The Outcomes of Pregnancy with Congenital Heart Disease: An Integrative Literature Review

Purpose: The purpose of this review was to identify the short-term and long-term outcomes of pregnancy in women suffering from congenital heart disease (CHD). Methods: An integrative review is used to identify the pregnancy outcomes in women with CHD. Data search was between 2010 and 2020 using Google Scholar, Scopus, Web of Science, Science Direct, Pub Med, Medline, CINAHL, EBSCO, Cochrane, and EBSCO host. Sixteen articles met the eligibility criteria. Results: The sixteen reviewed articles utilized descriptive retrospective and prospective design. Themes were short-term outcomes that include;cardiac maternal and obstetric outcomes, and long-term outcomes. Conclusion: Previous uncertainty about the ability of CHD patients to successfully become pregnant and deliver safely has replaced by the recognition that a large number can have excellent outcomes. However, these patients do continue to have higher cardiac, obstetric, and fetal risks than the general population. This illuminates the importance of preconception counseling and risk assessment for women suffering from CHD regarding the expected maternal and fetal outcomes. Moreover, there is a need for providing accurate and appropriate education about pregnancy and delivery options.

Patients’ Involvement in Decision Making at End of Life—A Systematic Review of Literature

Background: involving patient in end of life decision is important to understand their wishes and preferences to help health care providers in improving the quality of dying and minimizing suffering. Aim: the aim of this review was to provide a detailed examination of the available literature related to patients’ involvement in decision making at end of life. Design: a systematic review following the PRISMA protocol was used, the review protocol was registered on PROSPERO: CRD42019128556. Data sources: we conducted a literature search in two electronic databases “CINAHL and Medline” during March-April 2019. The retrieved articles were included if they were: research reports or literature review;examined patient involvement in end-of-life discussions;full text publications, written in English and published from 2000-2019. Results: a total of (22) articles were included in the review;there was diversity in the purposes and design approach of the retrieved studies. The available literature explored patient’s involvement at end-of-life decision making through;describing current practices;understanding perspectives of end of life discussions;investigating the impact and identifying the barriers and facilitators of patients’ involvement in end of life discussions. Conclusion: involvement in end-of-life discussions improved the recognition of patients’ wishes, improved death experience, and decreased posttraumatic stress, depression, and anxiety among family members. Despite the documented benefits, some barriers against patient’s involvement in end-of-life decisions were recognized;lack of awareness;lack of education, training and experience;concerns about ethical and legal issues;and personal preferences of doctors or nurses were among the most commonly identified barriers.

The Translation of Perinatal Anxiety Screening Scale (PASS) into Arabic

Background: early detection of perinatal anxiety using appropriate measures helps in reducing maternal and fetal complication. WHO guidelines for instrument translation and adaptation provide rigor and transparent method for Perinatal Anxiety Screening Scale (PASS) translation and expand the knowledge in diversity cultural contexts. Aim: to describe the process of cultural adaptation of the PASS into the Jordanian context based on the WHO framework for instrument translation and adaptation. Methods: PASS was completed by a convenience sample of 31 pregnant women. In which PASS went through WHO framework for instrument translation and adaptation process includes forward translation, expert panel, blind back translation, pre testing and cognitive interview, and the final version is ready for piloting. Some comments were added to three items by five expert panel, then the modified version was ready for piloting. Result: the internal consistency reliability of PASS was 0.869 and five experts who reviewed PASS confirmed the scale appropriateness and clarity after a slight modification to three items. Participants found PASS in general easy to complete but some of them found difficulties in understanding two items located in the Perfectionism, control and trauma subscale where they need an explanation of their meaning to answer them. Conclusion: using WHO guidelines for instruments translation considered a rigorous method and revealed that PASS is reliable and valid tool to be used within the Jordanian context to measure perinatal anxiety. However, the focus on explaining items 11 and 14 to participants is important due to difficulty in understanding their meaning.

The Effectiveness of Video Distraction on Children Preoperative Anxiety: An Integrative Literature Review

Background: Children who undergo a day case surgery experience high levels of preoperative anxiety. Preoperative anxiety interferes with anesthesia induction compliance and is associated with many short and long term postoperative complications. Recently, video distraction intervention has been evaluated for its anxiolytic effects in preoperative children. Aim: The aim of this integrative review was to demonstrate the varying methodological approaches utilized to evaluate the effectiveness of a video distraction intervention in reducing preoperative anxiety in children undergoing day case surgery. Methods: A total of 8 articles, meeting the inclusion criteria, were evaluated and included. Findings: The eight studies investigating the effect of video distraction on children preoperative anxiety concluded that video distraction was significant in controlling children preoperative anxiety. Four of the eight studies (50%), investigated video distraction effectiveness against pharmacological comparisons and demonstrated superior or equal anxiolytic effect of video distraction on different points along the surgical continuum. Three of the eight studies compared video distraction against parental presences and video distraction showed superior anxiolytic effect. Three of the eight studies evaluated the effect of video distraction on anesthesia induction compliance and emergence delirium. A significant effect on anesthesia induction was demonstrated while non-significant effect on emergence delirium was documented. Conclusion: Video distraction is a safe, time and cost effective non pharmacological anxiolytic intervention. It can be provided by nurses to control children high level of anxiety before surgery and during anesthesia induction.

Implementing Surviving Sepsis Campaign Guidelines and Mortality of Adult Patients in Intensive Care Units: An Integrative Review

Background: Sepsis is a common dangerous body response to infection that can deteriorate into septic shock. Both sepsis and septic shock require early and timely managed care, which can be implemented by using the Surviving Sepsis Campaign (SSC) guidelines for management of sepsis and septic shock. The purpose of this study was to examine the literature related to the effect of implementing SSC guidelines for management of sepsis and septic shock on adult patients’ mortality rate in Intensive Care Units (ICUs). Methods: The method of Whittemore and Knafl was used to guide this integrative literature review. The literature search revealed 16 eligible quantitative research studies between 2004 and 2018. The quality of methods used in the included articles was assessed and data were analyzed. Results: Results showed that implementing SSC guidelines reduced the mortality rate among adult patients in ICUs. In addition, implementing selected practices from SSC guidelines, such as collecting blood cultures and administration of a broad-spectrum antibiotic and vasopressors were found to decrease the mortality rate among adult patients in ICUs. The SSC guidelines need to be taught to nurses and nursing students to increase their awareness and capability of implementing these guidelines in clinical practice.

The Outcomes of Integrating High Fidelity Simulation in Nursing Education: An Integrative Review

Purpose: The purpose of this review was to identify the best evidence on the effectiveness of using high fidelity simulation technology for learning outcomes in nursing education. Methods: An integrative review was used to assess the effectiveness of high fidelity simulation in nursing education. Data search was between 2008 to 2018 using Google Scholar, Scopus, Web of Science, Science Direct, Pub Med, Medline, CINAHL, EBSCO, Cochrane, ERIC, Joanna Briggs Institute and EBSCO host. A total of 17 articles met the eligibility criteria. Results: The seventeen reviewed articles were adopted mixed method designs, randomized controlled trial, quazi-experimental, and correlational studies. Themes were: self-satisfaction and confidence, clinical decision-making, and clinical judgment. Conclusion: Nursing literature supports the importance of including high fidelity simulation in nursing education. HFS provides diverse learning experiences, promotes decision-making and clinical judgment, self-satisfaction and self-confidence to develop assessment and safe practice. Implication: Nursing educators can create a variety of patient conditions for collaborative nursing care for increasing learning outcomes.

Exploring Healthcare Experiences and Needs of Children with ADHD, Jordanian Mothers Perspective: A Phenomenological Study Protocol

Background: Attention deficit hyperactivity disorder ADHD is a common behavioral problem among children in the world as in Jordan. However, Children with ADHD were significantly less likely to have appropriate health care services when they need health care. Thus, phenomenological study is important and needed as a gap exists in the literature concerning the health care experiences and needs of children with ADHD from the parents’ perspective. Accordingly, this study will conduct to gain an in-depth understanding of the healthcare experiences and needs of children with ADHD. Aim: The aim of the current qualitative study is to explore and describe the health care experiences and health care needs of children with ADHD from their mothers’ perspectives within the context of the phenomenological approach. Study Method: Descriptive phenomenological research design. Semi-structured interview will be conducted with the mothers of children with ADHD who will be recruited purposefully from special Attention Deficit and Hyperactivity Disorders Medical Clinics in order to ensure and to confirm the diagnosis from the specialist there. Data will be transcribed, managed and analyzed using descriptive, phenomenological analysis. The Jordan University Ethics Committee approved the study. Discussion: The findings of this study will make an original contribution to our knowledge about the health care experiences and health care needs of children with ADHD from their mothers’ perspectives within the context of the phenomenological approach, in order to help health care providers in general, and nurses, in particular, to provide optimal health care services for children with ADHD that address the children physical and mental health care needs of the highest priority from mothers’ perspectives.