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Ayer — Mayo 14th 2024Internacionales

Spillover effects of organizational support for patient and workplace safety on safety outcomes: The mediating role of safety compliance

Abstract

Aim(s)

To investigate spillover effects of organizational support for patient and workplace safety on safety outcomes and to examine the mediating role of safety compliance in these relationships.

Design

A cross-sectional, correlational survey design.

Methods

This study analysed data from 1255 nurses in 34 Korean hospitals. A structured questionnaire was used including items from the Hospital Survey on Patient Safety Culture and Safety Compliance scales. Data were collected between February and June 2022. We employed structural equation modelling (SEM) for analysis with a significance level set at 0.05.

Results

Organizational support for patient and workplace safety showed direct impacts on patient and workplace safety outcomes. Findings supported our hypotheses regarding spillover effects, as organizational support for patient safety was related to enhanced workplace safety and organizational support for workplace safety was associated with improved patient safety. SEM analysis showed safety compliance's mediating role. When the distribution of serial indirect effects was examined, three out of eight indirect pathways were statistically significant.

Conclusion

Improving organizational support for patient safety can lead to better workplace safety outcome, and enhancing support for workplace safety can result in better patient safety outcome. Given this mutually beneficial relationship, healthcare organizations should simultaneously promote safety in both areas rather than focusing on just one.

Implications for the Profession and/or Patient Care

Study results highlight the need to recognize the interconnected nature of patient and workplace safety in order to achieve better overall safety outcomes.

Impact

This study shows that organizational safety efforts for patients and workers are interconnected and mutually beneficial. The study's results have both theoretical and practical implications in demonstrating that organizational support for both patient and workplace safety plays a strong role in promoting nurses' safety compliance and improving overall safety outcomes.

Reporting Method

STROBE checklist.

Patient Contribution

No patient or public contribution.

Development of a Predictive Model for Survival Over Time in Patients With Out-of-Hospital Cardiac Arrest Using Ensemble-Based Machine Learning

imageAs of now, a model for predicting the survival of patients with out-of-hospital cardiac arrest has not been established. This study aimed to develop a model for identifying predictors of survival over time in patients with out-of-hospital cardiac arrest during their stay in the emergency department, using ensemble-based machine learning. A total of 26 013 patients from the Korean nationwide out-of-hospital cardiac arrest registry were enrolled between January 1 and December 31, 2019. Our model, comprising 38 variables, was developed using the Survival Quilts model to improve predictive performance. We found that changes in important variables of patients with out-of-hospital cardiac arrest were observed 10 minutes after arrival at the emergency department. The important score of the predictors showed that the influence of patient age decreased, moving from the highest rank to the fifth. In contrast, the significance of reperfusion attempts increased, moving from the fourth to the highest rank. Our research suggests that the ensemble-based machine learning model, particularly the Survival Quilts, offers a promising approach for predicting survival in patients with out-of-hospital cardiac arrest. The Survival Quilts model may potentially assist emergency department staff in making informed decisions quickly, reducing preventable deaths.

Identifying Main Themes in Diabetes Management Interviews Using Natural Language Processing–Based Text Mining

imageThis study aimed to identify the main themes from exit interviews of adult patients with type 2 diabetes after completion of a diabetes education program. Eighteen participants with type 2 diabetes completed an exit interview regarding their program experience and satisfaction. Semistructured interview questions were used, and the interviews were auto-recorded. The interview transcripts were preprocessed and analyzed using four natural language processing–based text-mining techniques. The top 30 words from the term frequency and term frequency–inverse document frequency each were derived. In the N-gram analysis, the connection strength of “diabetes” and “education” was the highest, and the simultaneous connectivity of word chains ranged from a maximum of seven words to a minimum of two words. Based on the CONvergence of iteration CORrelation (CONCOR) analysis, three clusters were generated, and each cluster was named as follows: participation in a diabetes education program to control blood glucose, exercise, and use of digital devices. This study using text mining proposes a new and useful approach to visualize data to develop patient-centered diabetes education.
AnteayerInternacionales

Differences in patient‐reported and clinical characteristics by age group in adults with type 2 diabetes

Abstract

Background

The global burden of type 2 diabetes (T2D) is growing, and the age of onset is widening, resulting in increasing numbers of young adults and elderly patients with T2D. Age-specific diabetes care needs have yet to be fully explored.

Aims

This study examined (1) differences in patient-reported and clinical characteristics by age group and (2) the effect of age on two proxy measures assessing psychological health and self-care adherence after adjusting for potential mediators.

Methods

A cross-sectional, correlational design was used. Adults with type 2 diabetes (T2D) were recruited from a university hospital in Korea between 2019 and 2020. Participants were divided into four groups based on years of age (40s and younger group [n = 27]; 50s group [n = 47]; 60s group [n = 54]; and 70s and older group [n = 48]) to compare patient-reported and clinical characteristics. Chi-square tests, ANOVA, Kruskal-Wallis tests, and logistic regression analysis were performed to assess group differences and effect of age on psychological health and self-care adherence.

Results

Of 178 participants, two-thirds were men (n = 114; 64.41%). The mean ages in the 40s and younger, 50s, 60s, and 70s and older groups were 39.4, 54.7, 63.9, and 76.0 years, respectively. There were significant differences in patient-reported and clinical characteristics by age group. The youngest group reported the poorest psychological health and self-care behaviors. Although the oldest group showed the poorest physical functioning, this group also showed the highest self-care adherence and the best psychological health. Regarding clinical characteristics, traditional diabetes-related blood test results showed no significant group differences.

Linking Evidence to Action

Age-specific diabetes care needs were identified in adults with T2D. Interventions to improve psychological health and priming effects of behavioral adherence need to be developed. Furthermore, meticulous investigation to detect potential complications early is essential in adults with T2D.

Effects of nurse managers' inclusive leadership on nurses' psychological safety and innovative work behavior: The moderating role of collectivism

Abstract

Introduction

In the rapidly evolving healthcare landscape, the capacity to foster innovative work behavior among nurses is increasingly important. This study examined the dynamics between inclusive leadership, psychological safety, collectivism, and innovative work behavior among nurses.

Design

The study used a cross-sectional, correlational design.

Methods

This study utilized data from 730 medical-surgical nurses who provided direct care to patients. Standardized instruments were used to assess key study variables. Statistical analyses, including moderated mediation regressions, were employed to investigate the complex interplay among these variables.

Results

We found a positive association between inclusive leadership and innovative work behavior, and psychological safety mediated this relationship. Collectivism moderated inclusive leadership's direct relationship with psychological safety and its indirect relationship with innovative work behavior. The results revealed that nurses with lower levels of collectivism were more responsive to their managers' inclusive behaviors, strengthening the relation between inclusive leadership, psychological safety, and innovative work behavior.

Conclusion

Our findings suggest that promoting inclusive leadership behaviors among nurse managers to create a psychologically safe environment can motivate nurses to engage in innovative work behavior. However, it is also important to understand that the effectiveness of leadership may differ depending on the collectivist values of individual nurses.

Clinical Relevance

Nurse managers should adopt inclusive leadership behaviors, such as valuing trust, open communication, and diversity, in order to foster psychological safety and innovative work behavior among nurses.

Digital Literacy and Associated Factors in Older Adults Living in Urban South Korea: A Qualitative Study

imageThis study aimed to explore digital literacy among community-dwelling older adults in urban South Korea. A semistructured interview guide was developed using the Digital Competence ( 2.0 framework, which emphasizes the competencies for full digital participation in five categories: information and data literacy, communication and collaboration, content creation, safety, and problem-solving. The data were analyzed using combined inductive and deductive content analysis. Inductive analysis identified three main categories: perceived ability to use digital technology, responses to digital technology, and contextual factors. In the results of deductive analysis, participants reported varying abilities in using digital technologies for information and data literacy, communication or collaboration, and problem-solving. However, their abilities were limited in handling the safety or security of digital technology and lacked in creating digital content. Responses to digital technology contain subcategories of perception (positive or negative) and behavior (trying or avoidance). Regarding contextual factors, aging-related physical and cognitive changes were identified as barriers to digital literacy. The influence of families or peers was viewed as both a facilitator and a barrier. Our participants recognized the importance of using digital devices to keep up with the trend of digitalization, but their digital literacy was mostly limited to relatively simple levels.

Effect of Virtual Game–Based Integrated Clinical Practice Simulation Program on Undergraduate Nursing Students' Attitude Toward Learning

imageGame-based virtual reality simulation programs can capitalize on the advantages of non–face-to-face education while effectively stimulating the interest of trainees and improving training efficiency. This study aimed to develop a game-based virtual reality simulation program for nervous system assessment and to evaluate the effects of the program on the learning attitudes of nursing students. Using a one-group pretest-posttest design, 41 senior nursing students were enrolled, and their learning attitudes (self-directed learning attitude, academic self-efficacy, flow-learning experience, and learning presence) were evaluated. The effect of the program was statistically significant in self-directed learning attitude (t = −2.27, P = .027) and learning presence (t = −3.07, P = .003), but the difference was not statistically significant in academic self-efficacy (t = −1.97, P = .054) and learning flow (t = −0.74, P = .459). The virtual gaming simulation program can be used to effectively replace field training in situations wherein field training is limited, such as during the COVID-19 pandemic.

Network visualization to interpret which healthcare services are central to people living with HIV

Abstract

Aim

To employ network analysis to identify the central healthcare service needs of people living with HIV (PLWH) for integrated care.

Design

Cross-sectional survey.

Methods

A list of healthcare services was identified through literature reviews, expert workshops and validity evaluations by PLWH. A total of 243 PLWH participated at five hospitals and self-reported their need for healthcare services on a four-point Likert scale. Centrality of healthcare service needs was analysed using network analysis.

Results

The mean score for 20 healthcare service needs was 3.53 out of 4. The highest scoring need, “Precaution for interaction between antiretroviral therapy and other drugs,” received a rating of 3.73 but had a centrality of only 0.31. The most central node in the network of healthcare service needs, “Information and coping with opportunistic infections,” had a strength centrality of 1.63 and showed significant relationships with “non-HIV-related medical services (e.g., health check-ups)” and “Regular dental services.” The correlation stability coefficient, which quantifies the stability of centrality, was 0.44 with an acceptable value.

Conclusions

The most central need was information on opportunistic infections that had connections with many nodes in network analysis. By interpreting the relationships between needs, healthcare providers can design interventions with an integrative perspective.

Implications for Patient Care

Network visualization provides dynamic relationships between needs that are unknown from the score scale by presenting them graphically and qualitatively.

Impact

Using network analysis to interpret need assessment offers an integrated nursing perspective. Coping with opportunistic infection is central to connecting the chain of healthcare. This study highlights the multifaceted understanding of patients' needs that nurses gain when they conduct network analysis.

Reporting Method

We adhered to the STROBE checklist.

Patient or Public Contribution

No patient or public contribution.

Experiences and Perceptions of E-Cigarette Cessation for Young Adults in Rural Communities

imageBackground Electronic nicotine delivery systems (ENDS), also known as e-cigarettes, are the most commonly used tobacco products among young adults in the United States. Young adults in rural areas have a higher prevalence of ENDS use compared to their urban counterparts, yet there is limited evidence regarding the in-depth understanding of experiences and perspectives directly from young adults. Objectives The aim of this study was to explore individual experiences and perspectives about use and cessation of ENDS from young adults in rural areas. Methods This was a qualitative study using interpretive description for analysis. Young adults (18–24 years) who used ENDS every day but not other tobacco products (cigarettes, smokeless, etc.) in the past month and had an address in a rural county of Wisconsin were eligible; there were nine participants interviewed using Zoom. Interview questions focused on initial use, maintenance of use, experiences of quitting, and social and rural environmental contexts regarding ENDS. Results Three themes emerged with eight categories: (a) addiction to ENDS and health, (b) cessation and resources, and (c) rural environment and culture in ENDS addiction. Discussion Findings have implications for ENDS cessation interventions targeting young adults in rural areas.

Identifying Latent Topics and Trends in Premature Infant–Related Nursing Studies Using a Latent Dirichlet Allocation Method

imageThis study aimed to identify topics and within-topic core keywords in premature infant–related nursing studies published in Korean and international academic journals using topic modeling and to compare and analyze the trends in Korean and international studies. Journal databases were searched to extract nursing studies involving premature infants from 1998 to 2020. Journal databases included MEDLINE, Web of Science, CINAHL, and EMBASE for international studies and DBpia, the National Digital Science Library, the Korea Citation Index, and the Research Information Sharing Service for Korean studies. Abstracts from the selected 182 Korean and 2502 international studies were analyzed using NetMiner4.4.3e. In results, four similar topics (Korean vs international) were “pain intervention” versus “pain management”; “breast feeding practice” versus “breast feeding”; “kangaroo mother care”; and “parental stress” versus “stress & depression.” Two topics that appeared only in the international studies were “infection management” and “oral feeding & respiratory care.” Overall, the international studies dealt with diverse topics directly associated with premature. Korean studies mainly dealt with topics related to mothers of premature infants, whereas studies related to premature infants were insufficient. Nursing research in Korea needs to be expanded to research topics addressing premature infants.

Comprehensive lifestyle modification interventions for metabolic syndrome: A systematic review and meta‐analysis

Abstract

Introduction

Previous systematic reviews and meta-analyses have mainly focused on improvements in the number of metabolic syndrome risk factors and individual changes in each risk factor, making it challenging to examine the impact of comprehensive lifestyle modification interventions on adherence to recommended health behaviors. To address this gap, we conducted a systematic and meta-analysis aimed at identifying clinical parameter levels associated with lifestyle modification outcomes and adherence to recommended health behaviors for individuals with metabolic syndrome.

Methods

A total of seven studies retrieved from four databases (CINAHL, Medline via PubMed, American Psychological Association PsycINFO, and Embase) were included in the review. The selected studies, which demonstrated improvements in health behaviors, all included diet and exercise as main factors of comprehensive lifestyle modification in home settings.

Results

Our findings suggest that a 6-month comprehensive intervention including diet and exercise can be effective in decreasing glucose levels and systolic blood pressure. However, given the limited available data, further studies investigating the efficacy of interventions of varying durations are needed.

Discussion

Although our review included a small number of studies, comprehensive lifestyle modifications consisting of at least two components (primarily diet and exercise) can improve health behaviors and some clinical parameters among individuals with metabolic syndrome. Future studies are needed to investigate the long-term effects of lifestyle modifications on health behavior adherence and explore effective interventions to address certain clinical parameters, such as high-density lipoprotein levels. Also, we recommend using objective and quantifiable measure to compare adherence to recommended lifestyle modifications across studies.

Clinical Relevance

This research provides empirical evidence of the effectiveness of comprehensive lifestyle modification and emphasizes the need to develop long-term nursing strategies in public health that can be used to effectively manage metabolic syndrome.

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