The objective of this review was to elucidate the evidence related to utilizing e-Health as a tool in improving the quality of life of informal caregivers of dependent patients due to cerebrovascular accident (CVA).
This systematic review with meta-analysis includes 13 studies. For these studies, seven databases were searched between 2009 and 2019. A random-effects model was adopted for overall estimation and to explain the heterogeneity.
A random-effects model was adopted for overall estimation and to explain heterogeneity. The results did not demonstrate statistical significance (p<0.05) and low heterogeneity (I 2 = 0).
There is a tendency toward improvement in psychological health, solving care-related problems, as well as better prevention of problems arising from the burden. Therefore, new studies with larger sample size and primarily to conduct them for more than 6 months for the accuracy.
This study reflects a trend toward improving psychological health, solving care-related problems, as well as improved the prevention of problems arising from the burden.
The purpose of this study was to assess the extent to which academic promotion and tenure (APT) criteria and guidelines in schools of nursing recognize predatory publishing. This assessment included an analysis of APT documents looking specifically for guidance about predatory publications by faculty in schools of nursing.
This study used a cross-sectional, descriptive design and was conducted in 2020.
A mixed methods approach was used to collect data from two sources. Data were extracted from APT documents for 92 research-intensive universities found online and specifically focused on documents for universities and for schools of nursing in the United States. Interviews were conducted with a subsample of academic administrators (n = 10) from selected schools.
The majority (57%; n = 50) of APT documents reviewed addressed quality of the journals in which faculty publish. However, very nonspecific terms, such as “high quality” or “peer reviewed” were used. None of the documents reviewed (n = 88) included any reference to predatory journals. Deans who were interviewed validated the analysis of the APT documents. While most deans reported faculty were aware of predatory journals and the risks of publishing in them, formal guidelines for consequences for publishing in predatory journals were not developed or available.
This study examined how schools of nursing in research-intensive universities address the issue of predatory journals. APT criteria do not provide guidance to faculty and promotion and tenure committees about issues related to predatory publications as low-quality publication outlets. Recommendations for APT committees, mentors, and faculty are provided.
Clinicians rely on researchers, many of whom are faculty, to publish rigorous studies that produce evidence they can translate into practice. One measure of the quality of a study's findings is where the paper is published and reflects the level of peer review it has been through. Faculty who publish in predatory journals may not have had their work reviewed by experts; evidence produced may or may not be adequate for translation to guide nursing practice.
To identify the potential benefits of heightened levels of affect balance in older adults with and without chronic pain on various cognitive domains, physical performance, and perceived cognitive and physical health.
Ninety-one older adults, some with and some without fibromyalgia (FM) participated. Objective tests included cognitive (immediate and delayed recall, delayed recognition—CERAD 10-item word list) and physical measures (Fullerton Advanced Balance Scale; lower body strength—30-s chair stand; gait velocity—30-ft. walk). Self-report measures were problems with forgetting, activities of daily living (perceived function), and affect (Positive and Negative Affect Scale [PANAS]). Affect balance was calculated as positive minus negative affect from the PANAS.
Hierarchical regression analyses revealed that—regardless of FM status—higher affect balance was associated with better episodic memory performance (immediate recall, delayed recognition), better balance, enhanced lower body strength (more chair stands), and healthier gait (30-ft. walk), as well as less forgetfulness and better perceived functional health.
Increased affect balance was associated with better objective and subjective health in older adults both without and with chronic pain. Positive psychology treatments which increase affect balance are easy to administer, cost effective, and may add an important, additional treatment modality for maintaining health in normal aging adults as well as those with chronic pain.
In order to help patients with healthy aging, nurses need to be aware of the potential long-term effect of emotional state on overall function and be able to counsel patients regarding potential treatments to enhance positive global emotions such as resilience.
The aim of this study was to examine the association between obstructive sleep apnea (OSA) diagnosis and diverse types of injuries.
This population-based retrospective cohort study compared records from 2000 to 2013 in the Taiwan National Health Insurance Research Database.
3025 patients identified with OSA were compared against the control cohort consisting of 12,100 age- and sex-matched patients. Cox proportional hazards regression analysis was performed to estimate the effects of OSA on injury risk.
Patients with OSA exhibited a significantly higher overall incidence of injury of 2599 per 100,000 person-years compared to the control cohort (2248 per 100,000 person-years). After the confounding factors were considered, subjects with OSA showed a higher risk of injury than subjects in the control group (adjusted hazard ratio [HR] = 1.78, 95% confidence interval [CI] = 1.64–1.93). The risk of unintentional injury (traffic, poisoning, falls) and intentional injury (suicide) in the group of patients with OSA was higher than that in the controls.
Our study strongly supports the conclusion that adults with OSA are at increased risk of injury.
The present results indicate the significance of OSA as a predictor of injury risk, which will provide valuable information for clinical practice and injury prevention.
Preschool-age children in hospitals are at a high risk of unexpected incidents. Safety incidents in hospitals can cause serious damage to the children.
To determine the effectiveness of the mobile-type mHealth Safe Kids Hospital (SKH) application (app) for the prevention of hospitalized child safety incidents.
This study used a three-group, randomized controlled trial pre-post design.
This study was conducted in the pediatric ward of three general hospitals in Korea.
A total of 124 eligible hospitalized children and their caregivers were enrolled in the study from June to December 2018. Of these, 116 finally participated in the study, and 8 were excluded because they were discharged before the intervention.
Hospitalized preschool-age children and their caregivers were randomly allocated into three groups: experimental group I (n = 39), experimental group II (n = 39), and the control group (n = 38). Experimental group I received the SKH app intervention, the experimental group II received a paper-based intervention, whereas the control group received the usual intervention. Participants’ outcomes of awareness, knowledge, and behavior related to hospital safety, were assessed at two time points: baseline and 24 h after the intervention.
Hospital safety awareness had a higher increase after intervention in experimental groups I and II than in the control group. Among the four subdomains of hospital safety awareness, there was a significant increase in the scores of experimental group I on three subdomains after the intervention: falls (F = 8.19, p < 0.001), burns (F = 6.73, p = 0.002), and medical devices (F = 6.81, p = 0.002). In hospital safety knowledge and safety behavior, experimental group I had the highest average score after the intervention compared with experimental group II and the control group; however, there was no statistically significant difference in the average score of the three groups.
Using the SKH app is easy to attract the interest of preschool-age children and is also easy for nurses to use in clinical trials; thus, it is considered to be a useful educational intervention to prevent safety incidents in clinical fields in future.
It is thought to contribute to the prevention of preschool-age children's safety incidents in pediatric wards.
COVID-19 has presented health care professionals with unprecedented challenges. Significant risks have emerged as nurses have continued to work in delivering frontline health care during the pandemic. Feeling “at risk” has significant deleterious effects on nurses. The study sought to explore the perceptions of risk by Australian primary health care nurses (PHC) during COVID-19.
Twenty-five Australian PHC nurses were purposively recruited from survey respondents who indicated a willingness to be interviewed. Phone interviews were undertaken between June and August 2020. Audio-recordings were transcribed and analyzed thematically.
Participants shared concerns about risks in the workplace that emerged during COVID-19 and described the strategies used to mitigate these identified risks. Three themes were identified: (a) Professional concerns, (b) Personal/family concerns, and (c) Patient needs.
Understanding PHC nurses’ perceptions of risk during COVID-19 provides an important insight into how they can be better supported to manage the risks that they face and feel safer in their workplace. Ensuring that PHC nurses are well-supported is important to optimize job satisfaction, reduce burnout and improve patient care.
There is a need to ensure that nurses feel safe during crises such as pandemics to protect both individual nurses and the broader workforce. Protecting the health workforce is essential to optimizing service delivery and promoting health outcomes.
The objective of this study was to determine how anxiety and/or depressive symptoms differentially affect specific cognitive domains over time in persons with subjective cognitive decline (SCD).
A longitudinal, observational study was conducted using data from the National Alzheimer’s Coordinating Center-Uniform Data Set. Mean follow-up was 4.1 ± 2.4 years.
Using information from a total of 1401 participants (age 74.0 ± 8.2 years), linear mixed-effects regression models were used to assess longitudinal changes in global cognition, episodic memory, attention, language, and executive function by baseline psychological (anxiety [A] and/or depressive [D]) symptoms in individuals with SCD. Reference was the group having no symptoms (A−/D−).
The A+/D− group was not associated with any cognitive changes. The A−/D+ group was associated with a greater decline in episodic memory and executive function. The A+/D+ group had a greater decline in attention. Changes in global cognition and language were not predicted by any psychological symptoms.
Depressive symptoms predicted lower episodic memory and executive function.
Nurses need to pay attention to depressive symptoms in older adults with SCD because managing depressive symptoms may help protect against cognitive decline more typical of early Alzheimer’s dementia.
Organizational context influences the effect of facilitation efforts on research use in care settings. The interactions of these factors are complex. Therefore, the use of traditional statistical methods to examine their interrelationships is often impractical. Big Data analytics can automatically detect patterns within the data. We applied the chi-squared automatic interaction detection (CHAID) algorithm and classification tree technique to explore the dynamic and interdependent relationships between the implementation science concepts—context, facilitation, and research use.
Observational, cross-sectional study based on survey data collected from a representative sample of nursing homes in western Canada.
We assessed three major constructs: (a) Conceptual research utilization (CRU) using the CRU scale; (b) facilitation of research use measured by the frequency of contacts between the frontline staff and a clinical educator, or person who brings new ideas to the care unit; and (c) organizational context at the unit level using the Alberta Context Tool (ACT). CHAID analysis was performed to detect the interactions between facilitation and context variables. Results were illustrated in a classification tree to provide a straightforward visualization.
Data from 312 care units in three provinces were included in the final analysis. Results indicate significant multiway interactions between facilitation and various aspects of the organizational context, including leadership, culture, evaluation, structural resources, and organizational slack (staffing). Findings suggested the preconditions of the care settings where research use can be maximized.
CHAID analysis helped transform data into usable knowledge. Our findings provide insight into the dynamic relationships of facilitators’ efforts and organizational context, and how these factors’ interplay and their interdependence together may influence research use.
Knowledge of the combined effects of facilitators’ efforts and various aspects of organizational context on research use can contribute to effective strategies to narrow the evidence-practice gap in care settings.
We aimed to synthesize the published evidence to evaluate the preventive efficacy of ginger on postoperative nausea and vomiting (PONV).
A systematic review and meta-analysis were conducted in this study.
PubMed, EMBASE, Cochrane Library, and CINAHL were systematically searched from their outset to October 2020, without language limitation. Randomized controlled trials (RCTs) comparing the effects of ginger and prophylactic antiemetics or placebo on PONV were included. Data were analyzed by the fixed effects model or random effects models regarding the results of heterogeneity.
A total of 14 studies involving 1417 participants were included. Compared with placebo, the ginger group had significantly lower nausea severity (MD = −0.71, 95% CI = −1.37 to −0.06, p = 0.03) and lower proportion of rescue antiemetic use (RR = 0.71, 95% CI = 0.62–0.82, p < 0.001; RR = 0.71, 95% CI = 0.56–0.91, p < 0.001). The ginger group had significantly lower incidence of nausea and vomiting over 6 h after operation (RR = 0.68, 95% CI = 0.55–0.85, p < 0.001; RR = 0.78, 95% CI = 0.42–1.44, p = 0.43) compared with placebo. When compared with the prophylactic antiemetic group, the ginger group had significantly lower incidence of nausea (RR = 0.75, 95% CI = 0.56–0.99, p = 0.04), but no significant differences in the incidence of vomiting and proportion of rescue antiemetic use were found.
Ginger was effective for the prevention of PONV. More RCTs comparing ginger and other prophylactic antiemetics are needed to evaluate whether ginger could replace the traditional prophylactic antiemetics.
This study’s results could be used as an evidence for all patients following surgery who are at risk of PONV without allergy to ginger.
The purpose of this study was to examine psychological safety as a mediator of the relationship between inclusive leadership and nurses’ voice behaviors and error reporting. Voice behaviors were conceptualized as speaking up and withholding voice.
This correlational study used a web-based survey to obtain data from 526 nurses from the medical/surgical units of three tertiary general hospitals located in two cities in South Korea.
We used model 4 of Hayes’ PROCESS macro in SPSS to examine whether the effect of inclusive leadership on the three outcome variables was mediated by psychological safety.
Mediation analysis showed significant direct and indirect effects of nurse managers’ inclusive leadership on each of the three outcome variables through psychological safety after controlling for participant age and unit tenure. Our results also support the conceptualization of employee voice behavior as two distinct concepts: speaking up and withholding voice.
When leader inclusiveness helps nurses to feel psychologically safe, they are less likely to feel silenced, and more likely to speak up freely to contribute ideas and disclose errors for the purpose of improving patient safety.
Leader inclusiveness would be especially beneficial in environments where offering suggestions, raising concerns, asking questions, reporting errors, or disagreeing with those in more senior positions is discouraged or considered culturally inappropriate.
To assess spiritual distress in patients with cancer who were initiating chemotherapy.
This was a quantitative, observational, cross-sectional study. Data collection was conducted between February and June of 2019. The Spiritual Distress Scale (SDS) was administered to 332 patients with cancer.
Most participants (56.6%) were female, with the mean age at 60.3 years (SD = ±11.73). The mean SDS score was 56.6 (SD = ±13.39), with 30% of the participants reporting moderate and 9.6% reporting high levels of spiritual distress. Younger age (β = -0.687, p = .008) and participants having no religious affiliation were predictors of SDS (β = -8.322, p = .035) in patients with cancer initiating chemotherapy.
Given the degree of spiritual distress reported, this study provides further evidence to support the need for nurses to assess spirituality in order to provide holistic care inclusive of spiritual domain.
These results are relevant to clinical practice and indicate a need for nurses to use the clinical reasoning process to assess spiritual distress and to plan nursing interventions aimed at meeting the spiritual needs of patients with cancer who are initiating chemotherapy.
The purpose of this study was to examine the relationship between emotional intelligence and nurse–nurse collaboration among registered nurses in Jordan.
This study used a cross-sectional, quantitative survey design to query 342 nurses who worked in two hospitals in Jordan.
We used Arabic versions of valid, reliable instruments to measure emotional intelligence and nurse–nurse communication.
A total of 311 questionnaires were returned (91% response rate). Nurses’ emotional intelligence was positively and significantly correlated with the nurse–nurse collaboration subscales. The results also indicated a statistically significant mean difference in communication subscale scores by gender and nursing unit.
The present study demonstrated that nurse–nurse collaboration is linked to benefits for nurses in terms of improved job satisfaction, better nurse retention, improved quality of patient care, and enhanced healthcare efficiency and productivity. This suggests that improving nurse–nurse collaboration may have spillover effects of benefits, not only for nurses but for patients, organizations, and the overall healthcare system.
Building an environment that encourages collaboration among nurses can greatly impact the performance of nurses and its benefit to nurses. Encouraging employees to participate in activities and to collaborate in making this an integral part of their evaluation will contribute to improving the teamwork in patient care.
To explore the association of genomic knowledge, self-epistemic authority (SEA; i.e., subjective perception of knowledge expertise), perceived importance of genomics in nursing, and the integration of genomic skills into nursing practice.
A cross-sectional study of nurses working in pediatric, obstetric, and internal wards of two medical centers in Israel between February and October 2018.
Participants completed anonymous questionnaires about genomic knowledge, SEA, perceived importance of genomics, and the performance of genomic skills in nursing practice. Associations between variables were analyzed using Pearson correlations, and a hierarchical regression model was used to determine which variables explained the performance of genomic practices among participants.
Altogether 423 nurses participated in the study. The mean genomic knowledge was low (55.05 ± 14.82%). Nurses reported a low integration of genomic skills in their practice (M = 1.90, SD = 0.71), although their overall perceived importance of genomics was positive (M = 2.88, SD = 0.68). Positive correlations were found between SEA and the integration of genomic skills in nursing practice. Obstetric nurses had more genomic knowledge, more positive perceptions about genomics, and performed more genomic skills in their nursing practice.
Although nurses realized the importance of genomics to their practice, and genomics is part of the Israeli nursing core curriculum, we found disappointingly low levels of knowledge and performance of genomic skills in nursing practice.
The results call for action to establish ongoing education programs in genomics for nurses, which would lead to the inclusion of genomic skills into routine nursing practice, and prepare nurses for providing personalized medicine.
The worldwide outbreak of the COVID-19 pandemic has posed challenges for nurses. The aim of this study was to examine the managerial and clinical challenges of nurse managers in mental health centers during the current COVID-19 pandemic.
A mixed-methods study based on an analysis of data obtained in focus groups with 25 nurse managers from two mental health centers in Israel.
The quantitative phase was conducted prior to the group sessions using a structured self-administered questionnaire that examined the nurse managers’ (a) background data, (b) communication with the staff nurses, (c) perceptions of nurses’ functioning, (d) perceptions of their own functioning, and (e) management as impacted by the pandemic. The qualitative phase included three sessions of focus groups in which the nurse managers discussed both their challenging and positive issues during the pandemic.
The most important challenges were related to the need to protect patients from infection and communicating with families and primary caregivers. Work policies and procedures were less well adapted to pandemic conditions; nevertheless, nurse managers felt a sense of purpose, duty, and pride in their work. Three themes emerged: (a) "management complexity" included the change from a familiar routine to a new reality, working in capsules, protecting against infection, functional confusion, and insights into future epidemics; (b) "challenging communication" included communication with patients through glass walls and communication with staff through screens and (c) "bright spots" referred to staff cohesion and the provision of respectful care.
Mental health nurse managers have experienced during the pandemic a change in their roles from being less managerial to focusing more on clinical work. Communication between nurse managers and staff nurses and between mental health patients and staff were the main challenges. Nurse managers favorably noted the uniformity and humanity of the staff, sense of cohesion, and shared responsibility.
In the first wave of the pandemic, there was confusion as to the functional role of ward nurse managers, as the focus of their activities became more clinical and less managerial. During and after the pandemic, preventive interventions should be carried out in order to assist patients, staff nurses, and nurse managers in mental health centers.
To use the Delphi Method to identify strategies used by triage nurses to effectively manage interruptions.
This study was based on the concepts of Benner’s Novice to Expert Model. An online, modified Delphi approach was used to engage triage, education, and operational management experts in generating consensus recommendations on successful strategies to address triage interruptions in the emergency department.
A panel of nine triage, education, and operational management experts were selected based on their publication and presentation history. This panel participated in three Delphi rounds, providing individual responses during each round. All responses were entered into a RedCap database, which allowed research team members to synthesize the results and return summaries to the participants. Final consensus was reached among this panel regarding recommendations for successful strategies to address triage interruptions that can be encompassed in a training module. The experts were then asked to identify the best instructional modality for teaching each of the interruption management strategies.
Eight strategies to mitigate the impact of interruptions were identified: (a) ensure nurses understand impact of interruptions; (b) ensure nurses understand consequences of interruptions on cognitive demands of healthcare workers that could influence behavior and lead to errors; (c) apologize to current patient before tending to interruption and give expectation of when you will return; (d) triage the interruption and decide to (i) ignore interruption, (ii) acknowledge, but delay servicing, interruption, or (iii) acknowledge and service interruption, delaying completion of interrupted task; (e) identify urgent communication as anything clinically significant that impacts the patient immediately or requires immediate intervention; (f) use focused questions to clarify whether interruption can wait; (g) redirect nonpriority interruptions; and (h) finish safety-critical task or tasks near completion before tending to an interruption. The Delphi participants recommended the best teaching modality was simulation for six of the strategies.
Participants agreed that there are strategies that can be taught to novice triage nurses to mitigate the impact of interruptions. The experts in operations management, emergency nursing, and education agree that creating simulations to teach each of these strategies is an effective way to educate nurses.
Interruptions impact the quality of care provided to patients. Training nurses to prevent interruptions and mitigate the impact of interruptions when they occur has the potential to improve patient outcomes.
Telehealth’s uptake has increased substantially in recent years, with an especially large jump in 2020 due to the emergence of COVID-19. This article provides background on and explores “telepresence” in healthcare literature. Telepresence strongly impacts the patient experience, but it is poorly defined in current research. The aim was to conceptually define telepresence using qualitative methods.
Dimensional analysis was used to analyze telepresence in clinical literature and create a clearer definition of telepresence as a concept. Multiple databases were searched for articles related to telepresence. Thirteen international articles related to telepresence were selected for analysis.
Dimensional analysis allowed for multiple viewpoints to be explored within each distinct context and perspective.
Twenty-five dimensions were discovered within the articles, which were synthesized to seven core dimensions of telepresence: connection, technological mediation, experienced realism, trust, being supportive, collaboration, and emotional consequence.
Telepresence is highly impactful on the patient’s experience of telehealth care visits. The conceptual map produced by this dimensional analysis provides direction for clinicians to improve their ability to be present with patients during telehealth care. Potential implications include a starting point for future qualitative research, and the use of this dimensional analysis to inform clinical guidelines, improve clinician training, and assist in the development of new care models.
A telepresence definition brings clarity to an ill-defined concept. COVID-19 magnifies the need for a better understanding of telepresence, which allows clinicians to improve telehealth encounters.
To highlight ongoing and emergent roles of nurses and midwives in advancing the United Nations 17 Sustainable Development Goals by 2030 at the intersection of social and economic inequity, the climate crisis, interprofessional partnership building, and the rising status and visibility of the professions worldwide.
Realizing the Sustainable Development Goals will require all nurses and midwives to leverage their roles and responsibility as advocates, leaders, clinicians, scholars, and full partners with multidisciplinary actors and sectors across health systems.
Making measurable progress toward the Sustainable Development Goals is critical to human survival, as well as the survival of the planet. Nurses and midwives play an integral part of this agenda at local and global levels.
Nurses and midwives can integrate the targets of the Sustainable Development Goals into their everyday clinical work in various contexts and settings. With increased attention to social justice, environmental health, and partnership building, they can achieve exemplary clinical outcomes directly while contributing to the United Nations 2030 Agenda on a global scale and raising the profile of their professions.
In 2015, all member states that comprise the United Nations unanimously adopted the Sustainable Development Goals (SDGs), a set of ambitious and inclusive targets toward global economic, social, and environmental betterment. Nurses have a key role to play in the achievement of the SDGs. The aim of this article was to conduct a scoping review to synthesize the literature related to nursing and the SDGs.
This scoping review utilized Arksey and O’Malley’s five-stage framework. Several electronic databases were searched for literature published from 2015 to 2020 using the key words “nurse OR nurses OR nursing” and “Sustainable Development Goals OR SDGs”.
A total of 447 articles were identified through the databases searches, of which 35 articles were deemed relevant and included for final review and content analysis. Analysis of relevant literature on nursing and the SDGs revealed two distinct, yet connected, perspectives: the nurse and the profession.
Individual nurses may feel disconnected from the SDGs and struggle to relate the goals to their clinical role, calling for an increase in awareness and education on the goals. The wider profession could also increase both research and policy with relation to the SDGs, strengthening nursing’s position to have a voice in and contribute towards achievement of the goals.
Individual nurses and the wider nursing profession have opportunities to more meaningfully contribute to the SDGs, beginning with an increased awareness through education and a commitment to research and participation in local and global decision making.