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Open access

Anna B. Pilewska-Kozak, Beata B. Dobrowolska, Anna Majewska, Grażyna Stadnicka, Agnieszka K. Pawłowska-Muc, Klaudia Pałucka, Agnieszka Bałanda-Bałdyga and Joanna Tkaczuk-Włach

Abstract

Aim. The study was to assess the level of stress and the health locus of control in parents of hospitalized newborns.

Material and methods. The study covered a group of 150 parents of 126 newborns who were hospitalized in the Neonatal Pathology Ward at the University Children’s Hospital in Lublin. The diagnostic survey method was applied with the use of an original questionnaire as well as some standardized tools: Perceived Stress Scale (PSS-10) and Multidimensional Health Locus of Control Scale (MHLC – version B).

Results. In more than a half of the subjects (54.0%), a high level of stress was observed. Every fourth (26.1%) parent was characterized by an average level of stress and nearly every fifth (19.3%) by a low level of stress. The highest indicator was characterized by the domain of the internal health control locus. Every fifth parent represented an undifferentiated type - weak or magnifying the impact of others (22.0% and 20.0% respectively). The smallest group of parents (5.3%) belonged to the externally-oriented, strong type.

Conclusions. The parents of hospitalized newborns are characterized mainly by high and average levels of stress and low level of severity of health control location within each of its domains. The highest indicator of internal locus control and the influence of others are characterized by parents with low and average levels of stress. The dominant type of locus of health control that characterizes parents is the undifferentiated type – weak and magnifying the impact of others.

Open access

Justyna Krukiewicz, Agnieszka Chrzan-Rodak, Aneta Kościołek, Małgorzata Brodziak and Kinga Augustowska-Kruszyńska

Abstract

Introduction. Professional aspirations appear to be the key factor, which motivates individual to take actions as well as to further self-development. According to medical professions, professional aspirations seem to be crucial because they motivate nurses and midwives to continuing education – what is believed to be the fundament of vocational professionalism.

Aim. The aim of the research was to show the professional aspirations of the graduates of bachelor degree in nursing and midwifery.

Material and methods. The research was conducted with the diagnostic survey based on the questionnaire composed by the authors, within a period from April to June 2017. The research consisted of 158 graduates of bachelor studies.

Results. The majority (89.2%) of the graduates of bachelor studies in nursing and midwifery is planning to improve their professional qualifications. Their main motives are: the desire for being a professional (69.6%), the desire for professional development (52.5%) and the desire for financial situation improvement (47.5%). The MSc studies are most frequently chosen as a way for professional qualifications improvement.

Conclusions. The graduates of the Faculty of Health Sciences express the desire for further professional development. The aspirations, which the examined graduates of bachelor studies in nursing and midwifery are led by, may have a positive impact on their carriers through the strengthening the appropriate moral attitudes, professional development and the sense of professional autonomy.

Open access

Lei Pan, Hui-Qin Xi, Xiao-Wei Shen and Chen-Yu Zhang

Abstract

A teaching strategy is a method, which can help students to gain knowledge, deliver information, and improve their learning. Different learning environments, such as clinical teaching, online teaching, and face-to-face traditional learning environments, require different teaching strategies for students. Choosing teaching strategies for a course is very important for nurse educators because various factors should be taken into account to make students meet the learning outcomes. The use of modern technologies in teaching strategies can improve students’ competencies and confidences. The purpose of this article is to create a toolbox integrating ten teaching strategies that can be used in different teaching environments.

Open access

Pakkapon Rattanachaisit, Paweena Susantitaphong, Kessarin Thanapirom, Roongruedee Chaiteerakij, Piyawat Komolmit, Pisit Tangkijvanich and Sombat Treeprasertsuk

Abstract

Background

Non-alcoholic fatty liver disease (NAFLD) is one of the major causes of chronic liver disease. The primary treatment of NAFLD by statins has not been clearly elucidated.

Objectives

To evaluate the effectiveness of statin use in patients with biopsy-proven NAFLD or non-alcoholic steatohepatitis on the change in liver histology.

Methods

We searched MEDLINE, Scopus, Google Scholar, and the Cochrane Central Register of Controlled Trials for clinical trials and observational studies investigating the effects of statins on histological change regardless of type or dosage from inception to December 2015. Random-effect model meta-analyses were used to compute changes in outcomes of interest. The study protocol was registered in advance with the International Prospective Register of Systematic Reviews (PROSPERO 2016 CRD42016033132).

Results

We identified 6 studies (111 patients), representing 5 cohort studies and 1 randomized controlled clinical trial. There was significant decrease in steatosis grading with a standardized mean difference of –2.580 (95% confidence interval [CI] –4.623 to –0.536; P = 0.013) and NAFLD activity score standardized mean difference of –1.488 (95% CI –2.506 to –0.471; P = 0.004). However, there was no significant change in fibrosis stage (0.156; 95% CI –0.553 to 0.865; P = 0.667).

Conclusions

Statin use can possibly reduce the extent of steatohepatitis but not the stage of fibrosis. Further randomized controlled studies to assess histological evidence with adequate sample size and duration are required in order to establish the role of statin as a primary treatment of NAFLD.

Open access

Nicole Mazur and Bożena Czarkowska-Pączek

Abstract

Introduction. It is estimated that every year 31 million people suffer from sepsis and even 6 million cases of illness end up in the patient’s death. In 2016 the current definition of sepsis was established as a life-threatening multiorgan failure resulting from an abnormal immune response caused by patient infection. The pathobiological approach rejects the current method of diagnosing sepsis based on the occurrence of SIRS, because many other non-infectious diseases may also cause its occurrence. There was proposed a scale of progressive organ failure called SOFA and qSOFA. In May 2017, WHO released a resolution that obliges European Union countries to raise awareness about sepsis prevention, diagnosis, treatment and management.

Results. A nurse is the person who spends the most time with a patient, thus becoming the best observer of changes in his/her vital functions and well-being. Nurses working in basic health care, hospital emergency ward and all departments not involved in intensive medical care, have an important role in prevention of infections, as over 70% of sepsis cases begins in a non-hospital environment, and the current level of public knowledge reaches only 14%.

Open access

Songkran Nakbun, Pramote Thongkrajai and Choosak Nithikathkul

Abstract

Background

Opisthorchiasis caused by Opisthorchis viverrini is a serious health issue in the Mekong basin region, resulting in a high prevalence of cholangiocarcinoma. Nakhon Phanom province had the highest prevalence of O. viverrini infection in Thailand at 60% of the surveyed population in 2009, despite the attempted control of opisthorchiasis for >50 years. Knowing risk factors for O. viverrini infection in Nakhon Phanom may lead to improved control and prevention of opisthorchiasis.

Objectives

To determine risk factors for O. viverrini infection in Nakhon Phanom.

Methods

We conducted a cross-sectional survey in Nakhon Phanom province from February to March 2014. The community was selected using a stratified random sampling method, and then, participants were selected by systematic random sampling. Individuals ≥15 years old were included. Knowledge of O. viverrini infection, and attitudes and practice to avoid it were assessed using a questionnaire. O. viverrini infection was determined by stool examination with a formalin–ether concentration method. Factors associated with the infection were determined using multivariate logistic regression analysis.

Results

Of the 134 participants, 75 (56%) were infected with O. viverrini. In the multivariate logistic regression analysis, 3 independent factors were associated with O. viverrini infection: age ≥ 55 years, odds ratio (OR) adjusted 6.36 (95% confidence interval (CI) 1.28–31.66); consumption of chopped raw-fish salad (koi pla), OR adjusted 28.74 (95% CI 3.59–230.24); and perceived susceptibility, OR adjusted 0.15 (95% CI 0.03–0.74).

Conclusions

Age ≥ 55 years, consuming koi pla, and perceived susceptibility were independently associated with O. viverrini infection in Nakhon Phanom.

Open access

Yan-Ping Zhu, Li-Xia Xia and Guo-Hong Li

Abstract

Objective

The aim of this study was to assess the management of early mobilization (EM) in Chinese intensive care units (ICUs).

Methods

This survey used a cross-sectional, observational design. A total of 65 tertiary and secondary hospitals were enrolled by convenience sampling and investigated using self-designed questionnaires.

Results

We identified 69 ICUs in Jiangsu, China (response rate: 94.2%). 74.2% (1,004/1,353) of the nurses and nursing managers from 65 ICUs reported mobility practice. For the mobility level, 98.1% (1,327) reported use of in-bed exercise, 5.7% (77) sitting on a side of bed, 21.7% (294) transfer to chair, and 2.4% (33) walking. The most frequently reported barriers to early mobility were unplanned extubation, nursing resource, and absence of physical therapist. Nurses’ educational backgrounds, nursing experience, the lack of nursing resources, absence of physician, and the weakness of patient were the factors that influenced ICU early rehabilitation (P<0.01).

Conclusions

Although implementation rates for EM in critically ill patients are high, the activity level is generally poor in most of the involved ICUs.

Open access

Thinley Dorji, Pempa Lhamo, Tshering Tshering, Lungten Zangmo, Kencho Choden, Deki Choden and Kesang Namgyal

Abstract

Background

The burden of diabetes has increased rapidly with an increasing cost of treatment.

Objectives

To describe the glycemic control, injection practices, and treatment adherence among diabetic patients treated with insulin.

Methods

This cross-sectional study was conducted using a convenience sampling method at the 3 tertiary referral hospitals in Bhutan. Sociodemographic, injection practices, and clinical details were collected. Good glycemic control was defined as glycated hemoglobin A (HbA1c) <7% if available or fasting blood sugar 70–130 mg/dL and 2 h postprandial blood sugar <180 mg/dL if HbA1c values were unavailable. Medication adherence was assessed using the Morisky, Green and Levine (MGL) scale. The injection technique was assessed using a 10-item checklist.

Results

We studied 207 patients. Good glycemic control was achieved by only 58 (28.0%) of patients. Using the MGL scale score, the objective adherence with insulin therapy was mostly low to medium and a gross discordance was with self-declared adherence (P < 0.001). The injection technique was fair to poor in half of the participants. Those with good injection techniques also had good adherence to medication (P = 0.025, adjusted odds ratio = 4.4, 95% confidence interval 1.2–16.4). The majority (154, 74.4%) had self-injected insulin, while the remaining were dependent on their home caregivers. Forty percent of the participants used storage practices that were not recommended. The disposal of the used insulin needles was generally unsafe.

Conclusions

Glycemic control and adherence to insulin administration recommendations were poor. The injection technique needs to be improved and standardized, and methods of safe disposal of sharps need to be developed.

Open access

Ya-Qian Liu, Yu-Feng Li, Meng-Jie Lei, Peng-Xi Liu, Julie Theobald, Li-Na Meng, Ting-Ting Liu, Chun-Mei Zhang and Chang-De Jin

Abstract

Objectives

To examine the best practice evidence of the effectiveness of the flipped classroom (FC) as a burgeoning teaching model on the development of self-directed learning in nursing education.

Data sources

The relevant randomized controlled trial (RCT) and non-RCT comparative studies were searched from multiple electronic databases including PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), Wanfang Data, China National Knowledge Infrastructure (CNKI), and Chinese Science and Technology Periodical Database (VIP) from inception to June 2017.

Review methods

The data were independently assessed and extracted for eligibility by two reviewers. The quality of included studies was assessed by another two reviewers using a standardized form and evaluated by using the Cochrane Collaboration’s risk of bias tool. The self-directed learning scores (continuous outcomes) were analyzed by using the 95% confidence intervals (CIs) with the standard deviation average (SMD) or weighted mean difference (WMD). The heterogeneity was assessed using Cochran’s I 2 statistic.

Results

A total of 12 studies, which encompassed 1440 nursing students (intervention group = 685, control group = 755), were eligible for inclusion in this review. Of 12 included studies, the quality level of one included study was A and of the others was B. The pooled effect size showed that compared with traditional teaching models, the FC could improve nursing students’ self-directed learning skill, as measured by the Self-Directed Learning Readiness Scale (SDLRS), Self-Directed Learning Readiness Scale for Nursing Education (SDLRSNE), Self-Regulated Learning Scale (SRL), Autonomous Learning Competencies scale (ALC), and Competencies of Autonomous Learning of Nursing Students (CALNS). Overall scores and subgroup analyses with the SRL were all in favor of the FC.

Conclusions

The result of this meta-analysis indicated that FCs could improve the effect of self-directed learning in nursing education. Future studies with more RCTs using the same measurement tools are needed to draw more authoritative conclusions.

Open access

Xiao-Jing Guo, Li-Li Wei, Xin-Hui Li, Ning- Ning Yu, Shao-Bo Gao, Dong-Yan Qin, Fu-Mei Chu and Kun Li

Abstract

Objective

The aim of this study was to explore the safe and effective method of expectoration in the preoperative period of patients with lung cancer resection and to promote the rehabilitation of patients.

Methods

A total of 100 cases of lung cancer patients undergoing elective surgery were divided into the observation group and the control group, with 50 cases in each group. The control group was treated with vibration expectoration vest for expectoration during the perioperative period, and the observation group was treated with respiratory function exerciser that has expectoration function in the perioperative period, three times a day, and the effect was evaluated after 5 days.

Results

The number of patients in the observation group after the first expectoration time was significantly less than that of the control group (P<0.001). Pain score, pulmonary atelectasis, and pulmonary infection rate of the observation group were significantly lower than those of the control group; the hospitalization time was significantly shorter than that of the control group; and the difference was statistically significant (P<0.05).

Conclusions

Lobectomy for lung cancer patients with perioperative respiratory training for respiratory function exercise, compared with conventional methods, is helpful for postoperative expectoration and to reduce the incidence of adverse events.