Hasil untuk "Nursing"

Leigh Ann Simmons, Jennifer E. Phipps, Sebastian Castro-Alvarez et al.

Abstract Background Rising rates of overweight and obesity globally have led to an increasing number of women who enter pregnancy with excess weight, posing significant health risks to mothers and infants. Mobile health interventions, such as smartphone apps, may be a solution to improving pregnancy outcomes, however, limited randomized studies have examined this approach for gestational weight gain (GWG) and postpartum weight retention (PPWR). We report results from a double-blinded, randomized control trial of Goals for Reaching Optimal Wellness (GROWell), a mobile app and text-based intervention designed to improve diet quality and associated weight outcomes in pregnant and postpartum women. Methods Women living in California with BMI = 25–42 kg/m2 and a singleton, uncomplicated pregnancy were recruited via social media or clinic in early pregnancy from January 2021 through March 2023. After completing a baseline survey, participants were randomized to GROWell or an educational control. Participants completed online surveys of diet quality and other health behaviors and self-weighed using study-provided Bluetooth scales. Modified Poisson regression tested for differences in excess GWG and 6-month PPWR. Results Using block randomization in permuted blocks of three based on prepregnancy BMI, race/ethnicity, and recruitment source) 453 racially and ethnically diverse participants (237 attention control, 216 intervention) were enrolled. Mean age was 33.6 ± 4.1 years and mean BMI was 30.9 ± 4.28 kg/m2. Excess GWG was observed in 36% of the control group and 35% of the intervention group. PPWR was observed in 26% of the control group and 23% of the intervention group. Conclusions Compared to an attention control, GROWell was not associated with lower rates of excess GWG or PPWR. However, study rates of excess GWG and PPWR were lower in both groups compared to averages in the US and several Western nations. Future studies should investigate the potential of text-based educational support on weight and other health indicators among childbearing women. Trial registration ClinicalTrials.gov identifier NCT04449432. Registered on June 26, 2020.

Dan Xu, Mengyan Xu, Liuxu Fang et al.

Abstract Background Childbirth is a complex process, and midwives involved in assisting or witnessing it often experience psychological trauma, which can impact their well-being and professional performance. Psychological trauma in midwives is under-researched, despite its implications for their mental health and the quality of childbirth services. Addressing this issue is critical for ensuring safe and compassionate care. This study aimed to explore the psychological trauma experienced by midwives during childbirth and identify key influencing factors to enhance the safety and humanization of childbirth services. Methods This descriptive qualitative study involved in-depth interviews with 13 midwives selected based on preset criteria. Data were analyzed using a qualitative content analysis framework, and thematic analysis was applied to identify recurring themes from the data. Results Four primary themes emerged from the data. First, midwives reported persistent emotional trauma, including ongoing fear, guilt, and self-blame associated with traumatic childbirth experiences. Second, they faced multifaceted professional challenges, including high expectations and systemic pressures. Emotional exhaustion was more closely associated with persistent trauma and vicarious exposure, as reflected in other themes. Third, participants described feelings of helplessness and powerlessness when managing critical or life-threatening situations. Fourth, vicarious trauma was common, stemming from deep empathy and emotional engagement with laboring women and their families. Conclusion Strategies to address these challenges include strengthening midwives’ psychological resilience and professional competencies, optimizing team collaboration, and enhancing psychological and emotional support. Implementing these measures can safeguard the mental health of midwives, promote humanistic care, and improve childbirth safety. Trial registration ChiCTR2400088104 August 12th, 2024.

Verusca Soares de Souza, Helder de Padua Lima, Soraia Geraldo Rozza et al.

ABSTRACT Objective: to describe the process of collective construction of the Continuing Health Education Center based on a survey of health workers’ needs. Method: action research conducted between 2021 and 2025, using multiple qualitative and quantitative data collection techniques. The exploratory phase identified the absolute frequency of educational needs, which were validated in a focus group, guiding educational initiatives. Concurrently, a working group held workshops/meetings to develop the documentation necessary to formalize the Continuing Health Education Center. Results: the thematic priorities for education were “humanization of care for people with mental health problems” in primary and tertiary care, and “management of situations of violence” in secondary care. Three educational initiatives were implemented: humanization for receptionists; basic life support for mid-level professionals; and patient safety for hospital professionals and patients/families receiving care. Finally, the process of establishing the center began with a workshop to develop an action plan and a monthly follow-up. However, political barriers, such as the absence of the position in the municipal organizational chart, hindered the formalization of the sector. Final considerations: the collective discussion of Continuing Health Education fostered dialogue between the different levels of care. The process of collectively building a Continuing Health Education Center is challenging. Furthermore, it requires the participation of managers, professionals, and healthcare services while overcoming organizational and political barriers.

Seyedeh Mahboobeh Hosseini Zare, Jafar Babapour, Mehdi Basakha et al.

Objective Insurance deductions are among the most important causes of hospital resource waste. Insurance deductions cause financial problems for hospitals and create tension between insurance organizations and hospitals. This study, done by the University of Social Welfare and Rehabilitation Sciences, investigates the reasons for deductions of inpatient bills covered by Social Security Insurance in Rofeideh Rehabilitation Hospital Materials & Methods The study was conducted cross-sectionally on 776 cases admitted to Rofeidah Rehabilitation Hospital in 2021. All invoices for inpatient services sent to Social Security Insurance were reviewed using the census method. To collect data, invoices sent to Social Security, inpatient records and checklists, and a 31-question questionnaire of Mohammadkhani et al. were used. The collected data were analyzed by descriptive (frequency and percentage) and analytical statistics (the Spearman correlation coefficient) in SPSS software, version 23. Results According to the findings, the highest frequency of inpatient prescriptions was related to November 2021 (7.48%). The most frequent deductions of inpatients’ bills were related to medicine and consumables to the amount of 310815448 Rails and surgeon’s fees in 187728448 Rails. Also, the most common reasons were requesting a surcharge and wrong coding. In this study, there was a significant relationship between the documentation of nurses and doctors and the amount of deductions (P<0.0001). Conclusion Multiple causes affect the reduction of insurance deductions. By teaching insurance rules and the book on the relative value of health services to medical and nursing staff groups, electronic documents to Social Security Insurance and creating warning mechanisms in it, continuous interaction with Social Security Insurance to justify the managers of the organization regarding the way of providing services to rehabilitation patients and the reason for the prolonged hospitalization time of such patients could be the potential solutions for preventing patients records deductions and help hospitals achieve financial goals.

David Rintu Das, Shamim Rayhan, Md. Rezoanul Haque et al.

An experiment on brood rearing and induced breeding of the near threatened fish species Raikor, Cirrhinus reba using the pituitary gland (PG), was conducted from March to August 2020 at the Floodplain Sub-station of Bangladesh Fisheries Research Institute, Santahar, Bogura. Broods were collected and reared in the ponds of the hatchery complex. The total length (cm), body weight (g), gonad weight (g), and gonado-somatic index (%) of this species were measured during the rearing period. To standardize the breeding technique, a total of 90 brood fish of C. reba were treated with different doses of PG, specifically, 2.0, 4.0, 6.0 mg/kg body weight for females and 1.0, 2.0, 3.0 mg/ kg body weight for males in different treatments, namely T1, T2, and T3 respectively. A significant difference (p&lt;0.05) was observed in fecundity, ovulation (%), and the fertilization rate (%) among the treatments. Based on the results, T2 (4.0 mg/kg body weight for females, 2.0 mg/kg body weight for males) produced the most favorable results. The current observations could be applied to C. reba stimulated breeding for the advancement of hatchery formation. More research on the nursing, nurturing, and culture of the near- threatened C. reba at varied densities and feedings is necessary for their conservation and restoration.

Linda Birt, Thando Katangwe-Chigamba, Sion Scott et al.

Abstract Background Influenza (flu) vaccination rates in UK care home staff are extremely low. Less than 40% of staff in care homes are vaccinated for influenza (flu), presenting risks to the health of frail residents and potential staff absence from cross-infection. Staff often do not perceive a need for vaccination and are unaware they are entitled to free flu vaccination. The FluCare study, a cluster randomised control trial (RCT), uses behavioural interventions to address barriers. Videos, posters, and leaflets are intended to raise awareness of flu vaccination benefits and debunk myths. On-site staff vaccination clinics increase accessibility. Financial incentives to care homes for improved vaccination rates and regular monitoring influence the environment. This paper outlines the planned process evaluation which will describe the intervention’s mechanisms of action, explain any changes in outcomes, identify local adaptations, and inform design of the implementation phase. Methods/design A mixed method process evaluation to inform the interpretation of trial findings. Objectives • Describe the intervention as delivered in terms of dose and fidelity, including adaptations and variations across care homes. • Explore the effects of individual intervention components on primary outcomes. • Investigate the mechanisms of impact. • Describe the perceived effectiveness of relevant intervention components (including videos, leaflets, posters, and flu clinics) from participant perspectives (care home manager, care home staff, flu clinic providers). • Describe the characteristics of care homes and participants to assess reach. A purposive sample of twenty care homes (ten in the intervention arm, ten in the control arm) for inclusion in the process evaluation. Data will include (1) study records including care home site profiles, (2) responses to a mechanism of action questionnaire, and (3) semi-structured interviews with care home staff and clinic providers. Quantitative data will be descriptively reported. Interview data will be thematically analysed and then categories mapped to the Theoretical Domains Framework. Discussion Adopting this systematic and comprehensive process evaluation approach will help ensure data is captured on all aspects of the trial, enabling a full understanding of the intervention implementation and RCT findings. Trial registration ISRCTN ISRCTN22729870. Registered on 24 August 2022.

Amir Hossein Hasanpour, Mahdi Sepidarkish, Abolfazl Mollalo et al.

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is a difficult to treat infection, particularly in residents of elderly care centers (ECCs). Despite the substantial burden of MRSA, an inadequate number of studies have analyzed MRSA prevalence in ECCs. Objectives We conducted a worldwide systematic review and meta-analysis on the prevalence and risk factors of MRSA in ECCs. Methods We searched MEDLINE/PubMed, EMBASE, Web of Science, and Scopus databases and the gray literature sources for all studies published between January 1980 and December 2022 on the prevalence of MRSA in ECCs. A random-effects model was utilized to estimate pooled prevalence rates at 95% confidence intervals (CI). Moreover, the data were analyzed based on World Health Organization-defined regions, income, and human development index levels. Results In total, 119 studies, including 164,717 participants from 29 countries, were found eligible for meta-analysis. The pooled global prevalence of MRSA was 14.69% (95% CI 12.39–17.15%; 16,793/164,717). Male gender [prevalence ratio (PR) = 1.55; 95% CI 1.47–1.64], previous MRSA infection (PR = 3.71; 95% CI 3.44–4.01), prior use of antibiotics (PR = 1.97; 95% CI 1.83–2.12), hospitalized within the previous year (PR = 1.32; 95% CI 1.20–1.45), have had any wound (PR = 2.38; 95% CI 2.23–2.55), have used urinary catheter (PR = 2.24; 95% CI 2.06–2.43), have used any medical device (PR = 1.78; 95% CI 1.66–1.91), and those with diabetes (PR = 1.55; CI 1.43–1.67) were more likely to be colonized by MRSA than other patients. Conclusion Screening programs and preventive measures should target MRSA in ECCs due to the high global prevalence rates.

Eudu James, Benon Wanume, Milton W. Musaba et al.

Abstract Background A rapid increase in community transmission of COVID-19 across the country overwhelmed Uganda’s health care system. In response, the Ministry of Health adopted the home-based care strategy for COVID-19 patients with mild-to-moderate disease. We determined the characteristics, treatment outcomes and experiences of COVID-19 patients under home-based care during the second wave in Kapelebyong district, in eastern Uganda. Methods We conducted a sequential explanatory mixed-methods study. We first collected quantitative data using an interviewer-administered questionnaire to determine characteristics and treatment outcomes of COVID-19 patients under home-based care. Cured at home was coded as 1 (considered a good outcome) while being admitted to a health facility and/or dying were coded as 0 (considered poor outcomes). Thereafter, we conducted 11 in-depth interviews to explore the experiences of COVID-19 patients under home-based care. Multivariable logistic regression was used to assess factors associated with poor treatment outcomes using Stata v.15.0. Thematic content analysis was used to explore lived experiences of COVID-19 patients under home-based care using NVivo 12.0.0 Results A total of 303 study participants were included. The mean age ± standard deviation of participants was 32.2 years ± 19.9. Majority of the participants [96.0% (289/303)] cured at home, 3.3% (10/303) were admitted to a health facility and 0.7% (2/303) died. Patients above 60 years of age had 17.4 times the odds of having poor treatment outcomes compared to those below 60 years of age (adjusted odds ratio (AOR): 17.4; 95% CI: 2.2–137.6). Patients who spent more than one month under home-based care had 15.3 times the odds of having poor treatment outcomes compared to those that spent less than one month (AOR: 15.3; 95% CI: 1.6–145.7). From the qualitative interviews, participants identified stigma, fear, anxiety, rejection, not being followed up by health workers and economic loss as negative experiences encountered during home-based care. Positive lived experiences included closeness to friends and family, more freedom, and easy access to food. Conclusion Home-based care of COVID-19 was operational in eastern Uganda. Older age (> 60 years) and prolonged illness (> 1 months) were associated with poor treatment outcomes. Social support was an impetus for home-based care.

Boohwi Hong, Chahyun Oh, Yumin Jo et al.

Fascial plane blocks are useful for multimodal analgesia after cardiac surgery since they can provide effective analgesia without the serious risks associated with conventional techniques such as neuraxial hematoma and pneumothorax. This narrative review covers blocks performed at the parasternal intercostal, interpectoral, pectoserratus, serratus anterior, erector spinae, and retrolaminar planes, which are targets for fascial plane blocks in cardiac surgery. Brief anatomical considerations, mechanisms, and currently available evidence are reviewed. Additionally, recent evidence on fascial plane blocks for subcutaneous-implantable cardioverter-defibrillator implantation are also reviewed.

Renan Gondim Araújo, Raquel Bezerra Barbosa de Moura, Adriana Gomes Cézar de Carvalho et al.

Objetivo: Analisar a produção científica acerca das consequências da sarcopenia em pacientes oncológicos em cuidados paliativos. Metodologia: Revisão integrativa, sendo realizado o levantamento bibliográfico por meio de busca eletrônica na Biblioteca Virtual de Saúde, Pubmed, LILACS e SciELO, utilizando os descritores controlados “sarcopenia”, “cuidados paliativos” e “câncer”, associados pelos operadores booleanos “AND” e “OR”. Resultados: Foram incluídos 18 artigos, dos quais foram extraídas três abordagens temáticas que tratam sobre a prevalência e fatores associados à sarcopenia, e sua influência na sobrevida, qualidade de vida e sintomas em pacientes oncológicos em cuidados paliativos. Conclusão: A sarcopenia nestes pacientes possui alta prevalência, leva ao maior risco de toxicidade à quimioterapia paliativa com influência na sobrevida, e, ainda, está relacionada a uma maior carga de sintomas, contribuindo para malograr a qualidade de vida desses pacientes, sendo necessária a discussão sobre o combate da sarcopenia durante o curso da doença oncológica.

Michael Anthony Huyck, Sarah Messmer, Stockton McQuade Mayer et al.

Vin Tangpricha, Ellen M. Smith, Jose Binongo et al.

Vitamin D deficiency is highly prevalent in children and adults with cystic fibrosis (CF). Recent studies have found an association between vitamin D status and risk of pulmonary exacerbations in children and adults with CF. The ongoing Vitamin D for enhancing the Immune System in Cystic fibrosis (DISC) study, a multi-center, double-blind, randomized, placebo-controlled trial, will test the hypothesis of whether high dose vitamin D given as a single oral bolus of 250,000 IU to adults with CF during a pulmonary exacerbation followed by a maintenance dose of vitamin D will improve time to next pulmonary exacerbation and re-hospitalization, improve survival and lung function compared to placebo and reduce the rates of pulmonary exacerbation. Subjects will be randomized 1:1 at each clinical site to vitamin D or placebo within 72 h of hospital admission for pulmonary exacerbation. Clinical follow-up visits will occur at 1, 2, 3, and 7 days, and 1, 3, 6 and 12 months after randomization. Blood and sputum will be collected and determination of clinical outcomes will be assessed at each visit. The primary endpoint will be the time to next pulmonary exacerbation requiring antibiotics, re-hospitalization or death. The secondary endpoints will include lung function assessed by forced expiratory volume in 1 s (FEV1), blood markers of inflammatory cytokines, anti-microbial peptide expression by peripheral blood mononuclear cells and circulating concentrations in blood. Other exploratory endpoints will examine the phenotype of neutrophils and monocyte/macrophages in sputum. Nutritional status will be assessed by 3 day food records and food frequency questionnaire.

Sarah Stahlke Wall

Autoethnography is an avant-garde method of qualitative inquiry that has captured the attention of an ever-increasing number of scholars from a variety of disciplines. Personal experience methods can offer a new and unique vantage point from which to make a contribution to social science yet, autoethnography has been criticized for being self-indulgent, narcissistic, introspective, and individualized. Methodological discussions about this method are polarized. As an autoethnographer and qualitative methodologist with an interest in personal experience methods, I have had the opportunity to review several autoethnographic manuscripts over the years. As my reviews accumulated, I began to see themes in my responses and it became apparent that I was advocating for an approach to autoethnography that lies in contrast to the frequently offered methodological polemics from philosophically divergent scholars. In this article, I draw from the reviews I have done to address topics such as applications and purposes for autoethnography, the degree of theory and analysis used within the method, data sources and dissemination of findings, and ethical issues. I then connect the concerns I see in the reviewed manuscripts to examples in the autoethnographic literature. Ultimately, I propose a moderate and balanced treatment of autoethnography that allows for innovation, imagination, and the representation of a range of voices in qualitative inquiry while also sustaining confidence in the quality, rigor, and usefulness of academic research.

Rupinderjeet Kaur, Paramdeep Singh, Krishan Singh Kajal et al.

A male patient presented with horizontal diplopia and conjugate gaze palsy. Magnetic resonance imaging (MRI) revealed acute infarct in right facial colliculus which is an anatomical elevation on the dorsal aspect of Pons. This elevation is due the 6th cranial nerve nucleus and the motor fibres of facial nerve which loop dorsal to this nucleus. Anatomical correlation of the clinical symptoms is also depicted in this report.

G. L. Noel, H. Suh, A. Frantz

John Powell

J. B. George

L. Zahr, S. Balian

Daniele Delacanal Lazzari, Natália Schmidt, Walnice Jung

Objective: to understand the perception of nurses, as is continuing education in intensive care units. Method: an exploratory study of qualitative approach, carried out with five nurses in intensive care units (ICU) in a hospital in the metropolitan area of Porto Alegre/RS. Data were collected in April 2010 through interviews with semi-structured. Results: the institution studied the educational process is theoretic-practical, general, comprises professionals from different areas, without regard to the specific needs of the work in intensive care. The courses take place as needed momentary or identification of deficiencies in team work, without any assessment of individual performance. Conclusion: despite the intensive care unit is a complex and highly specialized in the institution studied, there is an education policy for the purpose of promoting the care with focus on this specialty. But no appreciation of the educational processes in general

Axilene Rizzi Remonatto, Andreia Orjana Ribeiro Coutinho, Emiliane Nogueira de Souza

Objective: verifying questions and expectations of patients on post operative of coronary artery bypass graft surgery about returning to daily life after discharge. Method: qualitative study, descriptive and exploratory, it was performed with patients hospitalized in clinical surgical unit. The data was discussed by content analysis technique. Results: eight patients were interviewed, aged between 51 and 64 years old. The main questions were related to performing household activities, sexual activities, continuous use of medicine, return to work and wound care. Conclusions: the darkness in the understanding of the information or even the lack of them makes the individuals feel uncertain about the actions of self-care after discharge