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It is unclear whether an implantable cardioverter-defibrillator (ICD) is generally beneficial in survivors of out-of-hospital cardiac arrest (OHCA).
We studied the association between ICD implantation prior to discharge and survival in patients with cardiac aetiology or initial shockable rhythm in OHCA.
We conducted a retrospective cohort study in the Swedish Registry for Cardiopulmonary Resuscitation. Treatment associations were estimated using propensity scores. We used gradient boosting, Bayesian additive regression trees, neural networks, extreme gradient boosting and logistic regression to generate multiple propensity scores. We selected the model yielding maximum covariate balance to obtain weights, which were used in a Cox regression to calculate HRs for death or recurrent cardiac arrest.
All cases discharged alive during 2010 to 2020 with a cardiac aetiology or initial shockable rhythm were included. A total of 959 individuals were discharged with an ICD, and 2046 were discharged without one.
Among those experiencing events, 25% did so within 90 days in the ICD group, compared with 52% in the other group. All HRs favoured ICD implantation. The overall HR (95% CI) for ICD versus no ICD was 0.38 (0.26 to 0.56). The HR was 0.42 (0.28 to 0.63) in cases with initial shockable rhythm; 0.18 (0.06 to 0.58) in non-shockable rhythm; 0.32 (0.20 to 0.53) in cases with a history of coronary artery disease; 0.36 (0.22 to 0.61) in heart failure and 0.30 (0.13 to 0.69) in those with diabetes. Similar associations were noted in all subgroups.
Among survivors of OHCA, those discharged with an ICD had approximately 60% lower risk of death or recurrent cardiac arrest. A randomised trial is warranted to study this further.
The study was carried out to investigate the effect of motivational interviewing on peer bullying and cyberbullying among adolescents.
A parallel-group randomized controlled trial.
The study population consisted of ninth-grade (aged 14 years) high school students (n = 200). The study was completed with 48 participants (intervention: 24; control: 24). The data were collected using the Participant Information Form, the Stages of Change Questionnaire, the Peer Bullying Scale, and the Cyberbullying Scale. The intervention group received a preparatory session and five weekly motivational interviewing sessions. Instruments were administered to both groups before the intervention, at the end of the last motivational interviewing session (post-test), and at 3rd- and 6th-month follow-ups. The data were analyzed using chi-square test, independent sample t-test, and two-way mixed-design ANOVA with Bonferroni's test.
In the pre-test, no statistically significant difference was observed between the intervention and control groups regarding mean scores for peer bullying and cyberbullying (p > 0.05). Following the motivational interviewing sessions, adolescents in the intervention group had a significantly lower mean score for peer bullying and cyberbullying than the control group at the post-test and follow-up tests (p < 0.001).
The present study concluded that motivational interviewing effectively reduced peer bullying and cyberbullying behaviors among adolescents.
Nurses would implement motivational interviewing to prevent bullying behaviors in schools.
This study aimed to investigate the relationship between nurses' perception of toxic leadership and their organizational trust levels and turnover intentions.
This cross-sectional study was conducted using an online survey of 168 nurses working in public and university hospitals.
Data were collected between April and November 2022 with the Toxic Leadership Scale, Organizational Trust Scale and Turnover Intention Scale. Descriptive statistics, correlations, and regression analyses were used to analyse these data.
It was determined that almost half of the nurses (46.4%) were exposed to negative behaviours from their managers within the last year. Nurses' perception of toxic leadership, organizational trust level and turnover intention were moderate. It was found that nurses' perceptions of toxic leadership had a negative effect on organizational trust level (R 2 = .691; β = −0.832; p < .05) and a positive significant effect on turnover intention (R 2 = .267; β = 0.521; p < .05).
This study revealed that toxic leadership behaviours in health organizations should be struggled with to increase nurses' organizational trust and reduce their turnover. In this context, an organizational culture in which toxic behaviours are not tolerated should be established in health organizations.
What problem did the study address? In the literature, mostly positive leadership behaviours of nurse managers are emphasized and little is known about their negative behaviours such as toxic leadership.
What were the main findings? It was determined that nurses who perceived more toxic behaviour from their managers had less trust in their organizations and higher turnover intention.
On whom will the research have an impact? To provide a positive working environment and reduce turnover, it is necessary to create an organizational culture in which the toxic behaviours of nurse managers are not tolerated.
No patient or public contribution.
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