermore, average total hospital stay (16.60 ± 5.14 vs. 20.69 ± 12.95 days) and PICU residence time (122.48 ± 46.00 vs. 133.66 ± 66.70 hours) were shorter in the intervention group than the control group. No adverse events occurred during the study period.

Conclusions/implications for practice: The early graded rehabilitation nursing model is safe and feasible. This model can help children achieve more difficult target functions, significantly improve their motor development ability, and shorten their hospital stay. Also, the model can help guide medical staff implement rehabilitation nursing in clinical settings.

Background: Depression, poor sleep quality, and perceived lack of control all commonly impact women in the third trimester of pregnancy. Depression can influence sleep quality, whereas sense of control during pregnancy is correlated with both sleep quality and depression. However, the mediating effect of sleep quality on the relationship between depression and sense of control has not been examined in women in their third trimester.

Purpose: This study was designed to explore depression, sleep quality, and sense of control in pregnant women during the third trimester and determine the degree to which sleep quality mediates the relationship between depression and sense of control.

Methods: An exploratory correlational cross-sectional design was used to recruit 263 pregnant women with a gestational age of 35-36 weeks. Data were collected using questionnaires. Depression, sleep quality, and sense of control were respectively assessed using the Edinburgh Postnatal Depression Scale, Pittsburgh Sleep Quality Index, and Labor Agentry Scale. Data on the main outcomes were analyzed using the PROCESS macro for SPSS.

Results: Depression in pregnant women was found to correlate positively with poor sleep quality and negatively with sense of control (all p s < .001). Thus, higher levels of depression and poorer sleep quality were associated with lower sense of control. The results confirmed the relationship between depression and sense of control to be mediated by sleep quality ( p < .001).

Conclusions: Pregnant women with lower levels of depression may experience better sleep quality and sense of control. Sleep quality mediates the relationship between depression and sense of control in women in the third trimester. Thus, prenatal counseling and psychological support should be provided to pregnant women to reduce depression while improving sleep quality and sense of control.

Background: Exercise is the most effective method of reducing visceral adipose tissue (VAT). However, the optimal exercise modality and strategy for reducing VAT have yet to be determined.

Purpose: This study was designed to identify the optimal sequence exercise strategy for reducing VAT in community residents with obesity.

Methods: A sequential multiple assignment randomized trial design was used to conduct a two-stage (8 weeks each) adaptive exercise for 40- to 64-year-old residents with obesity. In the first stage, the participants were randomly allocated into two groups, one of which did 30 minutes of moderate-intensity continuous training (MICT; n = 58) and the other which did 20 minutes of high-intensity interval training (HIIT; n = 58) three times per week. In the second stage, the nonresponders (with VAT decreases < 3%) were randomly reallocated into a group that performed MICT combined with an additional 10 minutes of resistance exercise or one that performed the opposite of the first-stage treatment (HIIT or MICT). Those who responded to the first-stage intervention (with VAT decreases of ≥ 3%) continued the same exercise treatment until 16 weeks.

Results: The MICT intervention was found to be more efficacious than the HIIT intervention in reducing VAT during the first 8 weeks (β = -4.10, p = .029). Among the nonresponders to MICT, the HIIT outperformed MICT combined with resistance exercise as the alternative choice in the second stage (β = -7.36, p = .006). On the contrary, there were no significant differences between MICT and MICT combined with resistance exercise for the nonresponders to HIIT (β = 1.34, p = .626). Those participants who repeated the same exercise modality (either MICT or HIIT) in both stages exhibited superior VAT reduction to those who changed exercise modalities after the first stage.

Conclusions/implications for practice: The optimal sequence exercise strategy for reducing VAT is captured by a two-stage sequential multiple assignment randomized trial design. Community residents with obesity are advised to reduce VAT efficiently through participation in an 8-week MICT program. For those preferring HIIT rather than MICT, a 16-week program without changing the modality midway is recommended.

Background: Nurses are frequently called upon to serve as first responders and care providers after natural hazards and disasters. As disaster relief nurses protect the health of and provide support to survivors who are forced to live in shelters, their experiences deserve to be analyzed. However, there is a paucity of research and systematic reviews (SRs) on this topic.

Purpose: This research was designed to systematically analyze the experiences of nurses providing care to people in shelters following natural hazards and disasters.

Methods: The authors searched CINAHL, PubMed, Scopus, Web of Science, and ProQuest Dissertations and Theses on July 2nd 2023 for qualitative studies published in English and Japanese since 1995 (the first year articles on this topic were published). After evaluating the methodological quality of the five included studies using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research and conducting a critical appraisal, the relevant qualitative data were extracted. The findings were categorized according to their quality and meaning. Based on these categories, a meta-synthesis was performed to produce a set of synthesized findings.

Results: The five qualitative studies included in this review covered the post-natural disaster care experiences of 45 participants. The meta-synthesis resulted in 25 findings, seven categories, and two synthesized findings, including (a) nurses play multiple roles for evacuees from affected communities and (b) nurses managing shelters to ensure the health and living conditions of evacuees. The synthesized findings explain the disaster relief experience of nurses comprehensively.

Conclusions: This qualitative SR included five moderate-quality studies designed to explore the experiences of disaster relief nurses following natural hazards and disasters. Nurses worked with and managed several teams, including those involved in rescue, resource management, organization, and record management, in a flexible manner, thus involving them in the management of all events within and involving evacuee shelters. These nurses are responsible for providing medical and nursing care and protecting evacuees from danger, while respecting the pace of each individual in the disaster-stricken community. Notably, the nurses leveraged their personal and disaster nursing experiences to learn and develop nursing care strategies and techniques unique to shelters.