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.
To validate the psychometric properties of the Paediatric-Friendly Care Assessment Scale in the Emergency Department (PFCAS-ED) among clinical nurses.
A cross-sectional study.
A total of 463 emergency nurses participated in the study between May and September 2023. The participants were randomly divided into two groups to assess the psychometric properties of the PFCAS-ED, including its reliability, construct validity, convergent validity, discriminant validity, and criterion-related validity.
Exploratory factor analysis on data from the first group revealed six components of the PFCAS-ED: paediatric/adolescent timely care and resources, child protection mechanisms and safety, paediatric emergency care competency training and practice, paediatric emergency consultation information and space, paediatric crisis management and response, and a harmless environment and actions for toddlers. These factors explained 69.408% of the total variance and exhibited strong internal consistency. This six-factor structure and its 28 items were further validated using confirmatory factor analysis on data from the second group, yielding satisfactory fit indices and convergent and discriminant validity. Additionally, the scale exhibited excellent 2-week test–retest reliability and criterion-related validity.
The PFCAS-ED had excellent psychometric properties when used with clinical nurses and was proven to be a reliable instrument for evaluating emergency nurses' perceptions of the importance of providing paediatric-friendly care to children and their families.
This standardised scale enables nurses to assess their perceptions of the importance of paediatric-friendly care and design targeted interventions on the basis of available resources. Additionally, hospital administrators can use the PFCAS-ED to identify priorities, strengths, and areas requiring improvement in paediatric emergency care, thereby informing the development of effective strategies and comprehensive policies.
This study adhered to the STROBE guidelines.
No patient or public involvement.
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.
To explore the incidence and factors influencing medication administration errors (MAEs) among nurses.
Medication administration is a global concern for patient safety. Few studies have assessed the incidence of MAEs or explored factors that considered the interplay between behaviour, the individual and the environment.
This retrospective study included 342 MAEs reported in the electronic nursing adverse event reporting system between January 2019 and September 2023 at a university-affiliated teaching hospital in China. Data on nurses' demographics and medication administration were extracted from the nursing adverse event reports. The reports were classified according to the severity of patient harm. The causes of the 342 MAEs were retrospectively analysed using content analysis based on Bandura's social cognitive theory. Descriptive statistics were used to calculate the proportion of medication errors and the distribution of subcategories.
In total, 74.3% of MAEs were adverse events owing to mistakes and resulted in no harm or only minor consequences for patients. Nurses aged 26–35 years and those with 6–10 years of experience were the most common groups experiencing MAEs. Factors influencing MAEs included personal (‘knowledge and skills’ and ‘physical state’), environmental (‘equipment and infrastructure,’ ‘work settings’ and ‘workload and workflow’) and behavioural (‘task performance’ and ‘supervision and communication’) factors. The study further highlighted the interrelationships among personal, behavioural and environmental factors.
Multiple factors influence MAEs among nurses. Nurse-related MAEs and the relationship between behaviours, individual factors and the environment, as well as ways to reduce the occurrence of MAEs, should be considered in depth.
Understanding the factors influencing MAEs can inform training programs and improve the clinical judgement of healthcare professionals involved in medication administration, ultimately improving patient prognoses and reducing MAEs.
The findings can help develop clinical guidelines for preventing MAEs.
This study aims to investigate whether the current wound classifications were valid for the treatment prognosis of subjects treated for limb-threatening diabetic foot ulcers (LTDFU). A total of 1548 patients with LTDFU and infection were studied, with wounds recorded using the Wagner, Texas, PEDIS and WIfI classifications while major lower extremity amputations (LEAs) or in-hospital mortality incidences were defined as poor outcomes. Among them, 153 (9.9%) patients received major LEAs and 38 (2.5%) patients died. After adjustments, the Wagner classification and Texas stage as well as clinical factors such as comorbidity with major adverse cardiac events (MACE), being under dialysis and having serum levels of C-reactive protein (CRP) and albumin were independent factors for prognosis. For patients without dialysis, Wagner and Texas stage stood out independently for prognosis. For patients on dialysis, only levels of CRP (odds ratio [OR] = 2.2 in Wagner, OR = 2.0 in WIfI, OR = 2.2 in Texas, OR = 2.3 in PEDIS) and albumin (OR = 0.4 in four classifications) were valid predictors. The Wagner system and Texas stage were valid for predicting prognosis in treatment for LTDFUs, suggesting a role of vascular perfusion. MACE history, levels of CRP and albumin level should assist in prediction; more significantly, only levels of CRP and albumin appeared valid for those subjects undergoing dialysis.
To prevent anastomotic leakage and other postoperative complications after laparoscopic rectal cancer surgery, a protective ileostomy is often used. However, the necessity of performing ileostomy after laparoscopic rectal cancer remains controversial. The aim of this meta-analysis was to assess the benefit of ileostomy on wound infection after laparoscopic rectal cancer. The Cochrane Library, EMBASE, Web of Science, and PubMed were used to retrieve all related documents up to September 2023. Completion of the trial literature was submitted once the eligibility and exclusion criteria were met and the literature quality assessment was evaluated. This study compared the post-operative post-operative complications of an ileostomy with that of non-ileostomy in a laparoscope. We used Reman 5.3 to analyse meta-data. Controlled studies were evaluated with ROBINS-I. The meta-analyses included 525 studies, and 5 publications were chosen to statistically analyse the data according to the classification criteria. There was no statistically significant difference in the rate of postoperative wound infections among ostomate and nonostomate (odds ratio [OR], 1.79; 95% confidence interval [CI], 0.66, 4.84; p = 0.25). In 5 trials, the incidence of anastomotic leak was increased after surgery in nonostomate patients (OR, 0.26; 95% CI, 0.12, 0.57; p = 0.0009). Two studies reported no significant difference in the length of operation time when nonstomal compared to stomal operations in patients with rectal cancer (mean difference, 0.87; 95% CI, −2.99, 4.74; p = 0.66). No significant difference was found in the rate of wound infection and operation time after operation among the two groups, but the incidence of anastomosis leak increased after operation. Protective ileostomy after laparoscopic rectal cancer was effective in reducing the risk of anastomotic leakage in patients, and we found no additional risk of infection. We cautiously conclude that protective ileostomy is active and necessary for patients with a high risk of anastomotic leakage after surgery, which needs to be further confirmed by high-quality studies with larger samples.
This meta-analysis was conducted to evaluate the effect of microinvasive and open operations on postoperative wound complications in low rectal carcinoma patients. Research on limited English has been conducted systematically in PubMed, Embase, Cochrane Library and Web of Science. The date up to the search was in August 2023. Following review of the classification and exclusion criteria for this research and the evaluation of its quality in the literature, there were a total of 266 related papers, which were reviewed for inclusion in the period from 2004 to 2017. A total of 1774 cases of low rectal cancer were enrolled. Of these 913 cases, the laparoscopic operation was performed on 913 cases, while 861 cases were operated on low rectal carcinoma. The overall sample was between 10 and 482. Five trials described the efficacy of laparoscopy have lower risk than open on postoperative wound infection in patients with low rectal cancer (OR, 0.72;95 % CI, 0.48,1.09 p = 0.12). Three studies results showed that the anastomotic leak was not significantly different between open and laparoscopy (OR, 0.86; 95% CI, 0.58,1.26 p = 0.44). Six surgical trials in low rectal cancer patients reported haemorrhage, and five cases of surgical time were reported, with laparoscopy having fewer bleeding compared with open surgery (MD, −188.89; 95% CI, −341.27, −36.51 p = 0.02). Compared with laparoscopy, the operation time was shorter for the open operation (MD, 33.06; 95% CI, 30.56, 35.57 p < 0.0001). Overall, there is no significant difference between laparoscopy and open surgery in terms of incidence of infection and anastomosis leak. However, the rate of haemorrhage in laparoscopy is lower，and operation time in open surgery is lower.
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