To conduct a systematic review and meta-analysis to evaluate the effects of cold application on pain and anxiety reduction after chest tube removal (CTR).
The act of removing the chest tube often causes pain among cardiothoracic surgery patients.
Most guidelines regarding CTR do not mention pain management. The effects of cold application on reducing pain and anxiety after CTR are inconsistent.
Systematic review and meta-analysis.
We searched six databases, including Embase, Ovid Medline, Cochrane Library, Scopus, the Index to Taiwan Periodical Literature System and Airiti Library, to identify relevant articles up to the end of February 2021. We limited the language to English and Chinese and the design to randomised controlled trials (RCTs). All studies were reviewed by two independent investigators. The Cochrane Collaboration's tool was used to assess the risk of bias, Review Manager 5.4 was used to conduct the meta-analysis. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology was used for assessing certainty of evidence (CoE).
Ten RCTs with 683 participants were included in the meta-analysis. The use of cold application could effectively reduce pain and anxiety after CTR. The subgroup showed that a skin temperature drops to 13°C of cold application was significantly more effective for the immediate reduction in pain intensity after CTR compared with control group. The GRADE methodology demonstrated that CoE was very low level.
Cold application is a safe and easy-to-administer nonpharmacological method with immediate and persistent effects on pain and anxiety relief after CTR. Skin temperature drops to 13°C or lasts 20 min of cold application were more effective for immediate reduction of pain intensity following CTR.
In addition to pharmacological strategy, cold application could be used as evidence for reducing pain intensity and anxiety level after CTR.
The aim of the study was to explore whether, and how, professional nurse educator identity is co-constructed by a community of practice.
A critical participatory action research (PAR) methodology was used as it extends the principles of action research by seeking purposeful and sustainable social change that recognizes participants as researchers and generators of knowledge.
Twenty-two sector-based nurse educators employed as either nurse educators or clinical nurse educators participated in the critical PAR. Multiple methods of data generation were pursued in a cyclic and sequential manner consistent in an action research process. Three distinct phases of the research across 2015–2017 involved the generation of data before, during and after the establishment of a nurse educator community of practice. A social constructionist lens of analysis was used to explore the social and relational outcomes. The COREQ checklist was used to appraise the study report.
A sustained period of community of practice engagement enhanced the participants' relationships and shifted their perceived professional identities towards being validated nurse educators with a stronger collective sense of their roles.
For this group of nurse educators, participation in the research resulted in collective meaning-making, praxis, knowledge generation and the co-construction of their professional identities.
To critically synthesize the literature that describes men's help-seeking and engagement with general practice.
Integrative literature review.
CINAHL plus, Medline and APA PsycInfo were searched for papers published between 1999 and March 2021.
After screening titles and abstracts, full-text papers were screened against inclusion / exclusion criteria. All included papers were assessed for methodological quality. Findings were extracted, critically examined and synthesized into themes.
Twenty studies met the inclusion criteria. Thematic analysis revealed four themes related to; (1) structural barriers, (2) internal barriers, (3) men's understanding of the role of general practice, and (4) self-care and help-seeking. The findings indicate that men can find general practice unwelcoming and unaccommodating. Men can also experience psychological barriers that impact engagement and help-seeking. Men predominantly view general practice as a source of acute health care and do not appreciate the role of general practice in preventive health care and advice.
This review has provided insight into the issues around the barriers to health care engagement, men's understanding of the role of general practice and their associated help-seeking. Seeking to further understand these issues could assist in the development of strategies to promote engagement of men with general practice health care.
This review highlights research about men's engagement with general practice and the missed opportunities in receiving preventive health care and education.
Enhancing men's engagement with general practice has the potential to reduce the impact of their health on quality of life and improve health outcomes.
To identify and synthesize the evidence on the perceptions of the health effects of dietary salt consumption and barriers to sustaining a salt-reduced diet for hypertension in Chinese people.
A systematic integrated review integrating quantitative and qualitative studies using the PRISMA guidelines.
Three databases, MEDLINE, PubMed and CINAHL, were systematically searched for articles published between January 2001 and July 2020.
The quality of the included studies was appraised using the Joanna Briggs Institute's critical appraisal tools for cross-sectional and qualitative studies. Descriptive analysis and constant comparison methods were used to analyse the extracted data.
Fourteen studies met the inclusion criteria. The synthesized results identified that (i) adequate salt-related health education had a positive influence on dietary behaviour modifications, (ii) the level of educational exposure to the health benefits of salt reduction influenced Chinese people's perceptions of the health impact associated with high salt intake, (iii) the complexity of salt measurement was a barrier to salt reduction, (iv) salt reduction is a challenge to Chinese food culture, and (v) Chinese migrants may experience linguistic and cultural challenges when they seek appropriate dietary education and advice for hypertension management in their host countries.
There is room for improvement in recognizing and translating the knowledge of salt-related health issues and the benefits of that knowledge about salt reduction into action. Future nursing interventions should incorporate individuals' cultural needs and the dietary culture of immediate family members.
This integrative review reveals that unique Chinese customs and practices reduce the effectiveness of salt reduction campaigns. The effects of education vanish without family support, resulting in suboptimal adherence to dietary salt reduction strategies.
To examine the psychometrics and measurement invariance of the Short-Form Health Literacy 12-item questionnaire (HL-SF12) among Vietnamese and Indonesian married immigrants.
A cross-sectional survey design.
In total, 1171 Vietnamese and Indonesian married immigrants were enrolled between September 2019 and December 2019. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to verify the structural validity of the suggested factor structure. The multiple-group CFA (MGCFA) used a series of hierarchical nested-in models as a measurement invariance test which confirmed the adequacy of the model fit at each stage.
The Kaiser–Meyer–Olkin coefficient was 0.898, and the Bartlett test of sphericity was statistically significant (χ 2 = 1965.97, p < 0.01). According to a scree plot and Kaiser's criterion for eigenvalues of >1, the EFA explained 61.6% of the total variance and confirmed three theoretically supported factors of health care, disease prevention and health promotion. The 12 items showed factor loadings of >0.4 and four items were in each subscale. The CFA showed adequate structural validity, including a relative chi-squared/degrees of freedom (X 2 /df) of 2.01, a comparative fit index (CFI) of 0.98 and a root mean square error of approximation (RMSEA) of 0.04 (95% confidence interval [0.03, 0.05]) in married immigrants. For the measurement invariance, a change in the goodness-of-fit measures did not exceed 0.02 for the RMSEA or 0.01 for the CFI. The results indicated Cronbach's α values of 0.87 for the HL-SF12 scale in Vietnamese and Indonesian combined samples (n = 1171). A t-test showed that the HL-SF12 and its three subscales were unable to significantly differentiate between Vietnamese and Indonesian groups (all p > 0.05).
The HL-SF12 scale showed acceptable theoretically supported structural validity, equivalent measurement invariance and reliable internal consistency among Vietnamese and Indonesian married immigrants. Measurements of immigrants' HL using the HL-SF12 could be integrated into future immigrant health policies.
As the first study of the measurement invariance of the HL-SF12 instrument among immigrants. Related factors of immigrants' HL can be further explored to increase immigrants' health and empowerment.
To explore the interactions between children, parents and nurses during postoperative pain management.
Despite the growing evidence relating to postoperative pain management in children and relevant practice guidelines, children still experience moderate to severe pain after surgery. One factor could be related to the relatively unexplored child–parent–nurse interaction.
A qualitative constructivist grounded theory methodology.
Data were collected from a paediatric hospital in the United Kingdom. Ten children aged between 6 and 11 years old who had undergone surgery, 11 parents and 10 nurses participated. Methods included face-to-face semi-structured interviews. Data were analysed using constant comparison technique, memos and constructivist grounded theory coding levels. The COREQ guidelines were followed for reporting.
Three concepts emerged from data, “Parents as a communicator for child-nurse interaction”, “Parents’ emotional turmoil in child-nurse interaction”, and “Parents’ actions in child-nurse interaction” which constructed the substantive theory of child–parent–nurse interaction during postoperative pain management: “Facilitating or Inhibiting Interactions: Parental Influence on Postoperative Pain Management”. The findings highlight an absence of a three-way interaction between children, parents and nurses and a dyadic interaction process between children and nurses was not apparent. Instead, child–parent–nurse interactions were constructed around two dyads of child–parent and parent–nurse interactions with child–nurse interaction constructed via parents. Parents, as a communicator, influenced the entire postoperative pain management processes between children, parents and nurses by facilitating or inhibiting the interaction processes.
This study identifies potentially important evidence about the unique position parents hold between their child and nurses as a central pivotal communicator during children’s postoperative pain management.
This study may help to explain how and why postoperative pain management remains suboptimal. The substantive theory could support improvements in the management of postoperative pain through a much wider recognition of parents’ central pivotal communicator role and the complexity of these child–nurse interactions.
The aim of this study was to discover the nature of the adverse events in Finnish long-term professional homecare reported by professionals, and to identify the circumstances in which adverse events occur and their consequences.
Adverse events are incidents causing unintended and unnecessary harm to older people at home. Safety is a basic human right and a fundamental prerequisite for independent living among older people at home. Few studies have focused on both long-term professional homecare environment and the safety of older people.
The research was a descriptive registry-based study.
This study consisted of adverse events (N = 61248) in Finnish public long-term professional homecare (2009–2019). Data were described using frequencies and percentages. STROBE statement checklist was chosen for reporting the study process.
By profession, practical nurses and registered nurses reported the most of adverse events (89.8%). These were either critical incidents (78.3%) or near misses (20.0%) and concerned medicine, injuries and accidents, information flow or management. Consequences for older people were usually rated from no-harm to moderate harm. For long-term professional homecare, image harm, extra financial costs, no-harm and prolonged care for older people were among the consequences. Personnel frequently observed the older people afterwards and informed older people of adverse events, yet some of actions were unknown.
Many harmful adverse events are considered harmless for older people. Sometimes this can lead to unmet care needs or missed care. The degree of harm needs to be assessed in terms of physical, mental and social health with the HaiPro reporting system for homecare.
An understanding and a comprehensive view of the situation and holistic assessment of care needs includes safety and safety risks to increase safety and feeling of safety for older people at home.
Preventing new cases of the human immunodeficiency virus (HIV) is key to the Centers for Disease Control and Prevention (CDC) Ending the HIV Epidemic: A Plan for America initiative. In 2012, Truvada became the first medication approved in the United States to prevent HIV infection, yet it has not seen widespread use.
This study aimed to allow for the incorporation of an HIV risk assessment into the primary care provider (PCP) visit and promote increased numbers of patients screened for pre-exposure prophylaxis of HIV (PrEP).
An educational program and an electronic HIV risk assessment tool were provided to the healthcare providers in an urban federally qualified health center to decrease barriers to providing PrEP.
Provider likelihood to prescribe PrEP increased among the internal medicine/family medicine (p = .0001, p = .0001) and obstetrics/gynecology providers (p = .0034, p = .0034), but there was no significant change among the pediatric providers (p = .4227, p = .1965).
Improvement among most providers demonstrated the success of this effort. Additional assessments and interventions are warranted among pediatric providers. Continued efforts are needed to progress to the incorporation of PrEP in the PCP visit.
Reproductive coercion is associated with poor health outcomes in women. This study examined exposure to and use of reproductive coercion and care seeking among college students.
A cross-sectional survey was administered to 2291 college students of all genders seeking care in college health and counselling centres as baseline data for a cluster-randomized controlled trial.
Online surveys were collected (9/2015–3/2017). Descriptive statistics, chi-square, Fisher's exact and t-tests were analysed.
Among female participants, 3.1% experienced reproductive coercion in the prior 4 months. Experience was associated with older age (p = .041), younger age at first intercourse (p = .004), Black/African American race (p < .001), behaviourally bisexual (p = .005), more lifetime sexual partners (p < .001) and ever pregnant (p = .010). Sexually transmitted infection (p < .001), recent drug use or smoking (p = .018; p = .001), requiring special health equipment (p = .049), poor school performance (p < .001) and all categories of violence (p = <.001–.015) were associated with women's reproductive coercion experience.
Participants who experienced reproductive coercion were more likely to seek care for both counselling and healthcare, (p = .022) and sexually transmitted infection (p = .004).
Among males, 2.3% reported recent use of reproductive coercion; these participants reported sexual violence perpetration (p = .005), less condom use (p = .003) and more sexual partners than non-perpetrators (p < .001).
Although reproductive coercion was reported infrequently among college students, those students experiencing it appear to be at risk for poor health and academic outcomes. Health and counselling centres are promising settings to address RC and related health behaviours.