Conectar
To explore how adults with congenital heart disease (ACHD) experience and express grit in the workplace.
Qualitative study using Husserl's descriptive phenomenology.
Between March 2022 and June 2023, semi-structured interviews were administered to 18 ACHD recruited from two medical centre outpatient departments. The collected data underwent analysis utilising Colaizzi's 7-step analysis method, coupled with Lincoln and Guba's framework, to ensure credibility and trustworthiness.
The analysis revealed five prominent themes derived from the data: (a) career choices amid constraints; (b) adjustments to one's work environment for reasons of fatigue; (c) crises in the workplace arising from exceeding one's physical limits; (d) supportive networks for better health and job stability; (e) resilience at work for balance and fulfilment in life.
Grit significantly influences life satisfaction and job performance among adults with congenital heart disease, highlighting its profound impact on their experiences. Patients exhibit perseverance in job pursuits, adapt work methods to manage physical fatigue, confront challenges during work crises, value family and societal support and aim for self-satisfaction. These findings highlight the impact of grit and mental health on ACHD's lives and work, providing insights for better psychological support and interventions.
This study clarifies the need for healthcare professionals to incorporate workplace grit training and assessment into ACHD care.
Recognising grit as a key factor in ACHD patients' lives informs holistic care, workplace inclusivity and policies that enhance their long-term well-being.
This study was performed in accordance with the COREQ guidelines.
No patient or public involvement.
Delirium is a frequent, yet often underdiagnosed, condition in intensive care units (ICUs), especially in postoperative patients. It has three subtypes: hyperactive, hypoactive and mixed, each with distinct clinical manifestations and outcomes. A deeper understanding of each subtype's prevalence and risk factors is essential for improving ICU patient care. This study aims to figure out the prevalence of each type of delirium and risk factors associated with each subtype of delirium.
This retrospective study included 4234 postoperative patients admitted to the surgical ICU between January 2017 and June 2019. Delirium was diagnosed using the Confusion Assessment Method for the ICU, and subtypes were determined using the RASS score. Multivariate logistic regression analysis was used to identify the risk factors associated with each delirium subtype. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist.
The prevalence of delirium was 8.7%, with mixed delirium being the most common subtype (47.7%), followed by hypoactive delirium (40.3%) and hyperactive delirium (12.0%). Each subtype was linked to different risk factors: hypoactive delirium was correlated with shorter ICU stays and pH and O2 imbalances, hyperactive delirium was associated with physical restraints and mixed delirium was linked to sedative medication and restraint use.
Among postoperative ICU patients, mixed delirium was the most prevalent subtype, followed by the hypoactive and hyperactive forms. Identifying the unique risk factors for each subtype highlights the need for targeted prevention and management approaches in ICU. Further research is warranted to investigate the underlying mechanisms and to develop effective interventions tailored to each delirium subtype.
This study is distinct from previous research in that it comparatively analysed the risk factors for delirium according to subtype. By distinguishing between the subtypes of delirium and identifying their incidence and risk factors, it is possible to enhance the overall understanding of delirium, particularly given that some of the known risk factors are more strongly associated with certain types of delirium. Identifying risk factors according to the type of delirium can facilitate the planning of proactive interventions based on risk factors. Furthermore, it can serve as a valuable resource for the development of tools for predicting different types of delirium to provide more tailored and evidence-based care for patients with delirium.
No patient or public contribution.
To determine the treatment effectiveness associated with mobile health-delivered cognitive behavioural therapy for insomnia (mCBT-I) interventions for adults with insomnia and to identify the potential characteristics associated with better treatment outcomes.
A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines.
Seven English- and two Chinese-language databases were searched, without restrictions on publication dates, up to July 2024. Reference lists of relevant reviews and grey literature were included in the search. Randomised controlled trials evaluating mCBT-I in adults with insomnia and published in either English or Chinese were included in this meta-analysis. A random-effects model was used for data analysis, accompanied by additional subgroup analyses and meta-regression.
Sixteen studies involving 2146 participants were included in this meta-analysis. mCBT-I interventions were associated with significantly reduced insomnia symptoms and improved sleep quality at post intervention, at 1–3-month follow-up, and at 4–6-month follow-up. Interventions that included five components of CBT-I, were delivered for 6 weeks or longer, and were conducted in a group format were linked to better treatment outcomes; the differences in other subgroup categories were not statistically significant. Studies involving participants with comorbid conditions showed a greater effect in reducing insomnia symptoms than those without such participants. In addition, mCBT-I interventions delivered by healthcare professionals resulted in statistically larger effect sizes for improving sleep quality than self-help regimens.
The systematic review and meta-analysis identified the effectiveness of mCBT-I in reducing insomnia symptoms and improving sleep quality and offered practical implications for the development of effective mCBT-I interventions in clinical practice. However, future robust studies are needed to explore the long-term effects of mCBT-I interventions.
No patient or public contribution.
PROSPERO CRD: 42023454647
Family strengths can be used to help families adapt to hardship and strain. However, meta-analytic evidence of the effectiveness of family involvement interventions on fear of cancer recurrence (FCR) in women with breast cancer and their caregivers is lacking.
To evaluate the effectiveness of family involvement interventions on FCR in women with breast cancer and their caregivers and to identify the characteristics of effective family involvement interventions.
Ten electronic databases were searched from database inception to October 2023. The updated Cochrane risk-of-bias tool was used to assess the quality of the included randomised controlled trials (RCTs). Data analyses were executed with Revman 5.3 software, and subgroup analyses were performed on the basis of interventional dosage. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 checklist was employed to provide guidance.
Seven studies were included in the review, and six were included in the meta-analysis. The main contents included content related to the disclosure of disease-related feelings/worries/concerns/experiences, education/psychological support plus some disclosure and education/counselling based on disclosure content. The results of the meta-analysis showed that family involvement interventions have large short-term positive effects on relieving FCR in women with breast cancer. The pooled results of subgroup analysis demonstrated that compared with usual care, education/psychological support plus some disclosure is ineffective, and disclosure alone has a moderate-to-large effect size, whereas disclosure with education or counselling targeting the specific needs of participants has an extremely large effect size. Only one study focused on FCR in caregivers, with an unfavourable result.
Family involvement interventions, especially those using disclosure combined with education or counselling targeting their specific needs, have considerable short-term effects on women's FCR alleviation. However, the evidence in caregivers is insufficient. Only a few interventional studies targeting patients and caregivers exist. Further high-quality RCTs with follow-ups are encouraged.
No patient or public contribution.
This study examined changes in health risk, daily activities and antipsychotic use after receiving Humanitude care for people with dementia.
Retrospective study design.
A total of 67 people with dementia were admitted to two municipal nursing hospitals and were receiving Humanitude care. Participants' medical records were collected at 5 time points: February 2023 (6 months before), May 2023 (3 months before), August 2023 (when over 70% of healthcare workers completed Level 1 Humanitude care training), November 2023 (3 months after) and February 2024 (6 months after). The changes were analysed using a generalised estimating equation model.
A statistically significant change in the fall risk group was observed in August 2023, November 2023 and February 2024, with 6%, 11% and 19% increases in the odds of moving to a lower-risk group, respectively, compared to February 2023. In the activities of daily living subscale, gargling showed significant changes in November 2023 and February 2024. This resulted in 62.7% and 58.7% increases in the odds of moving to the high-independence category, respectively. The number of antipsychotic agents used was significantly lower in February 2024 (3.82) compared to that in February 2023 (4.47), May 2023 (4.74) and August 2023 (4.6).
The results demonstrate that Humanitude care significantly contributes to reducing fall risk, improving gargling in activities of daily living and decreasing the number of antipsychotic agents in people with dementia.
Problem the study addresses: The impact of Humanitude care remains understudied. Main findings: Humanitude care helps in not only reducing health risks but also circumventing coercive pharmacological treatments. Impact on research: Humanitude care focuses on the dignity and autonomy of people with dementia.
This study was conducted following the Strengthening the Reporting of Observational Studies in Epidemiology.
No patient or public involvement.
To examine the effectiveness of acupressure on sleep quality in cancer patients and to identify the population-level and intervention-level characteristics associated with the intervention outcome of sleep quality.
Systematic review and meta-analysis.
PubMed, EMBASE, APA PsycInfo, Web of Science, CINAHL, Cochrane Library, China National Knowledge Infrastructure and WanFang were searched for eligible randomised controlled trials from inception to April 2024.
Methodological quality was assessed using the Cochrane Risk of Bias Tool for Randomised Trials 2.0. A random-effects model was used for the meta-analysis. Subgroup analyses and the meta-regression aimed to investigate potential heterogeneity and identify characteristics that may be associated with more favourable acupressure outcomes.
In total, 22 randomised controlled trials involving 2113 participants were included in this meta-analysis. Compared with various control groups, acupressure exhibited a significant beneficial effect on sleep quality in cancer patients at post-intervention (SMD = −1.38, 95% CI [−1.81, −0.95], p < 0.001) and at 4-week follow-up (SMD = −0.33, 95% CI [−0.56, −0.10], p = 0.004). Acupressure also showed statistically significant improvements in sleep efficiency (SMD = 0.77, 95% CI [0.27, 1.26], p = 0.002) and total sleep time (SMD = 0.68, 95% CI [0.15, 1.22], p = 0.010) at post-intervention. None of the characteristics significantly affected the overall effect size on sleep quality.
Acupressure appears to be a promising intervention for enhancing sleep quality among cancer patients. Future studies should elucidate the long-term effects of acupressure on sleep quality, identify effective acupressure characteristics and determine which types of cancer patients benefit from this intervention.
This study provides a comprehensive summary of evidence supporting the use of acupressure to enhance sleep quality in cancer patients and demonstrates its effectiveness in clinical nursing practice.
PRISMA 2020 statement.
No Patient or Public Contribution.
To develop and validate a model to predict cognitive decline within 12 months for home care clients without a diagnosis of dementia.
We included all adults aged ≥ 18 years who had at least two interRAI Home Care assessments within 12 months, no diagnosis of dementia and a baseline Cognitive Performance Scale score ≤ 1. The sample was randomly split into a derivation cohort (75%) and a validation cohort (25%). Significant cognitive decline was defined as an increase (deterioration) in Cognitive Performance Scale scores from ‘0’ or ‘1’ at baseline to a score of ≥ 2 at the follow-up assessment.
Using the derivation cohort, a multivariable logistic regression model was used to predict cognitive decline within 12 months. Covariates included demographics, disease diagnoses, sensory and communication impairments, health conditions, physical and social functioning, service utilisation, informal caregiver status and eight interRAI-derived health index scales. The predicted probability of cognitive decline was calculated for each person in the validation cohort. The c-statistic was used to assess the model's discriminative ability. This study followed the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) reporting guidelines.
A total of 6796 individuals (median age: 82; female: 60.4%) were split into a derivation cohort (n = 5098) and a validation cohort (n = 1698). Logistic regression models using the derivation cohort resulted in a c-statistic of 0.70 (95% CI 0.70, 0.73). The final regression model (including 21 main effects and 8 significant interaction terms) was applied to the validation cohort, resulting in a c-statistic of 0.69 (95% CI 0.66, 0.72).
interRAI data can be used to develop a model for identifying individuals at risk of cognitive decline. Identifying this group enables proactive clinical interventions and care planning, potentially improving their outcomes. While these results are promising, the model's moderate discriminative ability highlights opportunities for improvement.
COVID-19 survivors may experience complex, distressing and persistent symptoms, referred to as long COVID, lasting months or years after diagnosis. More evidence is needed for effective long COVID screening and management.
To explore the clinical profile of long COVID and factors associated with its development.
A multicentre correlational study using a cross-sectional design.
Adults diagnosed with COVID-19 6–9 months earlier were recruited via social media and referrals from three facilities. Participants provided demographic data and assessed their symptoms and functional status using validated questionnaires. Data were analysed using descriptive statistics and binomial logistic regression.
Among 102 participants, 13%–30% reported significant impairments in cognitive, emotional and physical functioning. Over 10% experienced symptoms such as diarrhoea, sleep problems, dyspnoea, nausea, fatigue and pain. These impairments and symptoms were associated with acute symptom severity, chronic disease, overweight status, regular exercise and living without partners.
This study adds to the literature by examining long-term functional status and symptoms in omicron survivors using comprehensive, validated tools. The findings highlight the prevalence and clinical significance of long COVID symptoms, aiding in the identification of functional impairments requiring medical and nursing interventions.
Nurses should recognise these symptoms and educate survivors about potential challenges. Policies addressing long-term issues, including research, health services and education, are essential.
This study follows the STROBE guideline (Table S1).
Patients self-reported symptoms for this study.
ClinicalTrials.gov (NCT05303103)
Care for patients in the intensive care unit (ICU) must support all body systems. However, ICU nurses often focus on life-threatening conditions, giving less attention to other critical areas such as eye care.
This study aims to determine ICU nurses' knowledge, attitudes and practices regarding eye care.
This descriptive study was conducted in Türkiye between 1 June 1 2024, and 15 August 2024. The sample included 210 nurses actively working in ICU settings, and data were collected using the snowball sampling method. An online survey was administered, which included demographic information and the ‘Eye Care Clinical Competence Questionnaire’ Statistical analysis was performed using SPSS 22.0. The normality of the data was assessed using kurtosis and skewness tests, and appropriate analysis methods were selected.
The average age of the participants was 32.48 ± 7.45 years, with 78.1% being female and 77.1% holding a bachelor's degree. Female nurses and those with intensive care nursing certification had significantly higher eye care clinical competency scores. Additionally, nurses working in Neonatal ICU's scored higher in knowledge and attitude sub-dimensions compared to other ICUs. Nurses who received in-service training and used protocols for eye care had higher competency scores. A total of 37 nurses (17.6%) stated that the obstacles to performing eye care were the perception that eye care is less important compared to other problems. Nurses with an ICU nursing certificate had significantly higher Eye Care Clinical Competence Questionnaire total scores (p = 0.002), attitude sub-dimension (p = 0.049) and practice sub-dimension (p = 0.004) total scores.
The clinical competency levels of ICU nurses in eye care improve with post-graduation education, the use of protocols, and updated information. Thus, it is recommended that standard protocols be developed and training programmes for eye care practicesbe expanded.
It was determined that intensive care nurses had limited knowledge about eye care and that a standard eye care practices were not performed. In order to increase the competence of intensive care nurses in eye care, this subject should be included in continuing evidence-based practice education, in-service training and certification programs and integrated into practices. Educational initiatives and policy advancements will enhance nurses' clinical competencies in eye care and promote patient safety.
This study determined the knowledge, attitudes and practices of intensive care nurses regarding eye care, as well as the influencing factors. It was found that nurses had limited knowledge about eye care but had good attitudes. Having certification and education for intensive care nurses improve clinical competence and attitudes in eye care.
STROBE checklist was followed for reporting in the study.
Nurses working in the intensive care unit participated in this study.
The fear of cancer recurrence (FCR) levels reported by caregivers are as high as those reported by women with breast cancer, with some caregivers even reporting FCR levels higher than women with breast cancer. The recognition of factors associated with caregiver FCR is important for providing proactive support to caregivers at risk.
To identify factors associated with high FCR in caregivers of women with breast cancer.
A systematic search of eight electronic databases was conducted from database inception to August 2023. The identified papers were screened, and their full texts were further assessed. The quality of the included studies was examined by using a checklist, and relevant data were extracted with a predeveloped data extraction form. The best-evidence synthesis model was used for data synthesis. Meta-analysis was conducted to calculate the prevalence of caregiver FCR.
The search yielded a total of 2137 studies, and 15 studies involving 2461 caregivers were included after the screening and full assessment of 56 papers. A total of 29 factors were identified. Of these factors, five factors with a moderate level of evidence associated with high FCR were identified: insufficient communication of women with breast cancer, low level of resilience, high social constraints, high protective buffering and insufficient communication of caregivers; 15 associated factors were supported by limited-level evidence and nine were supported by conflicting-level evidence. The prevalence of FCR in caregivers was 45%.
The associated factors examined provide some evidence for identifying caregivers who are at high risk of high FCR. Identifying factors contributing to FCR in caregivers is important for developing interventions for those caregivers most in need and reducing adverse health outcomes related to caregiver FCR. Additional studies are needed to examine the relationship between conflicting factors and caregiver FCR.
No patient or public contribution.
Trial Registration: PROSPERO registration number: CRD42023469754; identifier: https://www.crd.york.ac.uk/PROSPERO/#recordDetails
To assess the effectiveness of using smart glasses to facilitate communication among nurses inside and outside the emergency department.
Complementary mixed-methods study with a one-group pretest-posttest design.
Thirty emergency nurses participated in surveys on demographics, digital literacy, and communication clarity before and after using smart glasses. Qualitative interviews explored user experiences.
Smart glasses improved communication clarity. No significant correlation was found between demographics or clinical experience and communication clarity. Qualitative analysis identified five facilitating factors—reduced nursing workload, enhanced patient care, improved efficiency, reliable support, and professional feel—and five barriers—user interface issues, surveillance burden, communication errors, technology-integration limitations, and ethical/patient privacy concerns.
Smart glasses improved communication in emergency isolation rooms, potentially enhancing patient safety and reducing treatment delays. Addressing usability and ethical concerns is key for successful integration.
Smart glasses offer significant potential to enhance communication. To maximise their benefits, it is crucial to address challenges such as the added stress on novice nurses, potential increases in workload, and ethical concerns regarding patient privacy. Providing comprehensive training and refining the technology will help to reduce user burden and ensure robust data security, ultimately improving patient care and supporting nursing staff in high-stress environments.
Smart glasses can improve communication among emergency nurses, especially in isolation rooms, by reducing treatment delays and enhancing collaboration, thus improving patient safety.
TREND (Nonrandomised evaluations of behavioural and public health interventions).
Emergency nurses' feedback was integral to evaluating the usability and effectiveness of smart glasses.
To analyse and synthesise current evidence on the effectiveness of cancer rehabilitation interventions in increasing physical activity, increasing healthy dietary habits, alleviating psychological distress, and increasing health-related quality of life (HRQoL) in women treated for gynaecological cancers (GCs).
A meta-analysis of randomised controlled trials (RCTs).
A systematic search was conducted in 12 databases from inception to 31 May 2024.
The quantitative results from comparable RCTs were pooled and meta-analysed using Review Manager 5.4 software. The results from non-comparable (i.e., clinically heterogeneous) RCTs were narratively summarised. The methodological quality of all RCTs was assessed using Version 2 of the Cochrane risk of bias tool for randomised trials.
Nine RCTs reported in a total of 12 articles met the inclusion criteria and comprised a total of 418 patients. The interventions had significant effects on total physical activity levels at post-intervention, 6-month follow-up, and 12-month follow-up, and on self-efficacy in physical activity at post-intervention and 3-month follow-up. However, the interventions did not significantly improve overall HRQoL or healthy dietary habits and did not significantly alleviate anxiety and depression. The key intervention components were information provision on health-promoting behaviours; adoption of behavioural change techniques (goal setting, action planning, relapse prevention, problem-solving, self-monitoring, and social support); and stress and emotion management.
Rehabilitation interventions effectively increase physical activity in women treated for GCs, leading to sustainable effects. However, there is limited evidence on the effectiveness of such interventions in improving overall HRQoL, encouraging healthy eating, and alleviating psychological distress in women treated for GCs.
This review found that rehabilitation interventions can increase physical activity levels among women treated for GCs. It also identified the key effective components of such interventions.
This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.
None.
Trial Registration: International Prospective Register of Systematic Reviews registration number: CRD42023442877
To evaluate the effects of exergaming on physical frailty in older adults.
Systematic review with meta-analysis.
Six electronic databases were searched for randomised controlled trials evaluating the effects of exergaming on frailty in older adults. Data were synthesised using narrative synthesis and meta-analysis. The risk of bias and the certainty of the evidence were assessed.
CINAHL, Cochrane Library, Embase, PubMed, Web of Science, and China Academic Journal Network Publishing Database were searched from their inception through February 2024.
Five studies (n = 391) were included. Exergaming, which was delivered in 20–36 sessions over 8–12 weeks, resulted in improvements in frailty scores and indices, frailty status, and frailty phenotypes, including exhaustion, low physical activity levels, gait speed, and muscle weakness over time. There was no effect on unintentional weight loss. Meta-analyses showed that the effects of exergaming were not significantly different from those observed in the control groups. The rate of adherence to the intervention of the exergaming group was slightly higher than that of the comparison group (87.3%–87.7% vs. 81.1%–85.4%). The overall risk of bias was high in all studies. The certainty of the evidence was very low.
Exergaming exerts effects on frailty comparable to those of conventional physical exercises. Participants appeared to have better adherence to exergaming. Future studies with robust designs are warranted.
With effects comparable to those of conventional physical exercises, exergaming could be considered in clinical settings to address frailty.
This review addressed the effects of exergaming on frailty instead of physical outcomes. Exergaming was comparable to conventional physical exercises in improving frailty scores and indices, frailty status, and four frailty phenotypes. The findings provide insights to healthcare providers on the design of exergames.
PRISMA guidelines.
PROSPERO number: CRD42023460495.
No Patient or Public Contribution.
Depressive symptoms are common among people with dementia (PWD). Exergaming consisting of combined cognitive and physical training in gaming is increasingly used to alleviate their depressive symptoms in research. With its potential synergistic neurobiological and psychosocial effects on reducing depressive symptoms among PWD, this review aimed to understand its effectiveness and contents.
This is a systematic review of the effectiveness of exergames on depressive symptoms among older adults with dementia. A search was conducted on 7 May 2024 of the online databases CINAHL, Embase, PsycINFO, PubMed and the China Academic Journal Network Publishing Database (CNKI). The methodological quality of randomised controlled trials (RCT) and quasi-experimental studies was assessed with RoB2 and ROBINS-I, respectively. A meta-analysis of the included RCTs was conducted.
Six studies consisting of four RCTs and two quasi-experimental studies involving 235 participants with various stages of dementia were included. The meta-analysis showed a significant overall improvement in depression with a large effect size (SMD = 1.46, 95% CI = −2.50, −0.43; p = 0.006). Despite high heterogeneity (I 2 = 91%), all studies demonstrated a trend of improvement in depression after the intervention. The exergames adopted in the included trials had the following elements: simultaneous motor-cognitive training, a scoring mechanism and a social play. The dose of exergames ranged from 15 to 60 min per session for at least 8 weeks, with a minimum of two sessions weekly. However, the included studies had a moderate-to-serious risk of bias. The certainty of the evidence was very low.
Exergames could be effective at improving the depressive symptoms of older adults with dementia. Yet, a moderate-to-severe risk of bias shows a rigorous study should be conducted in the future.
This study provides evidence for healthcare professionals and informal caregivers to use exergames to address depressive symptoms in PWD.
The review was registered on PROSPERO with the reference CRD42022372762.
To develop deep learning models to predict nursing need proxies among hospitalised patients and compare their predictive efficacy to that of a traditional regression model.
This methodological study employed a cross-sectional secondary data analysis.
This study used de-identified electronic health records data from 20,855 adult patients aged 20 years or older, admitted to the general wards at a tertiary hospital. The models utilised patient information covering the preceding 2 days, comprising vital signs, biomarkers and demographic data. To create nursing need proxies, we identified the six highest-workload nursing tasks. We structured the collected data sequentially to facilitate processing via recurrent neural network (RNN) and long short-term memory (LSTM) algorithms. The STROBE checklist for cross-sectional studies was used for reporting.
Both the RNN and LSTM predicted nursing need proxies more effectively than the traditional regression model. However, upon testing the models using a sample case dataset, we observed a notable reduction in prediction accuracy during periods marked by rapid change.
The RNN and LSTM, which enhanced predictive performance for nursing needs, were developed using iterative learning processes. The RNN and LSTM demonstrated predictive capabilities superior to the traditional multiple regression model for nursing need proxies.
Applying these predictive models in clinical settings where medical care complexity and diversity are increasing could substantially mitigate the uncertainties inherent in decision-making processes.
We used de-identified electronic health record data of 20,855 adult patients about vital signs, biomarkers and nursing activities.
The authors state that they have adhered to relevant EQUATOR guidelines: STROBE statement for cross-sectional studies.
Despite widespread adoption of deep learning algorithms in various industries, their application in nursing administration for workload distribution and staffing adequacy remains limited. This study amalgamated deep learning technology to develop a predictive model to proactively forecast nursing need proxies. Our study demonstrates that both the RNN and LSTM models outperform a traditional regression model in predicting nursing need proxies. The proactive application of deep learning methods for nursing need prediction could help facilitate timely detection of changes in patient nursing demands, enabling the effective and safe nursing services.
People with HIV have a higher risk of developing non-AIDS-defining cancers in older age, leading to a significant population living with two conditions, HIV and cancer. There is an increasing interest in cannabis use for symptom management in people with chronic conditions; in 2023, the American Nurses Association officially recognised cannabis nursing as a specialty nursing practice focusing on the care of individuals seeking education/guidance in the therapeutic use of cannabis, supporting the urgency of its research. However, the scientific literature lacks a synthesised review in the focused populations.
To explore observational research on cannabis use for symptom management among people with HIV and/or cancer and identify gaps in current knowledge to inform future research and policy development.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, a literature search of relevant articles was conducted in the databases PubMed (n = 552), PsycInfo (n = 204), CINAHL (n = 164) and Embase (n = 976). Upon screening 1738 articles, 142 were identified for full-text review and 51 were retained for data extraction.
There were more studies evaluating cannabis use among people with cancer than with HIV and no studies among people living with comorbid HIV and cancer. Most studies were cross-sectional with limited metrics on the perceived effectiveness and safety of cannabis use for symptom management and its dosing/mode of delivery for reducing symptoms. While studies focused on cannabis therapy under the provision of healthcare providers, individuals reported obtaining information about cannabis from friends/family/the Internet.
This body of research could be strengthened by rigorous longitudinal study designs to build causal relationships on the therapeutic effects of cannabis use and the inclusion of reliable and valid symptom assessment measures over time, which facilitates developing clinical practice guidance and policymaking in cannabis nursing.
No patient or public contribution.
This study aims to compare the effectiveness of the case management model and the primary nursing care model by focusing on hospital stay length, readmission, follow-up resource utilisation and survival.
To improve patient continuity of care, a discharge planning team has been established at the hospital to implement the service concept of long-term medical care. The team works with a multidisciplinary medical team to provide case management, which ensures high-quality patient care.
Retrospective case–control study.
This study collected data from the medical record information system database and the Ministry of Health and Welfare's care service management information system to explore medical and follow-up care utilisation of patients discharged between 2017 and 2018. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, with the checklist used to ensure transparent and complete reporting of the methodology and results.
To ensure comparability between the case management model group and the primary nursing model group, propensity score matching was used. After matching, 660 individuals from the case management model group and 2876 individuals from the primary nursing model group were selected for further analysis. In this study, patients were primarily involved in the research as participants, providing data through their medical records for analysis. However, no direct involvement from the public or patients was used in the planning or design stages of the research.
The study found that factors such as activities of daily living (ADL) score ≤ 60 points, catheterisation, poor chronic disease control and inadequate primary caregiver capacity can lead to longer hospitalisations. Males and patients with catheters have a higher risk of readmission within 30 days, and men, those aged ≥ 75 years, those with ADL score ≤ 60, catheterisation, pressure sores or unclean wounds, financial problems, insufficient primary caregiver capacity and those readmitted within 14 days after discharge had significantly increased mortality after discharge. Although the case management model group had higher hospitalisation days, they had lower readmission rates and higher survival rates than the primary nursing model group.
Early consultation with the case manager for discharge planning can help patients to continue to receive care and utilise relevant resources after returning home.
Identifying and addressing patient-specific factors can significantly improve patient outcomes by reducing hospitalizations and readmissions, and lowering mortality rates. The case management model is more effective than the primary nursing care model in reducing readmission rates and increasing survival rates. Early consultation with case managers for discharge planning is crucial to ensuring patient care continuity and resource utilization.
To systematically analyse expert perspectives on paediatric-friendly care in the emergency department and establish specific indicators.
With an increasing number of children seeking emergency care, nurses must understand the specific needs of paediatric patients and their families.
A two-round modified Delphi method was used in this study.
In this study, experts from clinical practice and academia assessed 56 paediatric-friendly care criteria in the emergency department. Data were collected to establish a consensus and ensure content validity.
Thirty experts completed two survey rounds with response rates of 100% and 93.3%, respectively. In the initial survey, no consensus was reached for eight items. After the items were consolidated, 37 paediatric emergency-friendly care needs were identified. For each need, the item-level content validity index exceeded 0.79 for importance and feasibility. The average scale-level content validity index values were 0.95 and 0.92 for importance and feasibility. These needs were categorised into six dimensions: timely comfort (3 items), emotional care (5 items), frontline safety (11 items), emergency response (10 items), human resources support (5 items) and treatment efficiency (3 items).
Paediatric emergency nurses play a vital role in caring for children, improving soft skills through compassion and training and ensuring a well-equipped, safe environment in the emergency department.
This study offers valuable insights for emergency department nurses on the needs of children and their families, emphasising the importance of patient and family education, environmental considerations and the role of certified child life specialists in supporting the emergency healthcare team and ensuring appropriate paediatric care.
No direct patient, service user, caregiver or public involvement existed in this study.
FreshRSS 