The journal of nursing research : JNR最新文献

Background: The prevalence of diabetes is a significant concern and is particularly impactful on the older adult population. Auricular acupressure is recognized as an effective complementary treatment for Type 2 diabetes.

Purpose: The purpose of this study is to examine the effect of auricular acupressure on glycemic markers, stress, and sleep quality in older adults with Type 2 diabetes in South Korea.

Methods: The study involved weekly acupressure therapy sessions for 8 weeks, with 25 participants in the intervention group and 26 in the placebo group. Specific acupoints associated with diabetes, sleep, and stress were targeted in the intervention group, while unrelated acupoints were used in the control group. Subjective indicators such as stress and sleep scales, along with objective measures such as blood tests, heart rate variability, and sleep activity recorders, were employed in the analysis.

Results: Significant differences were observed in blood sugar ( F =5.20, p <.001) and glycated hemoglobin ( Z =-2.345, p= .019) between the two groups after administration of the acupressure therapy. However, no significant between-group differences were found in either glycated albumin or fructosamine. Also, activity in the sympathetic and parasympathetic nerves showed significant between-group variation. Although no significant between-group differences were found for subjective sleep indicators, notable changes in the number of awakenings, duration of awakening, REM sleep, and deep sleep conditions were identified.

Conclusions: Although the effects are not strong, the findings suggests auricular acupressure influences glycemic index, stress, and sleep quality in older individuals with Type 2 diabetes positively. The results of this study support the potential of using auricular therapy as a nursing intervention in diabetes management.

Background: The factors of influence on caregiver burden with regard to dementia care provided in residential care homes are multifaceted. Few studies in the literature have simultaneously investigated the variables related to residential care recipients with dementia and their formal caregivers.

Purpose: This study was designed to assess caregiving burden in formal caregivers of residential care recipients with dementia and to identify significant predictors of this burden associated with these care recipients and their caregivers.

Methods: This prospective cross-sectional study enrolled 206 registered nurses and nursing assistants working as formal caregivers, as well as 256 residents with dementia across 6 residential care homes. Structured questionnaires were used to collect data on the sociodemographic characteristics, attitudes, dementia care knowledge, and caregiver burden of nursing staff, as well as data on the sociodemographic characteristics, daily functional ability, cognitive functioning, and neuropsychiatric symptoms of residential care recipients with dementia.

Results: The formal caregivers in this study reported experiencing mild to moderate care burden. Stepwise linear regression analysis identified prior dementia care training, confidence in care provision, and attitude in the formal caregivers and number of medications and agitation/aggression levels in the residents as significant predictors of caregiving burden, explaining 32% of the variance. Unexpectedly, the basic dementia care knowledge of the caregivers and the physical dependence and other neuropsychiatric symptoms of the residents were not identified as significant predictors of caregiver burden.

Conclusions/implications for practice: The findings of this study underscore the critical importance of caregiver attitude, confidence, and coping skills in determining caregiving burden, noting that not all behavioral and psychological symptoms impact this burden equally. These insights emphasize the need to enhance confidence and positive attitudes in formal caregivers and to effectively manage residents' aggressive behaviors through both pharmacological and nonpharmacological approaches to ameliorate the high caregiver burden associated with dementia care.

Background: Food avoidance, common in patients with inflammatory bowel disease (IBD), impacts their recovery and psychological health. However, limited insight is provided in the literature regarding the food avoidance experiences and perceptions of patients. A systematic qualitative synthesis exploring these experiences and perceptions may be expected to enhance scholarly understanding of their implications for IBD.

Purpose: This study was developed to review and characterize existing qualitative studies on food avoidance in patients with IBD and to use relevant data from previous studies to guide and optimize diet management strategies for patients.

Methods: Eight databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, and three Chinese databases) were searched to identify qualitative studies on the food avoidance experiences and perspectives of patients with IBD. Critical Appraisal Skills Program (CASP) Qualitative Checklists were applied to appraise the included studies, and a meta-synthesis approach was used to analyze the data. The findings and quotations from the studies were recharacterized into new themes and categories using inductive thematic synthesis and reciprocal interpretation.

Results: Of the 1,224 studies retrieved, 19 were included in this meta-synthesis. The experiences and feelings of food avoidance in patients with IBD included the four categories of Coping Strategies, Disruption of Life and Mood, Needs and Expectations, and Social Alienation, from which the following eleven themes were derived: (a) motivations and perspectives, (b) safe recipes updated in failure, (c) positive impact, (d) reshaping life planning and increasing life stress, (e) negative emotional challenges, (f) the role of family and friends in dietary management, (g) workplace support deficiencies, (h) lack of professional dietary guidelines, (i) alienation from intimacy, (j) alienation of culinary culture, and (k) social distancing.

Conclusions/implications for practice: The findings of this study highlight the complexities that underlie food avoidance behaviors in people with IBD and reveal the challenges faced by patients in managing their diet and emotions. The importance of personalized dietary guidance based on food avoidance, negative emotion de-escalation, and strong social support for disease management is highlighted.

Background: Children experience fear and anxiety not only during painful procedural interventions but also during painless procedural interventions such as electrocardiography (ECG). Pediatric nurses should be aware of the emotional changes experienced by children during ECG procedures.

Purpose: The aim of this single-center, single-blinded, randomized controlled intervention study was to investigate the impact of the undersea-themed examination table cover (UTETC) on the levels of fear and anxiety experienced by children during ECG procedures.

Methods: This study was conducted between April 1 and July 31, 2022, in the pediatric emergency department of a training and research hospital in Turkey. The participants included 80 children (experimental group = 40, control group = 40) aged 3-12 years. The experimental group underwent the procedure in the ECG room using the UTETC, while the control group underwent the routine procedure in the examination room. The entire process was video-recorded. Video recordings were watched by two nurses who were not otherwise involved in this study, and the data were collected using the Descriptive Data Form, the Children's Fear Scale, and the Children Emotional Manifestation Scale.

Results: No statistically significant difference was found in the descriptive characteristics of the two groups ( p > .05). The experimental group completed the procedure more successfully than the control group with significantly lower levels of procedure-related fear and anxiety ( p < .05).

Conclusions/implications for practice: The UTETC was found to be effective in reducing fear and anxiety in children aged 3-12 years during ECG procedures in a pediatric emergency department.

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.