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Anteayer Journal of Advanced Nursing

Daily self‐care practices influence exit‐site condition in patients having peritoneal dialysis: A multicenter cross‐sectional survey

Abstract

Aims

To investigate practice patterns in exit‐site care and identify the risk factors for exit‐site infection.

Design

A quantitative cross‐sectional design.

Methods

Data were collected in 12 peritoneal dialysis (PD) centres in 2018. Daily exit‐site care practice patterns and exit‐site status of patients receiving PD were assessed through interviews and questionnaires.

Results/findings

Most of the 1,204 patients adhered with the protocols about main aspects of exit‐site care, such as cleansing agents selection, frequency of cleansing, catheter fixation, and following the catheter protective measures. However, their adherence levels on hand hygiene, mask wearing, observing exit site, examining secretion, and communicating with PD staff were rather low. Eighty‐four patients' exit sites were evaluated as problematic exit site (PES). And 186 patients had catheter‐related infection (CRI) history. After multivariable logistic regression analysis, diabetes (OR = 1.631), traction bleeding history (OR = 2.697), antibiotic agents use (OR = 2.460), compliance on mask wearing (OR = 0.794), and observing exit site (OR = 0.806) were influencing factors of CRI history. Traction bleeding history (OR = 2.436), CRI history (OR = 10.280), and effective communication (OR = 0.808) with PD staff were influencing factors for PES.

Conclusions

The adherence levels on different aspects of exit‐site care were varied in patients having PD. Their self‐care behaviours did correlate with the exit‐site status.

Impact

The adherence level of patients’ exit‐site care practice needs attention of medical staff. Further studies about the optimal procedure in exit‐site care were warranted.

Exploring the roles of advanced practice nurses in the care of patients following fragility hip fracture: A systematic review

Abstract

Aim

This study aimed to explore the role and impact of advanced practice nurses (APNs) in care of patients following fragility hip fracture by systematically reviewing the available evidence.

Review Design

Systematic review.

Data sources

A search of the databases Ovid Medline, CINAHL, Embase, Emcare, Cochrane Library, and Google Scholar was conducted from January–February 2019.

Method

This systematic review adhered to The PRISMA Statement. Study selection was managed using the Covidence software platform and quality was assessed using JBI Critical appraisal tools. Studies included adults >18 years and described the role and impact of APNs in care of patients following fragility hip fracture on clinical and non‐clinical outcomes.

Results

There were 19 papers identified that met the inclusion/exclusion criteria. Quality was graded as moderate to low risk of bias. Six characteristics of APNs were identified: (1) coordination; (2) collaboration; (3) education; (4) assessment, investigation and treatment recommendations; (5) discharge planning, support and follow up; and (6) documentation. Overall mortality and LOS improved when characteristics of the APN role were present.

Conclusion

Key findings from this systematic review showed: (1) The APN title and role are not clearly defined, but characteristics of the APN role are evident; (2) characteristics of APNs promote the delivery of best practice hip fracture care and have a positive impact on mortality and LOS; and (3) innovative service delivery models involving APNs should be considered to address future projections of hip fracture rates and improve outcomes.

Impact

This systematic review provides evidence of the role characteristics of APNs in fragility hip fracture and the impact of the role on outcomes. Findings from this research could be used to develop service delivery models using APNs to care for patients following fragility hip fracture and to inform practice where APN roles may improve outcomes for other patient cohorts.

The experience of women following first acute coronary syndrome: An integrative literature review

Abstract

Aim

There is lack of evidence and research understanding among women's lived experiences following first acute coronary syndrome, thus their recovery process remains poorly understood. To date research has largely focused on men's experience of acute coronary syndrome while this area of health care and recovery has considerable impact on women's health and quality of life. Our aim was to review the literature exploring lived experience of women following first acute coronary syndrome.

Design

Integrative review of the literature.

Data source

We searched PubMed, MEDLINE, EMBASE, CINAHL and Scopus from 2008–2018 for articles published in English.

Review method

Of 1675 publications identified, 18 qualitative, quantitative, and mixed method studies met our inclusion criteria. Quality of included studies was assessed using Joanna Briggs Institute quality assessment tools. Findings were integrated using thematic synthesis.

Results

Experiencing acute coronary syndrome was reported to have significant impacts on women's lives. The most common issues reported were physical limitations, fear, and uncertainties about the future, sexual dissatisfaction, and social isolation. Women also reported to have higher short‐ and long‐term mortality rate, stroke, recurrent, and hospital readmissions compared with men.

Conclusion

This review identified current knowledge and gaps about lived experience of women following first acute coronary syndrome. It is anticipated that the information gained from this literature review will support new research aimed at improving the care women receive following acute coronary syndrome and therefore enhance their recovery and quality of life.

Impact

This review contributes to the current body of knowledge by addressing women's physical, psychosocial, and sexual state following acute coronary syndrome. Improvement in women's quality of life after acute coronary syndrome necessitates further research which ultimately results in better management and treatment of women and their recovery following first acute coronary syndrome.

Features and diversity of symptoms of moyamoya disease in adolescents: A cluster analysis

Abstract

Aims

The purpose of this study is to explore the symptoms experienced by adolescents with moyamoya disease and to identify the characteristics of each symptom cluster associated with moyamoya disease.

Design

A retrospective and descriptive design, which is a secondary data analysis study based on electronic medical record data from hospitals.

Methods

To assess the symptoms associated with moyamoya disease, a qualitative study was conducted on 12 adolescents, 12 caregivers and 12 experts on moyamoya disease. According to a qualitative study, 12 main symptoms (limb weakness, numbness, pins and needles, difficulty in speech, blurred vision, facial paralysis, hand tremors, involuntary movements, convulsions, dizziness, nausea/vomiting and headaches) were selected. Data were collected around these symptoms. The data collection was carried out through the Electronic Medical Record (EMR) data of 303 adolescents aged 13–19 who were diagnosed with moyamoya disease (ICD 10 Code: I67.5) between January 2010–December 2019 in a hospital in Seoul, South Korea. Cluster analysis was applied to identify symptom clusters with the hierarchical cluster agglomerative approach. We used the log‐likelihood distance to measure the similarity of variables. Proximity between groups of variables was measured using the two‐step method.

Results

The physical symptoms experienced by adolescents with moyamoya disease were ‘limb weakness’ – the most common – followed by a ‘headache,’ ‘difficulty in speech,’ and ‘nausea/vomiting.’ A total of five symptom clusters were derived: cluster 1 was characterized by ‘limb weakness’; cluster 2 participants were asymptomatic or experienced ‘convulsions’; cluster 3 experienced ‘difficulty in speech’ and ‘facial paralysis’; cluster 4 is prone to ‘dizziness’ and ‘pins and needles’; and cluster 5 displays ‘headaches’ and ‘nausea/vomiting’.

Conclusion

This study offers a multidimensional approach for identifying differences in clinical symptoms of moyamoya disease among adolescents.

Impact

These results will help provide interventions concerning the characteristics of the symptoms of moyamoya disease among adolescents.

Influence of transition readiness from paediatric to adult health care on quality of life in child–parent dyads with long‐term conditions

Abstract

Aim

To delineate the impact of perspective of children's transition readiness from paediatric to adult health care on quality of life in child–parent dyads with long‐term conditions. We used Actor–Partner Interdependence Model to identify actor effects (effect of one's own transition readiness on one's own quality of life) and partner effects (effect of one's own transition readiness on the partner's quality of life).

Design

A multi‐centre cross‐sectional survey.

Methods

The study was conducted in two paediatric hospitals in China from October 2018‐August 2019. We used a researcher‐designed questionnaire to collect demographic and clinical characteristics. Furthermore, we used four questionnaires assessing transition readiness and quality of life in child and parent respectively to collect data from 370 child–parent dyads. Structural equation modelling was applied to estimate the effect of actor–partner interdependence models.

Results

The total score of transition readiness had two actor effects on total child and parent quality of life controlling for age (β children = 3.335, p = .032 and β parents = 8.952, p < .001), while only one actor effect controlling for gender (β parents = 8.891, p < .001). Specific transition readiness dimensions had different partner effects on different domains of children and parents' quality of life. Moreover, younger children and fathers had a better quality of life.

Conclusion

Our study verified inherently interpersonal relationship that transition readiness appeared to influence quality of life in child–parent dyads with long‐term conditions.

Impact

This study was the first to verify mutual influence of transition readiness and quality of life in child–parent dyad using actor–partner interdependence model. Nurses who design the transition promoting programs should consider the effective communication between healthcare provider and child–parent dyads and support parents' involvement to improve shared understanding about managing child's condition, especially for older children and mothers.

Self‐reported competences of public health nurses for developing needs‐oriented local healthcare plans: A nationwide cross‐sectional survey

Abstract

Aim

To identify self‐reported competencies of public health nurses for reflecting community healthcare needs in local healthcare plans.

Design

We conducted a nationwide cross‐sectional survey in Japan from October 7‐November 30, 2019.

Methods

We sent 2,185 self‐reported questionnaires to public health nurses in Japan who had developed a local healthcare plan since 2013. Self‐reported questionnaires included questions regarding demographic data and the reflection of community healthcare needs in local healthcare plans, and the involvement in local healthcare planning.

Results

We analysed 1,042 questionnaires: 651 (62.5%) were from public health nurses who reported that they elicited and shared community views to be reflected for purposes of local healthcare planning (the reflecting group), and 391 (37.5%) of the remaining public health nurses who reported that they did not do so (the non‐reflecting group). The logistic regression analysis revealed that public health nurses in the reflecting group were more likely to be in a managerial position, have colleagues who played an active role in healthcare planning, conduct a questionnaire survey, engage in group work, participate in a municipal healthcare planning committee with community‐dwelling people, and identify the opinions of the professional organizations.

Conclusions

Identifying community healthcare needs through collaboration with community‐dwelling people and professional organizations should be essential competencies for public health nurses (the reflecting group) in developing needs‐oriented local healthcare plans.

Impact

Identification of their related competencies for developing a needs‐oriented local healthcare plan as an upstream strategy to mitigate the prevalence of health inequities in each community.

A systematic review of supportive interventions to promote women's comfort and well‐being during induction of labour

Abstract

Aims

To evaluate the effectiveness of non‐pharmacological non‐invasive supportive interventions for impacts on women's comfort and well‐being during induction of labour.

Design

A quantitative systematic review without meta‐analysis.

Data Sources

Databases were searched for primary research published in English between 2000–2019: AMED, CINAHL, Medline, Maternity and Infant Care database, PsycINFO, and ProQuest. The quality of studies was evaluated using JBI levels of evidence and established critical appraisal tools. Studies describing measures of comfort, coping, and well‐being for women during induction of labour were included.

Results

Two articles met the criteria for inclusion. There is limited evidence to suggest that women having outpatient cervical priming were more satisfied with their experience than women having inpatient cervical priming and that outpatient cervical priming did not increase women's anxiety. A specifically designed information brochure explaining the induction process improved women's knowledge and understanding.

Review Methods

The quantitative systematic review followed the Centre for Reviews and Dissemination guidelines and Cochrane Effective Practice and Organisation of Care guidance. Quality appraisal was conducted using JBI levels of evidence, Cochrane Risk of Bias, and other established tools. A narrative description of the quantitative data was undertaken. There was insufficient evidence to perform a narrative synthesis or meta‐analysis due to the nature of the study designs and insufficient outcome data.

Conclusions

Globally, the number of women having an induction of labour is increasing and there is a lack of evidence on the effectiveness of supportive interventions. Components of supportive care for women having induction of labour require urgent evaluation. Measurement tools which capture the complexity of supportive care for women having induction of labour need to be developed and validated.

Impact

This is the first review to evaluate non‐pharmacological, non‐invasive supportive interventions for women having induction of labour. The findings of this review identify the urgent need to develop an evidence base for effective supportive.

Issue Information

Journal of Advanced Nursing, Volume 77, Issue 5, May 2021.

Association between illness perception and health behaviour among stroke patients: The mediation effect of coping style

Abstract

Aims

This study aims to explore illness perception and coping style in relation to health behaviour and the mediating role of coping style between illness perception and health behaviour among stroke patients.

Design

Cross‐sectional study.

Methods

This survey was conducted with 515 stroke patients aged ≥18 years from September 2019 to January 2020 in Zhengzhou, China. The demographic and clinical characteristics questionnaire, Stroke Illness Perception Questionnaire‐Revised, Simplified Coping Style Questionnaire, and Health Behavior Scale for Stroke Patients were included in this study. Data analysis was performed by correlation analysis, multiple linear regression analysis, and structural equation modelling.

Results

The valid questionnaires were 495 (effective response rate: 96.1%). Low negative illness perception, high positive coping style, and low negative coping style are related to high level of health promoting behaviour (all p < 0.01). The results revealed that the effect of illness perception on health behaviour was partly mediated by coping style. It also confirmed that the mediation effect accounts for 43.7% (−0.169/−0.387) of the total effect.

Conclusion

Illness perception may influence health behaviour partly because of coping style.

Impact

This study implies that targeted interventions for stroke patients' illness perception are needed to motivate them to take proactive coping strategy to ultimately improve their health behaviours.

Finding a balance in family caregiving for people with dementia: A correlational longitudinal study

Abstract

Aims

The “Finding a Balance Point” framework was used to explore the caregiving process over time for family caregivers of people with dementia in Taiwan. This study aimed to: (a) identify Taiwanese caregivers’ different balance trajectories; (b) explore predictors of trajectory group membership; and (c) examine associations of different balance trajectories with caregiving outcomes.

Design

A correlational longitudinal design was used.

Methods

Data were collected from 200 family caregivers’ self‐completed questionnaires and they were followed over 2 years (June 2015–May 2017). Discrete balance trajectories were identified by group‐based trajectory modelling. Predictors of trajectory group membership were identified from potential predictors of caregiving characteristics and caregiving factors using multivariate logistic regression. Associations of trajectory groups with caregiving outcomes (depressive symptoms and health‐related quality of life) were explored using the generalized estimating equation.

Results

Balance trajectories best fit a two‐group trajectory model (poor and good). Caregivers with a poor sense of balance between competing needs were more likely to have more depressive symptoms (b = 11.71, 95% CI [9.04, 14.38], < .001), worse physical health (b = −6.22, 95% CI [−8.71, −3.74], < .001), and worse mental health (b = −11.1, 95% CI [−13.58, −8.63], < .001) than caregivers with a good sense of balance. Caregivers experiencing lower role strain (b = −1.45, SE = 0.48, = .003) or higher predictability (b = 2.83, SE = 0.76, < .001) were more likely to belong to the good‐balance group.

Conclusions

Caregivers with poor balance between competing needs are more likely to have worse caregiving outcomes. Role strain and predictability significantly predicted balance trajectory groups. Family caregivers with lower caregiving task difficulty and/or better knowledge of the care receiver were more likely to be in the good balance trajectory group.

Impact

Our findings support the framework, “Finding a Balance Point,” and clarify the family caregiving process for people with dementia. This framework could be used to tailor interventions for home care nurses to improve family caregivers’ caregiving outcomes.

Nursing‐sensitive outcomes in adult inflammatory bowel disease: A systematic review

Abstract

Aims

To evaluate nursing activity through outcomes that are affected, provided, and/or influenced by nurses and defined as nursing‐sensitive outcomes in adult IBD patients.

Design

Systematic review without meta‐analysis.

Data Sources

PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library databases on August 2019.

Review Methods

Peer‐reviewed articles published between 2000–2020 were reviewed. The outcome measures were contextualized and presented by OMERACT Filter 2.0.

Results

Twenty‐four studies were included. Eighteen nursing‐sensitive outcomes were identified. These outcomes defined eight domains for health intervention, fitting into three core areas (resource use/economic impact, life impact, pathophysiological manifestations). Fifty‐three measurement instruments were identified.

Conclusions

Through 53 measurement tools, with use of OMERACT framework, 18 nursing‐sensitive outcomes in the main 3 core areas were identified, highlighting the multidimensional role of nursing. Further insights are to be carried out to define nursing outcomes included in IBD nursing intervention studies.

Impact

These results could serve as a cornerstone for further investigations and validation by a panel of experts to standardizing nursing activity in a multidisciplinary context.

A systematic review and meta‐analysis of mindfulness‐based interventions for patients with coronary heart disease

Abstract

Aims

To assess the effects of mindfulness‐based interventions for patients with coronary heart disease.

Design

A systematic review with meta‐analysis.

Data sources

Eight mainstream databases, including Ovid MEDLINE, Embase, Ovid Emcare, PsycInfo, CINAHL complete, Web of Science, CENTRAL and PubMed, were searched from January 1979–March 2020.

Review methods

Randomized controlled trials that evaluated mindfulness‐based interventions on psychological outcomes, cardiovascular risk factors and quality of life in adults with coronary heart disease were considered. We conducted meta‐analyses using the random‐effects model.

Results

Nine studies involving 644 participants were included. Compared with inactive controls (e.g. usual care), mindfulness‐based interventions significantly reduced depression (SMD −0.72, 95% CI −1.23 to −0.21, p < .01) and stress (SMD −0.67, 95% CI −1.00 to −0.34, p < .01), but not anxiety and blood pressure. There were no significant psychological effects compared with active controls (e.g. other psychological interventions). In one of three studies that assessed generic quality of life, mindfulness‐based interventions significantly improved psychological and social domains compared with active control. The intervention effects on other cardiovascular risk factors were inconclusive given that only one study assessed each outcome with non‐significant findings. Subgroup analyses suggest that intervention type and participants’ depression and anxiety status may influence intervention effects.

Conclusions

Mindfulness‐based interventions may benefit patients with coronary heart disease in reducing depression and stress, but the effects on cardiovascular risk factors and quality of life are inconclusive.

Impact

This review offers preliminary evidence for the potential of mindfulness‐based interventions as an effective complementary approach to addressing psychological distress among people with coronary heart disease. Given the limitations in current studies, further rigorously designed and well‐reported research is necessary to give robust evidence. Studies exploring the intervention effects on cardiovascular risk factors and quality of life are warranted to remedy the research and knowledge gap.

Pre‐existing mental health disorders in patients admitted to the intensive care unit: A systematic review and meta‐analysis of prevalence

Abstract

Aims

To determine the reported prevalence rate of pre‐existing mental health disorders in patients admitted to adult ICUs and identify the most commonly occurring types of these disorders.

Design

Systematic review and meta‐analysis.

Data sources

Five electronic databases were searched from 1 January 2000 ‐15 April 2020. Google Scholar was used to perform forwards citation searching.

Methods

This review was conducted in line with the PRISMA guidelines and protocol registered with PROSPERO CRD42020181818. Meta‐analyses were performed using the quality effects model to calculate weighted pooled prevalence estimates and heterogeneity was tested using the I 2 statistic.

Results

Seven articles were included in the final review and meta‐analysis (143,179 participants). Identified prevalence rates varied considerably, ranging from 6.2–28.0%, reflecting variation in each study's clinical context, as well as different patient selection and identification methodologies. The pooled prevalence rate of all pre‐existing mental health disorders was 19.4% (95% CI 8.9–32.6%). Depression was the most common subtype, accounting for an estimated 60.5% (95% CI 54.4–66.5%) of identified mental health disorders. All analyses showed significant heterogeneity with I 2 > 95%.

Conclusion

Approximately 19% of adult ICU patients have a history of a mental health disorder, most commonly depression. Further research is needed to improve the accuracy of this estimate as well as determine the best identification method.

Impact

This study has demonstrated that patients with pre‐existing mental health disorders, particularly depression, constitute a significant subgroup in ICU. Given that the presence of a pre‐existing mental health disorder appears to confer an increased mortality risk following ICU discharge, clinicians need to be made aware of this group of patients to provide additional support. Further research is needed to more accurately quantify this vulnerable group and establish methods to enable clinicians to readily identify and refer these patients for appropriate follow‐up treatment.

Physical activity in the context of advanced breast cancer: An integrative review

Abstract

Aims

To describe and synthesize diverse empirical evidence regarding physical activity (PA) in the context of advanced breast cancer (ABC).

Design

Integrative review guided by the work of Whittemore and Knafl (2005).

Data sources

Six electronic databases were systematically searched to identify relevant literature published between January 2007–June 2019.

Review methods

Abstracts of papers that met the inclusion criteria were reviewed by two researchers and full texts of eligible papers were assessed. Data were extracted by two independent researchers and inter‐rater reliability of data extraction established. Quality of papers was evaluated using the Mixed Methods Appraisal Tool. Data were organized according to comprehensive thematic analysis and the biobehavioural model for the study of exercise interventions.

Results

Of the 532 abstracts, 18 studies met the inclusion criteria which included six randomized controlled trials, one quantitative non‐randomized study, seven quantitative descriptive studies, three mixed method studies and one qualitative study. Results from studies enrolled fell into four domains: PA performance and its influence on survival; barriers and preferences for PA; interventions to enhance PA; perceived benefits of PA from qualitative feedback.

Conclusion

Evidence suggests that ABC patients are physically inactive. Main barriers of PA are less aerobic fitness and heavy symptom burden. Simple, tailored and specialist‐supervised PA is preferred by ABC patients. Form of joint self‐instructed and group accompanying is advocated as well. PA intervention programmes identified in this review vary on type, intensity, duration and frequency, while generally, are found to be feasible, safe and beneficial to patients’ physical and psychosocial well‐being.

Impact

The results propose tailored, supervised, group‐based PA programmes are in urgent need for ABC patients. Clinical professionals should manage more feasible and safer PA interventions to help improve patients’ overall health. More research with rigorous methodology design is warranted to explore PA’s effect on long‐term health outcomes.

An integrative review: Women’s psychosocial vulnerability in relation to paid work after a breast cancer diagnosis

Abstract

Aim

The aim of this integrative review was to explore psychosocial vulnerabilities in women after a breast cancer diagnosis that are related to their paid work.

Design

The review methodology was guided by Whittemore and Knafl. The Mehnert Cancer Survivorship and Work Model provided a lens through which to view vulnerability in working women with a focus on facilitating interventions to improve both recovery and work outcomes.

Data Sources

PUBMED, CINAHL, Web of Science, and PsycNET databases were searched for English language papers published between January 2014–June 2020.

Review Methods

Titles and abstracts were screened. Inclusion/exclusion criteria were then applied to full text screen of the remaining articles following PRISMA guidelines. Thirteen studies meeting the inclusion criteria were critically appraised using the Critical Appraisal Skills Programme (CASP) checklist. A constant comparison approach was used to systematically distil findings into categories and assess their fit within the Mehnert Model subdomains.

Results

Vulnerabilities coalesced predominantly within the following subdomains: (a) changes in identity and role functioning; (b) social reintegration; (c) coping strategies; and (d) social supports. Patterns and themes within these subdomains were related both positively and negatively to form the contours of a survivor's satisfaction/dissatisfaction with quality of life related to work and breast cancer recovery.

Conclusion

Overall, findings highlight the importance of employment and work environments in bolstering women's psychosocial health after a breast cancer diagnosis.

Impact

Findings from this review support adapting psychosocial distress screening to include vulnerabilities relating to work life. Nurses are ideally positioned to facilitate this screening and engage clinicians in a dialogue surrounding patient's support needs due to nursing's central role on the interdisciplinary team. Nurses may also foster collective accountability for implementing ongoing multidisciplinary survivorship care plans that include a return to work component.

Integrative literature review of evidence‐based patient‐centred care guidelines

Abstract

Aim

To summarize what facilitates patient‐centred care for adult patients in acute healthcare settings from evidence‐based patient‐centred care guidelines.

Design

An integrative literature review.

Data sources

The following data sources were searched between 2002‐2020:

Citation databases: CINAHL, Medline, Biomed Central, Academic Search Complete, Health Source: Nursing/Academic Edition and Google Scholar.

Guideline databases: US National Guideline Clearinghouse, Guidelines International Network, and National Institute for Health and Clinical Excellence (NICE).

Websites of guideline developers: Scottish Intercollegiate Guidelines Network, Royal College of Nurses, Registered Nurses Association of Ontario, New Zealand Guidelines Group, National Health and Medical Research Council, and Canadian Medical Association. Guidelines.

Review methods

Whittemore and Knafl's five‐step integrative literature review: (1) identification of research problem; (2) search of the literature; (3) evaluation of data; (4) analysis of data; and (5) presentation of results.

Results

Following critical appraisal, nine guidelines were included for data extraction and synthesis. The following three groups of factors were found to facilitate patient‐centred care: 1) Patient care practices: embracing values foundational to patient‐centred care, optimal communication in all aspects of care, rendering basic nursing care practices, and family involvement; 2) Educational factors: staff and patient education; and 3) Organizational and policy factors: organizational and managerial support, organizational champions, healthy work environment, and organizational structures promoting interdisciplinary partnership.

Conclusion

Evidence from included guidelines can be used by nurses, with the required support and buy‐in from management, to promote patient‐centred care.

Impact

Patient‐centred care is essential for quality care. No other literature review has been conducted in the English language to summarize evidence‐based patient‐centred care guidelines. Patient care practices and educational, organizational, and policy factors promote patient‐centred care to improve quality of care and raise levels of awareness of patient‐centred care among nursing staff and patients.

Effects of a mobile phone application for graduate nurses to improve central venous catheter care: A randomized controlled trial

Abstract

Aim

To develop and test a mobile phone application (app) for graduate nurses on the use and care of central venous catheters.

Design

A randomized controlled trial was conducted at a teaching hospital in the central east coast of Taiwan.

Methods

Recruitment occurred from 1 August 2019 ‐31 October 2019. All graduates (N = 90) attending a 2‐week induction program attended a lecture and completed a 10‐item questionnaire on central venous catheter assessment and care at the end of Week 1 (Time 1). Volunteers were then randomly allocated to receive a link to the learning app on their mobile phone (n = 39 Group A) or control condition (N = 40 Group B). One week later, all graduates completed the knowledge assessment (Time 2) and a simulated clinical assessment with a mannequin. Skills were assessed using an 11‐item, direct observation of procedural skills form. Only data from consenting participants were analysed.

Results

Compared with controls, nurses receiving the intervention reported significantly better knowledge (t = −7.98, p < .001, CI = 20.9~34.8) and skill scores (t = 2.83, p = .006, CI = 1.14~6.61). More frequent use of the mobile phone app was associated with higher knowledge (r = 0.39, p = .02, CI = 0.11~0.99) and skills (r = 0.42, p = .008, CI = 0.17~1.03).

Conclusion

Mobile app instruction for graduate nurses on central venous catheter care increased specific knowledge and skills compared with conventional methods of instruction.

Impact statement

Implementation of mobile phone application technology can be considered a feasible means to proactively provide training and education. Mobile phone apps could be developed for a range of clinical procedures and various settings. Future studies with a larger sample and a longitudinal follow‐up are warranted to confirm results.

Assessment of compliance with oral nutritional supplementation and exploration of barriers and facilitators for patients after gastrectomy: A mixed‐methods study

Abstract

Aims

To evaluate the compliance of patients after gastrectomy in taking oral nutritional supplementation and to explore the promoting and hindering factors.

Design

A mixed‐methods design with an explanatory sequential approach was employed.

Methods

We conducted a 12‐week longitudinal study to evaluate the oral nutritional supplementation compliance of 122 patients after gastric cancer surgery and the factors that affected their compliance. After the quantitative phase, we selected the interview subjects and developed the interview outline based on the analysis of the quantitative results. In‐depth interviews (n = 15) were conducted to explain and supplement the quantitative phase results. Data were collected from October 2019 to May 2020.

Results

The average overall compliance rate of oral nutritional supplementation in patients with gastric cancer over 12 weeks was 30.59%. Adverse reactions to oral nutritional supplementation, the identity of the main caregivers and the patient's financial ability were independent factors that affected patient compliance. In subsequent interviews, we extracted four themes: social support plays an important role in patients taking oral nutritional supplementation, adverse reactions discourage patients from continuing to take oral nutritional supplementation, patients' attitudes affect their motivation to take oral nutritional supplementation, and the different needs of patients for oral nutritional supplementation affect patient compliance.

Conclusion

Patients' compliance with oral nutritional supplementation after gastric cancer surgery is very low. Health education should pay more attention to the management of adverse reactions and the role of patients' peers and family members. Oral nutritional supplementation products should be diversified to provide patients with more choices.

Impact

This study clarifies the factors that hinder and promote oral nutritional supplementation compliance and provides an important reference for the establishment and revision of health education strategies for patients after gastric cancer surgery.

Future outcomes and health needs of chronic hepatitis C patients after receiving antiviral therapy

Abstract

Aims

To study the future outcomes and health needs of chronic hepatitis C (CHC) patients after receiving direct‐acting antiviral (DAA) therapy based on the health promotion perspectives and cardiometabolic risks in a rural setting.

Design

This cross‐sectional study was conducted from May to December 2019 in coastal western and southern Taiwan.

Methods

We included CHC patients who were diagnosed and transferred by the gastroenterologist and hepatologist in outpatient clinics and completed DAA treatments. Data on demographic characteristics, health‐related behaviours and physiological biomarkers were collected through one‐on‐one interview using a questionnaire and from medical records obtained from a teaching hospital.

Results

In total, 124 participants were enrolled. Most participants (87.1%) had no side effects and 79.8% felt satisfied after treatment. However, 62.1% had metabolic syndrome, 48.4% had hypertension and 37.9% had diabetes. Furthermore, 71.8% patients were considered to have medium‐to‐high risk based on Framingham risk scores. In the multiple regression model, after adjusting for education level, other chronic diseases were negatively associated with health‐promoting behaviours in participants.

Conclusions

Although there were few side effects and most patients were satisfied after treatment, there was a high prevalence of cardiometabolic risk factors and cardiometabolic diseases and less adoption of healthy behaviours in CHC patients. Despite the small sample size, the study suggests that clinicians can reduce the burden of the aforementioned comorbidities by providing adequate treatment and individualized lifestyle modification.

Impact

This study highlights that primary healthcare providers should consider the health needs of CHC patients after DAA treatment since many patients have high cardiometabolic risks, but only a few adopt a healthy lifestyle. Further studies are needed to initiate health‐promoting programs for these patients to reduce further injury to vital organs.

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