The journal of nursing research : JNR最新文献

Background: Chronic pain and sleep disorders are commonly seen symptoms in community-dwelling older adults at traditional Chinese medicine (TCM) clinics. TCM modalities such as herbal medication and acupuncture have side effects and usage limitations. Therefore, nonpharmacological and noninvasive interventions may be applied to relieve the symptoms of these conditions.

Purpose: This study was designed to test the effect of Qigong Wuqinxi exercise on chronic pain, sleep quality, TCM constitutions, and tongue features in community-dwelling older adults.

Methods: This was a cluster randomized controlled trial. Older adults in two community care centers who met the inclusion criteria were assigned by drawing lots to either the experimental group (n = 32) or the control group (n = 31). Experimental group members practiced the Qigong Wuqinxi exercise for 50 minutes three times each week for 12 weeks, whereas those in the control group maintained their normal daily routine. Before and after the 12-week study, data on chronic pain, sleep quality, TCM constitutions, and tongue features were collected from all participants to assess the effectiveness of the intervention. Between-group pretest and posttest comparisons were analyzed using independent samples t tests, and within-group differences were analyzed using paired t tests.

Results: The experimental group reported significantly greater average posttest improvements in chronic pain, yang deficiency, phlegm-stasis, thick fur, and red dots than the control group (all ps < .05). The maximum change in pretest to posttest pain scores favored the experimental group (-0.56 ± 0.76 vs. 0.39 ± 1.91, p = .011). Also, the experimental group had a significantly better change in the pain interference index (-3.31 ± 3.30 vs. -0.58 ± 1.91, p < .001). In addition, the experimental group exhibited greater improvements in yang-deficiency tendency (-2.38 ± 4.89 vs. 0.35 ± 4.67, p = .027), phlegm and stasis tendency (-2.19 ± 4.52 vs. 1.77 ± 2.47, p < .001), thick fur (1.44 ± 11.28 vs. 6.03 ± 6.04, p = .049), and red dots (-5.09 ± 21.45 vs. 2.81 ± 4.03, p = .048). However, no significant between-group difference in posttest sleep quality (p = .357) was observed.

Conclusions/implications for practice: The Qigong Wuqinxi exercise was found to positively improve chronic pain and TCM constitutions in community-dwelling older adults and may be promoted in community care centers to improve the health status of older adults.

Background: In light of the rising incidence of mild cognitive impairment in women, an appropriate cognitive reserve enhancement program is urgently needed for women experiencing climacteric symptoms.

Purpose: The purpose of this study was to develop a cognitive reserve enhancement program for climacteric women based on cognitive reserve theory (CRT) and to verify its effectiveness.

Methods: A nonequivalence control group, pre- and post-quasi-experimental design was used. The 58 climacteric women with subjective memory deterioration enrolled as participants were divided into the experimental group (28 women), which received a 24-session CRT-based cognitive reserve enhance program, and the control group (30 women), the members of which received the cognitive training via a mobile application after completion of the study. Valid data from 24 experimental and 26 control participants were available for analysis. Objective cognitive functions, including overall cognitive, memory, attention, and language, were measured pretest and posttest using the following tools: Everyday Cognition Scale (subjective cognitive function), Center for Epidemiologic Studies Depression Scale (depression), and World Health Organization Quality of Life-Brief Version (quality of life).

Results: The experimental group showed a statistically significant increase in overall cognitive function (t = 3.82, p = .001), memory (t = 2.63, p = .012), attention: number of correct answers (t = 2.12, p = .040), language high-frequency response speed (Z = -2.49, p = .013), and language low-frequency response speed (Z = -2.77, p = .006) in objective cognitive function after 8 weeks in comparison to the control group.

Conclusions/implications for practice: The intervention program tested in this study to enhance cognitive reserve in climacteric women includes cognitive training, emotional and social support, and group physical activity components was found to be effective in enhancing cognitive function.

Background: Approximately 50% of residents living in institutions have insufficient fluid intake, and 20%-30% experience dehydration. Implementing strategies that effectively increase fluid intake is crucial to preventing dehydration-related complications and reducing complications and comorbidities in this population.

Purpose: This study was designed to explore the effects on fluid intake and hydration status of a hydration game-based learning program in institutional residents.

Methods: A single-blind, cluster, randomized controlled trial was conducted. Sixty-four subjects from five long-term care facilities in northern Taiwan were randomly assigned to either an experimental or control group. The experimental group received a 40-minute game-based hydration care program intervention twice weekly for 8 weeks. The control group received routine care. The data obtained were analyzed using generalized estimating equation analysis to verify changes in observed variables in the two groups at 4 and 8 weeks (during and immediately after the intervention).

Results: The results showed a significant improvement in fluid intake in the experimental group at 4 and 8 weeks (p = .002 and p < .001, respectively). In terms of dehydration-related indicators, although total body water was significantly improved at 8 weeks in the experimental group (p = .009), no significant improvement was found in urine-specific gravity. In terms of signs of possible urinary tract infection, the experimental group showed significant improvement in urine leukocytes (p = .029) and nitrites (p = .004) at 8 weeks.

Conclusions/implications for practice: The findings of this study support the positive effects of applying the concept of uncertain rewards and game-based learning in institutional group activities. Specifically, the interventions increased social interaction and enhanced enjoyment of drinking. The findings call for nursing professionals at institutions to offer similar hydration game-based learning programs as part of residents' daily activities to improve fluid intake.

Background: The importance of online educational resources enhancing self-management among patients is underscored by the growing prevalence of diabetes. It is crucial to comprehend how patients with diabetes in China seek diabetes-related information and use mobile applications (apps) designed for diabetes management. Although the Knowledge-Attitude-Practice theory plays an integral role in diabetes management, in-depth studies on eHealth literacy (eHL) and Knowledge-Attitude-Practice in populations with diabetes remain scarce.

Purpose: This study was developed to provide insights into the online information-seeking behaviors of and diabetes apps used by individuals living with diabetes by exploring the relationships among eHL, diabetes knowledge, self-efficacy, and self-care behaviors.

Methods: A cross-sectional survey was conducted from November 2022 to June 2023 on 380 inpatients with diabetes at the Yantai Yuhuangding Hospital in Shandong Province. The participants voluntarily completed surveys covering sociodemographic characteristics, diabetes status, diabetes app usage, online diabetes information searching, eHL, diabetes knowledge, self-efficacy, and self-care behaviors. Structural equation modeling analyses were employed to assess model fitness and the interrelationships between latent constructs and observable variables.

Results: Of the 380 participants, 57.1% (217/380) reported actively seeking diabetes information online, whereas only 3.7% (14/380) had used diabetes apps. eHL was shown to have a direct effect on diabetes knowledge (β = 0.377, p < .001) but no direct impact on self-care behaviors (β = 0.017, p = .860). However, an indirect effect on self-care behaviors was observed via diabetes knowledge and self-efficacy.

Conclusions/implications for practice: The results of this study indicate that, despite widespread online information-seeking behavior, diabetes app utilization remains limited in China. Also, the findings indicate enhancing patients' eHL contributes to more comprehensive diabetes knowledge. Furthermore, eHL was shown to influence self-care behaviors via diabetes knowledge and self-efficacy. A self-managed intervention strategy should be developed to improve eHL that utilizes internet resources to improve patients' knowledge and self-efficacy and promote better self-care behaviors.

Background: Needle-related procedures are commonly performed in childhood and lead to considerable pain.

Purpose: This randomized controlled study was conducted to compare the effects on venipuncture pain of the Buzzy, an informational animated video, multiple interventions, and standard care in children aged 6-12 years.

Methods: One hundred eighty children were assigned to the groups using a computerized randomization program. Pain level was evaluated by the children, parents, and their nurses using the Wong-Baker Faces Pain Scale. The level of agreement among the nurse, parents, and children's pain reports was evaluated. Multivariable regression analysis was performed to identify the factors significantly associated with pain score.

Results: The participants in the Buzzy, video watching, and multiple intervention groups reported lower mean pain scores (child: KW = 28.24, p < .001; parent: KW = 18.51, p < .001; nurse: KW = 44.4, p < .001) than their peers in the control group. Moreover, age was identified as a risk factor affecting pain level ( OR = 1.375, 95% CI [1.086, 1.740]; p = .008).

Conclusions: Buzzy and informational videos are potentially effective methods to facilitate venipuncture-related pain management in children. The use of pain management methods during venipuncture is recommended, especially in children younger than 10 years old.

Background: Although the proportion of male nurses in the nursing profession has risen in recent years, their turnover rate remains higher than their female counterparts. Male nurses tend to report lower levels of job satisfaction. However, there has been a dearth of research examining the relation among perceptions of work environment, social support, and job satisfaction in male nurses.

Purpose: The aim of this study was to investigate the associations among work environment, social support, and job satisfaction in male nurses in Korea. In addition, the potential mediating effect of social support on the relationship between work environment and job satisfaction was explored.

Methods: A cross-sectional design was employed to investigate the research questions. The study was conducted in a metropolitan area in South Korea, and self-administered questionnaires were distributed to participants. Hierarchical multiple regression analysis was utilized to explore the potential associations among work environment, social support, and job satisfaction.

Results: Work environment was found to correlate positively with job satisfaction (r = .53, p < .001) and social support (r = .57, p < .001) in the participants, whereas a positive correlation was also found between social support and job satisfaction (r = .57, p < .001). Social support was shown to partly mediate the relationship between work environment and job satisfaction.

Conclusions: The findings of this study suggest that social support partially mediates the relationship between work environment and job satisfaction in male nurses as well as confirm the importance of both work environment and social support as factors that can positively influence job satisfaction in this group.

Background: Heart failure is prevalent among aging populations. Given the increasing median age in many countries, sustainably improving self-care behaviors in heart failure patients is crucial. Physical symptoms predict self-care in patients with heart failure, whereas psychological factors such as depressive symptoms and uncertainty negatively affect disease management efficacy.

Purpose: The mediating and indirect effects of depressive symptoms and disease uncertainty regarding the relationship between physical symptoms and self-care behaviors were examined in older South Korean men with heart failure.

Methods: A descriptive correlational survey design was used to collect data from 185 older men with heart failure. Data were obtained from medical records and self-reported questionnaires addressing physical symptoms, depressive symptoms severity (Patient Health Questionnaire-9), illness uncertainty (Mishel Uncertainty in Illness Scale-Community Form), and self-care behaviors (European Heart Failure Self-care Behavior Scale). The mediating effects of depressive symptoms and disease uncertainty were assessed using a bootstrapping method via PROCESS Model 4, a parallel mediation model, in SPSS.

Results: The mean age of the participants was 77.41 ( SD = 5.35) years. Half (50.8%) had a diagnosis of New York Heart Association Class II heart failure, and 21.6% had a diagnosis of New York Heart Association Class III/IV heart failure. Self-care behaviors were found to correlate negatively with physical symptoms, depressive symptoms, and uncertainty. Depressive symptoms ( B = -0.10, 95% confidence interval [CI] [-0.18, -0.01]) and uncertainty ( B = -0.05, 95% CI [-0.09, -0.01]) were found to mediate the relationship between physical symptoms and self-care behaviors.

Conclusions/implications for practice: The findings reveal depressive symptoms and disease uncertainty significantly mediate the relationship between physical symptoms and self-care behaviors in older South Korean men with heart failure. In light of this, cardiovascular nurses should join in targeted educational initiatives tailored to address the unique needs of older men with heart failure that consider psychological factors such as depressive symptoms and uncertainty as well as physical symptom management.

Background: Turnover among newly employed nurses is an indicator of workforce stability in healthcare organizations. The factors influencing turnover intention in this group are complex and differ by generation. The relationships among variables including work-life quality, personal accomplishment, resilience, and turnover intention have been explored separately. However, a knowledge gap exists in terms of scholarly understanding regarding the respective impacts of perceived personal accomplishment and resilience on the relationship between work-life quality and turnover intention.

Purpose: This study was designed to explore the respective effects of resilience and personal accomplishment on the relationship between work-life quality and turnover intention.

Methods: A cross-sectional approach was used, and 387 newly employed nurses who had worked for just 1 month at six medical centers in Taiwan were enrolled as participants. The following four instruments were used for data collection: Quality of Nurse Work-life Scale, Connor-Davidson Resilience Scale, the personal accomplishment subscale of the Maslach Burnout Inventory, and Turnover Intention Scale. Hayes PROCESS analysis method was used to analyze the influence of resilience and personal accomplishment on the relationship between work-life quality and turnover intention.

Results: There was a positive correlation among work-life quality, resilience, and personal accomplishment, and a negative correlation was found between all three variables and turnover intention. Resilience was found to negatively mediate the relationship between work-life quality and turnover intention ( B = -.032, p < .001). The moderating effect of work-life quality on personal accomplishment was significant ( B = .012, p < .05). Work-life quality and sense of personal accomplishment explained 61% of the variance in resilience. Work-life quality and resilience explained 50.5% of the variance in turnover intention. Furthermore, sense of personal accomplishment moderated the mediating effect of resilience on the relationship between work-life quality and turnover intention.

Conclusions/implications for practice: Resilience mediates the relationship between work-life quality and turnover intention, whereas personal accomplishment may moderate the mediating effect of resilience in the relationship. Administrators should provide strategies to improve professional competence and improve psychological capacity in new nurses to increase their sense of personal accomplishment and resilience to decrease turnover intention.