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☐ ☆ ✇ BMJ Open

Qualitative study on the core competencies of nursing personnel in emergency medical rescue teams at comprehensive hospitals in Chongqing, China

Por: Deng · J. · Kou · X. · Ma · H. · Niu · A. · Luo · Y. — Abril 11th 2024 at 04:41
Objective

As an integral part of emergency medical rescue teams during public health events, understanding the core competencies that nursing personnel should possess—including theoretical knowledge, practical skills, comprehensive abilities and personal traits—can provide a practical basis for better preparation and targeted training for future emergency rescue works. Thus, this study aims to provide a scientific and applicable reference for perfecting the routine training strategy of nursing personnel assembled by emergency medical rescue teams and improving the overall guarantee ability level of this group.

Design

This is a qualitative study conducted using individual semi-structured interviews. All interviews were recorded and transcribed verbatim for the purpose of thematic analysis and extraction.

Setting

Participants were recruited from February to March 2023, from four comprehensive hospitals in Chongqing China with the highest number of emergency relief works.

Participants

A sample of experts (N=15) with extensive experience in emergency relief works was recruited in Chongqing, China.

Results

60% of the experts held master’s degrees or higher, 73.3% held senior or higher titles, 36.7% had participated in work execution more than five times and 73.3% held leadership positions in their current units and in the execution of emergency relief works. Four main themes and 22 corresponding subthemes were derived for the core competencies required for nursing personnel selected for emergency medical rescue teams in public health events, including theoretical knowledge, practical skills, comprehensive abilities and personal traits.

Conclusions

Our study revealed that through interviews with 15 experts with extensive experience in the public health event, the essential elements of core competencies for nursing personnel assigned to emergency medical rescue teams during the public health event were identified. These can serve as a reference standard for the selection of nursing personnel in public health events, and provide a basis for the cultivation and evaluation of competency for nursing personnel assigned to emergency medical rescue teams in the public health event in China and globally.

☐ ☆ ✇ BMJ Open

Caring burden and coping with haemodialysis: a qualitative study with family caregivers in Sri Lanka

Por: Lasanthika · C. · Janlöv · A.-C. · Amarasekara · T. · Larsson · H. — Abril 5th 2024 at 09:09
Objective

The number of patients with end-stage kidney disease (ESKD) requiring renal replacement therapy in Sri Lanka is significantly rising. Most of these patients depend on haemodialysis, carrying a significant burden on their family caregivers. To develop care and support for both the patient and their family caregiver, it is crucial to understand how caregivers experience their caregiving situation. Therefore, this study aimed to explore family caregivers’ experiences of burden and coping when caring for a family member receiving haemodialysis in the Sri Lankan context.

Design

Qualitative study with an exploratory design.

Setting

Family caregivers were recruited at a haemodialysis unit of a main government sector hospital in Sri Lanka between October and November 2021.

Participants

A purposive sampling of 11 family caregivers who cared for a family member receiving haemodialysis in a main government teaching hospital in Sri Lanka for at least 3 consecutive months. Data were collected through individual semistructured telephone interviews and analysed using qualitative content analysis.

Results

The results showed an overarching theme, ‘striving to hold on and not let go’, with four categories: (1) feeling exhausted by the care burden, (2) feeling burdened as failing the care responsibility, (3) striving to cope and find meaning in caregiving, and (4) coping with caregiving through others’ support.

Conclusion

The results show that the family caregivers have a multifaceted burden. They continued caring for their family member receiving haemodialysis while making adjustments to the burdensome caregiving situation despite many constraints and suffering. Psychosocial support and financial assistance, including family counselling, are needed by family caregivers, through a community support system, to ensure endurance during their family members’ illness trajectory. Advance care planning is vital to alleviate care uncertainty and to meet the care needs of patients with ESKD, particularly in resource-constrained settings.

☐ ☆ ✇ BMJ Open

Relationship among core competency, self-efficacy and transition shock in Chinese newly graduated nurses: a cross-sectional study

Por: Tong · Y. · Wang · T. · Tong · S. · Tang · Z. · Mao · L. · Xu · L. · Shi · X. — Abril 3rd 2024 at 18:19
Objectives

To investigate how core competency and self-efficacy of newly graduated nurses affect their experience of transition shock, and to determine the relationship between these factors.

Design

A cross-sectional study.

Methods

262 newly graduated nurses participated in a cross-sectional study by using demographic data, the transition shock scale, the competency inventory for registered nurses scale and the self-efficacy scale.

Results

Among newly graduated nurses, the score of transition shock was 77.641±24.140, the score of core competency was 125 (109.5, 163.5) and the score of self-efficacy was 2.5 (2,3), all of which were at a moderate level. The core competency and self-efficacy of the newly graduated nurses had a negative impact on the transition shock (β=–0.151, p=0.026; β=–0.379, p

Conclusions

The transition shock of newly graduated nurses was at a moderate level, with the highest level of transition shock occurring within the first year of employment. Self-efficacy plays a mediating role in the relationship between core competency and transition shock. Nursing managers should create standardised training for newly graduated nurses within the first year of employment to reduce their transition shock. This will help improve newly graduated nurses’ core competency, enhance self-efficacy and support the graduates. This will alleviate the impact of transition shock on newly graduated nurses, helping them transition smoothly and successfully.

☐ ☆ ✇ BMJ Open

Collaborative design of a health research training programme for nurses and midwives in Tshwane district, South Africa: a study protocol

Por: Gundo · R. · Mulaudzi · M. F. — Abril 3rd 2024 at 18:19
Introduction

Nurses are essential for implementing evidence-based practices to improve patient outcomes. Unfortunately, nurses lack knowledge about research and do not always understand research terminology. This study aims to develop an in-service training programme for health research for nurses and midwives in the Tshwane district of South Africa.

Methods and analysis

This protocol outlines a codesign study guided by the five stages of design thinking proposed by the Hasso-Plattner Institute of Design at Stanford University. The participants will include nurses and midwives at two hospitals in the Tshwane district, Gauteng Province. The five stages will be implemented in three phases: Phase 1: Stage 1—empathise and Stage 2—define. Exploratory sequential mixed methods including focus group discussions with nurses and midwives (n=40), face-to-face interviews (n=6), and surveys (n=330), will be used in this phase. Phase 2: Stage 3—ideate and Stage 4—prototype. A team of research experts (n=5), nurses and midwives (n=20) will develop the training programme based on the identified learning needs. Phase 3: Stage 5—test. The programme will be delivered to clinical nurses and midwives (n=41). The training programme will be evaluated through pretraining and post-training surveys and face-to-face interviews (n=4) following training. SPSS V.29 will be used for quantitative analysis, and content analysis will be used to analyse qualitative data.

Ethics and dissemination

The protocol was approved by the Faculty of Health Sciences Research Ethics Committee of the University of Pretoria (reference number 123/2023). The protocol is also registered with the National Health Research Database in South Africa (reference number GP_202305_032). The study findings will be disseminated through conference presentations and publications in peer-reviewed journals.

☐ ☆ ✇ Evidence-Based Nursing

Early career nurse researchers: insights, challenges and strategies for success

Por: Sisson · H. — Marzo 28th 2024 at 14:43

The term early career researcher (ECR) is commonly used, although its meaning is expressed by a wide range of definitions which vary globally, and may be institutionally determined.1 2 Length of time since the start or completion of doctoral training (or equivalent professional training) or a first academic appointment is often used by research councils such as the UK Research and Innovation (UKRI) (see Early career researchers–UKRI). Stage of career is also sometimes referred to with ECRs being a catch-all term for doctoral and immediately postdoctoral researchers as well as those making the transition to an independent research career (see Early career researchers–UKRI).

Increasingly, the challenges associated with such time-bound definitions of ECRs are being acknowledged. Many bodies which offer funding for ECRs (eg, see Early career research fellowships–InterAct Hub (interact-hub.org) and Early career researchers: career and skills development–UKRI)...

☐ ☆ ✇ Evidence-Based Nursing

Engaging clinicians in research: barriers, benefits and building a blueprint

Por: Mickan · S. — Marzo 28th 2024 at 14:43

Commentary on: Boucher NA, Tucker MC, White BS, et al. Frontline clinician appraisement of research engagement: "I feel out of touch with research". J Gen Intern Med 2023:1–7. doi: 10.1007/s11606-023-08200-9.

Implications for practice and research

  • Leadership action by prioritising clinical research activities and introducing a range of clinician engagement strategies for research can lead to better staff retention and patient care.

  • Implementation of clinician engagement strategies needs further research to clarify and enhance key benefits for staff and patients.

  • Context

    There is a growing body of international research evidence highlighting the benefits of clinicians’ research engagement and documenting associated barriers and facilitators.1 This study offers an insightful consolidation of clinicians’ perception of research alongside their barriers and facilitators to effective engagement.2 Full time clinicians in a specific healthcare system often do not see research as a core part of their...

    ☐ ☆ ✇ Evidence-Based Nursing

    Unravelling the complexities of nutritional behaviours in hospital nurses: a commentary on enablers and barriers to healthy eating

    Por: Abujaber · A. A. · Nashwan · A. J. — Marzo 28th 2024 at 14:43

    Commentary on: Marko S, Wylie S, Utter J. Enablers and barriers to healthy eating among hospital nurses: a systematic review. Int J Nurs Stud. 2023 Feb;138:104412. doi: 10.1016/j.ijnurstu.2022.104412. Epub 2022 Dec 5

    Implications for practice and research

  • Multi-faceted interventions are key in addressing various influences on nurses’ healthy eating beyond individual choices.

  • Rigorous studies are needed to assess multi-level socio-ecological interventions’ effectiveness on nurses’ eating habits.

  • Context

    Nurses, despite playing a significant role in healthcare, have been found to possess poor dietary habits and face elevated rates of chronic illnesses. A recent systematic review by Marko and colleagues explored factors influencing healthy eating among nurses in hospital settings. Barriers included high accessibility of unhealthy foods, high costs and lack of storage/preparation facilities. Enablers included proximity to healthy options, roster planning and structured workplace programmes. Supportive networks were an interpersonal enabler, while work culture and...

    ☐ ☆ ✇ Evidence-Based Nursing

    Social prescribing integrated in primary care enhances access to type 2 diabetes preventative approaches among high-risk patient population

    Por: Fitzpatrick · S. L. — Marzo 28th 2024 at 14:43

    Commentary on: Calderón-Larrañaga S, Greenhalgh T, Clinch M, Robson J, Dostal I, Eto F, Finer S. Unravelling the potential of social prescribing in individual-level type 2 diabetes prevention: a mixed-methods realist evaluation. BMC Med. 2023 Mar 13;21(1):91. doi: 10.1186/s12916-023-02796-9.

    CommentaryImplications for practice and research

  • Integrating social prescribing (SP) in primary care increases opportunities to deliver holistic care and facilitate clinic-community partnerships.

  • Research examining the effect of SP on prediabetes-related clinical outcomes is needed.

  • Context

    Recent data suggest that 464 million adults worldwide have pre-diabetes and are at increased risk for type 2 diabetes (T2D).1 Social risks (eg, food insecurity, housing instability, financial strain) largely contribute to health inequities, particularly in diabetes incidence.2 SP, also referred to as navigation, involves connecting patients to community-based programmes and resources to address health and social needs. This study by Calderón-Larrañaga et al used...

    ☐ ☆ ✇ Evidence-Based Nursing

    Ghost in the inbox: AI may help alleviate the burden of patient messages

    Por: Rose · C. · Preiksaitis · C. — Marzo 28th 2024 at 14:43

    Commentary on: Ayers JW, Poliak A, Dredze M, Leas EC, Zhu Z, Kelley JB, Faix DJ, Goodman AM, Longhurst CA, Hogarth M, Smith DM. Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum. JAMA Intern Med. 2023 Jun 1;183(6):589-596. doi: 10.1001/jamainternmed.2023.1838.

    CommentaryImplications for practice and research

  • AI assistants could be used to draft responses for physicians and nurses, potentially addressing a key element of burn-out.

  • Further research is needed to assess the impact of communication on healthcare outcomes and should incorporate patient evaluations and feedback.

  • Context

    In the setting of increasing adoption of virtual healthcare and the surge in electronic patient messages, there has been a higher workload for physicians and nurses, contributing to burnout and potentially terse, unanswered or unhelpful patient messages. Given these challenges, there is a need to explore innovative solutions...

    ☐ ☆ ✇ Evidence-Based Nursing

    Scoping review of contributors to fatigue and medication administration errors among nurses

    Por: Abou Hashish · E. A. — Marzo 28th 2024 at 14:43

    Commentary on: Bell T, Sprajcer M, Flenady T, Sahay A. Fatigue in nurses and medication administration errors: A scoping review. J Clin Nurs. 2023 Sep;3217-18,:5445-5460. doi: 10.1111/jocn.16620. Epub 2023 Jan 27.

    CommentaryImplications for practice and research

  • Revising the ‘safe working hours policy’, limiting overtime, and developing fatigue management systems are vital approaches for managing nurses’ fatigue and reducing medication administration errors (MAEs).

  • Future research should use large-scale studies and diverse approaches of data collection to better report registered nurses’ (RNs) fatigue’s impact on MAEs.

  • Context

    Preventing MAEs is a top priority to ensure patient safety. The presence of fatigue among RNs has been recognised as a growing factor in the occurrence of MAEs.1 In light of the fact that nurses allocate a substantial amount of their time to the administration of medications, Bell et al conducted this scoping review to analyse...

    ☐ ☆ ✇ Evidence-Based Nursing

    Patient-centered perspectives in diabetic retinopathy care: phenomenology and practice

    Por: Raman · R. · Kumar · S. — Marzo 28th 2024 at 14:43

    Commentary on: Zhang M, Zhang C, Chen C, et al. The experience of diabetic retinopathy patients during hospital-to-home full-cycle care: a qualitative study. BMC Nurs. 2023 Mar 3;22(1):58. doi: 10.1186/s12912-023-01206-y.

    Implications for practice and research

  • Consideration of patients' life experiences, which aids in examining their feelings and patient’ experiences.

  • Future research should further investigate the phenomenological approach in diverse healthcare contexts.

  • Context

    The transition from hospital to home treatment for patients with diabetic retinopathy (DR) is the subject of a study by Zhang and colleagues. The authors attempt to comprehend the substance of this phenomenon a shift towards patient-centric healthcare research by using a phenomenological method.1 Such first-hand experiences may help to close the gap between patient demands and medical practise, laying the groundwork for personalised and emphathetic care strategies.

    Methods

    The descriptive phenomenology method was used to implement this...

    ☐ ☆ ✇ Evidence-Based Nursing

    Are we ready for prehospital troponin testing by paramedics?

    Por: Vrints · C. J. M. — Marzo 28th 2024 at 14:43

    Commentary on: Dawson LP, Nehme E, Nehme Z, Zomer E, Bloom J, Cox S, Anderson D, Stephenson M, Ball J, Zhou J, Lefkovits J, Taylor AJ, Horrigan M, Chew DP, Kaye D, Cullen L, Mihalopoulos C, Smith K, Stub D. Chest Pain Management Using Prehospital Point-of-Care Troponin and Paramedic Risk Assessment. JAMA Intern Med. 2023 Mar 1;183(3):203-211. doi: 10.1001/jamainternmed.2022.6409.

    Implications for practice and research

  • In patients calling the emergency medical system for acute chest pain without ST-segment elevation, prehospital risk stratification using validated risk scores and point-of-care (POC) cardiac troponin measurement by emergency nurses or paramedics can result in substantial cost savings.

  • The safety of this strategy needs confirmation by sufficiently powered prospective randomised clinical trials.

  • Context

    Acute chest pain is one of the most common reasons for emergency system activation and transfer to the emergency department (ED).1 Only a minority of...

    ☐ ☆ ✇ Evidence-Based Nursing

    Trajectory patterns of self-care behaviour over 1 year provide nurses insights to tailor individualised care for patients with heart failure

    Por: Chang · W.-T. · Chen · H.-M. — Marzo 28th 2024 at 14:43

    Commentary on: Son YJ, Jang I. One-year trajectories of self-care behaviours and unplanned hospital readmissions among patients with heart failure: A prospective longitudinal study. J Clin Nurs. 2023 Sep;32(17-18):6427-6440. doi: 10.1111/jocn.16658. Epub 2023 Feb 23.

    Implications for practice and research

  • Timely identifying self­care behaviour patterns over time may reduce the risk of hospital readmissions in patients with heart failure (HF).

  • Further research studies are required to examine the effects of every 3–6 months self-care intervention on hospital readmissions among patients with HF.

  • Context

    Unplanned readmissions within 30 days and 6 months postdischarge are notably common in patients with HF.1 2 Effective self-care behaviours are essential to lower readmissions. However, the trajectories of self-care behaviours throughout the HF progression can vary among patients.3 Limited research studies have examined the relationships among the influencing variables, self-care behaviours and readmissions over...

    ☐ ☆ ✇ Evidence-Based Nursing

    Smoking cessation interventions are cost-effective in people affected by stroke

    Por: Suner-Soler · R. — Marzo 28th 2024 at 14:43

    Commentary on: Wechsler PM, Liberman AL, Restifo D, Abramson EL, Navi BB, Kamel H, Parikh NS. Cost-Effectiveness of Smoking Cessation Interventions in Patients With Ischemic Stroke and Transient Ischemic Attack. Stroke. 2023 Apr;54(4):992-1000. doi: 10.1161/STROKEAHA.122.040356. Epub 2023 Mar 3.

    Implications for practice and research

  • Measures to promote smoking cessation should go beyond brief counselling to include intensive counselling with pharmacotherapeutic support, such as varenicline, which are cost-effective.

  • Future research is needed to study to what extent the results obtained here are reproducible in other healthcare settings.

  • Context

    Smoking cessation in stroke survivors is associated with a reduction in vascular events and death.1 Despite this, less than half of stroke survivors stop smoking2 although if the stroke affects the insular cortex, cessation is easier.3 Clinical practice often fails to go beyond brief counselling to encourage people to stop smoking...

    ☐ ☆ ✇ BMJ Open

    Communication to adult patients undergoing cancer care by non-specialist nurses: a scoping review protocol

    Por: Kachimanga · C. · McGlashan · J. · Cunningham · N. · Hoyle · L. — Marzo 20th 2024 at 16:56
    Introduction

    Little is known regarding how non-specialist nurses communicate with patients living with cancer when the patients are receiving care outside of their cancer units/teams. This scoping review aims to identify, examine and report on the currently available evidence about communication by non-specialist nurses when caring for adults living with cancer outside of their cancer care unit/teams.

    Methods and analysis

    A scoping review following the JBI methodology for scoping reviews will be conducted. We will search for empirical studies that meet the inclusion criteria in six databases (MEDLINE, PubMed, CINAHL, Embase, Scopus and PsycINFO). Handsearching in references of included articles will be performed to find additional articles. The population of interest will be non-specialist nurses. Three concepts will be explored, namely (1) all adult patients living with cancer, (2) a focus on three stages of the cancer continuum of care (cancer diagnosis, treatment and survivorship) and (3) a focus on communication between non-specialist nurses and patients living with cancer. We will include studies describing all healthcare settings outside patients’ specialised cancer units or oncology teams. After article selection, two reviewers will independently screen titles and abstracts and perform a full-text article review, risk of bias assessments and data extraction. A third reviewer will resolve all disagreements. A narrative summary will provide an overview of how the results relate to the research aims and questions. The included articles will be limited to English and published between 2012 and 2023.

    Ethics and dissemination

    No ethical approval is required since we will use publicly available empirical research sources. This review will provide current research on communication by non-specialist nurses with patients with a cancer diagnosis outside of an oncology setting, evidence that will support effective communication. As such, we aim to disseminate the findings in academic conferences and peer-reviewed journals.

    ☐ ☆ ✇ BMJ Open

    Development of a tool for assessing the clinical competency of Chinese masters nursing students based on the mini-CEX: a Delphi method study

    Por: Peng · Q. · Gao · Y. · Liu · N. · Gan · X. — Marzo 20th 2024 at 16:56
    Objective

    To construct a scientific and systematic competency evaluation tool for master of nursing specialists (MNS) and to provide a reference for the training, assessment and competency evaluation of MNS.

    Methods

    A first draft of the indicators for assessing MNS core competencies was developed on the basis of published research and group discussions. Between June and December 2020, the indicators were revised using two rounds of the Delphi expert consultation method, with questionnaires completed by 16 experts from five provinces in China.

    Results

    The valid retrieval rate of the two questionnaires was 100.00%, and the coefficient of expert authority was 0.931. The Kendall’s concordance coefficients of the two rounds of questionnaires were 0.136 (p

    Conclusions

    The MNS competency assessment tool constructed in this study is focused and highly credible. The findings can be used as a guide for the training, assessment and competence evaluation of MNS in the future.

    ☐ ☆ ✇ BMJ Open

    Barriers and facilitators to pressure ulcer prevention behaviours by older people living in their own homes and their lay carers: a qualitative study

    Por: Roddis · J. · Dyson · J. · Woodhouse · M. · Devrell · A. · Oakley · K. · Cowdell · F. — Marzo 19th 2024 at 04:02
    Objective

    To identify barriers and facilitators to pressure ulcer prevention behaviours in community-dwelling older people and their lay carers.

    Design

    Theoretically informed qualitative interviews with two-phase, deductive then inductive, thematic analysis.

    Setting

    The study was conducted in one geographical region in the UK, spanning several community National Health Service Trusts.

    Participants

    Community-dwelling older patients at risk of pressure ulcer development (n=10) and their lay carers (n=10).

    Results

    Six themes and subthemes were identified: (1) knowledge and beliefs about consequences (nature, source, timing and taboo); (2) social and professional role and influences (who does what, conflicting advice and disagreements); (3) motivation and priorities (competing self-care needs and carer physical ability); (4) memory; (5) emotion (carer exhaustion and isolation, carergiver role conflict and patient feelings) and (6) environment (human resource shortage and equipment).

    Conclusions

    There is minimal research in pressure ulcer prevention in community-dwelling older people. This study has robustly applied the theoretical domains framework to understanding barriers and facilitators to pressure ulcer prevention behaviours. Our findings will support co-design of strategies to promote preventative behaviours and are likely to be transferable to comparable healthcare systems nationally and internationally.

    ☐ ☆ ✇ BMJ Open

    Exploring the experiences of mental health nurses in the management of schizophrenia in the Upper East Region of Ghana: a qualitative study

    Por: Daliri · D. B. · Laari · T. T. · Abagye · N. · Afaya · A. — Marzo 19th 2024 at 04:02
    Objective

    Schizophrenia is a chronic condition, of which the diagnosis and management require comprehensive care. The role mental health nurses play in this management cannot be overemphasised. In an effort to give their best, several challenges confront them which need to be sought and addressed. This study aimed to explore the factors that influence the management of schizophrenia by mental health nurses in the Upper East Region.

    Design and participants

    A descriptive phenomenology design was used in this study. Individual in-depth interviews were conducted among 18 purposively sampled mental health nurses using a semistructured interview guide. Audio-recorded interviews were transcribed verbatim and analysed thematically using Colaizzi’s approach.

    Setting

    The study was conducted in five primary and secondary-level health facilities in the Upper East Region of Ghana.

    Findings

    Five themes were deduced from the theoretical framework, which were as follows: individual factors, interpersonal factors, organisational factors, community-level factors, and policy-level factors. At the individual level, factors such as the condition of the patient at presentation, medication side effects, inadequate knowledge, and poor adherence were identified. Interpersonal factors identified were poor communication, lack of mutual respect, and poor communication, while organisational factors such as inadequate staff, inadequate infrastructure and logistics, and unavailability of antipsychotics were reported. Moreover, the study identified community-level factors such as stigma and cultural beliefs, while policy-level factors such as laws regarding suicide, patient rights, and non-inclusion of mental health services into the National Health Insurance Scheme were reported as factors influencing the management of schizophrenia by mental health nurses.

    Conclusions

    Addressing these factors is essential to ensure sustainable improvements and the effective management of schizophrenia. It is imperative to consider these factors when designing interventions and policies to optimise the management of schizophrenia by mental health nurses in Ghana.

    ☐ ☆ ✇ BMJ Open

    Comparison of the effects of different functional exercise sequences on lymphedema in breast cancer: protocol for an exploratory randomised controlled cross-over trial

    Por: Qiu · L. · Wu · J. · Huang · Y. · Ye · M. · Song · L. · Huang · H. · Jin · Y. — Marzo 15th 2024 at 02:35
    Introduction

    Breast cancer-related lymphedema (BCRL) is a common postoperative complication of breast cancer. It develops in a chronic and vicious cycle. Once lymphedema occurs, it cannot be cured and bring serious physiological, psychological, social and economic burden to patients. Upper limb functional exercises are an effective and convenient intervention for managing lymphedema. However, the optimal exercise sequence remains unclear. Therefore, we aim to compare the effects of exercise sequences under the guidance of commonly used exercise sequences and lymphatic flow theory.

    Methods

    An exploratory randomised controlled cross-over trial will be conducted. 32 patients with BCRL are randomly allocated into two groups (group A and group B). Group A patients will perform functional exercise from wrist joint to shoulder joint, and the exercise direction of group B is opposite to that of group A, that is, from shoulder joint to wrist joint end. Exercise time is once a day, each 20–30 min, for 2 weeks. After 2 weeks of washout period, A and B groups of exchange exercise sequences (exercise frequency and duration unchanged). The primary outcome is upper limb circumference, and secondary outcomes are upper limb function and lymphedema symptoms.

    Ethics and dissemination

    This study protocol is presented in accordance with the Standard Protocol Items: Recommendations for Interventional Trials guidelines. All participants will sign a written informed consent. The research ethics regional committee of Shanghai Seventh People’s Hospital has approved the study. Regardless of the outcome of this study, the results will be published in open-access journals to ensure public access.

    Trial registration number

    ChiCTR2200066463.

    ☐ ☆ ✇ BMJ Open

    Exploring promotion factors of resilience among emergency nurses: a qualitative study in Shanghai, China

    Por: Jiang · J. · Liu · S. · Chi · C. · Liu · Y. · Han · P. · Sun · L. · Zhuang · Y. — Marzo 13th 2024 at 05:20
    Objective

    To qualitatively explore the factors that enhance resilience among emergency nurses (ENs).

    Design

    This study is an exploratory qualitative investigation. Semistructured in-depth interviews were used for data collection, while qualitative content analysis was applied for data analysis.

    Setting

    A grade A tertiary hospital in Shanghai, China.

    Participants

    The study subjects comprised 17 ENs, who were selected using a purposive sampling method.

    Results

    Three main themes and the nine subthemes emerged from the study, that is, individual resources, including competency, personality traits and occupational benefits; family resources, including close parent–child attachment and supportive family dynamics; social resources, including peer support, organisational support, resilient leadership and popular support.

    Conclusion

    This qualitative study explored the factors promoting resilience among ENs and provided a reference for managers to formulate future management strategies. From the perspective of positive psychology, nurses should receive comprehensive support, focusing on improving their professional accomplishment and role ability while prioritising the development of resilient leadership. These efforts are expected to drive progress and growth across the emergency care team.

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