The journal of nursing research : JNR最新文献

Background: Despite its status as a prevalent clinical concern, vertigo lacks an effective treatment, especially one that addresses the factors commonly associated with women affected by this condition.

Purpose: This study was designed to clarify the relationship between Traditional Chinese Medicine Body Constitution (Yang-Xu, Yin-Xu, and Phlegm stasis) and vertigo in adult women.

Methods: A cross-sectional study was conducted on 1,423 women enrolled in the Taiwan Biobank between 2012 and 2017. The participants completed the 44-question Body Constitution Questionnaire (BCQ), developed in Taiwan, to assess their body constitution. To investigate the relationship between body constitution and vertigo prevalence, a stepwise-forward multiple-regression analysis was conducted to investigate the influence of three specific body constitutions (Yang-Xu, Yin-Xu, and Phlegm stasis) on the risk of contracting vertigo.

Results: Nearly one out of 10 (9.0%) participants had experienced vertigo, with an average onset age of 56.23 years, with vertigo sufferers showing a significantly higher mean BCQ score compared to those who had not experienced vertigo (Yang deficiency: adjusted Odds Ratio [a OR ]=1.033, Yin deficiency: a OR =1.049, and Phlegm stasis: a OR =1.041). Age, having migraines, and having endometrial polyps were identified as factors influencing the risk of experiencing vertigo.

Conclusions/implications for practice: Unbalanced constitution types were independently associated with a higher risk of vertigo in women, alongside age, migraine, and endometrial polyps. These findings suggest that the constitution serves as an important underlying susceptibility factor. Incorporating constitution assessment into routine health evaluation may facilitate earlier identification of at-risk women and provide a foundation for preventive or constitution-balancing strategies in clinical care.

Background: Human immunodeficiency virus (HIV) remains a serious challenge to public health. Stress is a primary issue affecting HIV care because it is highly prevalent among people living with HIV and negatively affects quality of life in this population.

Purpose: This study was designed to examine the efficacy of a yoga intervention in reducing stress and enhancing coping self-efficacy in people with HIV.

Methods: A parallel-group, randomized controlled trial with single blinding and repeated measures was used. The intervention group engaged at home in eight biweekly online Hatha yoga classes of 120 min (two 60-min sessions) in length. The effects were assessed at baseline, at the end of the 2-month intervention, and at 1 month after the end of the intervention.

Results: Sixty-six people were enrolled as participants, five of whom were lost to follow-up at the second assessment. Sixty-one participants took part in the third assessment. After practicing yoga for 8 weeks, the intervention group had lower mean stress scores and higher mean coping self-efficacy scores than the control group.

Conclusions/implications for practice: The yoga intervention applied in this study was shown to effectively reduce perceived stress and strengthen coping self-efficacy in patients with HIV. This study adds evidence gathered in a new social context (Bali, Indonesia) to existing research showing practicing yoga to be effective in reducing stress in patients with HIV. Yoga is a promising complementary intervention that may be offered to patients with HIV suffering from stress.

Background: Despite global population aging, fragmented care remains a significant obstacle to the provision of effective health care, particularly to older adults with complex health needs.

Purpose: This study was designed to synthesize current qualitative research on nurses' experiences with care fragmentation in caring for aging populations.

Methods: A comprehensive search of two electronic databases was conducted to identify relevant literature published in English. A total of 20 articles covering a total of 296 nurse participants were included in this synthesis. The extracted data were thematically synthesized.

Results: Four main themes and 10 subthemes were identified in the synthesis. The themes included (1) challenges in accessing and delivering health care services, (2) challenges in communications and coordination, (3) the need to advance nurses' roles and recognize their contributions, and (4) the importance of providing patient-centred care.

Conclusions/implications for practice: The findings of this study highlight the complexities and challenges of providing care to aging populations within fragmented health care systems. The difficulties faced by nurses in accessing resources, coupled with communication and coordination barriers, underscore the need for systemic improvements to facilitate effective care delivery. The theme related to nurse recognition highlights the need for greater support and acknowledgement of the contributions of nurses, which is essential to ensuring care quality and patient outcomes. Moreover, the emphasis on patient-centered care reinforces the importance of adopting individualized care strategies that cater to the unique needs of older adults. Health care systems should prioritize initiatives aimed at improving communication and coordination among health care providers, supporting nursing staff, and implementing patient-centered care practices. These efforts are crucial to overcoming the challenges of fragmented care and ensuring older populations receive the comprehensive and effective care they deserve.

Background: Patients undergoing open heart surgery may experience negative emotions such as anxiety, fear, panic, and anger in the preoperative period that may negatively affect their postoperative recovery.

Purpose: This study was designed to compare the effects of preoperative fear and anxiety on postoperative pain and complications in a referral group and on a non-referral group.

Methods: This descriptive study was conducted at a cardiovascular surgery hospital in Turkey from July 1, 2020, to December 31, 2020, on 96 patient participants. The referral group ( n = 48) comprised patients who were diagnosed in another hospital and received cardiovascular surgery at our hospital, while the non-referral group ( n = 48) comprised patients who received their angiography and cardiovascular surgery in our hospital. A Personal Information Form, Surgical Fear Questionnaire, and the Beck Anxiety Inventory were administered to all of the participants in the preoperative period. In the postoperative period, pain levels were determined using the Visual Analog Scale, and complications were recorded.

Results: No statistically significant difference were found in the overall occurrence of complications between the two groups ( p > .05). However, those in the referral group who developed lung-related complications exhibited significantly higher levels of surgical fear ( p < .05). No statistically significant differences were observed between the groups in terms of length of stay in the intensive care unit, length of intubation, length of mobilization, length of hospitalization, pain levels, or mean anxiety and surgical fear scores ( p > .05). A significantly positive relationship was observed between anxiety and surgical fear levels in both groups ( p < .05).

Conclusions/implications for practice: The results indicate neither the timing of surgical treatment decision nor preoperative fear and anxiety are associated with postoperative pain and certain complications. However, a significant relationship was detected between preoperative anxiety and surgical fear. No relationship between the way patients are taken to surgery and levels of anxiety and surgical fear or postoperative complications was found. The literature should be further expanded by conducting different studies on this subject.

Background: The rising global incidence of dementia is an escalating public health issue. In 2021, the rate of dementia cases in Indonesia had already risen to 27.9%. Dementia literacy, which refers to the ability to acquire, assess, and apply knowledge about dementia, is crucial for increasing public awareness and improving dementia care. However, obstacles persist in advancing dementia literacy owing to difficulties in obtaining information and a lack of awareness regarding the importance of dementia knowledge. Addressing these challenges is essential to enhance dementia care at a societal level.

Purpose: This study was implemented to translate and adapt the Consumer Access, Appraisal, and Application of Services and Information on Dementia (CAAASI-Dem) instrument into Indonesian (CAAASI-Dem-INA) and to evaluate its psychometric properties to ensure it is a valid and reliable tool for assessing dementia literacy in Indonesia.

Methods: In this cross-sectional study, a two-stage translation procedure followed by psychometric testing was used. A sample of 319 older adults aged 60 years or older was recruited from Semarang, Central Java, Indonesia, using a convenience sampling method. Data were analyzed using descriptive statistics and confirmatory factor analysis (CFA) to assess the validity and reliability of the translated instrument.

Results: The results of the psychometric evaluation indicate that CAAASI-Dem-INA offers satisfactory validity and reliability. Moreover, the good model fit obtained in the CFA confirms the construct validity, while the Cronbach alphas obtained demonstrate strong internal consistency (.934), and composite reliability (.744-.930), further supporting the reliability of this tool.

Conclusions: The CAAASI-Dem-INA is a valid and reliable tool for measuring dementia literacy among older adults in Indonesia. Thus, it represents an important addition to existing dementia literacy assessment tools and may be used to gain a comprehensive understanding of dementia literacy levels in Indonesia. As a tool to help assess and promote improvements in dementia literacy, the CAAASI-Dem-INA can contribute to improving care and support for the growing number of people affected by dementia in Indonesia.

Background: Although compassion fatigue has received significant attention in nursing management, compassion satisfaction has been less studied.

Purpose: This study was designed to elucidate the positive and negative trends in nursing empathy from a dialectical perspective and investigate the impact of difficult nurse-patient relationship on compassion fatigue and satisfaction, and the underlying mechanisms.

Methods: A cross-sectional study was conducted from November to December 2022 at a tertiary hospital in a northeastern province of China on 1,756 nurses. A moderated mediation model was constructed using structural equation modeling, and multi-group comparative analysis was used to examine the differences in the proposed model.

Results: After adjusting for controlled variables, empathic concern and personal distress were shown to mediate the relationship between difficult nurse-patient relationship and, respectively, compassion satisfaction and burnout. Personal distress was found to mediate the relationship between difficult nurse-patient relationship and secondary traumatic stress, while self-reflection was found to moderate the effect of difficult nurse-patient relationship on empathic concern. Finally, differences in the structural model were detected between those with and without hospital traumatic experience.

Conclusions/implications for practice: The findings reveal the mechanisms and boundary conditions underlying difficult nurse-patient relationship that influence compassion fatigue and compassion satisfaction. Interventions that increase the level of self-reflection and empathic concern may help reduce burnout and increase compassion satisfaction in nurses.

Background: Adolescents exposed to secondhand smoke (SHS) and those living with parents who smoke are at higher risk for tobacco use and adverse health outcomes. School nurses are expected to support smoke-free policies on campuses and play a prominent role in health promotion. However, few nursing studies on SHS exposure prevention have included recommended strategies for advising family smokers (AFS).

Purpose: This study was developed to examine the prevalence of SHS exposure among adolescents in rural areas and assess the impact of implementing a pilot program that incorporates innovative strategies for AFS.

Methods: A school-based, educational intervention study was conducted in four middle schools in western coastal Yunlin County between March and September 2023. Innovative strategies for AFS were integrated into the school's health education curricula using a 6-hour secondhand smoke prevention program. Data were collected using self-administered, anonymous questionnaires. Descriptive and inferential statistical analyses were employed to examine the factors and barriers associated with AFS.

Results: Of the 1,202 adolescents who participated at baseline, 806 (51.4% boys; mean age=13.5 years) reported living with a smoker at home (67%). Among these 806, 91.4% reported family members smoked indoors, and, after completing the AFS program, 46.9% reported having attempted to advise their family members to quit smoking or smoke outdoors. The factors identified as significantly associated with AFS included being female, practicing avoidance behaviors, and witnessing smoking on campus. Only 8.1% felt their advice was successful, with common challenges including parental refusal, being scolded, and feelings of hopelessness. Also, many of the participants reported experiencing moral dilemmas, particularly with regard to cultural values such as filial piety, when advising parents.

Conclusions/implications for practice: Exposure to secondhand smoke among adolescents living in rural areas is a serious issue. Teaching them strategies on how to advise family smokers may help reduce home exposure, particularly among boys. However, in Eastern cultures, advising parents about smoking presents moral challenges due to cultural values. Regulatory changes are needed to protect youths from secondhand smoke at home.

Background: Open-heart surgery is effective but may involve significant postoperative complications and long recovery times that can be exacerbated by patient anxiety. Nonpharmacological approaches such as reflexology have gained attention in the field of medicine for their ability to alleviate anxiety without significant side effects.

Purpose: This systematic review and meta-analysis were designed to determine the effect of reflexology on anxiety in patients undergoing open-heart surgery.

Methods: The PubMed, EBSCO (including MEDLINE and CINAHL), OVID, Web of Science, and Cochrane databases were searched from May 15 to July 15, 2024. Randomized controlled trials that evaluated patients who had open-heart surgery were included in the analysis. Studies were appraised using the Critical Appraisal Checklists for Randomized Controlled Trials developed by the Joanna Briggs Institute (JBI). The meta-analysis was conducted using the Comprehensive Meta-Analysis Version 2, and heterogeneity between studies was assessed using the χ 2 test and I2 statistic. The results were reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Results: Eight studies encompassing 485 patients were included in the meta-analysis. All of the included studies used common measurement times for anxiety and compared intervention groups with either standard care or a placebo. In the meta-analysis performed using a random-effects model, reflexology was found to significantly reduce anxiety ( g =-1.49, 95% confidence interval (CI)=[-2.35, -0.63], with a statistically significant difference observed between the intervention and control groups ( z =-3.41, p =.001). However, the findings of the meta-analysis should be interpreted with caution.

Conclusions: Reflexology may be effective in reducing anxiety in patients undergoing open-heart surgery. However, the significant heterogeneity identified among the included studies indicates variability among study conditions. Therefore, their outcomes should be evaluated carefully. Reflexology may be used as an adjunct to standard patient care. Additional studies with more homogeneous methodologies are required to strengthen the evidence base for the efficacy of reflexology in reducing anxiety in this vulnerable patient population.

Background: The number of patients with end-stage renal disease (ESRD) in Taiwan continues to rise steadily, and hemodialysis is the primary treatment for these patients. More than 50% of patients on hemodialysis are over 65 years of age, indicative of an aging patient population. Changes in lifestyle, dietary habits, and social roles after commencing hemodialysis easily cause patients to feel uncertain, depressed, and/or lonely. However, a limited number of studies have examined the issue of loneliness among older adults on hemodialysis.

Purpose: This study was designed to better understand loneliness and its associated factors among older patients receiving hemodialysis.

Methods: A cross-sectional research design with convenience sampling was employed with a total of 146 patients. Eligible participants aged 65 years or older and receiving hemodialysis for more than 3 months were recruited from two hospitals in northern Taiwan. Structured questionnaires, including a demographic characteristics questionnaire, the Hemodialysis Patient Fatigue Scale, Social Support Scale, and UCLA Loneliness Scale version 3, were used to collect data.

Results: The mean loneliness score was 41.5 out of a maximum of 80. A significant positive relationship was found between fatigue and loneliness, and a significant negative relationship was found between social support and loneliness. Gender, fatigue, and social support were identified as predictors of loneliness.

Conclusions/implications for practice: The results indicate that older patients receiving hemodialysis have a moderate level of loneliness. Based on the identified predictors, nurses should pay particular attention to patients who are female, are experiencing a higher fatigue level, and/or have lower social support. Future studies may use these results to develop strategies for preventing and improving loneliness among older adults receiving hemodialysis.