Hasil untuk "Nursing"

Zhirong Xu, Wen Ding, Wen Ding et al.

AimGuided by the health ecology model, which posits that an individual’s health is shaped by the dynamic interplay between personal and environmental factors, we investigated factors associated with depression in community-dwelling older adults with multimorbidity and developed a nomogram-based risk prediction model. While previous research has predominantly focused on depression in the context of single chronic diseases, the psychosocial and clinical complexities inherent to multimorbidity remain largely overlooked. This study addresses this gap by constructing a tailored prediction model that integrates the multidimensional determinants of depression in this vulnerable population.MethodsUsing convenience sampling, a questionnaire survey was conducted among 679 older patients with chronic diseases from 12 community health institutions in China between March and August 2023. Participants were randomly divided into a training group (n = 475, 70%) and a validation group (n = 204, 30%). Depressive status was assessed using the Geriatric Depression Scale-15 (GDS-15). Logistic regression analysis identified factors associated with depression, based on which a nomogram prediction model was constructed. The model was internally validated using the Bootstrap method with 1,000 resamples. Its predictive performance was comprehensively evaluated using receiver operating characteristic (ROC) curve analysis, calibration curves, and decision curve analysis.ResultsThe prevalence rate of depression among older community residents with comorbid chronic conditions was 29.90%. We identified specific predictors for depression in this population: age ≥ 80 years, excess body weight, types of medication, self-management (the ability to actively manage one’s health conditions), self-efficacy (confidence in one’s ability to perform health-related actions), and educational level. For the training group, the area under the receiver operating characteristic (ROC) curve was 0.815, indicating a model accuracy of 74%, a sensitivity of 79%, and a specificity of 72%. Hosmer-Lemeshow fitting testing results in a χ2 value of 8.801 (p = 0.359).ConclusionOur new predictive model for the risk of depression in older patients in the community with multiple chronic diseases exhibited good discrimination, calibration and clinical practicability, serving as a valuable reference for the early detection of depression among this population.

Nisreen Salama, Rebhi Bsharat, Abdallah Alwawi et al.

Abstract Background AI can improve medical practice, address staff shortages, and enhance diagnostic efficiency. The ChatGPT of Open AI, launched in 2022, uses AI in medical education. However, the long-term impact is uncertain, and integration varies globally, particularly in the Middle East. Aim To explore the knowledge, practices, and attitudes of nursing students in Palestinian universities regarding AI, specifically the use of ChatGPT. Methodology A cross-sectional design was used to conduct this study. The study was performed at 8 private and governmental universities in the West Bank, Palestine, from 1st May 2024 to 30 May 2024, and 304 nursing students participated. Results The study revealed that 84.5% of nursing students at Palestinian universities were aware of AI technology, yet 69.9% lacked formal education or training related to ChatGPT. Despite this gap, 79% supported the integration of AI into nursing curricula and specialized training programs, reflecting strong optimism about its role in education and healthcare. While 58.6% had used AI in their coursework and 68.1% felt comfortable with technology, disparities in proficiency and access remain key barriers to effective AI integration. Major challenges to AI adoption in Palestine include insufficient training, the absence of AI-focused curricula, and financial constraints, underscoring the need for institutional and pedagogical reforms. Concerns about AI’s reliability, costs, and potential diagnostic errors persist, emphasizing the complexities of its integration into nursing education and practice. Conclusion This study highlights the knowledge, attitudes, and practices of Palestinian nursing students regarding AI and ChatGPT. It reveals that, despite growing awareness, the lack of formal education on AI underscores the need for comprehensive curricula. While students’ express optimism about AI’s potential in healthcare, concerns about its reliability and integration persist. The study also reveals that barriers such as inadequate training, limited curricula, and financial constraints must be addressed to effectively integrate AI into nursing education and prepare students for its expanding role in healthcare.

Heilok Cheng, James John, Jane Scott et al.

Objective: Bottle feeding to sleep may increase early childhood caries (ECC) and overweight risk through sugar exposure and overfeeding. This study examined the association between feeding to sleep at 24 and 36 months on both ECC and overweight at 3-4 years. Methods: Participants were children in the Healthy Smiles Healthy Kids longitudinal birth cohort. Exposure was bottle feeding to sleep at 24 and 36 months. Outcomes were ECC (prevalence; number of caries-affected tooth surfaces, dmfs) and overweight at 3-4 years. Results: 718 and 729 children had dental examinations and anthropometric measurements, respectively. 30.3% and 21.7% of children were bottle-fed to sleep at 24 and 36 months, respectively. Feeding to sleep at 24 months was associated with higher odds of overweight (OR 1.90, 95%CI 1.06-3.38) and moderately associated with higher caries (dmfs 1.48, 95%CI 1.00-2.20). Feeding to sleep at 36 months was associated with higher caries (dmfs 1.88, 95%CI 1.22-2.91). Conclusions: Feeding to sleep was associated with higher odds of overweight and higher numbers of caries-affected tooth surfaces. Communicating appropriate sleep, settling and bottle cessation methods throughout early childhood may prevent ECC and overweight. Implications for Public Health: Early interventions addressing bottle feeding could reduce the dual burden of ECC and obesity.

Sumedha Verma, Prerna Varma, Aimee Brown et al.

Background Disturbed sleep is common among people living with dementia and their informal caregivers, and is associated with negative health outcomes. Dyadic, multi-modal interventions targeting caregiver and care-recipient sleep have been recommended yet remain limited. This protocol details the development of a single-arm feasibility trial of a multi-modal, therapist-led, six-week intervention targeting sleep disturbance in dyads of people living with dementia and their primary caregiver. Methods We aim to recruit 24 co-residing, community-dwelling dyads of people living with dementia and their primary informal caregiver (n = 48) with sleep concerns (Pittsburgh Sleep Quality Index ≥5 for caregivers, and caregiver-endorsed sleep concerns for the person living with dementia). People who live in residential care settings, are employed in night shift work, or are diagnosed with current, severe mental health conditions or narcolepsy, will be excluded. Participants will wear an actigraph and complete sleep diaries for two weeks prior, and during the last two weeks, of active intervention. The intervention is therapist-led and includes a mix of weekly small group video sessions and personalised, dyadic sessions (up to 90 min each) over six weeks. Sessions are supported by a 37-page workbook offering strategies and spaces for reflections/notes. Primary feasibility outcomes are caregiver: session attendance, attrition, and self-reported project satisfaction. Secondary outcomes include dyadic self-reported and objectively-assessed sleep, depression and anxiety symptoms, quality of life, and social support. Self-report outcomes will be assessed at pre- and post-intervention. Discussion If feasible, this intervention could be tested in a larger randomised controlled trial to investigate its efficacy, and, upon further testing, may potentially represent a non-pharmacological approach to reduce sleep disturbance among people living with dementia and their caregivers. ANZCTR Trial registration ACTRN12622000144718: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382960&showOriginal=true&isReview=true

Sook Hyun Park, Won Chul Cha

Javier Varas de la Fuente, Rosa Isabel Sánchez Alonso

Introducción: El trasplante de microbiota fecal se ha comenzado a utilizar como tratamiento de patologías intestinales como la infección por Clostridium Difficile. Dado su éxito en esta patología, se hace necesario investigar si también es efectivo en otras patologías intestinales y su grado de seguridad. Objetivo: encontrar evidencias actuales que demuestren la efectividad del trasplante de microbiota fecal en el tratamiento de la patología intestinal, mostrando tanto los beneficios potenciales para la salud como los efectos adversos si los hubiera. Método: Revisión bibliográfica en Medline a través de Pubmed, Biblioteca Cochrane, CINAHL y SciELO. Publicados entre 2014 y 2019. Ensayos clínicos, metaanálisis y revisiones sistemáticas. Se excluyeron los estudios que realizaron intervenciones concomitantes y los que trataran la infección por Clostridium Difficile. Evaluación de calidad mediante herramienta CASPe. Extracción manual de los resultados. Variables resultado: remisión clínica y endoscópica de la patología, alivio sintomático, efectos adversos graves. Resultados: Se encontraron 45 estudios primarios y 18 revisiones, de los que se seleccionaron 4 estudios primarios y 5 revisiones. Esta revisión proporciona evidencia de nivel medio a favor de la utilización del trasplante de microbiota fecal en el tratamiento de la enfermedad intestinal inflamatoria, la encefalopatía hepática y la constipación intestinal. No se encontraron resultados favorables a su uso en el tratamiento del síndrome del intestino irritable. ABSTRACT Introduction: Fecal microbiota transplantation has begun to be used as a treatment for intestinal pathologies such as Clostridium Difficile infection. Due to its success in this pathology, it is necessary to investigate if it is also effective in other intestinal pathologies and its degree of security. Objective: to find current evidences demonstrating the effectiveness of fecal microbiota transplantation in the treatment of intestinal pathology, showing both potential health benefits and adverse effects, if any. Method: Bibliographic review in Medline via Pubmed, Cochrane Library, CINAHL and SciELO. Published between 2014 and 2019. Clinical trials, meta-analysis and systematic reviews. Studies had been conducted concurrent interventions and those that treated Clostridium Difficile infection were excluded Quality assessment by CASPe tool. Manual removal of the results. Outcomes: Clinical and endoscopic remission, diversity of intestinal microbiota, serious adverse effects. Results: 45 primary studies and 18 reviews were found, of which 4 primary studies and 5 reviews were selected. This reviews provides midlevel evidence for use the fecal microbiota transplantation as treatment of inflammatory bowel disease, hepatic encephalopathy and intestinal constipation. No favorable results were found for its use as treatment of irritable bowel syndrome.

Keydis Sulay Ruidiaz-Gómez, Jasmin Viviana Cacante-Caballero

Introducción: La calidad de vida es un concepto multidimensional influenciado por la salud física, el estado psicológico, el nivel de independencia, las condiciones de vida y relaciones sociales del individuo. Esta revisión analiza los aspectos conceptuales y teóricos que incorpora el concepto calidad de vida y sus aportes en diferentes disciplinas. Metodología: Se realizó una revisión crítica de la literatura. Se consultaron 16 artículos publicados en idioma español, inglés, y portugués presentes en las bases de datos Scopus, Scielo, Ovid, Medline, Google Scholar, y Jstor publicados entre 1993 -2017; la estrategia de búsqueda se estableció con los descriptores Calidad de vida, historia y concepto. Artículos representados en el flujo-grama de la escala PRISMA. Resultados: El concepto calidad de vida nace en las ciencias económicas, se incorpora en las ciencias sociales y de salud. Tiene dominios comunes como: salud, ámbito social, económico, político, psicológico-espiritual, familiar y bienestar subjetivo. Conclusiones: El análisis del concepto ofrece una visión integradora que provee claridad conceptual en los resultados de investigación, la práctica clínica y el desarrollo científico y tecnológico.

Limakatso Lebina, Mary Kawonga, Tolu Oni et al.

<h4>Background</h4>A cost analysis of implementation of interventions informs budgeting and economic evaluations.<h4>Objective</h4>To estimate the cost of implementing the integrated chronic disease management (ICDM) model in primary healthcare (PHC) clinics in South Africa.<h4>Methods</h4>Cost data from the provider's perspective were collected in 2019 from four PHC clinics with comparable patient caseloads (except for one). We estimated the costs of implementing the ICDM model current activities for three (facility reorganization, clinical supportive management and assisted self-management) components and additional costs of implementing with enhanced fidelity. Costs were estimated based on budget reviews, interviews with management teams, and other published data. The standard of care activities such as medication were not included in the costing. One-way sensitivity analyses were carried out for key parameters by varying patient caseloads, required infrastructure and staff. Annual ICDM model implementation costs per PHC clinic and per patient per visit are presented in 2019 US dollars.<h4>Results</h4>The overall mean annual cost of implementing the ICDM model was $148 446.00 (SD: $65 125.00) per clinic. Current ICDM model activities cost accounted for 84% ($124 345.00) of the annual mean cost, while additional costs for higher fidelity were 16% ($24 102.00). The mean cost per patient per visit was $6.00 (SD:$0.77); $4.94 (SD:0.70) for current cost and $1.06 (SD:0.33) for additional cost to enhance ICDM model fidelity. For the additional cost, 49% was for facility reorganization, 31% for adherence clubs and 20% for training of nursing staff. In the sensitivity analyses, the major cost drivers were the proportion of effort of assisted self-management staff and the number of patients with chronic diseases receiving care at the clinic.<h4>Conclusion</h4>Minimal additional cost are required to implement the ICDM model with higher fidelity. Further research on the cost-effectiveness of the ICDM model in middle-income countries is required.

Panduleni P. Shimanda, Hans J. Amukugo, Fredrik Norström

Anemia remains a public health concern, and its prevalence varies between countries as well as between age, sex and levels of poverty. This study aims at examining the association between socio-demographic factors and anemia among children aged 6–59 months in Namibia. Data was extracted from the 2013 Namibian Demographic Health Survey. The association between anemia and other factors was examined with logistic regression. Results are reported in odds ratio (OR), with 95% confidence intervals (CI). In total, 1,383 children aged 6–59 months had complete data and included in the analyses. Our study shows that there is a statistically significantly increased risk of anemia among children from poorer households compared with the richest quintile. Also, there was a statistically significance supporting anemia being more common among boys than girls. There was also a statistically significant negative effect related to age. Our study shows that young children, boys and children in poorer households have an increased risk of anemia. Considering the adverse impact of anemia on child development, policies must prioritize factors exacerbating anemia risk.

Mohsen Dowlati, Shandiz Moslehi, Hesam Seyedin et al.

Natural disasters are always among the main problems and challenges facing societies. Earthquakes had many adverse effects on human life, causing mortality, morbidity, and economical, psychological, and environmental damages. Tehran is one of the most vulnerable regions for disasters, especially earthquake due. In recent decades, ambient air pollution represents one of the most environmental risks to health in Tehran. One of the main factors increasing the concentration of air pollutants is vehicles. After the earthquake, people left their homes and stayed into their cars until morning. Therefore, due to the pollution caused by leaving the cars on, the concentration of pollutants increased and the caused a greater number of deaths attributed to air pollution.

Wahyuningsih Wahyuningsih, Fikri Rizky

<p><em>The high incidence of breast cancer is due to the lack of awareness of women to immediately check themselves in case of abnormalities in the breast. Therefore the need for knowledge about the early prevention of breast cancer by providing health education with various media such as slides and video. The purpose of this research was to know the effectiveness of health education with slide and video media to the level of knowledge about breast care on the students of class VII and VIII. This study was a pre-experimental study with three group pre-test and post-test design. The population in this research was the students of class VII and VIII SMP 2 Kasihan which amounted to 147 people. Sampling technique in this research used total sampling. The results obtained p value 0.000 with slide media, p value 0.002 with video media, and p value 0.000 with slide and video media which means that values are smaller than the error level is 0.05 so Ha was accepted and H0 rejected. Health education with slide and video media effectively improve students' knowledge. Health education with the most effective slide media increased the knowledge of VII and VIII SMP Negeri 2 Poor students compared to video media and slide and video media.</em></p>

Katarzyna Stefańska, Monika Jakimiec-Komisarczyk, Paulina Terlecka et al.

Cystic fibrosis (CF) is classified as metabolic and multisystem disease with autosomal recessive inheritance caused by mutations in the gene located on chromosome 7 encoding cystic fibrosis transmembrane conductance regulator (CFTR) protein. CFTR is a transmembrane chloride channel of epithelial cells and affects the activity of the mucous membrane of the sweat glands, airway epithelium, pancreatic ducts, vas deferens, bile ducts and intestines. In CF, increased concentration of chlorides in the sweat, pancreatic insufficiency and impaired absorption are observed as well as changes in the respiratory system related to, among others, impaired airway patency, weakening of the mucociliary clearance mechanism and the development of bacterial infections. CF is a chronic condition requiring comprehensive therapy. Nutritional treatment is an essential element of CF therapy. Malnutrition is a common complication in patient with CF and eating disorders. The majority of patients with CF have higher energy, protein and fat needs. In addition, supplementation with enzyme preparations, vitamins, sodium chloride, as well as the use of high-energy nutrients is recommended. The aim of the study was to evaluate current nutritional recommendations of patients with CF.

陈玉焕, 张青, 陈思 et al.

Abstract

Rubia Rodrigues Neves, Priscila dos Santos Ferro, Laura Maria Vidal Nogueira et al.

Objetivo: Avaliar o acesso aos serviços de atenção primária à saúde para o controle da tuberculose, identificando as facilidades e dificuldades, além de analisar a forma como os doentes são acolhidos pela equipe multidisciplinar. Método: Estudo operacional realizado em cinco Unidades Básicas de Saúde do município de Belém. Constituíram a amostra 34 doentes com tuberculose. Estudo aprovado pelo Comitê de Ética em Pesquisa, sob Parecer nº 206.875.Resultados: Constatou-se como facilidades para o acesso ao tratamento a proximidade da Unidade Básica de Saúde à residência dos doentes, o pouco tempo de espera para a consulta e o vínculo com a equipe de saúde. Como dificuldade identificou-se a não realização de visitas domiciliares. Conclusão: O fortalecimento do vínculo, a garantia de acesso e o acolhimento pela equipe de saúde são fatores que podem contribuir para o sucesso do tratamento. Descritores: tuberculose; acesso aos serviços de saúde; atenção primária em saúde.

吴九妹, 刘勇燕, 郜青叶 et al.

Abstract

Mayorga-Álvarez Jorge Humberto, Montoya-Restrepo Luz Alexandra, Montoya-Restrepo Iván et al.

Introduction: in Colombia, the study of the chronic disease (CD) has been declared as priority of investigation Objective: to determine a methodology for the analysis of the financial burden attributable to the familiar care of a person with CD. Methods: methodological study that proposes a way of analyses of the financial burden of the familiar care of a person with CD. It was developed in four phases: [A] Review of the literature. [B] Development of the survey “Financial costs of the care of the chronic non-communicable disease”. [C] Structuring of a proposal of methodological approach for the analysis of the data. [D] Development of final details of the definitive version of the designed methodology by means of its application to the results of the survey of 30 Colombian families Results: according to the literature review and keeping in mind the obtained data by means of the application of the survey “Financial costs of the care of the chronic non-communicable disease”, a methodological proposal of the analysis of the familiar financial burden attributable to the care of a person with CD in Colombia was done and it was named: CARACOL. On having applied the methodology in a pilot study with the information of thirty families, it was found that the costs generates them a major financial burden in terms of health and transportation Conclusion: the CARACOL methodology is an original contribution that could allow analyzing the financial burden attributable to the familiar care of a person with CD from the variation generates in the effective real consumption. Rev.cienc.biomed. 2015;6(1):96-106 KEYWORDS Cost of Illness; health economics; chronic disease; methodology.

刘敏, 任朝芝, 任明琼 et al.

C. Campbell, C. Foulis

Home-based care (HBC) plays a vital role in the care of people living with AIDS. Most carers perform their arduous role in adverse conditions. Yet little is known about how to facilitate contexts that maximise the effectiveness of carers. This paper reviews existing research into home-based care in sub-Saharan Africa to highlight gaps in understanding and to outline new conceptual frameworks for future research. Current research identifies multi-level factors that undermine carers in performing their role. These include e.g. lack of knowledge, skills and support - both at the individual and organisational levels; physical and psychological burnout; the destruction of household economies in the face of the demands of care; community stigma and rejection. Research and policy documents repeatedly advocate ‘partnerships’ or ‘linkages’ between carers/ patients and more powerful groupings (locally, nationally and/or internationally) as a solution to these problems. Yet they give no indication as how best to mobilise already over-burdened carers and their terminally ill charges. Furthermore, partnerships between poor communities and more influential groupings and agencies are notoriously difficult to promote and sustain. If partnerships are indeed to play such a key role in supporting carers and their patients, there is an urgent need for systematic research into the effectiveness of various partnership styles and strategies. The concepts of bonding, bridging and linking social capital - within a framework sensitive to the interaction between social capital and poverty - are put forward as a valuable starting point for the development of better understandings of the types of networks and partnerships most likely to support carers and their local communities.

Jackçon L. Savi, Rosita Saupe

Na seqüência do acompanhamento da disciplina "Métodos Terapêuticos Alternativos" (MTA). implantada no Curso de Graduação em Enfermagem da UFSC em 1990. focalizou-se os egressos com o objetivo de verificar a utilização das terapias alternativas na assistência de enfermagem que prestam como enfermeiros. Nenhum dos entrevistados posicionou-se contrário e a maioria confirmou utilizar uma ou mais terapias na assistência que prestam aos usuários dos serviços onde atuam.