Conectar
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.
A sequential explanatory mixed-methods study was conducted in Singapore.
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.
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.
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.
Strategies to enhance one's coping abilities with death and death attitudes should be developed to stimulate the uptake of advance care planning.
This paper was reported according to the Good Reporting of A Mixed Methods Study framework.
Community-dwelling adults participated in the survey and interviews.
To clarify the definition and evolution of Patient and Public Involvement and Engagement (PPIE) and identify its attributes, antecedents, and consequences in health-related research.
This study follows Rodgers' evolutionary concept analysis with a seven-step framework.
Datasets were searched using terms related to PPIE and key categories (i.e., attributes, antecedents, and consequences). Data were sourced from CINAHL, PsycInfo, Scopus, PubMed, and Web of Science covering publications from inception to October 31, 2024. Document titles, abstracts, and keywords were manually screened to identify relevant studies for full-text review.
A total of 1751 documents were screened, resulting in 38 eligible studies included in the final analysis. PPIE has evolved from a narrow focus on patient inclusion and participation, where patients had minimal influence on research and researchers resisted sharing control of research, to a collaborative model emphasising sustained partnerships, shared contributions, equitable power distribution, and active involvement across research stages. This shift has been driven by research innovation, a growing emphasis on healthcare equity and patient-centred care, technological advances, and stakeholder advocacy (e.g., patients, funders, ethics committees). While PPIE enhances research relevance and impact, barriers, such as resource constraints, power imbalances, patient limited research capabilities and increased researcher workload persist. Facilitators, such as training programmes, standardised guidelines, flexible arrangements and transparent communication can enable meaningful partnerships.
The concept of PPIE is evolving toward greater clarity and consistency in research, positioning patients and the public as active, essential contributors rather than passive participants. Barriers and facilitators were identified to inform its utilisation in research.
This study clarifies the conceptual ambiguities of PPIE, informs theory development, and provides actionable insights. Healthcare and nursing researchers can draw on its findings to utilise PPIE to enhance collaborative and inclusive research practices that align with the needs of patients and the public.
This study adheres to the PRISMA (2020) reporting guidelines for systematic reviews.
One of our co-authors is a patient with lived experience of cancer, who contributed valuable comments and suggestions to enhance this paper.
To discuss the multi-centre qualitative methodology as a unique design, articulate its guiding paradigm/theoretical perspectives, and highlight its methodological and methodical issues. A secondary objective is to generate further scholarly discourse regarding the multi-centre approach within the broader qualitative research tradition.
Methodological discussion.
Rather than an emphasis on only experiences, the multi-centre approach is presented as a unique design which also focuses on uncovering why a phenomenon or problem exists and perceptions regarding the phenomenon/problem. With its focus on capturing multiple subjective realities, the multi-centre qualitative design is arguably underpinned by pragmatist constructivism which offers a robust framework for researching phenomenon in a way that is both theoretically informed and practically relevant. Methodologically, the multi-centre qualitative research design emphasises a problem-centred enquiry, collaborative approach and rigorous study protocols, systematic site selection, contextual immersion and sensitivity and methodical flexibility.
With the rapidly evolving nursing and global health landscape, the multi-centre design lends itself to exploring and capturing perceptions on a larger scale compared to single site studies. Careful planning, availability of adequate resources, rigorous protocols and quality assurance plans are critical to ensuring its success.
The multi-centre approach offers the possibility of undertaking the same study across multiple settings/locations which has the potential to improve representation and strengthen transferability.
This methodological discussion offers clarity regarding the use of the multi-centre approach and offering strategies for its subsequent uptake in nursing and healthcare research.
Not applicable.
No patient or public contribution.
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.
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.
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.
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.
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.
To evaluate the impact of game-based teaching on undergraduate nursing students' learning satisfaction, clinical thinking, clinical skills, and anxiety.
Systematic review and meta-analysis.
China National Knowledge Infrastructure, Wanfang, Weipu, SinoMed, CINAHL, PubMed, Web of Science, Cochrane Library, and Embase. Our systematic literature search was conducted up to 31 October 2024 and included all studies published before this date, with no restrictions on publication year.
The study quality was appraised using version 1 of the Cochrane risk-of-bias tool and the JBI Critical Appraisal Tools for Quasi-Experimental Studies. A meta-analysis was performed using STATA version 12.
1712 undergraduate nursing students from 19 studies were included. Meta-analysis showed that game-based teaching improved undergraduate nursing students' learning satisfaction, critical thinking, clinical decision-making, and clinical skills. Game-based teaching did not significantly enhance undergraduate nursing students' problem-solving skills.
Our research findings indicated that game-based teaching had more significant potential to enhance undergraduate nursing students' learning satisfaction, critical thinking, clinical decision-making, and clinical skills. However, game-based teaching did not show a substantial advantage in improving problem-solving skills compared to other teaching methods. Limited studies of the effects of game-based teaching on clinical reasoning and anxiety in nursing students cannot be meta-analysed. Future studies could improve how game-based learning is designed to support undergraduate nursing students' development of these competencies.
This study explores the effects of game-based teaching in nursing education and finds that it promotes learning satisfaction, critical thinking, clinical decision-making, and clinical skills in undergraduate nursing students, while having no significant effect on problem-solving skills. Game-based teaching can be a functional pedagogical approach to guide nursing educators to improve learning outcomes for undergraduate nursing students.
Inapplicable.
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.
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.
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.
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.
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.
This was a mixed methods systematic review using the convergent integrated analysis framework.
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.
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.
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.
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.
This review followed the PRISMA 2020 guidelines.
No patient or public contribution due to design.
To construct and validate a prediction model for enteral feeding intolerance in critically ill patients during the first 7 days of enteral feeding.
A retrospective cohort study.
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.
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.
The model demonstrated strong predictive performance in assessing the risk of enteral feeding intolerance during the early stage of nutrition initiation.
Enhancing clinicians' capacity to reduce the incidence of enteral feeding intolerance and improve patient outcomes.
The prediction model shows a good capacity to discriminate critically ill patients at risk of enteral feeding intolerance, is helpful to provide personalised care.
TRIPOD + AI checklist.
No patient or public contribution.
Trial Registration: https://www.chictr.org.cn/ ChiCTR2400090757
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.
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.
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.
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.
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.
No patient or public contribution.
Chronic wounds are susceptible to bacterial infections and at high risk of developing antibiotic-resistant bacterial infections. Silver is an antimicrobial by targeting almost all types of bacteria in chronic wounds to reduce the bacterial load in the infected area and further facilitate the healing process. This study focused on exploring whether silver-based dressings were superior to non-silver dressings in the treatment of chronic wounds. PubMed, Web of Science and Embase were comprehensively searched from inception to March 2024 for randomized clinical trials and observational studies. The endpoints in terms of wound healing rate, complete healing time, reduction on wound surface area and wound infection rate were analysed using Review Manager 5.4 software. A total of 15 studies involving 5046 patients were eventually included. The results showed that compared with patients provided with non-silver dressings, patients provided with silver-based dressings had higher wound healing rate (OR: 1.43, 95% CI: 1.10–1.85, p = 0.008), shorter complete healing time (MD: −0.96, 95% CI: −1.08 ~ −0.85, p < 0.00001) and lower wound infection rate (OR: 0.56, 95% CI: 0.40–0.79, p = 0.001); no significant difference in the reduction on wound surface area (MD: 12.41, 95% CI: −19.59–44.40, p = 0.45) was found. These findings suggested that the silver-based dressings were able to enhance chronic wound healing rate, shorten the complete healing time and reduce wound infection rate, but had no significant improvement in the reduction on wound surface area. Large-scale and rigorous studies are required to confirm the beneficial effects of silver-based dressings on chronic wound healing.
To evaluate the effectiveness and safety of nutritional interventions (i.e. nutritional support, dietary patterns and dietary supplements) on cognitive function in cancer survivors.
Systematic review.
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.
PRISMA.
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.
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.
This work can support the construction of nutritional support interventions and dietary guidance programs to prevent cancer-related cognitive decline.
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.
PROSPERO.
No patient or public contribution.
Pressure injuries are a significant concern for patients undergoing neurosurgical procedures due to prolonged immobility and the complexity of care. This study evaluates the efficacy of standardized pressure ulcer management protocols in preventing pressure injuries and enhancing patient care in a neurosurgical context. A comprehensive retrospective analysis was conducted at a single institution from December 2020 to December 2023, comparing 50 patients who received standardized pressure ulcer management (intervention group) with 50 patients who received conventional care (control group). The study assessed the incidence of pressure ulcers, patient comfort levels using the Kolcaba Comfort Scale and sleep quality using the Richards-Campbell Sleep Questionnaire (RCSQ). Statistical analysis was performed using SPSS software, version 27.0, applying t-tests and chi-square tests as appropriate. The intervention group exhibited a significantly lower incidence of pressure ulcers at all measured time points post-surgery compared to the control group. Patient comfort levels in the intervention group were consistently higher across psychological, environmental, physiological and socio-cultural domains. Sleep quality metrics, including sleep depth, latency to sleep onset and overall sleep quality, were significantly improved in the intervention group. The implementation of standardized pressure ulcer management protocols in neurosurgical care significantly reduces the incidence of pressure injuries, enhances patient comfort and improves sleep quality. These findings highlight the importance of adopting structured care protocols to improve postoperative outcomes and patient well-being in neurosurgical settings.
Oral mucosa is an ideal model for studying scarless wound healing. Researchers have shown that the key factors which promote scarless wound healing already exist in basal state of oral mucosa. Thus, to identify the other potential factors in basal state of oral mucosa will benefit to skin wound healing. In this study, we identified eight gene modules enriched in wound healing stages of human skin and oral mucosa through co-expression analysis, among which the module M8 was only module enriched in basal state of oral mucosa, indicating that the genes in module M8 may have key factors mediating scarless wound healing. Through bioinformatic analysis of genes in module M8, we found IGF2 may be the key factor mediating scarless wound healing of oral mucosa. Then, we purified IGF2 protein by prokaryotic expression, and we found that IGF2 could promote the proliferation and migration of HaCaT cells. Moreover, IGF2 promoted wound re-epithelialization and accelerated wound healing in a full-thickness skin wound model. Our findings identified IGF2 as a factor to promote skin wound healing which provide a potential target for wound healing therapy in clinic.
To identify the contaminated areas of the hand collection and analyse the distribution characteristics of bacteria in the hand after swab collection.
This study used a cross-sectional design.
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.
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.
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.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.
To identify and appraise the quality of evidence of transitional care interventions on quality of life in lung cancer patients.
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.
Systematic review and meta-analysis.
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).
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.
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.
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.
No Patient or Public Contribution.
Venous leg ulcer (VLU) is the most severe manifestations of chronic venous disease, which has characterized by slow healing and high recurrence rates. This typically recalcitrant and recurring condition significantly impairs quality of life, prevention of VLU recurrence is essential for helping to reduce the huge burden of patients and health resources, the purpose of this scoping review is to analyse and determine the intervention measures for preventing recurrence of the current reported, to better inform healthcare professionals and patients. The PubMed, Embase, Web of Science, Cochrane Library databases, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wan Fang Data and Chongqing VIP Information (CQVIP) were accessed up to June 17, 2023. This scoping review followed the five-steps framework described by Arksey and O'Malley and the PRISMA extension was used to report the review. Eleven articles were included with a total of 1503 patients, and adopted the four effective measures: compression therapy, physical activity, health education, and self-care. To conclude, the use of high pressure compression treatment for life, supplementary exercise therapy, and strengthen health education to promote self-care are recommended strategies of VLU prevention and recurrence. In addition, the importance of multi-disciplinary teams to participate in the care of VLU in crucial.
This study systematically evaluates the efficacy of autologous platelet-rich plasma (PRP) combined with negative pressure sealing drainage (NPSD) in the treatment of diabetic foot ulcers (DFU). A comprehensive computerized search was conducted in PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases for randomized controlled trials (RCTs), from database inception to November 2023, on the treatment of DFU using autologous PRP combined with NPSD. Two researchers independently screened the literature, extracted data, and conducted quality assessments based on inclusion and exclusion criteria. Data analysis was performed using RevMan 5.4 software. A total of 17 RCTs involving 1325 DFU patients were included. The analysis revealed that the application of autologous PRP combined with NPSD in DFU patients significantly increased the ulcer healing rate (OR = 3.54, 95% CI: 2.71–4.62, p < 0.001) and the overall treatment efficacy rate (OR = 4.99, 95% CI: 3.46–7.19, p < 0.001), and significantly reduced the wound healing time (SMD = −2.05, 95% CI: −2.61 to −1.49, p < 0.001). This study indicates that the treatment of DFU with autologous PRP combined with NPSD accelerates wound healing, improves the overall treatment efficacy rate, and offers a new option for the management of DFU.
Rhinoplasty is a frequently performed aesthetic surgery with a high procedural volume. Despite the operational ease and safety profile of biocompatible materials such as silicone and inflatable prosthetics, postoperative complications like surgical site infections can lead to significant clinical challenges. These complications necessitate effective therapeutic and reconstructive interventions. This study aims to evaluate the efficacy of different flap transplantation techniques for early treatment of post-rhinoplasty nasal tissue deficiencies. A retrospective study was conducted from May 2018 to May 2023, involving 38 patients divided into a control group receiving standard anti-infective treatment and an observation group undergoing early flap grafting procedures. Efficacy was evaluated using objective metrics—namely, nasal appearance, function and flap condition—each assessed through a 10-point scoring system, and subjective metrics such as patient satisfaction gauged through self-administered questionnaires. Statistical analyses were performed using SPSS version 27.0. Both groups were statistically comparable in terms of demographics such as age, marital status and educational background. The observation group displayed significantly improved outcomes in terms of nasal aesthetics (mean score 7.92 ± 1.00), nasal function (mean score 8.47 ± 0.51) and flap condition (mean score 7.89 ± 1.12) compared to the control group. Flap transplantation techniques demonstrated superior therapeutic and reconstructive efficacy in the management of nasal tissue deficiencies arising from post-rhinoplasty surgical infections. These findings contribute to evidence-based recommendations for optimal clinical practice.
Although pressure ulcers are related to substantial health burdens, they may be preventable. Since nurses play a fundamental role in pressure ulcer prevention, their knowledge and attitude are of great importance. This study aims to investigate the current situation and associated factors of nurses' knowledge and attitude on the prevention of pressure ulcers from both tertiary and secondary hospitals. A total of 11 347 nurses were recruited including 7108 nurses (62.6%) from tertiary hospitals and 4239 nurses (37.4%) from secondary hospitals. The median (interquartile range) of the pressure ulcer knowledge score was 51% (38%, 90%) for all the participants with the lowest scores on prevention of pressure ulcers (51.33%). The mean (standard deviation) of attitude towards pressure ulcer prevention was 39.64 (4.65) with the lowest scores on personal competency to prevent pressure ulcers (mean 3.09). The results of multivariate linear regression showed that hospital level, nurses' age, years of work experience, initial education level at work and time of last training significantly associated with nurses' knowledge of pressure ulcer prevention. Meanwhile, hospital level, job title, previous training, time of last training and subjective needs for further training had significant association with nurses' attitude towards pressure ulcer prevention (all p < 0.05). Results showed inadequate knowledge but relative positive attitudes in nurses indicating the importance to deliver continuing education and training regarding pressure ulcer prevention in practice to improve the quality of care.
FreshRSS 