To describe the patient's experience of family function and its importance in diabetes‐related self‐management.
Many patients fail to reach the targeted glycemic level due to low self‐management adherence. Knowledge is needed regarding the impact of family function on diabetes self‐management.
A qualitative descriptive design.
A purposive sample of 20 patients with type 2 diabetes. Data were collected in March‐June 2017 via audio recorded semi‐structured interviews, field notes and Eco‐maps. Analyzed using thematic framework matrix and thematic analysis.
Four themes were identified: (1) Downplaying disease. The disease was trivialized creating a barrier to family involvement; (2) Second guessing. When diabetes was not discussed, patient and family made their own assumptions; (3) Going it alone. The participants preferred sole disease responsibility to maintain usual family life; (4) No regrets. The participants managed their disease with medications only to maintain family cohesion and “the good life”.
The participants in our study downplayed the consequences of type 2 diabetes and chose to control their disease medically rather than by lifestyle changes. They renounced family involvement to maintain their lifestyle and promote family cohesion.
To systematically review the effectiveness of vinegar consumption in improving glycemic control in adults with type 2 diabetes mellitus.
A systematic review and meta‐analysis.
The CINAHL, Excerpta Medica database (EMBASE), Medline, PubMed, Scopus and Cochrane databases were searched in April 2019. Interventional studies published in the English language, from inception to 15 April 2019, were included.
Two investigators independently assessed the quality of the studies, discussed their findings to reach consensus, and complied with the standards of the Cochrane.
Handbook for Systematic Reviews of Interventions. Random‐effects meta‐analysis was conducted in Review Manager 5.3.5 to assess the effect size. A series of subgroup and sensitivity analyses were conducted to explore the causes of heterogeneity. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
A total of 6 relevant studies, including 317 patients with type 2 diabetes mellitus, were selected from 356 studies identified through electronic searches and reference lists. The meta‐analysis showed significantly better fasting blood glucose and hemoglobin A1c (HbA1c) level. In secondary analyses, there was a remarkable reduction in total cholesterol and low‐density lipoprotein postintervention.
Vinegar content varied across the studies, and the sample sizes in the included studies were relatively small. Therefore, caution should be exercised when trying to extrapolate the results to a larger population.
Existing reviews are limited to narrative synthesis, lacking critical appraisal, heterogenous outcomes, nor any report of fasting blood glucose and HbA1c. This meta‐analysis review extends the evidence on the beneficial effects of vinegar on glycemic control as measured by HbA1c and fasting blood glucose. Clinicians could incorporate vinegar consumption as part of their dietary advice for patients with diabetes.
In an editorial concerned with radicalism, it is perhaps appropriate to start with Karl Marx. To paraphrase this greatest of political philosophers, we must learn the lessons of history. So, I wish to consider the idea of nursing radicalism, with recourse to a selective consideration of the past, contemplation of the present, and, most crucially, to inspire a critical imagination of what could be the future. Latterly, the very vocabulary of ‘radical’ has been demeaned, denigrated and demonised. I wish to reclaim an appreciation of nursing radicals as a wholesome and positive force for good, with huge potential for making a difference at various degrees of scale; from the global to the everyday. Indeed, I contend no change of any worth can neglect attention to the everyday human relationships bound up in making the change happen.
To systematically identify, appraise and synthesise patients’, residents’, and nurses’ experiences of fundamental nursing care for nutrition, elimination, mobility, and hygiene.
The evidence base for effective nursing behaviours to assist people with their fundamental care needs is sparse, hampering the development of effective interventions. Synthesising data on patients’ and nurses’ experiences of fundamentals of nursing care could contribute to the development of such an intervention.
Systematic review and synthesis of qualitative data from qualitative studies on patients’ and nurses’ experiences of fundamental nursing care behaviours addressing peoples’ nutrition, elimination, mobility, and hygiene needs. We appraised study quality and relevance and used a narrative approach to data synthesis, fulfilling PRISMA criteria (Supplementary file 1).
We identified 22,374 papers, 47 met our inclusion criteria. Most papers were of low quality. Sixteen papers met our quality and relevance criteria and were included for synthesis. Papers were about nutrition (2) elimination (2), mobility (5), hygiene (5) and multiple care areas (2). We found nurses and patients report that fundamental nursing care practices involve strong leadership, collaborative partnerships with patients and cohesive organisational practices aligned to nursing care objectives and actions.
To improve fundamental care and interventions suitable for testing may require attention to leadership, patient‐nurse relationships and organisational coherence plus the fundamentals of care nursing interventions themselves.
More rigorous mixed methods research about fundamental nursing care is needed to inform nursing practice and improve patient’s experience. Nursing interventions should include effective nurse leadership and nurse patient collaboration and a focus on fundamental care by the host organisation.
The purpose of this scoping review is to synthesize and map the literature on the psychological outcomes reported following debriefing of healthcare providers who experience expected and unexpected patient death in either clinical practice or simulation setting.
Patient death occurs in both the clinical and simulation environments and can result in psychological stress in healthcare providers and students. While debriefing following patient death has demonstrated the ability to promote positive psychological outcomes, addressing the psychological or emotional stress of the event is inconsistently addressed.
A scoping review was conducted using the Arksey and O’Malley framework.
The Cochrane Library, MEDLINE, CINAHL, PsycINFO, JBI, and Scopus databases were searched with English language constraints and no limit on publication date. The Scoping Reviews (PRISMA‐ScR) Checklist was used (Tricco et al., 2018) (see Supplementary File 1).
Eighteen articles (16 research papers, 2 review papers) met the inclusion criteria. Of the 16 research papers, 9 reported on debriefing models in the simulation environment and 7 in the clinical setting. The types of debriefing models found in the simulation setting tended to focus on healthcare providers’ learning, while those in the clinical setting typically focused on healthcare providers’ emotional reactions and resulted in positive psychological effects. Conclusion: Debriefing has the potential to positively affect psychological outcomes of healthcare providers who experience patient death. The type of debriefing that is selected is a key component to achieving these positive outcomes.
To clarify beliefs linked with depression among older adults with depression in Japan.
As a result of global population aging, caring for older adults with depression has become an important issue worldwide. In this paper, the concept of “beliefs” pertains to phenomena that lead to distress about disease and can be alleviated through talk therapy. While previous studies focused on illness beliefs in people with mental illness and depression, no studies have yet focused on such beliefs among older adults with depression.
Qualitative, narrative‐research–based method.
Observation and 1–5 narrative interviews lasting 60–90 min were conducted with each of 19 older adults with depression in a Japanese psychiatric ward. The resulting narratives were thematically analyzed to derive relevant themes and subthemes. Reporting of this research adheres to COREQ guidelines.
Four themes and twelve subthemes were revealed. Depression‐linked beliefs among older adults with depression were (1) “guilt and regret,” (2) “pessimism,” (3) “futility of treatment,” and (4) “desire to be needed by loved ones and society.”
Depression‐linked beliefs among older adults with depression constituted spiritual pain reflecting character tendencies, including experiences of loss and developmental challenges related to aging as well as subjects’ natural diligence and consideration for others.
(1) Helping nurses better understand distress experienced by older adults with depression, who are prone to feel guilt and regret when reflecting on the past, and to alleviate distress through dialogue and providing positive affirmation for patients. (2) To understand and assuage distress over experiences of loss in old age. (3) To help older adults with depression form a more relaxed attitude toward life, so that even if they have experienced loss as a result of old age, they can maintain their self‐esteem and existential sense of self‐worth.
My interest in research ethics began more than 20 years ago when I was a doctoral student seeking research ethics approval for my Grounded Theory study exploring what it was like to live with Normal Pressure Hydrocephalus. To cut a long story short, my application was rejected on two occasions primarily because the Research Ethics Committee (REC) didn't understand what I trying to do or how I was going to do it. This experience motivated me to get more involved in the ethical review of research and now, more than 20 years later, I spend considerable amounts of my time thinking about research ethics and the ethical conduct of research, as a researcher, as a research ethicist and as the Chair of an NHS REC.
To assess the incidence of voluntary stopping of eating and drinking in long‐term care and to gain insights into the attitudes of long‐term care nurses about the voluntary stopping of eating and drinking.
A cross‐sectional study.
Heads of Swiss nursing homes (535; 34%) answered the Online‐Survey between June and October 2017, which was evaluated using descriptive data analysis.
The incidence of patients who died in Swiss nursing homes by voluntarily stopping eating and drinking is 1.7% and 67.5% of participants consider this phenomenon highly relevant in their daily work. Most participants (64.2%) rate voluntary stopping of eating and drinking as a natural death accompanied by health professionals and patients are also granted the right to care (91.9%). This phenomenon is expected by the participants less at a young age and more in old age.
Participants' overall views on the voluntary stopping of eating and drinking are very positive, whereas it is assumed that voluntary stopping of eating and drinking is a phenomenon of old age. Professionals still lack sufficient knowledge about this phenomenon, which could be clarified through training.
International Registered Report Identifier (IRRID): DERR1‐10.2196/10358.
Voluntary stopping of eating and drinking is much discussed interprofessional, but there is a lack of knowledge on how this is perceived in the context of long‐term care and about the incidence of the phenomenon.
Voluntary stopping of eating and drinking is rare but noticeable end‐of‐life practises that is considered by professionals to be mainly dignified and peaceful, although moral concerns make it difficult to accompany.
These findings call on long‐term care institutions to discuss voluntary stopping of eating and drinking as an end‐of‐life practice. Positioning on the issue provides clarity for staff and patients and promotes to develop standardized care.
To investigate the long‐term psychological reactions and resilient process of the young survivors after a large‐scale burn disaster of the Formosa Color Dust Explosion in Taiwan.
Longitudinal study with follow‐up interviews using standardized questionnaire during November 2015 ‐ June 2018.
The burn survivors received structured assessment in the four‐wave interviews including the five‐item Brief Symptom Rating Scale, nine‐item Concise Mental Health Checklist and two‐item Patient Health Questionnaire for depressive symptoms and suicide risk assessment. Post‐traumatic psychological symptoms were assessed through the four‐item Startle, Physiological Arousal, Anger and Numbness Scale and six‐item Impact of Event Scale.
The response rates were 65.1%, 74.2%, 76.9% and 78.5% across the four‐wave interviews among 484 burn survivors. The participants were mean‐aged 23.1 years with just over half having 40% or more burn wounds in total body surface area. The respondents at each wave were similar in gender, age and percent of total body surface area burned. In the first two years of recovery, the respondents showed resilience in coping with stress of trauma under family and social support. While there was a decreasing trend of psychological symptoms over the first two years, hypnotic use and alcohol consumption remained at about 10% in the final interview, which were accompanied by psychological symptom recurrence.
Young burn survivors recovered both psychologically and physically under supportive care and personal resilience in two years after the burn event, yet post‐traumatic mental distress and coping efforts after two years during community reintegration should be detected and managed. Early prevention and detection of mental health deterioration is needed even after two years of burn disasters.
The study demonstrated post‐burn longitudinal changes on psychological reactions. Nursing staffs may help young burn survivors identify mental distress and stress management needs in the long‐term psychological adaptation process.
To discuss nurses’ contributions to global health through their participation in GAPFON®.
Discussion paper that reviews literature related to global health, global nursing and midwifery based on the contributions of the GAPFON® report.
A literature search of electronic databases was conducted for published articles during 2014–2018 in English focusing on the main themes of the GAPFON® report. Manual searches of relevant journals and internet sites were also undertaken.
Recommendations and strategies were discussed that could have an impact on the advancement of the nursing profession's contribution to global health based on the GAPFON® report outcomes.
GAPFON® provides a framework to synergize and converge our activities to address professional issues around the globe, through implementation of the suggested strategies identified in the GAPFON® report. GAPFON® has engaged with nursing and midwifery leaders around the globe to determine both the most pressing health issues and professional issues within regions and the report is a synthesis of all the data, reflecting regional and global challenges. This article explores ways of how the report can be used as a basis for engagement with decision makers in global health.
Advances in the professional areas embedded in the GAPFON® Model are expected to lead to capacity building, evidence‐based practice and ultimately improved quality of global health care. The strategies for implementation identified by regional stakeholders can have an impact on the global health agenda by focusing on nurses and midwives as the drivers of this change.
To explore the experience and feelings associated with the endocrine therapy treatment trajectory in women with breast cancer and what affects medication taking behaviour.
Qualitative systematic review
Qualitative studies were extracted from PubMed, EMBASE, CINAHL, PsycINFO from inception of each database until February 2019.
The systematic search method SPIDER (sample, phenomenon of interest, design, evaluation, research type) was used. Thematic synthesis of the qualitative data was used.
A total of 478 were identified in the initial search. Only 17 articles met inclusion criteria and were included in this review. Five analytical themes and 17 descriptive subthemes were identified.
The systematic review highlights knowledge, balancing the scales, self‐efficacy and support influence medication taking behavior to women with breast cancer.
To examine the content, focus and effectiveness of person‐centred care (PCC) interventions aimed at increasing staff PCC behaviour in health and social care settings for people with dementia.
Systematic search and narrative synthesis of quantitative data.
PsychINFO, Medline, EMBASE, Web of knowledge, CINAHL, ASSIA and BNI were searched from inception to 5 November 2016.
All records retrieved were screened using predetermined eligibility criteria. Quality assessment was performed with the Effective Public Health Practice Project tool (EPHPP).
A total of 4,367 records were screened and 33 studies examining the impact of PCC interventions were included. Eight different categories of PCC intervention were identified, with seven of these having at least some evidence to support their effectiveness in increasing staff PCC behaviour.
The range of interventions and outcome measures identified in this review highlight different ways PCC behaviour can be demonstrated by staff and the range of interventions that can be used to enhance PCC staff behaviour. Future, more rigorously controlled research comparing the relative effectiveness of these interventions, will support nursing facilities and staff to choose appropriate interventions to support them in enhancing PCC.
This study addressed the health priority of increasing PCC for people with dementia. It found preliminary evidence that seven of the eight intervention types identified are effective at increasing staff PCC behaviour in health and social care settings for people with dementia.
To describe the type and the amount of formal and informal care received during the first year after home discharge and to identify the baseline predictors of the formal and informal care needs of stroke survivors.
Longitudinal study. Data were collected between June 2013–May 2016.
Survivors (N = 415) were enrolled during discharge from rehabilitation hospitals and interviewed at 3 (T1), 6 (T2), 9 (T3), and 12 (T4) months. The linear mixed effects model with random intercept and random slopes was used to trend for the amount of formal and informal care received by survivors during the four observation times.
Regarding formal care, only physiotherapy and speech therapy decreased significantly over time. Stroke survivors received a mean of 17 hr of paid informal care per week at T1 and these hours did not significantly decrease after one year from discharge, while unpaid informal care decreased significantly over time. Higher numbers of paid informal caregiving were predicted by older age, higher education levels, lower physical functioning, and living without unpaid informal caregivers while higher numbers of unpaid informal care were predicted by lower physical functioning and living with unpaid informal caregivers.
Stroke has a great effect on survivors’ lives. During the first few months after rehabilitation hospital discharge, survivors need further care because they are often discharged before achieving independent functioning.
The results of this study could be important to guide future interventions aimed at imporving stroke survivors' conditions after post rehabilitation hospital discharge.
To examine the experiences of health transitions for young people with intellectual disabilities and their carers and identify the implications for nursing practice.
A systematic review and critical appraisal of qualitative, quantitative, and mixed methods studies.
A search of the relevant literature published 2007–2017 was carried out in AMED, ASSIA, CINAHL, MEDLINE, PsycINFO, PubMed, and Science Direct Sociological Abstracts databases.
A total of 12 of 637 papers identified in the search met the inclusion criteria for this review. A narrative review of the papers was undertaken by synthesizing the key findings and grouping them into concepts and emergent themes.
Four main themes were identified: (a) becoming an adult; (b) fragmented transition process and care; (c) parents as advocates in emotional turmoil; and (d) making transitions happen.
The range of issues that have an impact on the transition from child to adult health services for young people with intellectual disabilities and their carers raise important implications for policy development, nursing practice, and education.
在AMED、ASSIA、CINAHL、MEDLINE、PsycINFO、PubMed和Science Direct Sociological Abstract数据库中搜索了2007至2017年间发表的相关文献。