Browse

1 - 10 of 1,149 items :

  • Assistive Professions, Nursing x
Clear All
Analytical study of care quality and moral distress in clinical situations and patient care

Abstract

Objective

Nursing profession conventionally meets a high standard of ethical behavior and action. One of the ethical challenges in nursing profession is moral distress. Nurses frequently expose to this phenomenon which leads to different consequences such as being bored by delivering patient care that decline care quality and make it challenging to achieve health purposes. This study was conducted to investigate the association between the aspects of moral distress and care quality.

Methods

In this descriptive–analytical study, 545 nurses of intensive and cardiac care units and dialysis and psychiatric wards were recruited by census sampling. Three questionnaires, Sociodemographics, Moral Distress Scale, and Quality Patient Care Scale, were distributed among the participants and collected within 9 months. Data analysis was conducted by descriptive statistics, analysis of variance, and the least significant difference in SPSS 13.

Results

Investigating moral distress domains (ignoring patient, decision-making power, and professional competence) and care quality domains (psychosocial, physical, and communicational) demonstrated that in being exposed to moral distress, ignoring patient had no effect on psychosocial domain (P=0.056), but decision-making and professional competence of moral distress had positive effect on psychosocial, physical (bodily), and communication domains of care quality.

Conclusions

Because moral distress domains are effective on patient care quality, it is recommended to enhance the knowledge of nurses, especially beginners, about moral distress, increase their strength alongside standardizing nursing services in decision-making domains, improve the professional competence, and pay attention to patients.

Open access
Awareness and knowledge of human papillomavirus vaccination and their influential factors among Chinese women: a systematic review

Abstract

Objectives

To systematically review the knowledge attitudes and the influential factors on human papillomavirus (HPV) vaccination among Chinese women.

Methods

Published studies on knowledge and attitudes of HPV vaccination for preventing cervical cancer among Chinese female population were retrieved using the major Chinese and English databases. Meanwhile, handwork retrieval was also conducted and the references including in the literature were retrieved. The quality of the literature was rigorously evaluated and extracted independently by two researchers and the data were analyzed and described by review manager 5.3 (RevMan5.3) software.

Results

In all, 19 articles including 8 articles in Chinese and 11 in English were chosen. A total of 30,176 participants were included and the sample size ranged from 64 to 6,024. The overall awareness of HPV and HPV vaccine among Chinese women was at a low level. Chinese women generally showed poor knowledge about HPV and HPV vaccine. Acceptance of HPV vaccination among Chinese women was at a high level. Vaccination intentions were influenced by the theory of planned behavior (TPB) and measured by attitudes subjective norms and perceived behavioral control.

Conclusions

The health authorities may evaluate and develop TPB-based interventions to increase HPV vaccination intentions of Chinese women. HPV vaccination programs should focus on carrying out multi-level and targeted health education and developing effective public health strategies after balancing the cost and benefit of HPV vaccine program. Medical staff should play the positive role in promoting the use of HPV vaccines in China. Integration of policy and community perspectives and multi-level interventions are essential to maximize the public health benefits of HPV vaccination.

Open access
Development of an assessment and intervention protocol for postpartum hemorrhage in the mainland of China: an evidence-based method and Delphi consult

Abstract

Objective

Postpartum hemorrhage (PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an early assessment and intervention protocol as a toolkit for PPH for midwives and obstetrical nurses.

Methods

Employing the evidence-based method, a systematic Internet search of guidelines was conducted and appraisal of literatures was conducted with AGREE system and Oxman-Guyatt Overview Quality Assessment Questionnaire (OQAQ), according to which a protocol draft was therefore developed. Then, a two-round modified Delphi method was utilized to reach a consensus of the protocol built on best practices. Selection criteria for each intervention measure included consensus level with a threshold of 70%, mean of importance (M) >3.5, and coefficient of variation (CV) <0.25. Reliability of experts’ opinion was calculated by positive coefficient and authoritative coefficient. Items without consistency were enlisted in the second-round consult. When all items met the selection criteria, the protocol would be finally formulated.

Results

A 122-measure protocol was established, including prevention, assessment, and intervention of PPH. With a panel of 14 experts participated in the consult, the positivity coefficient was 0.93 and 1.00 for two rounds, respectively, and the authority coefficient was 0.88. After a two-round consult and revision of the draft, the final program was formulated, containing 5 first-level indexes and 14 second-level indexes with a total item of 120.

Conclusions

The PPH protocol, based on high-quality evidences, was formulated with a two-round Delphi method, which can provide insight for midwives and obstetrical nurses to effectively deal with PPH.

Open access
Effects of abdominal massage on gastrointestinal function in ICU patients: a meta-analysis

Abstract

Objective

To evaluate the effects of abdominal massage on gastrointestinal function in the intensive care unit (ICU) patients.

Methods

Randomized controlled trials about the effects of abdominal massage on gastrointestinal function in ICU patients were included from multiple electronic databases: PubMed, Web of Science, the Cochrane Library, Embase, CINAHL, China Academic Journals Full-Text Database (CNKI), Wanfang Database, and CQVIP, until November 2018. Studies were selected according to inclusion and exclusion criteria, extracting data and assessing. Data were analyzed by RevMan 5.3.

Results

Nine studies with 720 patients were included. The results of meta-analysis in the intervention group were as follows: abdomen circumference: mean difference (MD)=-4.22, 95% confidence interval (CI)=(-6.20, -2.24), P<0.00001; abdominal distension: MD=0.34, 95% CI=(0.22, 0.52), P<0.00001; gastric residual: MD=-41.51, 95% CI=(-55.86, -29.15), P=0.001; gastric retention: MD=-0.23, 95% CI (-0.30, -0.15), P<0.00001; and vomiting: MD=0.12, 95% CI=(0.04, 0.35), P=0.0001.

Conclusions

Abdominal massage is effective in reducing abdominal distension, gastric residual, and vomiting. When the intervention period was <7 days, abdominal massage could not reduce the abdominal circumference in ICU patients, and when the intervention period was equal to 7 days, abdominal massage could reduce the abdominal circumference in ICU patients.

Open access
Identifying nursing research priorities in Vietnam: a modified Delphi study

Abstract

Objective

There is no single study that has examined nursing research priorities in Vietnam. This study aimed to gain consensus from experts on the nursing research priorities in Vietnam.

Methods

A three-round modified Delphi study was used in this study. A focus group discussion among experts was conducted in round I to identify the nursing research priorities (n=23). Data in round I were analyzed using content analysis. In round II, participants were invited to rate the importance of each nursing priority topic in a 5-point Likert scale questionnaire, which had a 74% (n=17) response rate. In round III, the questionnaire was returned to the experts (n=17) until consensus was reached. Data from round II and round III were analyzed to produce mean score and final rank.

Results

The top 12 research priority lists were identified, which included subthemes and areas of possible investigations. All priorities were classified into three groups in the rank order, namely: (i) nursing management and leadership, which included (1) nursing care quality, (2) management and leadership of nurse managers, (3) nursing image, (4) professional nurse competency, and (5) human resource management; (ii) nursing education, which included (1) knowledge-specific domain, (2) the linkage between education and practice, and (3) nurse teacher workforce; and (iii) nursing service, which included (1) adult nursing concern, (2) patient safety, (3) public health nursing concern, and (4) quality of life of patients and nurses.

Conclusions

Consensus among experts was achiever, and the findings are considered as the basis of resources to the most essential research needs in Vietnam.

Open access
Influence of education training in patients with type 2 diabetes in the improvement of lifestyle and biochemical characteristics: a randomized controlled trial

Abstract

Objective

The objective of this randomized controlled trial study was to evaluate the education training in relation to lifestyle improvement in patients with type 2 diabetes through its influence in the levels of glycated hemoglobin (HbA1c), blood pressure, triglyceride, cholesterol levels, and body mass index (BMI).

Methods

The study included patients with type 2 diabetes randomly selected from 20 residential areas in Tirana, Albania where family physicians provide services. The sample size in total was 200 patients in both groups (control and intervention). The education training (four sessions) was conducted by trained nursing staff for 6 months. Patients were screened for the biochemical profile before and after the intervention. To compare the groups with respect to the interest outcomes, the t-test was used. The value of P < 0.05 was considered significant.

Results

There were 104 male patients and 96 female patients. The mean age was 54.9 ± 8.7. No significant differences were found between the study groups in relation to clinical and biochemical data before the education sessions. After the intervention, in the intervention group, the mean level of HbA1c was significantly lower than the value in the control group (6.2% vs 6.8%, P = 0.001) as well as for the mean values of BMI. The mean reduction (more than 15%) in HbA1c after the intervention was 43% in the intervention group and 2% in the control group (OR = 36.9, P < 0.05). Differences in BMI, HbA1c, triglycerides, and cholesterol were more significantly visible in the intervention group. However, the difference in systolic and diastolic blood pressure values was almost the same (P > 0.05).

Conclusions

The results of this study further support that the approach for education of patients with type 2 diabetes on changing lifestyle benefit the patient in controlling diabetes. It is believed that the establishment of diabetes education classes in health centers is an important investment in improving the management of type 2 diabetes.

Open access
Nursing students’ experiences of caring for dying patients and their families: a systematic review and meta-synthesis

Abstract

Objective

Nurses play important roles in caring for dying patients and their families. Difficulties students confronted when facing dying patients challenge the quality of nursing education. A better understanding of students’ experiences would enhance teachers’ ability in helping students. This study aims to describe available evidence about nursing students’ experiences when caring for dying patients and their families.

Methods

A review of qualitative studies published between 2005 and 2017 was undertaken using the following databases: MEDLINE, CINAHL, ProQuest Central, ScienceDirect, and CNKI. The keywords included were nursing students, experience, care, end-of-life, and dying. Qualitative Assessment and Review Instrument was used to assess the quality of the studies by two independent reviewers. The data from the studies were analyzed by meta-synthesis.

Results

Eighteen English and two Chinese studies were selected in this review. Four themes were emerged: (1) Students with dying patients: students did not have enough ability in symptoms control, comfort supply, and therapeutic communication for dying patients. (2) Students with the patients’ families: students advocated more caring for patients’ families. (3) Students with the surroundings: professional medical staffs, especially the nursing preceptors, were key roles in constructing a supporting system for students. (4) Students with themselves: nursing students underwent various negative feelings and adopted both negative and positive strategies to cope with such feelings; students experienced professional and personal development during the caring for dying patients.

Conclusions

Nursing students’ abilities in terminal symptom control, comfort supply, and therapeutic communication should be improved by more theoretic learning and simulation practice. The nursing preceptors were key roles in constructing a supporting system for students and helping them to control the negative emotions when facing dying patients.

Open access
Patient safety culture regarding intravenous therapy in Guangzhou, China: a cross-sectional survey

Abstract

Objective

To investigate the patient safety culture regarding intravenous therapy in parts of tertiary hospitals in Guangzhou, China.

Methods

A cross-sectional survey was conducted. A total of 333 medical staffs members from eight hospitals in Guangzhou were included in our study using convenience sampling. An evaluation about the patient safety culture regarding intravenous therapy was conducted.

Results

The summarized results show that the total and level one items’ scores are greater than 4.3 points (the full mark is 5 points). The lowest scoring of the five level one items is for the hospital’s security resources (4.53±0.526), and the highest is for the hospital’s safety management commitment (4.65±0.445). Among the 25 secondary entries, the four lowest-scoring entries are “doctors who can master the knowledge of drug efficacy and adverse reactions” (4.44±0.622), “doctors who can master the knowledge of the choice of medicine” (4.45±0.621), “a guarantee of sufficient human resources” (4.46±0.647), and “doctors who can master the knowledge related to the observation and complications with the treatment of intravenous therapy operation” (4.435±0.634).

Conclusions

The patient safety culture regarding intravenous treatment in parts of tertiary hospitals in Guangzhou is promising, but there are still shortcomings, including the need to increase relevant resources, such as equipment facilities, training resources, and especially human input.

Open access
Percutaneous vertebroplasty versus percutaneous kyphoplasty for the treatment of delayed post-traumatic vertebral body collapse (Kümmell’s disease) in Chinese patients: a systematic review and meta-analysis

Abstract

Objective

To compare the clinical efficacy between percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of Kümmell’s disease in Chinese patients.

Methods

The studies using randomized controlled trials to compare clinical efficacy between PVP and PKP in the treatment of Kümmell’s disease in Chinese patients were retrieved from Embase, Pubmed, Central, Cinahl, PQDT, CNKI, CQVIP, Wanfang Data, and CBM (from September 2008 to September 2018). Keywords for both Chinese and English search were: percutaneous vertebroplasty, PVP, percutaneous kyphoplasty, PKP, and Kümmell’s disease. A total of 132 articles were retrieved based on the search strategy through online database searching and manual searching. Finally, one foreign report and seven Chinese reports were included. After extracting the data, statistical software Review Manager 5.3 was used for data analysis.

Results

Through comparison, Cobb angle (95% CI [0.54, 4.42), P = 0.01] and Oswestry Dysfunction Index (ODI) (95% CI [0.21, 2.15], P= 0.02) of PKP group was smaller than that of PVP group. Postoperative anterior vertebral body height of the PKP group was better than PVP group (95% CI [−1.27, −0.66], P < 0.001]. However, the PVP group had shorter operation time than PKP group (95% CI [−13.48, −7.43), P = 0.001]. In the other outcome measures, including Visual Analogue Scale (VAS) score (95% CI [−0.04, 0.27), P = 0.15), cement volume (95% CI [−0.82, 0.32], P = 0.39) and cement leakage (95% CI [0.90, 2.76], P = 0.11), there was no significant differences between the two procedures.

Conclusions

At this stage, there is sufficient evidence to support that PKP is better than PVP in the treatment of Kümmell’s disease in Chinese patients. Although PVP surgery requires much less operation time, PKP has better postoperative radiological results and lower ODI. Moreover, both of them had similar clinical results (e.g., analgesic effects, cement dosage, and leakage rate). Further evidence is dependent on the emergence of randomized controlled trials with higher quality and larger sample sizes in the future.

Open access
Relationship between self-directed learning readiness, learning attitude, and self-efficacy of nursing undergraduates

Abstract

Objective

The purposes of this study were to analyze the influencing factors of self-directed learning readiness (SDLR) of nursing undergraduates and explore the impacts of learning attitude and self-efficacy on nursing undergraduates.

Methods

A total of 500 nursing undergraduates were investigated in Tianjin, with the Chinese version of SDLR scale, learning attitude questionnaire of nursing college students, academic self-efficacy scale, and the general information questionnaire.

Result

The score of SDLR was 149.99±15.73. Multiple stepwise regressions indicated that academic self-efficacy, learning attitude, attitudes to major of nursing, and level of learning difficulties were major influential factors and explained 48.1% of the variance in SDLR of nursing interns.

Conclusions

The score of SDLR of nursing undergraduates is not promising. It is imperative to correct students’ learning attitude, improve self-efficacy, and adopt appropriate teaching model to improve SDLR.

Open access