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The role of evidence‐based practice and empathy in shared decision‐making attitudes among newly graduated nurses: A cross‐sectional study

Abstract

Aim

Examine the levels of variables and explore drivers associated with shared decision-making attitudes among newly graduated nurses.

Design

This was a descriptive and cross-sectional study.

Methods

From August 2022 to October 2022, a cross-section of 216 newly graduated nurses from four comprehensive A-level hospitals in northern China was recruited using convenience sampling. Newly graduated nurses are generally defined as nurses with a service period of six months to one year. Data were collected using an online questionnaire support platform, including the Nursing Shared Decision-Making Attitude scale, Jefferson scale of Empathy-Health profession students and the Health Sciences Evidence-Based Practice questionnaire. All data were analysed descriptively, and correlational analysis and hierarchical regression were used to make identical connections between variables.

Results

Newly graduated nurses supported shared decision-making. Perceptions of shared decision-making were correlated with the experiences of empathy and evidence-based practice. Additionally, perspective-taking of empathy and beliefs, and the ability to search for and apply existing scientific findings of evidence-based practice had a significant impact on more positive attitudes.

Conclusion

The survey showed that acceptance of shared decision-making was positive among newly graduated nurses. Clinical nursing managers and teachers should pay attention to cultivating the evidence-based practice and empathy of newly graduated nurses to adopt an optimistic attitude towards shared decision-making in the long term.

Impact

The survey addresses attitudes of shared decision-making among newly graduated nurses and determines whether empathy and evidence-based practice has an impact on it. The main finding is that newly graduated nurses have an optimistic outlook on the implementation of shared decision-making. This survey showed that empathy and evidence-based practice competencies are associated with shared decision-making attitudes among newly graduated nurses. The results of this survey have an impact on educational institutions and hospitals in the form of recommendations. Several training programmes on empathy and evidence-based practice can help adopt the shared decision-making attitudes of newly graduated nurses.

Patient or public contribution

No patient or public contribution.

BMP9 is a potent inducer of chondrogenesis, volumetric expansion and collagen type II accumulation in bovine auricular cartilage chondroprogenitors

by Oliver F. W. Gardner, Yadan Zhang, Ilyas M. Khan

Reconstruction of the outer ear currently requires harvesting of cartilage from the posterior of the auricle or ribs leading to pain and donor site morbidity. An alternative source for auricular reconstruction is in vitro tissue engineered cartilage using stem/progenitor cells. Several candidate cell-types have been studied with tissue-specific auricular cartilage progenitor cells (AuCPC) of particular interest. Whilst chondrogenic differentiation of competent stem cells using growth factor TGFβ1 produces cartilage this tissue is frequently fibrocartilaginous and lacks the morphological features of hyaline cartilage. Recent work has shown that growth factor BMP9 is a potent chondrogenic and morphogenetic factor for articular cartilage progenitor cells, and we hypothesised that this property extends to cartilage-derived progenitors from other tissues. In this study we show monoclonal populations of AuCPCs from immature and mature bovine cartilage cultured with BMP9 produced cartilage pellets have 3-5-fold greater surface area in sections than those grown with TGFβ1. Increased volumetric growth using BMP9 was due to greater sGAG deposition in immature pellets and significantly greater collagen accumulation in both immature and mature progenitor pellets. Polarised light microscopy and immunohistochemical analyses revealed that the organisation of collagen fibrils within pellets is an important factor in the growth of pellets. Additionally, chondrocytes in BMP9 stimulated cell pellets had larger lacunae and were more evenly dispersed throughout the extracellular matrix. Interestingly, BMP9 tended to normalise the response of immature AuCPC monoclonal cell lines to differentiation cues whereas cells exhibited more variation under TGFβ1. In conclusion, BMP9 appears to be a potent inducer of chondrogenesis and volumetric growth for AuCPCs a property that can be exploited for tissue engineering strategies for reconstructive surgery though with the caveat of negligible elastin production following 21-day treatment with either growth factor.

Meta‐analysis on the efficacy of Traditional Chinese Medicine in enhancing surgical site wound healing post‐colorectal surgery

Abstract

This meta-analysis aimed to evaluate the efficacy of Traditional Chinese Medicine (TCM) in enhancing surgical site wound healing following colorectal surgery. We systematically reviewed and analysed randomized controlled trials (RCTs) that investigated the outcomes of TCM interventions in postoperative wound management, adhering to the PRISMA guidelines. The primary outcome was the assessment of wound healing through the REEDA (redness, oedema, ecchymosis, discharge and approximation) scale at two different time points: the 10th day and 1-month post-surgery. Seven RCTs involving 1884 patients were included. The meta-analysis revealed a statistically significant improvement in wound healing in the TCM-treated groups compared to the control groups at both time intervals. On the 10th day post-surgery, the TCM groups exhibited a significant reduction in REEDA scale scores (I2 = 98%; random: SMD: −2.25, 95% CI: −3.52 to −0.98, p < 0.01). A similar trend was observed 1-month post-surgery, with the TCM groups showing a substantial decrease in REEDA scale scores (I 2 = 98%; random: SMD: -3.39, 95% CI: −4.77 to −2.01, p < 0.01). Despite the promising results, the majority of the included studies were of suboptimal quality, indicating a need for further high-quality RCTs to substantiate the findings. The results suggest that TCM interventions can potentially enhance wound healing post-colorectal surgery, paving the way for further research in this area to validate the efficacy of TCM in postoperative management.

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