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Ayer — Enero 17th 2026Tus fuentes RSS

Measuring the Core Competency of Community Nurses for Public Health Emergencies: Instrument Development and Validation

ABSTRACT

Aim

To develop a comprehensive and psychometrically validated scale for evaluating the core competencies of community nurses for public health emergencies.

Design

A study of instrument development and validation was conducted.

Methods

A total of 1057 community nurses provided valid responses for this study conducted in Shanghai, China. Building upon previous study findings of the adapted core competency model and integrating the World Health Organisation's Framework for Action, this study was conducted in two phases. First, scale items were developed through systematic review, qualitative research, stakeholder meeting, and Delphi survey, refined with cognitive interviews to establish version 1.0 of the scale. Second, item analysis was performed with item-total correlations, Cronbach's alpha, and exploratory factor analysis, resulting in version 2.0. The final scale was produced after assessing the validity (content validity, confirmatory factor analysis, known-groups validity) and reliability (internal consistency, test–retest reliability).

Results

The final scale consisted of 47 items categorised into four competency factors: prevention, preparation, response, and recovery competency. Factor analysis results indicated adequate factor loadings, excellent model fit, and well-established construct validity. The overall scale and its sub-factors exhibited high internal consistency and good test–retest reliability.

Conclusions

The study presents a theoretically grounded and scientifically validated scale measuring the competencies that community nurses need for public health emergency response.

Implications for the Profession

This study enhances the theoretical framework of community nurses' core competencies in public health emergencies, provides a validated assessment tool, and clarifies their role in enhancing preparedness and effectiveness.

Impact

The study addressed the need for a standardised tool for assessing community nurse core competency for public health emergencies and will impact policy initiatives to enhance early prevention, emergency response, and integrated recovery practices in crisis management.

Reporting Method

Strengthening the Reporting of Observational studies in Epidemiology checklist.

Patient or Public Contribution

No Patient or Public Contribution.

Effects of Nursing Workforce and Work Environment on Health System Resilience in Public Health Emergencies: A Multicenter Cross‐Sectional Study

ABSTRACT

Aim

The study examines the associations between nursing competence, work environment, and health system resilience. It also analyzes how nursing competence and work environment relate to different patterns of health system resilience.

Design

A multiple center cross-sectional study was conducted between December 2023 and January 2024 across 33 hospitals in eastern China, involving 2435 nurses.

Methods

Questionnaires measuring nursing competence, work environment resources, nurse disaster resilience, and organizational commitment to resilience were utilised, along with the collection of additional personal demographic data. Structural equation modelling and cluster analysis were performed to explore the underlying mechanisms within the overall model and across multiple groups. Multivariable regression was conducted to identify variables associated with resilience in different subgroups.

Results

Structural equation modelling demonstrated significant influences of nursing competence and work environment support on system resilience. Cluster analysis identified four resilience patterns: strong, marginal, low, and critical vulnerability. Strong resilience correlated with balanced individual-organizational resources, while vulnerable systems relied heavily on environmental support.

Conclusion

Our findings support policymakers and managers in developing systematic strategies with distinct focal points—targeting nurse workforce investment and optimised work environment—to enhance health system resilience across varying levels of public health emergencies.

Implications for the Profession

This study validated the framework connecting individual and organizational resilience, offering evidence-based insights for nurse training and resource allocation to enhance healthcare systems' adaptability during disasters.

Impact

The study addressed how nursing competence and work environment significantly influenced resilience during public health emergencies, identified four resilience patterns, and provided insights to guide policymakers and healthcare managers in developing targeted, effective strategies.

Reporting Method

Strengthening the Reporting of Observational studies in Epidemiology checklist.

Patient or Public Contribution

No patient or public contribution.

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Effectiveness of Nurse‐Led Interventions on Emergence Delirium in Pediatric Patients: A Systematic Review and Meta‐Analysis

ABSTRACT

Background

Nurse-led interventions have demonstrated effectiveness in managing emergence delirium (ED), but there is a lack of evidence in pediatric studies.

Aim

To systematically synthesize the evidence on the effectiveness of the nurse-led interventions on ED in pediatric patients.

Study Design

A comprehensive literature search was conducted in PubMed, CINAHL, EMBASE, MEDLINE, Web of Science, Cochrane Library, and APA PsycINFO from the inception to January 13, 2025. Risk of bias was assessed by using the revised Cochrane risk-of bias tool (ROB2) and the Cochrane risk of bias in non-randomized studies-of interventions (ROBINS-I). The meta-analysis was performed using Stata16.0. The forest plots showed the overall effect of the included study.

Results

A total of 20 studies were included, involving 2369 children, comprising 17 RCTs, 1 quasi-experimental study and 2 cohort studies. Compared with usual care, nurse-led interventions significantly reduced the incidence of ED (risk ratio [RR]: 0.50, 95% confidence interval [CI]: 0.33 to 0.77, p = 0.002, I 2 = 77.2%), m-YPAS scores (weighted mean difference [WMD]: −7.67, 95% CI: −10.96 to −4.39, p = 0.000, I 2 = 91.7%), PAED scores (WMD: −1.47, 95% CI: −2.35 to −0.60, p = 0.000, I 2 = 91.3%), and FLACC scores (WMD: −0.97, 95% CI: −1.59 to −0.35, p = 0.000, I 2 = 92.9%). However, no significant effect was observed on the length of PACU stay or the anesthesia induction compliance.

Conclusions

Nurse-led interventions can reduce the incidence and severity of ED in children, as well as in alleviating preoperative anxiety and postoperative pain. However, more research is needed on influencing PACU length of stay and induction compliance.

Relevance to Clinical Practice

Nurse-led interventions can be integrated into the perioperative management of children to reduce the incidence of ED. However, in clinical practice, these interventions should be flexibly adapted based on the individual differences of pediatric patients.

Trial Registration

This study protocol was registered on PROSPERO with the registration number CRD42024601191

The Relationship Between Work Engagement and Safety Behaviour of Oncology Nurses: A Latent Profile Analysis

ABSTRACT

Aims

This study aims to identify distinct profiles of work engagement among oncology nurses through Latent Profile Analysis and explore how these profiles influence nurse safety behaviour.

Design

A cross-sectional design with latent profile analysis.

Methods

A total of 957 oncology nurses from tertiary hospitals across five provinces and municipalities in China participated in this questionnaire-based study. Data were collected on demographic information, the Work Engagement Scale, the General Self-Efficacy Scale and the Nurse Safety Behaviour Scale. The analysis was conducted using SPSS 24.0 and Mplus 8.3, with Latent Profile Analysis, R3STEP and BCH methods employed to uncover underlying patterns and relationships.

Results

The results revealed three distinct profiles of work engagement: ‘Highly Efficient and Focused Type’ (43.7%), ‘Moderately Balanced Type’ (37.4%) and ‘Low Effort and Coping Type’ (18.9%). The distribution of these profiles was closely related to factors such as weekly working hours, adverse event experiences, safety training experiences and self-efficacy. Moreover, these work engagement profiles positively impacted nurse safety behaviour.

Conclusion

The study demonstrates that different work engagement profiles significantly influence the safety behaviour of oncology nurses. Key factors such as weekly working hours, adverse event experiences, safety training experiences and self-efficacy play a crucial role in shaping these work engagement profiles.

Implications for the Profession

The findings provide a new perspective and intervention approach for enhancing work engagement and nurse safety behaviour. It is recommended that hospital management develop personalised training and incentive measures tailored to nurses with different characteristics to improve overall nursing quality and patient safety.

Patient or Public Contribution

No patient or public involvement.

Empathy and Humanistic Care Ability in Oncology Nurses: The Mediating Role of Emotional Intelligence

ABSTRACT

Aim

To investigate the level of humanistic care ability of oncology nurses, its association with empathy and emotional intelligence, and the mediative role of emotional intelligence on empathy and humanistic caring ability.

Design

This was a cross-sectional study conducted in a cancer hospital in China.

Methods

We enrolled a total of 1189 oncology nurses from several cancer hospitals from December 2023 to January 2024. All participants completed three general questionnaires: the Caring Ability Inventory, the Jefferson Scale of Empathy-Health Professionals and the Emotional Intelligence Scale.

Results

The overall scores for the three scales were 202.35 ± 23.89, 112.38 ± 18.85 and 137.49 ± 17.81, respectively. A positive correlation was detected between caring ability, empathy and emotional intelligence (r = 0.741, p < 0.001; r = 0.577, p < 0.001). And emotional intelligence mediates the association between empathy and caring ability in oncology nurses (0.233, p < 0.001). The total and direct effect were also significant (0.825, p < 0.001; 0.592, p < 0.001).

Conclusion

The study findings indicated that oncology nurses exhibit a moderate level of caring ability. Emotional intelligence mediates the relationship between empathy and caring ability, at least in part. Therefore, an increase in the level of emotional intelligence in oncology nurses could improve their caring ability.

Implications for the Profession and/or Patient Care

When designing training to improve humanistic care, we recommend the integration of specific training relating to empathy and emotional intelligence into the training system.

Impact

Oncology patients experience multiple forms of distress and require high-quality humanistic care. This study identified a moderate association between empathy and emotional intelligence. Our findings provide further recommendations for nurse leaders in medical institutions relating to how the humanistic care ability of oncology nurses can be improved by specific training in empathy and emotional intelligence.

Reporting Method

This study was reported using the STROBE Checklist for cross-sectional studies.

Patient or Public Contribution

Nurse leaders organised this survey in their own hospital.

Identification of pathogenic variants for the development of ultra-long axial length in myopic children

by YanYing Zhu, XueYan Li, YueXin Chen, HaiYan Xie, YuKun Liu, XiaoChen Xu, Jing Wang

Purpose

Axial elongation is a key factor in myopia progression, yet its genetic basis remains incompletely understood. This study aims to identify pathogenic genetic variants associated with excessively elongated axial length in children.

Methods

This study included 56 children with axial lengths exceeding the normal range for their age group, and whole-exome sequencing (WES) was performed on their oral mucosal samples. Clinical evaluations included axial length measurement, refraction testing, and fundus photography to assess the degree of myopia and retinal changes. Co-segregation analysis was conducted in selected families (F#1, F#2, F#5) to validate the familial inheritance patterns of the variants.

Results

Fifteen children carried variants in genes including BBS2, OPN1LW, P4HA2, FBN1, LOXL3, FZD4, USH2A, COL2A1, and BFSP2, with five novel variants identified: BBS2 (c.700C > T), P4HA2 (c.1382C > G), FBN1 (c.7130T > C), LOXL3 (c.1580delC), and FZD4 (c.1315G > A). Notably, a rare compound heterozygous BBS2 variant (c.700C > T/c.534 + 1G > T) was found in a non-syndromic child, and the P4HA2 (c.419A > G) variant in family F#5 exhibited a phenotype distinct from previous studies.

Conclusions

This study identified five novel variants sites and discovered two cases with phenotypes distinct from previous studies, thereby expanding the genetic variant spectrum associated with myopia and providing new targets for genetic screening and intervention.

Summary of the Best Evidence for Weaning From Mechanical Ventilation in Neurocritical Care Patients

ABSTRACT

Aim

The best evidence on programmed weaning from mechanical ventilation in neurocritical care patients should be gathered, evaluated, and integrated to provide an evidence basis for determining the optimal weaning program for these patients.

Methods

According to the ‘6S’ pyramid model of evidence-based practice resources, Chinese and international guideline websites, websites of relevant professional societies, and Chinese and English databases were systematically searched. The databases were searched from the time of establishment to October 2024. Literature screening was subsequently performed according to the inclusion and exclusion criteria. Two researchers independently evaluated the literature quality and extracted and summarised the evidence.

Results

A total of 21 publications were included, including 3 guidelines, 5 expert consensus papers, 1 evidence summary, and 12 systematic reviews. A total of 29 pieces of best evidence in the following 5 aspects were summarised: preweaning preparation and screening, a weaning protocol, extubation assessment, extubation preparation and procedure, and postextubation management.

Conclusions

This study summarises the best evidence for the programmed weaning of neurocritical care patients from mechanical ventilation and provides a basis for clinical medical personnel to standardise this weaning process. Evidence-based application of these strategies should be implemented to verify their clinical efficacy and safety in practice.

Implications for Clinical Practice

Successful weaning is key in the management of neurocritical care patients receiving mechanical ventilation. The establishment of a localised extubation protocol guided by a multidisciplinary team can significantly reduce the extubation failure rate, the duration of mechanical ventilation and the incidence of related complications. However, evidence-based application is needed to verify the efficacy and safety of these strategies in clinical practice.

Reporting Method

This evidence review adhered to the evidence review report guidelines formulated by the Evidence-Based Nursing Center of Fudan University. These guidelines cover aspects such as problem establishment, literature search, literature screening, literature evaluation, evidence summary and classification, as well as the formulation of practical suggestions. This evidence summary followed the evidence summary reporting specifications of the Fudan University Center for Evidence-Based Nursing (http://ebn.nursing.fudan.edu.cn) with registration number ES20244849.

Trial Registration

This study was based on the evidence summary reporting specifications of the Fudan University Center for Evidence-based Nursing; the registered name is ‘Summary of the best evidence for weaning from mechanical ventilation in neurocritical care patients’; the registration number is ES20231823

Otago exercise programme for physical function and mental health among older adults with cognitive frailty during COVID‐19: A randomised controlled trial

Abstract

Aims and Objectives

Quarantine during the COVID-19 pandemic resulted in longer-term sedentary behaviours and mental health problems. Our study aimed to evaluate the impact of the Otago exercise programme (OEP) on physical function and mental health among elderly with cognitive frailty during COVID-19.

Background

Lockdowns and restrictions during the COVID-19 pandemic result in longer-term sedentary behaviours related disease and mental problem. Older people with cognitive frailty are more vulnerable to be influenced. Timely intervention may achieve better outcomes, OEP exercise was designed as a balance and muscle-strengthening programme for elderly people.

Design

A parallel-group, assessor-blinded randomised controlled trial was performed according to CONSORT guidelines.

Methods

This study was conducted from July 2020 to October 2020 among 62 elderly people with cognitive frailty from a nursing home. Participants were randomly divided into an OEP group (n = 31) or a control group (n = 31). Both groups received sleep- and diet-related health education. The OEP group also received a 12-week group exercise programme. The Five Times Sit to Stand Test (FTSST), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT) were used to assess physical function. The Geriatric Depression Scale-15 (GDS-15) and the 12-Item Short Form Health Survey Mental Component Summary (SF-12 MCS) were used to assess mental health. Outcomes were measured at 6 and 12 weeks.

Results

Physical function and mental health were similar in the two groups at baseline. At 12 weeks, the OEP group (difference in change from baseline: FTSST, −2.78; TUGT, −3.73; BBS, 2.17; GDS-15, −0.72; SF-12 MCS, 2.58; all p < .001) exhibited significantly greater improvements than the control group (difference in change from baseline: FTSST, 1.55; TUGT, 1.66; BBS, −0.10; GDS-15, 1.07; SF-12 MCS, −5.95; all p < .001).

Conclusion

Our findings showed the OEP group had better physical function and mental health outcomes than the control group. OEP can be used to improve the physical and mental function among elderly people with cognitive frailty during the COVID-19 pandemic.

Relevance to clinical practice: Otago exercise program intervention programmes should be implemented to improve physical function for cognitive frailty elderly to reduce the harm of longer-term sedentary behaviours, and to ruduce depression symptom and improve mental health, particularly during COVID-19 pandemic period.

Effectiveness, Process, and Economic Outcomes of Integrated Care for Community‐Dwelling Frail Older Adults: A Systematic Review and Meta‐Analysis

ABSTRACT

Aims

To assess the effectiveness, process, and economic outcomes of integrated care for community-dwelling frail older adults.

Design

A systematic review and meta-analysis.

Data Sources

We searched nine databases, including PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, CNKI, SinoMed, Wanfang, and VIP, three trial registers, grey literature, and reference lists up to April 2024, with an updated search in March 2025.

Review Methods

Randomised controlled trials and non-randomised studies of interventions involving integrated care for community-dwelling frail older adults were included. Data analysis was conducted using the Comprehensive Meta-Analysis software.

Results

This review included 12 studies involving 6819 community-dwelling frail older adults from high-income regions. The results indicated that integrated care had significantly positive effects on frailty and functional ability, but not on social function, hospitalisation, nursing home admission, quality of life, and mortality. Outcomes of caregivers and professionals were rarely reported. The cost-effectiveness of integrated care has not been confirmed by limited evidence. Few studies have adopted a systematic approach to designing and conducting comprehensive process evaluations guided by scientific frameworks.

Conclusion

Integrated care improves frailty and functional ability in community-dwelling frail older adults but lacks consistent benefits for other outcomes. The lack of evidence on cost-effectiveness and the caregiver and professional outcomes highlight critical gaps in current research. The absence of systematic process evaluations underscores the need for future studies to adopt rigorous frameworks to assess them.

Impact

This implicates that more research, particularly in underserved regions that lack a high standard of usual medical services, should emphasise the outcomes of caregivers and healthcare professionals, process evaluation, and health economics. Policymakers and practitioners must consider these gaps when implementing integrated care programmes to ensure equitable and sustainable healthcare solutions.

Reporting Method

PRISMA 2020 Checklist.

Patient or Public Contribution

No patient or public contribution.

PROSPERO Registration Number

CRD42024568811

The Role of Advance Care Planning on Community Dwelling Adults' Coping Abilities and Death Attitudes: A Sequential Mixed‐Methods Study

ABSTRACT

Aim

To (1) examine the attitudes of community-dwelling adults towards death and their ability to cope with death, as well as (2) understand the influence of advance care planning on community-dwelling adults' death attitudes and coping with death.

Design

A sequential explanatory mixed-methods study was conducted in Singapore.

Methods

In Phase I, a case–control study was conducted to examine the differences in death attitudes and coping with death ability between community-dwelling adults who have completed advance care planning and those who have not. A univariate general linear model was used to compute the mean difference in death attitudes and coping with death scores. In Phase II, a descriptive qualitative study was conducted to provide an in-depth understanding of the influence of advance care planning among community-dwelling adults. Thematic analysis was used for qualitative analysis. Mixed-methods analysis was conducted to integrate the quantitative and qualitative data.

Results

In Phase I, 80 community-dwelling adults who had completed advance care planning and 81 community-dwelling adults who did not have advance care planning were included. Adults who had completed advance care planning had significantly higher coping with death scores (t = 4.14, p < 0.01). In Phase II, a purposive sample of 24 adults who had completed advance care planning was selected for individual semi-structured interviews. From the thematic analysis, three themes were developed: (1) Advance care planning enables coping with death, (2) overcoming fear of death with advance care planning and (3) confronting death with advance care planning.

Conclusion

Advance care planning may influence death attitudes and coping with death. Further work on longitudinal designs and among individuals from different age groups should be used to gain further in-depth understanding of the impacts of advance care planning.

Implications for the Profession and/or Patient Care

Strategies to enhance one's coping abilities with death and death attitudes should be developed to stimulate the uptake of advance care planning.

Reporting Method

This paper was reported according to the Good Reporting of A Mixed Methods Study framework.

Patient or Public Contribution

Community-dwelling adults participated in the survey and interviews.

Chatbot‐Delivered Interventions for Improving Mental Health Among Young People: A Systematic Review and Meta‐Analysis

ABSTRACT

Background

The characteristics, application, and effectiveness of chatbots in improving the mental health of young people have yet to be confirmed through systematic review and meta-analysis.

Aim

This systematic review aims to evaluate the effectiveness of chatbot-delivered interventions for improving mental health among young people, identify factors influencing effectiveness, and examine feasibility and acceptability.

Methods

To identify eligible interventional studies, we systematically searched 11 databases and search engines covering a publication period of January 2014 to September 2024. Meta-analyses and subgroup analyses were performed on randomized controlled trials to investigate the effectiveness of chatbot-delivered interventions and potential influencing factors. Narrative syntheses were conducted to summarize the feasibility and acceptability of these interventions in all the included studies.

Results

We identified 29 eligible interventional studies, 13 of which were randomized controlled trials. The meta-analysis indicated that chatbot-delivered interventions significantly reduced distress (Hedge's g = −0.28, 95% CI [−0.46, −0.10]), but did not have a significant effect on psychological well-being (Hedge's g = 0.13, 95% CI [−0.16, 0.41]). The observed treatment effects were influenced by factors including sample type, delivery platform, interaction mode, and response generation approach. Overall, this review demonstrates that chatbot-delivered interventions were feasible and acceptable.

Linking Evidence to Action

This review demonstrated that chatbot-delivered interventions had positive effects on psychological distress among young people. Chatbot-delivered interventions have the potential to supplement existing mental health services provided by multidisciplinary healthcare professionals. Future recommendations include using instant messenger platforms for delivery, enhancing chatbots with multiple communication methods to improve interaction quality, and refining language processing, accuracy, privacy, and security measures.

The Psychological Status of Elderly Patients During the Acute Phase of Stroke: A Mixed Methods Analysis

ABSTRACT

Objective

This study aims to understand the experiences of elderly patients in the acute phase of stroke, to determine the factors that predict the level of psychological resilience, and to examine the moderating role of rumination between illness perception and psychological resilience.

Methods

A mixed-method of embedded design was employed in this study. In the qualitative study, 13 elderly patients with acute stroke were interviewed based on semi-structured interview guides and recordings. The data were transcribed, and thematic content analysis was conducted. In the quantitative study, a cross-sectional survey was conducted on 240 elderly acute stroke patients using paper-based questionnaires, and data analysis was performed using SPSS25.0 and AMOS24.0.

Results

From the qualitative analysis, we identified risk factors affecting the psychological status of elderly patients with acute stroke, which can be summarised into four major themes and six categories. The content of the four major themes is: lack of disease cognition, facing disease threats and challenges, prominent psychological issues, sense of disease gain. The content of the six categories is: lack of stroke-related disease knowledge and cognitive bias, single source of disease information; significant sequelae, concern about medical expenses; apparent symptoms of anxiety and depression, disease uncertainty and fear. In the Quantitative analysis, results indicated that illness perception had a direct effect on psychological resilience (β = −0.34, p < 0.01) and rumination (β = 0.51, p < 0.01). Also, rumination was directly related to psychological resilience (β = −0.24, p < 0.01). In addition, illness perception was indirectly related to psychological resilience (β = 0.51*−0.24 = −0.12, p < 0.01) mediated through rumination.

Conclusion

Improving the level of rumination in elderly patients with acute stroke can mitigate adverse Illness perception and enhance psychological resilience. This study provides a theoretical basis for developing relevant intervention measures.

Experiences and Needs of Caregivers of Community‐Dwelling Frail Older Adults: A Mixed Methods Systematic Review

ABSTRACT

Aim

This study aimed to synthesise current evidence about the experiences and needs of informal caregivers of community-dwelling frail older adults to inform targeted interventions for improving their caregiving situations.

Design

This was a mixed methods systematic review using the convergent integrated analysis framework.

Methods

We conducted systematic searches across 11 databases, including CINAHL, CNKI, EMBASE, OpenGrey, ProQuest, PsycINFO, PubMed, SinoMed, VIP, WanFang and Web of Science, as well as reference lists, for studies published between January 1, 2000 and March 12, 2025. Quality appraisal was performed using the Mixed Methods Appraisal Tool. Findings were synthesised using a narrative approach.

Results

Of the 5297 citations, 2905 were screened for titles and abstracts, 176 were further screened for full-texts and eight studies were included (n = 6 quantitative, n = 2 qualitative; 1949 caregivers). The themes of caregiving experiences related to (1) influential factors contributing to negative, (2) or positive caregiver outcomes; (3) coping strategies or resources that caregivers employed to address caregiving situations; the outcomes that could be (4) negatively, (5) or positively impacted by caregiving; and (6) difficulties they encountered related to caring for frail older adults. Caregivers expressed needs for psychological support, detailed information on available resources, and family-centred and integrated public services with self-advocacy and coordinators.

Conclusions

This review highlights broad areas that require more attention for enhancing the well-being of these caregivers. More research is warranted on caregivers' experiences, needs, and interventions, especially their support needs. A theoretical framework, comparative analyses between child caregivers and spousal caregivers, as well as emphasising both mastery and competence, is recommended for future research and practice.

Relevance to Clinical Practice

Our findings hold the potential to guide the development of needs-oriented and evidence-based interventions tailored to the unique challenges faced by caregivers, thereby supporting them in their caregiving roles.

Reporting Method

This review followed the PRISMA 2020 guidelines.

Patient or Public Contribution

No patient or public contribution due to design.

Development and Validation of a Prediction Model for Enteral Feeding Intolerance in Critical Ill Patients: A Retrospective Cohort Study

ABSTRACT

Aim

To construct and validate a prediction model for enteral feeding intolerance in critically ill patients during the first 7 days of enteral feeding.

Design

A retrospective cohort study.

Methods

We reviewed the medical records of two intensive care units from January 2015 to August 2023, to develop a prediction model by univariate analysis and logistic regression analysis. Model's performance was evaluated through discrimination, calibration and decision curve analysis.

Results

This study involved a total of 471 patients, with an enteral feeding intolerance incidence rate of 35.7%. The prediction model comprised six variables, namely neurological disease, chronic gastrointestinal disease, Acute Physiological and Chronic Health Assessment II score, sedatives, acid suppressants and serum albumin. The model showed robust discrimination, calibration and clinical net benefit, indicating significant potential for practical application with readily available variables.

Conclusions

The model demonstrated strong predictive performance in assessing the risk of enteral feeding intolerance during the early stage of nutrition initiation.

Implications for the Profession and/or Patient Care

Enhancing clinicians' capacity to reduce the incidence of enteral feeding intolerance and improve patient outcomes.

Impact

The prediction model shows a good capacity to discriminate critically ill patients at risk of enteral feeding intolerance, is helpful to provide personalised care.

Reporting Method

TRIPOD + AI checklist.

Patient or Public Contribution

No patient or public contribution.

Trial Registration: https://www.chictr.org.cn/ ChiCTR2400090757

Nurses' acceptance of nursing information systems: A multi‐center cross‐sectional study in China

Abstract

Background

In China, nursing information systems (NIS) implementation can face numerous barriers to acceptance, including the attitudes of potential users. However, few studies have evaluated this acceptance.

Objective

The aim of this study was to explain the acceptance of NIS utilizing a survey based on unified theory of acceptance and use of technology.

Methods

A multi-center cross-sectional study utilizing an online survey was conducted. SPSS AMOS was used to conduct a structural equation modelling analysis. This research followed the STROBE Checklist.

Results

A total of 3973 Nurses participated in the study between January 2023 and March 2023. The acceptance of NIS among nurses was overall moderate to high. The proposed model has been rigorously tested and validated using empirical data, ensuring its credibility and dependability. Performance expectancy (PE), social influence (SI), and attitude significantly and positively affected intentions to use NIS. Effort expectancy (EE) did not show any significant effects in the sample. Facilitating conditions (FCs) was found to have a negative relationship with the intention to use NIS. There was a statistically significant difference BI between the different age groups, working years, and computer training experience. The model demonstrates a good fit with the observed data.

Conclusions

This study identified PE, SI, and attitude as facilitators of nurses' intentions to use NIS. The findings about EE indicates that the ease of using NIS does not seem to be a concern among nurses. Moreover, high FC might be perceived as indicative of a complex system or extensive usage, that can lead to increased workload and reduced behavioural intention (BI). The significant differences in BI among various demographic groups highlight the need for more studies understanding the preferences and barriers faced by different, levels of experience and training backgrounds.

Patient or Public Contribution

No patient or public contribution.

Effects of nutritional interventions on cognitive function in adult cancer survivors: A systematic review

Abstract

Aim

To evaluate the effectiveness and safety of nutritional interventions (i.e. nutritional support, dietary patterns and dietary supplements) on cognitive function in cancer survivors.

Design

Systematic review.

Methods

A systematic and comprehensive search of PubMed, Web of Science, the Cochrane Library, Embase, and CINAHL was conducted from the inception until March 10, 2023. The last search was conducted on December 10, 2023.

Reporting Method

PRISMA.

Results

A total of 59 randomized controlled trials were included for analysis. Nutritional support, dietary patterns and dietary supplements improved cognitive function in cancer survivors with no apparent safety concerns. The anti-inflammatory diet, the fasting-mimicking diet and the web-based diet significantly improved cognitive function. Whereas the ketogenic diet or dietary advice to consume more soluble dietary fibres and less insoluble dietary fibres and lactose could not. There was evidence from dietary supplements to support the beneficial effects of polyunsaturated fatty acid supplements, traditional herbal medicines and other supplements.

Conclusions

Nutritional interventions have great promise for improving cognitive function in adult cancer survivors. Further validation of the nutritional interventions supported in this study in other survivors and exploration of more effective nutritional interventions are needed.

Implications for the Profession and/or Patient Care

This work can support the construction of nutritional support interventions and dietary guidance programs to prevent cancer-related cognitive decline.

Impact

This work filled a gap in preventive strategies for cancer-related cognitive decline from a nutritional perspective. Nutritional support, dietary patterns, and dietary supplements can prevent cancer-related cognitive decline without serious safety concerns. This work highlighted nutritional interventions that have the potential to improve cognitive function in cancer survivors, benefiting the further construction of evidence-based nutritional intervention programs.

Protocol Registration

PROSPERO.

Patient or Public Contribution

No patient or public contribution.

Distribution and characteristics of bacteria on the hand during oropharyngeal swab collection: Which handwashing points are affected?

Abstract

Aims

To identify the contaminated areas of the hand collection and analyse the distribution characteristics of bacteria in the hand after swab collection.

Design

This study used a cross-sectional design.

Methods

A cross-sectional study sampling 50 pairs of hands (sampling hand and auxiliary hand) of healthcare workers was performed. Ten samples were collected from each participant. The optimal hand hygiene rates and bacterial colony counts of the whole hand and different hand sections without hand hygiene were identified as the primary outcomes.

Results

The optimal hand hygiene rates of the sampling hand and auxiliary hand were 88.8% (222/250) and 91.6% (229/250), respectively. The lowest optimal hand hygiene rates for the sampling hand and the auxiliary hand were both on the dorsal side of the finger and the dorsum of the hand (86.0%, 86.0% vs. 90.0%, 86.0%); the optimal hand hygiene rates for both sites of the sampling hand were 86.0% (43/50), and the optimal hand hygiene rates for the auxiliary hand were 90.0% (45/50) and 86.0% (43/50). The bacteria colony counts did not differ between the sampling hands and auxiliary hand.

Conclusions

The dorsal side of the finger and dorsum of the hand were the most likely to be contaminated during oropharyngeal swab collection. Therefore, it is essential to pay extra attention to hand hygiene care of these two sites during the collection process to minimize the risk of cross-contamination.

Reporting Method

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.

Effects of transitional care interventions on quality of life in people with lung cancer: A systematic review and meta‐analysis

Abstract

Aim

To identify and appraise the quality of evidence of transitional care interventions on quality of life in lung cancer patients.

Background

Quality of life is a strong predictor of survival. The transition from hospital to home is a high-risk period for patients' readmission and death, which seriously affect their quality of life.

Design

Systematic review and meta-analysis.

Methods

The PubMed, Embase, Cochrane Library, Web of Science and CINAHL databases were searched from inception to 22 October 2022. The primary outcome was quality of life. Statistical analysis was conducted using Review Manager 5.4, results were expressed as standard mean difference (SMD) with a 95% confidence interval (CI). The risk of bias of the included studies was assessed using the Cochrane risk of bias assessment tool. This study was complied with PRISMA guidelines and previously registered in PROSPERO (CRD42023429464).

Results

Fourteen randomized controlled trials were included consisting of a total of 1700 participants, and 12 studies were included in the meta-analysis. It was found that transitional care interventions significantly improved quality of life (SMD = 0.21, 95% CI: 0.02 to 0.40, p = .03) and helped reduce symptoms (SMD = −0.65, 95% CI: −1.13 to −0.18, p = .007) in lung cancer patients, but did not significantly reduce anxiety and depression, and the effect on self-efficacy was unclear.

Conclusions

This study shows that transitional care interventions can improve quality of life and reduce symptoms in patients, and that primarily educational interventions based on symptom management theory appeared to be more effective. But, there was no statistically significant effect on anxiety and depression.

Relevance to Clinical Practice

This study provides references for the application of transitional care interventions in the field of lung cancer care, and encourages nurses and physicians to apply transitional care plans to facilitate patients' safe transition from hospital to home.

Patient or Public Contribution

No Patient or Public Contribution.

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