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☐ ☆ ✇ Journal of Clinical Nursing

Nurses' attitudes towards COVID‐19 vaccines: A qualitative study (PROACTIVE‐study)

Abstract

Aim

To explore the attitudes of healthcare workers towards COVID-19 vaccines.

Design

A qualitative descriptive design was used.

Methods

Five focus groups were conducted between October and November 2021, with a total of 30 nurses from different contexts in Northern Italy. Thematic analysis was used to analyse the transcripts.

Results

Three main themes were identified: ‘favourable’, ‘unsure’ and ‘contrary to’ COVID-19 vaccines. The favourable position was underpinned by trust in science, research and vaccination; protection for themselves, their families, patients and the population; duty as professionals; necessity to set an example for others. Participants who were unsure had doubts about the composition, safety and efficacy of the vaccine and were sometimes afraid that media provided incomplete information. The main reason why nurses were against was the feeling that being forced to vaccinate perceived as blackmail. Favourable or unsure nurses struggled to deal with those who were against and developed a series of emotions that ranged from respect and attempt to rationalize, to frustration and defeat.

Conclusions

Identifying the areas of hesitation is essential to understand what affects the choices of acceptance, delay or refusal of vaccination. The issues that emerged regarding proper communication within the vaccination campaign highlights the key importance of adequate vaccination strategies.

Implication for the Profession and/or Patient Care

Understanding attitudes towards vaccine and related motivations among healthcare workers could help develop more specific and targeted vaccination campaigns that can ensure proper vaccination coverage rates and avoid hesitancy or refusal.

Impact

Healthcare workers experiences of COVID-19 vaccines, their views and know how they feel during COVID-19 vaccinations. Healthcare workers had three different positions in COVID-19 vaccination. This research will guide and target future vaccination campaigns.

Reporting Method

The study is reported using the Standards for Reporting Qualitative Research (SRQR).

Patient or Public Contribution

No Patient or Public Contribution.

☐ ☆ ✇ Journal of Clinical Nursing

Prevalence and risk factors of depression and anxiety symptoms in intensive care unit patients with cardiovascular disease: A cross‐sectional study

Por: Saikun Wang · Ruiting Zhu · Hongwei Cai · Jing Mao · Wei Zhou · Changyue Zhang · Mengjiao Lv · Hongli Meng · Lirong Guo — Mayo 6th 2024 at 09:48

Abstract

Aims

To investigate the prevalence of anxiety and depression symptoms in intensive care unit (ICU) patients with cardiovascular disease (CVD) and to explore which elements are risk factors for the development of anxiety and depression symptoms.

Design

A cross-sectional study.

Methods

A total of 1028 ICU patients with CVD were enrolled in this cross-sectional study. Logistic regression was used to assess risk factors and associations between anxiety and depression symptoms, and mediation analysis was used to explore the effect of risk factors on the association between anxiety and depression symptoms. Reporting of the study followed the STROBE checklist.

Results

The results showed that among ICU patients with CVD, 38.1% had anxiety symptoms, 28.7% had depression symptoms and 19.3% had both anxiety and depression symptoms, and there was a significant association between anxiety and depression symptoms. We also identified female gender, hypertension, hyperlipidemia and cardiac function class IV as independent risk factors for anxiety and depression symptoms. Importantly, these factors also mediated the association between anxiety and depression symptoms, emphasising their role in the psychological well-being of this patient group.

Conclusion

ICU patients with CVD were prone to anxiety and depression symptoms. Female gender, hypertension, hyperlipidemia and cardiac function class IV were identified as independent risk factors that also served as mediators in the relationship between anxiety and depression symptoms. Especially, cardiac function class IV emerged as a critical factor in this association.

Relevance to Clinical Practice

It is imperative for critical care professionals to recognize the elevated risk of depression and anxiety among ICU patients with severe CVD, especially those with cardiac function class IV, hypertension, hyperlipidemia and females. Proactive and supportive measures are essential for this vulnerable group during their ICU stay to safeguard their mental health and prevent negative outcomes.

Patient or Public Contribution

No Patient or Public Contribution.

☐ ☆ ✇ Journal of Clinical Nursing

The role of nurse–patient mutuality on self‐care behaviours in patients with chronic illness

Abstract

Aim

To examine the role of nurse–patient mutuality on three self-care behaviours in chronic illness patients.

Design

A cross-sectional multi-centre study was conducted.

Methods

Mutuality was measured with the Nurse–Patient Mutuality in Chronic Illness scale which has the dimensions of developing and going beyond, being a point of reference and deciding and sharing care, and self-care was measured with the Self-care of Chronic Illness Inventory (SC-CII). Multivariable linear regression analyses were used to assess the contribution of three dimensions of mutuality on self-care maintenance, monitoring and management behaviours controlling for patient gender, age, education, number of medications, and presence of a family caregiver.

Results

The sample included 465 inpatients and outpatients with at least one chronic illness. The three dimensions of mutuality had different roles in their influence on the three dimensions of self-care. Developing and going beyond was significantly associated with self-care maintenance and self-care monitoring behaviours. Point of reference was significantly associated with self-care maintenance behaviour. Deciding and sharing care was significantly associated with self-care monitoring and self-care management behaviours.

Conclusion

The mutuality between nurse and patient may be a novel area of research to support and improve patient self-care behaviours with implications for clinical practice and education.

Implication for Profession and Patient Care

Mutuality between nurse and patient increases patient engagement, symptom recognition, decision-making process and patient-centred approach favouring the development of self-care behaviours.

Impact

Mutuality between nurse and patient is a new concept and its association with the patient outcomes could bring relevance to the nursing profession. Self-care behaviours are important in the management of chronic diseases, but are difficult to perform. Mutuality between nurse and patient influences the three different behaviours of self-care in chronic illness, for this reason it is important to increase the level of mutuality in this dyad.

Reporting Method

STROBE checklist for cross-sectional studies was followed in this study.

Patient or Public Contribution

Patients were involved in the sample of the study.

☐ ☆ ✇ Journal of Advanced Nursing

The mental workload of ICU nurses performing human‐machine tasks and associated factors: A cross‐sectional questionnaire survey

Por: Yan Yan · Chenglei Zhao · Xuanyi Bi · Calvin Kalun Or · Xuchun Ye — Abril 30th 2024 at 19:32

Abstract

Aims

To assess the level of mental workload (MWL) of intensive care unit (ICU) nurses in performing different human-machine tasks and examine the predictors of the MWL.

Design

A cross-sectional questionnaire study.

Methods

Between January and February 2021, data were collected from ICU nurses (n = 427) at nine tertiary hospitals selected from five (east, west, south, north, central) regions in China through an electronic questionnaire, including sociodemographic questions, the National Aeronautics and Space Administration Task Load Index, General Self-Efficacy Scale, Difficulty-assessing Index System of Nursing Operation Technique, and System Usability Scale. Descriptive statistics, t-tests, one-way ANOVA and multiple linear regression models were used.

Results

ICU nurses experienced a medium level of MWL (score 52.04 on a scale of 0–100) while performing human-machine tasks. ICU nurses' MWL was notably higher in conducting first aid and life support tasks (using defibrillators or ventilators). Predictors of MWL were task difficulty, system usability, professional title, age, self-efficacy, ICU category, and willingness to study emerging technology actively. Task difficulty and system usability were the strongest predictors of nearly all typical tasks.

Conclusion

ICU nurses experience a medium MWL while performing human-machine tasks, but higher mental, temporal, and effort are perceived compared to physical demands. The MWL varied significantly across different human-machine tasks, among which are significantly higher: first aid and life support and information-based human-machine tasks. Task difficulty and system availability are decisive predictors of MWL.

Impact

This is the first study to investigate the level of MWL of ICU nurses performing different representative human-machine tasks and to explore its predictors, which provides a reference for future research. These findings suggest that healthcare organizations should pay attention to the MWL of ICU nurses and develop customized management strategies based on task characteristics to maintain a moderate level of MWL, thus enabling ICU nurses to perform human-machine tasks better.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ BMJ Open

Study protocol for assessment of the efficacy of calcium dobesilate versus placebo on SARS-CoV-2 viral load in outpatients with COVID-19 (CADOVID study): a randomised, placebo-controlled, double-blind, monocentric phase II trial

Por: Salamun · J. · Da Silva · T. · Ustero · P. · Gosmain · Y. · Guessous · I. · Calmy · A. · Spechbach · H. — Mayo 8th 2024 at 17:36
Introduction

SARS-CoV-2 mainly infects respiratory endothelial cells, which is facilitated through its spike protein binding to heparan sulphate. Calcium dobesilate (CaD) is a well-established, widely available vasoactive and angioprotective drug interacting with heparan sulphate, with the potential to interfere with the uptake of SARS-CoV-2 by epithelial cells. The CADOVID trial aims to evaluate the efficacy and safety of CaD in reducing the SARS-CoV-2 viral load in non-hospitalised adult patients diagnosed with COVID-19, confirmed by a positive SARS-CoV-2 PCR, including its efficacy to reduce the impact of persistent COVID-19 symptoms.

Methods and analysis

This is a randomised, placebo-controlled, double-blind, monocentric phase II trial. Enrolment began in July 2022. A total of 74 adult patients will be randomly allocated to the CaD arm or the placebo group with a 1:1 ratio, respectively. Participants in the intervention arm will receive two capsules of CaD 500 mg two times per day and the placebo arm will receive two matching capsules of mannitol 312.5 mg two times per day, with a treatment period of 7 days for both arms, followed by a 77-day observational period without treatment administration. Participants will be asked to complete secured online questionnaires using their personal smartphone or other electronic device. These include a COVID-19 questionnaire (assessing symptoms, temperature measurement, reporting of concomitant medication and adverse events), a COVID-19 persistent symptoms’ questionnaire and the Short Form 12-Item (SF-12) survey. SARS-CoV-2 PCR testing will be performed on nasopharyngeal swabs collected on days 1, 4, 8 and 21. The primary endpoint is the reduction from baseline of SARS-CoV-2 viral load determined by RT-PCR at day 4.

Ethics and dissemination

This trial has received approval by the Geneva Regional Research Ethics Committee (2022-00613) and Swissmedic (701339). Dissemination of results will be through presentations at scientific conferences and publication in scientific journals.

Trial registration number

NCT05305508; Clinicaltrials.gov; Swiss National Clinical Portal Registry (SNCTP 000004938).

☐ ☆ ✇ BMJ Open

Efficiency assessment of follow-up methodology of patients with knee replacement to predict post-surgical functionality: a protocol for randomised control PROKnee trial

Por: San Martin Valenzuela · C. · Tabares-Seisdedos · R. · Paya Rubio · A. · Correa-Ghisays · P. · Pedrero-Sanchez · J.-F. · Silvestre Munoz · A. — Mayo 7th 2024 at 18:05
Introduction

Even when total knee arthroplasty (TKA) is an extended treatment, most patients experience a suboptimal evolution after TKA. The objectives of this study are the following: (1) to determine the effectiveness of two different prosthesis stabilisation systems on the functionality in activities of daily life, and (2) to determine prognostic biomarkers of knee prosthesis function based on radiological information, quantification of cytokines, intra-articular markers and biomechanical functional evaluation to predict successful evolution.

Methods and analysis

The PROKnee trial was designed as a randomised controlled patient-blinded trial with two parallel groups that are currently ongoing. The initial recruitment will be 99 patients scheduled for their first TKA, without previous prosthesis interventions in lower limbs, who will be randomly divided into two groups that differed in the stabilisation methodology incorporated in the knee prosthesis: the MEDIAL-pivot group and the CENTRAL-pivot group. The maximum walking speed will be reported as the primary outcome, and the secondary results will be patient-reported questionnaires related to physical status, cognitive and mental state, radiological test, laboratory analysis and biomechanical instrumented functional performance, such as the 6-minute walking test, timed up-and-go test, gait, sit-to-stand, step-over, and ability to step up and down stairs. All the results will be measured 1 week before TKA and at 1.5, 3, 6 and 12 months after surgery.

Ethics and dissemination

All procedures were approved by the Ethical Committee for Research with Medicines of the University Clinical Hospital of Valencia on 8 October 2020 (order no. 2020/181). Participants are required to provide informed consent for the study and for the surgical procedure. All the data collected will be treated confidentially since they will be blinded and encrypted. The results from the trial will be published in international peer-reviewed scientific journals, regardless of whether these results are negative or inconclusive.

Trial registration number

ClinicalTrials.gov Registry (NCT04850300).

☐ ☆ ✇ Journal of Advanced Nursing

Reclaiming Self‐Balancing on a Tightrope Across Time a grounded theory of transition to survivorship in older adult blood cancer survivors

Por: Sylvia K. Wood — Abril 23rd 2024 at 13:29

Abstract

Aim

To develop a theoretical understanding of the transition to survivorship in older adult blood cancer survivors.

Design

Qualitative research employing Classic Glaserian Grounded Theory methods.

Methods

Purposive and theoretical sampling recruited 17 participants via Leukaemia & Lymphoma Society© Community webpages (65–83 years) from across the US and Canada. Data from individual semi-structured interviews using HIPPA-compliant Zoom© were analysed from September 2020 to March 2021.

Results

Participants' main concern was losing their sense of self and reclaiming self was the core category. The substantive theory of Reclaiming Self-Balancing on a Tightrope Across Time is a six-phase transition process to survivorship: receiving a blood cancer diagnosis, finding bearings, reclaiming self, persevering through, realizing a transition and living in a new reality.

Conclusions

The transition to survivorship in older adult blood cancer survivors is a complex process because of age and disease type.

Implications

Age-related aspects of one's sense of self and its relation to health, well-being and quality of life, as older adult blood cancer survivors advance into older age need further research. Ageism and its impact on cancer survivorship care in older adults should also be explored.

Impact

What problem did the study address?: Existing theoretical frameworks do not explain the complex process of transition to survivorship for older adult blood cancer survivors. What were the main findings?: A substantive theory Reclaiming Self-Balancing on a Tightrope Across Time is a six-phase transition process from cancer diagnosis to survivorship characterized by an uncertain and liminal nature. Where and on whom will the research have an impact?: Understanding how older adults experience the transition to survivorship can inform age-appropriate person-centered nursing practices and healthcare policies specific to their needs.

Reporting Method

COREQ.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Clinical Nursing

Protective and risk factors of workplace violence against nurses: A cross‐sectional study

Abstract

Aims

To describe how workplace violence (WPV) is experienced by nurses in hospitals and community services and identify protective and risk factors.

Methods

An online cross-sectional national study was conducted from January to April 2021 in Italy. Hospitals and community services were involved in the study. The survey combined the adapted and validated Italian version of the Violence in Emergency Nursing and Triage (VENT) questionnaire, which explores the episodes of WPV experienced during the previous 12 months, the Practice Environment Scale of the Nursing Work Index (PES-NWI) and some additional questions about staffing levels extracted from a previous RN4CAST study. Nurses working in all clinical settings and community services were invited to participate in the survey. Descriptive and inferential statistics were used for data analysis. We adhered to the STROBE reporting guidelines.

Results

A total of 6079 nurses completed the survey, 32.4% (n = 1969) had experienced WPV in the previous 12 months, and 46% (n = 920) reported WPV only in the previous week. The most significant protective factors were nurses' age, patients' use of illegal substances, attitude of individual nurses and considering effective the organization's procedures for preventing and managing episodes of violence. The most significant risk factors included workload, recognizing violence as an inevitable part of the job, patients' cultural aspects and patients' agitated behaviour. The frequency of WPV was significantly higher in certain areas, such as the emergency department and in mental health wards.

Conclusion

Workplace violence (WPV) against nurses is a very frequent and concerning issue, especially in hospitals and community services. Based on our findings, integrated and multimodal programmes for prevention and management of WPV are recommended. More attention and resources need to be allocated to reduce WPV by improving the quality of nurses' workplace environment and implementing violence-free policies for hospitals.

Implications for the Profession and/or Patient Care

Impact

Workplace verbal and physical violence is a widespread phenomenon, both in hospital and community settings, and even during COVID-19 pandemic. This problem is exacerbated by the lack of effective reporting systems, fear of retaliation and the tendency to consider violence as an inevitable part of the job. The characteristics of professionals, patients, work environment and organizational factors are involved in the spread of workplace violence, determining its multifactorial nature. Integrated and multimodal programmes to prevent and manage of workplace violence are probably the only way to effectively counteract workplace violence against nurses. Healthcare policymakers, managers of hospital and community services need to proactively prevent and effectively manage and monitor episodes of violence. Nurses need to feel protected and safeguarded against any form of verbal or physical violence, to provide high-quality care in a totally safe environment.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ PLOS ONE Medicine&Health

Test-retest reliability of Latin American Group for Maturity (GDLAM) protocol in older women

by Álvaro Huerta Ojeda, Emilio Jofré-Saldía, Jimena Arriagada Molina, Patricia Rojas Quinchavil, María Paz Parada Toledo, Sergio Galdames Maliqueo, María-Mercedes Yeomans-Cabrera, Carlos Jorquera-Aguilera, Frano Giakoni-Ramirez, Maximiliano Bravo

Functional autonomy (FA) is a critical factor in determining the quality of life of older adults (OA), especially in the case of older women (OW), as they face a decline in FA in their later years of life. FA should be assessed early, using valid, reliable, and low-cost tests. This study evaluated the test-retest reliability of GDLAM and GDLAM autonomy index (GI) in OW. Thirty-nine OW (71.2 ± 6.50 years) participated in the study. A repeated measures design was used to compare the interday test-retest reliability of the five GDLAM tests (seconds) and the GI (points). The five tests represent activities of daily living, such as dressing or wandering around the house, while the GI provides a weighting of the results of the five tests. The analysis consisted of the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and coefficient of variation (CV). A CV ≤ 10% and an ICC ≥ 0.80 were considered acceptable reliability, whereas a CV ≤ 5% and an ICC ≥ 0.90 were considered high reliability. The outcome of the five tests, represented by the GI, showed high interday test-retest reliability (CV = 6.00% and ICC = 0.91). The results of this study demonstrate that the five tests of the GDLAM protocol and the GI have high interday test-retest reliability and good interday reproducibility. From a practical point of view, the GDLAM protocol allows the assessment of FA of community-dwelling OW, providing background for early diagnosis and, with it, the possibility of developing an individualized physical exercise prescription.
☐ ☆ ✇ BMJ Open

Functional therapy and adenotonsillectomy clinical trial for class II malocclusion (FACT-II): protocol for a randomised controlled trial

Por: Guo · F. · Lv · C. · Tang · B. · Lin · L. · Zhang · C. · Zheng · J. · Zhao · T. · He · H. — Abril 16th 2024 at 18:01
Introduction

Class II malocclusion with mandibular retrognathia is a common complication of paediatric obstructive sleep apnoea (OSA), often accompanied by transverse maxillary deficiency. In early orthodontic treatment, a twin block (TB) is a regular functional appliance for correcting this malocclusion. For paediatric OSA, the most common risk factor is adenotonsillar hypertrophy (AHT). Untreated AHT may lead to the persistence and worsening of obstructive sleep-disordered breathing traits, including habitual mouth breathing. Additionally, the clockwise mandibular rotation associated with AHT-induced pharyngeal crowding can undermine the effectiveness and stability of TB treatment. Adenotonsillectomy (T&A) is currently the first-line treatment for paediatric OSA. This proposed trial will investigate the impact of T&A surgery timing on the efficacy and stability of TB functional treatment in children with class II mandibular retrognathia and ATH.

Methods and analysis

This will be a single-centre, parallel-group, superiority randomised controlled trial with participants randomised to intervention (T&A followed by TB treatment) or control arms (TB treatment followed by T&A) in a 1:1 ratio. A total of 40 patients aged 8–14 years, diagnosed with class II mandibular retrognathia and co-existing ATH-induced OSA, and indicated for both T&A surgery and TB treatment, will be recruited at the School and Hospital of Stomatology, Wuhan University. The primary outcomes will be the changes in the apnoea-hypopnoea index and the point A-nasion-point B angle from baseline to postorthodontic treatment between the two groups. Secondary outcomes will include other dental, skeletal, upper airway and soft tissue changes, as well as subjective sleep-related and oral-related quality of life. Outcome changes within each group and between groups will be analysed.

Ethics and dissemination

This study is approved by the Ethics Committee of the School and Hospital of Stomatology, Wuhan University (no. 2022-D07). The research findings will be faithfully disseminated through scientific conferences or published articles.

Trial registration number

ChiCTR2200061703 (https://www.chictr.org.cn).

☐ ☆ ✇ BMJ Open

Effects of a therapeutic lifestyle modification intervention on cardiometabolic health, sexual functioning and health-related quality of life in perimenopausal Chinese women: protocol for a randomised controlled trial

Por: Wang · Y. · Miao · X. · Viwattanakulvanid · P. — Abril 16th 2024 at 08:27
Introduction

Perimenopause is a critical transitional period in reproductive ageing. A set of physiological and psychological changes can affect perimenopausal women’s quality of life and further threaten their older adult health conditions. In China, less than one-third of midlife women with menopausal symptoms have actively sought professional healthcare. Regarding the public health significance of comprehensive menopause management, the current study aims to investigate the effects of a therapeutic lifestyle modification (TLM) intervention on cardiometabolic health, sexual functioning and health-related quality of life among perimenopausal Chinese women.

Method and analysis

A randomised controlled trial with two parallel arms will be conducted at the gynaecology outpatient department of Yunnan Provincial Hospital of Traditional Chinese Medicine in China. 94 eligible perimenopausal women aged between 40 and 55 years will be recruited for the study. The TLM intervention consists of four elements: menopause-related health education, dietary guidance, pelvic floor muscle training and Bafa Wubu Tai Chi exercise. Participants will be randomly assigned (1:1) to receive either the 12-week TLM intervention or routine care via stratified blocked randomisation. The primary outcome is quality of life; secondary outcomes of interest include sexual functioning and cardiometabolic health. The outcome measures will be assessed at baseline and post-intervention. To explore the effects of the intervention, linear mixed models will be applied to test the changes between the two groups over time in each outcome based on an intention-to-treat analysis.

Ethics and dissemination

The Research Ethics Review Committee of Chulalongkorn University (COA No 178/66) and the Medical Ethics Committee of Yunnan Provincial Hospital of Traditional Chinese Medicine (IRB-AF-027-2022/02-02) approved the study protocol. Written informed consent will be obtained from all participants. Results will be published in peer-reviewed journals and disseminated through conferences.

Trial registration number

ChiCTR2300070648.

☐ ☆ ✇ International Wound Journal

The role of orthobiologics in chronic wound healing

Abstract

Chronic wounds, characterized by prolonged healing processes, pose a significant medical challenge with multifaceted aetiologies, including local and systemic factors. Here, it explores the complex pathogenesis of chronic wounds, emphasizing the disruption in the normal phases of wound healing, particularly the inflammatory phase, leading to an imbalance in extracellular matrix (ECM) dynamics and persistent inflammation. Senescent cell populations further contribute to impaired wound healing in chronic lesions. Traditional medical management focuses on addressing underlying causes, but many chronic wounds resist to conventional treatments, necessitating innovative approaches. Recent attention has turned to autologous orthobiologics, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF) and mesenchymal stem cells (MSCs), as potential regenerative interventions. These biologically derived materials, including bone marrow aspirate/concentrate (BMA/BMAC) and adipose tissue-derived stem cells (ADSCs), exhibit promising cytokine content and regenerative potential. MSCs, in particular, have emerged as key players in wound healing, influencing inflammation and promoting tissue regeneration. This paper reviews relevant scientific literature regarding basic science and brings real-world evidence regarding the use of orthobiologics in the treatment of chronic wounds, irrespective of aetiology. The discussion highlights the regenerative properties of PRP, PRF, BMA, BMAC and SVF, showcasing their potential to enhance wound healing. Despite advancements, further research is essential to elucidate the specific roles of each orthobiologic and determine optimal applications for different wound types. The conclusion underscores the evolving landscape in chronic wound management, with a call for more comprehensive studies to refine treatment strategies and maximize the benefits of regenerative medicine.

☐ ☆ ✇ Journal of Advanced Nursing

Status quo and influencing factors of multiprofessional and multidisciplinary teamwork for early mobilization in mechanically ventilated patients in ICUs: A multi‐centre survey study

Por: Xueqin Wang · Ying Lv · Chuanlin Zhang · Jie Mi · Qinghua Zhao — Abril 16th 2024 at 08:48

Abstract

Aim

To understand the status quo of multiprofessional and multidisciplinary collaboration for early mobilization of mechanically ventilated patients in Chinese ICUs and identify any factors that may influence this practice.

Design

A multi-centre cross-sectional survey.

Methods

From October to November 2022, the convenience sampling method was used to select ICU multiprofessional and multidisciplinary early mobility members (including physicians, nurses and physiotherapists) from 27 tertiary general hospitals in 14 provinces, cities and autonomous regions of China. They were asked to complete an author-developed questionnaire on the status of collaboration and the Assessment of Inter-professional Team Collaboration Scale. A multiple linear regression model was used to analyse the factors associated with the level of collaboration.

Results

Physicians, nurses and physiotherapists mostly suffered from the lack of normative protocols, unclear division of responsibilities and unclear multiprofessional and multidisciplinary teams when using a collaborative approach to early activities. Multiple linear regression analysis showed that the number of ICU patients managed, the existence of norms and processes, the attitude of colleagues around them, the establishment of a team, communication methods and activity leaders were significant influences on the level of collaboration among members of the multiprofessional and multidisciplinary early activities.

Conclusion

The collaboration of multiprofessional and multidisciplinary early activity members for mechanically ventilated patients in the ICU remains unclear, and the collaboration strategy needs to be constructed and improved, taking into account China's human resources and each region's economic development level.

Impact

This study investigates the collaboration status of multiprofessional and multidisciplinary activity members from the perspective of teamwork, analyses the reasons affecting the level of collaboration and helps to develop better teamwork strategies to facilitate the implementation of early activities.

Patient or Public Contribution

The participants in this study were multiprofessional and multidisciplinary medical staff who performed early activities for ICU patients.

☐ ☆ ✇ PLOS ONE Medicine&Health

Predictive value of CD86 for the occurrence of sepsis (Sepsis-3) in patients with infection

Por: Dan lv · Keji Zhang · Changqing Zhu · Xinhui Xu · Hao Gong · Li Liu — Abril 11th 2024 at 16:00

by Dan lv, Keji Zhang, Changqing Zhu, Xinhui Xu, Hao Gong, Li Liu

This prospective observational study explored the predictive value of CD86 in the early diagnosis of sepsis in the emergency department. The primary endpoint was the factors associated with a diagnosis of sepsis. The secondary endpoint was the factors associated with mortality among patients with sepsis. It enrolled inpatients with infection or high clinical suspicion of infection in the emergency department of a tertiary Hospital between September 2019 and June 2021. The patients were divided into the sepsis and non-sepsis groups according to the Sepsis-3 standard. The non-sepsis group included 56 patients, and the sepsis group included 65 patients (19 of whom ultimately died). The multivariable analysis showed that CD86% (odds ratio [OR] = 1.22, 95% confidence interval [CI]: 1.04–1.44, P = 0.015), platelet count (OR = 0.99, 95%CI: 0.986–0.997, P = 0.001), interleukin-10 (OR = 1.01, 95%CI: 1.004–1.025, P = 0.009), and procalcitonin (OR = 1.17, 95%CI: 1.01–1.37, P = 0.043) were independent risk factors for sepsis, while human leukocyte antigen (HLA%) (OR = 0.96, 05%CI: 0.935–0.995, P = 0.022), respiratory rate (OR = 1.16, 95%CI: 1.03–1.30, P = 0.014), and platelet count (OR = 1.01, 95%CI: 1.002–1.016, P = 0.016) were independent risk factors for death in patients with sepsis. The model for sepsis (CD86%, platelets, interleukin-10, and procalcitonin) and the model for death (HLA%, respiratory rate, and platelets) had an area under the curve (AUC) of 0.870 and 0.843, respectively. CD86% in the first 24 h after admission for acute infection was independently associated with the occurrence of sepsis in the emergency department.
☐ ☆ ✇ BMJ Open

Side effects of COVID-19 vaccines in paediatric patients: a review systematic and meta-analysis protocol

Por: Freitas · C. L. · Sarmento · A. C. A. · Serquiz · N. · Nobre · M. L. · Costa · A. P. F. · Medeiros · K. S. · Goncalves · A. K. — Abril 10th 2024 at 03:18
Introduction

The paediatric population represents a quarter of the world’s population, and like adult patients, they have also suffered immeasurably from the SARS-CoV-2 pandemic. Immunisation is an effective strategy for reducing the number of COVID-19 cases. With the advancements in vaccination for younger age groups, parents or guardians have raised doubts and questions about adverse effects and the number of doses required. Therefore, systematic reviews focusing on this population are needed to consolidate evidence that can help in decision-making and clinical practice. This protocol aims to assess the safety of COVID-19 vaccines in paediatric patients and evaluate the correlation between the number of vaccine doses and side effects.

Methods and analysis

We will search the PubMed, ClinicalTrials.gov, Web of Science, Embase, CINAHL, Latin American and Caribbean Health Sciences Literature, Scopus and Cochrane databases for randomised and quasi-randomised clinical trials that list the adverse effects of the COVID-19 vaccine and assess its correlation with the number of doses, without any language restrictions. Two reviewers will select the studies according to the inclusion and exclusion criteria, extract data and asses for risk of bias using the Cochrane risk-of-bias tool. The Review Software Manager (RevMan V.5.4.1) will be used to synthesise the data. We will use the Working Group’s Grading of Recommendations Assessment, Development and Evaluations to grade the strength of the evidence of the results.

Ethics and dissemination

Formal ethical approval is not required as no primary data are collected. This systematic review will be disseminated through a peer-reviewed publication.

PROSPERO registration number

CRD42023390077.

☐ ☆ ✇ BMJ Open

Adherence to pharmacological therapy in patients with hypertension: protocol of a qualitative study by focus groups

Por: Rosendo-Silva · B. · Prazeres · F. · Santiago · L. M. · Rosendo · I. — Abril 10th 2024 at 03:18
Introduction

Non-adherence to antihypertensive medication significantly contributes to inadequate blood pressure control. Regarding non-pharmacological interventions to improve medication adherence, the question remains of which interventions yield the highest efficacy.

Understanding the complementary perspectives of patients and healthcare professionals can be valuable for designing strategies to enhance medication adherence. Few studies explored the perspectives of patients and healthcare professionals regarding medication adherence. None of them focused specifically on adherence to pharmacological therapy for hypertension in Portugal.

Considering the high prevalence of non-adherence and its location-specific aspects, the priority should be identifying its barriers and developing tactics to address them.

This study aims to gather the perspectives of patients with hypertension and healthcare professionals such as family doctors, nurses and community pharmacists from Portugal, regarding the most effective strategies to enhance antihypertensive medication adherence and to understand the factors contributing to non-adherence.

Methods and analyses

We will conduct qualitative research through synchronous online focus groups of 6–10 participants. Some groups will involve patients with hypertension, while others will include family doctors, nurses and community pharmacists. The number of focus groups will depend on the achievement of theoretical saturation. A purposive sample will be used. Healthcare participants will be recruited via email, while patients will be recruited through their family doctors.

The moderator will maintain neutrality while ensuring interactive contributions from every participant. Participants will be encouraged to express their opinions on the meeting summary. Meetings will be recorded and transcribed.

Two researchers will perform content analyses using MAXQDA V.12 through comparative analyses and subsequent consensus. A third researcher will review the analyses. The results will be presented narratively.

Ethics and dissemination

The Ethics Committee of the University of Coimbra has approved this study with the number: CE-026/2021. The results will be disseminated via peer-reviewed publications and national and international conferences.

☐ ☆ ✇ Cultura de los cuidados

Comunidad compasiva para la inclusión social y calidad de vida de las personas con esclerosis múltiple y sus cuidadores familiares

Objetivo: Evaluar cualitativamente la experiencia de pacientes con esclerosis múltiple (PEM) y cuidadores familiares (CFPEM) vinculados al programa de esclerosis múltiple del Hospital Universitario Nacional de Colombia (PrEM-HUNC), durante la formación y consolidación de una comunidad compasiva (CC), para la inclusión social y promoción de calidad de vida. Materiales y Método: estudio cualitativo interpretativo, con entrevistas a profundidad a nueve colaboradores. Con el método de análisis de espiral de Creswell y Poth, emergieron cuatro categorías y un tema. Resultados: el tema “Un nido comunitario de crecimiento y transformación” señala el proceso de conformación de la CC como una experiencia que posibilitó cambios de significados en torno a la enfermedad, la situación personal y familiar; revela un proceso de descubrimiento y aprendizaje de conformación de diferentes relaciones y roles. Conclusiones: La CC es una opción para construcción de redes de apoyo, fortalecimiento de las capacidades personales y familiares, una forma para hacer frente a los diferentes impactos y retos que implica vivir con esclerosis múltiple, se constituye en una alternativa para la promoción de la calidad de vida y la inclusión social.

☐ ☆ ✇ Cultura de los cuidados

Necesidades humanas básicas en gestantes con alto riesgo obstétrico analizado bajo la Teoría de Wanda Horta

Objetivo: identificar las necesidades humanas básicas de las embarazadas de alto riesgo hospitalizadas con base en la Teoría de Wanda Horta. Método: investigación asistencial realizada con dieciséis gestantes de alto riesgo hospitalizadas en una maternidad de referencia en Ceará entre septiembre y noviembre de 2019. Se recolectó información a través de diario de campo y ficha de caracterización de las gestantes y registros de necesidades humanas básicas. Los resultados se analizaron mediante estadística descriptiva simple y un enfoque integral a la luz del marco de Wanda Horta. Resultados: las gestantes presentaron necesidades psicobiológicas, psicosociales y psicoespirituales, siendo prevalentes: ausencia de actividades de ocio, inseguridad emocional, escaso conocimiento, sueño y descanso perjudicados, y actividades físicas restringidas por indicación de descanso. Consideraciones finales: se cree que el razonamiento crítico y el juicio clínico de los enfermeros se centraron en la individualidad de las gestantes, identificando necesidades en los tres niveles propuestos por la teoría, apuntando caminos para cualificar el cuidado de enfermería a las gestantes de alto riesgo.

☐ ☆ ✇ Cultura de los cuidados

Necesidades de cuidado en la persona consumidora de alcohol en un contexto hospitalario

Introducción: El consumo de alcohol es considerado uno de los transcendentales factores de riesgo de discapacidad y muerte prematura. Develar el sentido de la experiencia de la persona consumidora de alcohol en cuanto a las necesidades de cuidado en el contexto hospitalario e incentiva que enfermería brinde un cuidado humano. Objetivo: Comprender las necesidades de cuidado de una persona consumidora de alcohol durante la estancia hospitalaria. Método: Investigación cualitativa fenomenológica. Muestreo por conveniencia, participaron 07 hombres y 02 mujeres que consumen alcohol e ingresaron al hospital. Para recolectar los datos se utilizó una entrevista fenomenológica, previo consentimiento informado. El análisis se realizó mediante el círculo hermenéutico de Martin Heidegger. Resultados: Fueron develadas cinco categorías: 1) Necesidades físicas ante deterioro corporal, 2) Necesidades emocionales y de apoyo con traspaso de energía para vivir, 3) Necesidades de confort humano dentro de la hospitalización, 4) Agradecimiento verbalizado y escrito ante acompañamiento y preocupación, 5) Anhelos de ser cuidado como persona. Conclusiones: Enfermería se encuentra con un ser vulnerable que muestra necesidades físicas debilitadas, necesidades emocionales que requieren apoyo y confort humano, un ser que anhela y agradece al ser enfermera.

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