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To construct a nursing programme to manage intra-abdominal pressure (IAP) in neurocritical care patients.
The consensus of 16 experts was collected using a two-round Delphi method.
First, we developed the early stages of the nursing programme for managing IAP in neurocritical care patients through preliminary study and relevant literature internationally. A questionnaire was then distributed to a panel of 16 experts, each with over 10 years of experience in respiratory critical care, neurocritical care or comprehensive intensive care unit treatment. Between April and May 2024, these experts reviewed the preliminary programme and provided feedback and recommendations for modifications.
Two rounds of expert consultation were conducted. After the first round of expert feedback, 22 items were revised. In the second round, eight additional items were revised. The questionnaire recovery rates in both rounds of correspondence were 88.9% and 100%, and the authority coefficients were 0.869 and 0.888, respectively. The Kendall W values ranged from 0.127 to 0.336 (p < 0.001). Consensus was reached on six Level 1 entries, 17 Level 2 entries, and 50 Level 3 entries.
A panel of 16 experts approved the proposed nursing approach for managing IAP in neurocritical care.
This nursing protocol offers a systematic approach for managing IAP throughout all stages of care in neurocritical settings. Moreover, this programme can guide neurocritical care nurses in maintaining optimal IAP at critical times. The protocol could potentially be used in training nurses on IAP regulation and enhancing their management skills in this specialised area of care, along with preventing IAP-related health issues.
The study is reported in accordance with the Guidance on Conducting and Reporting DElphi Studies (CREDES) recommendations.
No patient or public contribution.
To construct a symptom network of maintenance hemodialysis patients and identify the core symptoms and core symptom clusters. Finally, this study provides a reference for accurate symptom management.
A correlational cross-sectional design. A total of 368 patients who underwent maintenance hemodialysis were enrolled from two hemodialysis centers in Chengdu, Sichuan Province, China. A symptom network was constructed with the R coding language to analyze the centrality index. Symptom clusters were extracted by exploratory factor analysis, and core symptom clusters were preliminarily determined according to the centrality index of the symptom network.
The most common symptoms in maintenance hemodialysis patients were fatigue, dry skin, and pruritus. In the symptom network, headache had the highest mediation centrality (rB = 2.789) and closeness centrality (rC = 2.218) and the greatest intensity of numbness or tingling in the feet (rS = 1.952). A total of six symptom clusters were extracted, including pain and discomfort symptom clusters, emotional symptom clusters, gastrointestinal symptom clusters, sleep disorder symptom clusters, dry symptom clusters, and sexual dysfunction symptom clusters. The cumulative variance contribution rate was 69.269%.
Fatigue, dry skin, and pruritus are the sentinel symptoms of maintenance hemodialysis patients, headache is the core symptom and bridge symptom, and pain symptom clusters are the core symptom clusters of MHD patients. Nurses can develop interventions based on core symptoms and symptom clusters to improve the effectiveness of symptom management in maintenance hemodialysis patients.
Understanding the core symptoms and symptom groups that plague maintenance hemodialysis patients is critical to providing accurate symptom management. To ensure that maintenance hemodialysis patients receive effective support during treatment, reduce the adverse effects of symptoms, and improve the quality of life of patients.
To identify available instruments for assessing cancer patients' spiritual needs and to examine their psychometric properties using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology.
Cancer patients frequently have significant spiritual needs. The nurse plays an integral role in assessing the patient's spiritual needs as part of providing holistic care. It is crucial to assess these needs using appropriate and reliable instruments.
A systematic review based on COSMIN methodology.
Seven electronic databases (PubMed, EMBASE, CINAHL, Web of Science, ProQuest, CNKI and WANFANG) were systematically searched from inception until 14 February 2023. Two authors independently screened eligible literature, extracted data and evaluated methodological and psychometric quality. This systematic review was conducted following the PRISMA checklist.
Sixteen studies have reported 16 different versions of the instruments. None of the instruments were properly assessed for all psychometric properties, nor were measurement error, responsiveness and cross-cultural validity/measurement invariance reported. All of the instruments failed to meet the COSMIN quality criteria for content validity. The quality of evidence for structural validity and/or internal consistency in five instruments did not meet the COSMIN criteria. Eventually, five instruments were not recommended, and 11 were only weakly recommended.
Instruments to assess spiritual needs exhibited limited reliability and validity. The Spiritual Care Needs Scale is provisionally recommended for research and clinical settings, but its limitations regarding content validity and cross-cultural application must be considered in practice. Future research should further revise the content of available instruments and comprehensively and correctly test their psychometric properties.
The review findings will provide evidence for healthcare professionals to select instruments for recognising spiritual needs in cancer patients.
This study is a systematic review with no patient or public participation.
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