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Concussion symptoms following a traumatic accident are both common and known to adversely affect mental health and recovery in patients with traumatic brain injury. Depression, highly prevalent among patients with traumatic brain injury, is also associated with the important factors of sleep quality and resilience. However, the mediator and moderator roles of depression following concussion in patients with traumatic brain injury have been underexplored. The aims of this study were to investigate the mediating role of sleep quality in the relation between concussion symptoms and depression and to examine the moderating effect of resilience on this mediated model.
Cross-sectional pretest data analysis of a randomized controlled trial.
A total of 249 adult patients with mild traumatic brain injury (Glasgow Coma Scale 13–15) at admission following brain injury were surveyed at a medical center in Taipei, Taiwan. The outcome variables were concussion symptoms (Rivermead Post-Concussion Symptom Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), resilience (Resilience Scale for Adults), and depression (Beck Depression Inventory II). These data were analyzed using moderated mediation regressions with the SPSS PROCESS macro.
In patients with mild traumatic brain injury, there was a significant positive relation between concussion symptoms and depression, of which sleep quality was a significant mediator. Additionally, resilience had a negative moderating effect on the relations between sleep quality and depression. Patients with less resilience showed a stronger negative effect of sleep quality on depression.
Our findings suggest that ameliorating both concussion symptoms and sleep disturbance is important for reducing the risk of depression in patients with mild traumatic brain injury, especially in those patients with less resilience.
It is essential for clinical nurses to develop interventions for patients with mild traumatic brain injury that will improve their sleep quality, while strengthening their resilience, to alleviate depression.
Hospital-acquired pressure injuries (HAPIs) are a global high-stakes patient safety issue. Key stakeholder perspectives regarding their role and experiences with pressure injuries is critical as part of the solution to minimizing HAPI occurrence and attain sustainability.
A qualitative, descriptive approach provided multiple perspectives of key stakeholders to support the complexity of HAPI care. The qualitative data are a part of a mixed method convergent research study examining pressure injury prevention and management practices.
Nursing system theory, mixed method convergent design, and participatory action research methodologies were chosen to address both the gap analysis development and results, achieve collaborative comprehensiveness, and enable key stakeholder involvement throughout this HAPI prevention and management initiative. Participants were recruited and enrolled from a large Level I trauma hospital and the key stakeholders. Demographic information were collected prior to the individual interview. Focused interviews were conducted virtually using zoom technology. Qualitative data were analyzed using NVivo software and thematic analysis was confirmed across the co-investigators for congruence and applicability to the research questions.
Qualitative interviews with 26 key stakeholders provided data to support and integrate a link with gap analysis results on the complex health issue of HAPIs. Specific barrier and recommendation themes identified interventions that could be prioritized. The 52 barrier and 52 recommendation themes/sub-theme(s) respectively were organized by Donabedian (structure, process, and outcome) with structure elements the majority. The top three structure barrier themes involved equipment and standards for use, staff prevention education, and specialized health professionals. The top three structure recommendation themes involved specialized health professionals, equipment and standards for use, and an educational plan for those at risk or with HAPIs.
The article provides findings from the qualitative portion of a mixed method study related to HAPIs. The qualitative findings associated with the gap analysis quantitative results, achieved the goal of the participatory action research key stakeholders' input into HAPI care and can be replicated internationally.
The benefit of key stakeholder's involvement in solving a clinical problem is sustainability. A quantitative approach and integrating qualitative stakeholders' perspectives provide an in-depth solution that will advance nursing capacity toward health care delivery and HAPI nursing science and policy development on a global level.
Nurses increasingly use mindfulness as an effective mental health intervention to reduce psychological distress. The effectiveness of mindfulness-based interventions remains inconclusive, which may lead to implementation of interventions in an inefficient or ineffective manner. This study aimed to examine the effects of mindfulness-based interventions on reducing stress, anxiety, and depression among nurses.
Systematic review and meta-analysis.
Randomized controlled trials (RCTs) were searched using six databases published through May 20, 2023, which evaluated the effects of mindfulness-based interventions on reducing psychological distress among nurses. To assess the quality of methodology included in the RCTs, version 2 of the Cochrane risk-of-bias instrument for RCTs with five domains was used. Standardized mean difference (SMD) with 95% confidence interval (CI) were calculated using the random–effects model in the meta-analyses. Publication bias was assessed using Egger's regression test. Further, the robustness effect size of the pooled analysis was assessed using leave-one-out sensitivity analysis.
A total of 16 RCTs were included in the final analysis. Overall, the modalities appeared to alleviate stress (pooled SMD: −0.50 [95% CI: −0.82 to −0.18]; p < 0.001) and depression (pooled SMD: −0.42 [95% CI: −0.78 to −0.06]; p = 0.02) among nurses.
Mindfulness-based interventions appear to alleviate stress and depression in nurses. Future research evaluating mindfulness-based interventions among working nurses with more rigorous methodological and larger sample size.
Support for nurses' mental health must be included while implementing personal and professional development plans.
The integration of generative artificial intelligence (AI) into academic research writing has revolutionized the field, offering powerful tools like ChatGPT and Bard to aid researchers in content generation and idea enhancement. We explore the current state of transparency regarding generative AI use in nursing academic research journals, emphasizing the need for explicitly declaring the use of generative AI by authors in the manuscript. Out of 125 nursing studies journals, 37.6% required explicit statements about generative AI use in their authors' guidelines. No significant differences in impact factors or journal categories were found between journals with and without such requirement. A similar evaluation of medicine, general and internal journals showed a lower percentage (14.5%) including the information about generative AI usage. Declaring generative AI tool usage is crucial for maintaining the transparency and credibility in academic writing. Additionally, extending the requirement for AI usage declarations to journal reviewers can enhance the quality of peer review and combat predatory journals in the academic publishing landscape. Our study highlights the need for active participation from nursing researchers in discussions surrounding standardization of generative AI declaration in academic research writing.
Metaphors are one of the most effective linguistic tools that are used to reveal how society describes nursing and what their vision of nursing is and to understand how effective the roles and responsibilities assumed by nurses in a multidisciplinary healthcare team are in protecting and maintaining the health of individuals, families, and society.
The aim of this study was to reveal the perceptions of society about “nurses” through metaphors.
The study was planned with a mixed design involving qualitative and quantitative research methods. It was carried out with 810 people living in Turkey who were between the ages of 15 and 65 and voluntarily participated in the study. Each participant was asked to fill in the blanks in the sentence, “A nurse is like a/an………………because…………” The data were analyzed by using qualitative (content analysis) and quantitative (chi-squared) data analysis methods.
It was determined that the participants produced 194 metaphors related to the concept of a “nurse.” It was observed that they frequently used metaphors of “angel,” “parent,” “doctor's assistant/right hand,” “lifesaver,” and “confidant” regarding the concept of nurse and conceptualized a nurse as “Beneficial/Helpful/Healer/Facilitator.”
The results showed that the awareness and perception of society toward nurses should be improved on the basis of the opportunity created by the COVID-19 pandemic period, and the concepts should be introduced to younger generations in a wider framework under the leadership of nursing faculties.
Intimate partner violence (IPV) is associated with multiple adverse health consequences. Nurses (including midwives) are well positioned to identify patients subjected to IPV, and provide care, support, and referrals. However, studies about nursing response to IPV are limited especially in low- and middle-income countries (LMICs). The study aimed to examine nurses' perceived preparedness and opinions toward IPV and to identify barriers and facilitators in responding to IPV.
An explanatory sequential mixed-methods study was conducted by collecting quantitative data first and explaining the quantitative findings with qualitative data.
The study was conducted in two tertiary general hospitals in northeastern (Shenyang city) and southwestern (Chengdu city) China with 1500 and 1800 beds, respectively. A total of 1071 survey respondents (1039 female [97.0%]) and 43 interview participants (34 female [79.1%]) were included in the study. An online survey was administered from September 3 to 23, 2020, using two validated scales from the Physician Readiness to Manage Intimate Partner Violence Survey. In-depth, semistructured interviews were conducted from September 15 to December 23, 2020, guided by the Consolidated Framework for Implementation Research.
The survey respondents largely agreed with feeling prepared to manage IPV, e.g., respond to discourses (544 [50.8%] of 1071) and report to police (704 [65.7%] of 1071). The findings of surveyed opinions (i.e., Response competencies; Routine practice; Actual activities; Professionals; Victims; Alcohol/drugs) were mixed and intertwined with social desirability bias. The quantitative and qualitative data were consistent, contradicted, and supplemented. Key qualitative findings were revealed that may explain the quantitative results, including lack of actual preparedness, absence of IPV-related education, training, or practice, and socially desirable responses (especially those pertaining to China's Anti-domestic Violence Law). Commonly reported barriers (e.g., patients' reluctance to disclose; time constraints) and facilitators (e.g., patients' strong need for help; female nurses' gender advantage), as well as previously unreported barriers (e.g., IPV may become a workplace taboo if there are healthcare professionals known as victims/perpetrators of IPV) and facilitators (e.g., nurses' responses can largely meet the first-line support requirements even without formal education or training on IPV) were identified.
Nurses may play a unique and important role in responding to IPV in LMICs where recognition is limited, education and training are absent, policies are lacking, and resources are scarce. Our findings support World Health Organization recommendations for selective screening.
The study highlights the great potential of nurses for IPV prevention and intervention especially in LMICs. The identified barriers and facilitators are important evidence for developing multifaceted interventions to address IPV in the health sector.
Widespread and sustained adoption of telemedicine in long-term residential care is emerging. Nursing home (NH) nurses play a key role in collaborating with remote physicians to manage residents' medical conditions through videoconferencing. Therefore, understanding of interprofessional collaboration and effective communication between nurses and physicians is critical to ensure quality of care and safety during teleconsultations.
To explore NH nurses' and physicians' experiences of interprofessional collaboration and communication during teleconsultations.
A qualitative descriptive design was adopted. Purposive sampling was conducted to recruit 22 physicians and nurses involved in NH teleconsultations. Semi-structured online interviews were conducted, and data were thematically analyzed.
Three themes were identified: (1) Manner of communication in telemedicine, (2) sociocultural influences in collaborative practice, and (3) role expectations in telemedicine. Both nurses and physicians recognized the importance of building and maintaining trust as physicians heavily depended on nurses for provision of objective information for clinical decision-making. However, practice differences were observed between nurses and physicians during teleconsultations. Sociocultural influences such as power relations and language barriers also affected the nurse–physician relationship and interpersonal communication. Additionally, different performance expectations were identified between nurses and physicians.
Interprofessional collaboration in teleconsultations is challenging because of lack of in-person assessment and dependence on nurses for clinical information. In addition, expectations and communication styles differ among healthcare professionals. This study called for interprofessional telemedicine training with incorporation of shared mental models to improve role clarity and communication. Given the international-dominated healthcare workforce in long-term care, the development of cultural competency could also be considered in telemedicine training to enhance nurse–physician collaborative practice.
Telemedicine is increasingly adopted in long-term care settings, where multidisciplinary healthcare professionals from different health institutions are involved in resident care. Interprofessional collaboration should be incorporated into telehealth education for enhanced clinical practice in this care delivery model.
Patient medication safety in the acute care setting is a foundational action provided by nurses and healthcare providers for safe patient care. Hospitalization of patients with Parkinson's disease (PD) can be dangerous due to the unique and variable medication regimen required. Patients with PD often have their medication administered inappropriately in the acute care setting (e.g., holding a PD medication in preparation for surgery, not administering the medication on the patient's home schedule, and delaying administration). The research question posed in this study was the following: does a PD medication educational intervention in the clinical setting enhance knowledge, comfort, and competence of practicing nurses in the care of patients with PD regarding their medication safety?
A mixed methods study design was used for this 5-month, two-part study with a sample of practicing RNs at three different hospitals. Part one of the study assessed nurses' initial knowledge of PD and PD medication safety and included an educational intervention. Part two of the study occurred 3 months later and evaluated if knowledge from the educational intervention was retained.
The study was conducted in two parts and included a pre-test, educational intervention, post-test, and follow-up test 3 months later. The educational intervention consisted of a 15-minute video of two PD advanced practice nurses being interviewed regarding the general care of a patient with PD. The pre-test, post-test, and follow-up test were identical and consisted of six questions regarding knowledge, comfort, and self-perceived competency. Participants were additionally asked three open-ended questions at follow-up to gain insight on the effectiveness of the educational intervention.
A total sample of 252 RNs participated in this study. Statistically significant improvements in knowledge, comfort, and self-perceived competency were observed in the post-test scores compared to pre-test scores. These statistically significant improvements were retained after 3 months, despite a 42.9% decrease in the number of responders (n = 252 vs. n = 144). Additionally, compared to the post-test, there were no statistically significant declines in knowledge, comfort, or competency in the follow-up test. Qualitative findings indicated that the training regarding PD medications was retained and found to be valuable, even if it was seldom applied in practice.
A review of the literature and this study both support the need for increased education for practicing nurses as it relates to PD and PD medication safety. Healthcare systems, organizations, and associations that support continuing education for nurses create a stronger workforce. Education has been found to keep nurses up to date on the latest advances in care and treatment while also providing exposure to other areas of nursing beyond their clinical settings.
Promoting better patient outcomes through safe medication administration is a hallmark of nursing care excellence. This study found that supporting the use of an educational intervention of PD medication safety for nurses improved RN levels of knowledge, comfort, and competency up to 3 months later. As the population of those with PD increases, healthcare systems, and nurses must now, more than ever, be poised to care for these individuals. This is a critical point in PD patient care since persons with PD are hospitalized 1.5 times more than their peers without PD.
This study aimed (1) to describe how trends in pediatric palliative care (PPC) utilization changed from 2002 to 2017, and (2) to examine factors predicting PPC utilization among decedent children in Taiwan.
This retrospective, correlational study retrieved 2002–2017 data from three national claims databases in Taiwan.
Children aged 1 through 18 years who died between January 2002 and December 2017 were included. Pediatric palliative care utilization was defined as PPC enrollment and PPC duration, with enrollment described by frequency (n) and percentage (%) and duration described by mean and standard deviation (SD). Logistic regression was used to examine the associations of various demographic characteristics with PPC enrollment; generalized linear regression was used to examine associations of the demographic characteristics with PPC duration.
Across the 16-year study period, PPC enrollment increased sharply (15.49 times), while PPC duration decreased smoothly (by 29.41%). Cause of death was a continuous predictor of both PPC enrollment and PPC duration. The children less likely to be enrolled in PPC services were those aged 1 to 6 years, boys, living in poverty, living in rural areas, and diagnosed with life-threatening noncancer diseases.
This study used nationwide databases to investigate PPC enrollment and PPC duration among a large sample of deceased children from 2002 to 2017. The findings not only delineate trends and predictors of PPC enrollment and PPC duration but also highlight great progress in PPC as well as the areas still understudied and underserved. This information could help the pediatric healthcare system achieve the core value of family-centered care for children with life-threatening diseases and their families.
Pediatric palliative care should be widely and continuously implemented in routine pediatric clinical practice to enhance quality of life for children and their families at the end of life.
FreshRSS 