Development of Nursing Protocol for Preventing Discontinuation of Treatments by Methods Other than Physical Restraint during Acute Exacerbation of Chronic Heart Failure in Patients with Impaired Cognitive Function

The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.

Barriers in performing physical assessment among nursing students:An integrative review

Objectives:This study aimed to identify barriers in performing physical assessments among nursing students through integrative review study.Methods:The literature were searched in Medline,CINAHL,ScienceDirect,Web of Science,ProQuest,and Taylor&Francis Online using the descriptors barrier,physical assessment,nursing student et al.Only English-language and peer-reviewed journal articles were included,and there were no year restrictions.Results:Twelve articles were selected for review.Two aspects were extracted:the barriers included personal challenges,challenges related to nursing education,challenges related to clinical practice;establishing competency-based education learning as a method to reduce physical assessment barriers.Student competencies and experiences were influenced by various factors that collectively hindered their successful performance of physical assessments.Conclusions:The review findings provide valuable insights into the complex issues involved in the performance of physical assessments and guidance for improvement in practice.A collaborative effort should be made to address the issues often faced by nursing students in performing routine physical assessments.Also,more constructive and competency-based teaching methods should be integrated into academic and clinical settings.

Influence of physical self and mindfulness on the academic possible selves of freshman nursing students

Objective:The purposes of this study were to investigate the general level of the mindfulness,physical self,and academic possible selves in the freshman nursing students,and to explore the relationship among the three variables,so as to provide a theoretical basis for the freshmen to improve their academic achievement on the basis of the correct understanding of the physical self.Methods:A total of 360 freshman nursing students were enrolled in this study from a medical school in Yantai City.Data were collected using three questionnaires:Body Self-description Questionnaire,Five Factors Mindfulness Questionnaire,and Academic Possible Selves Questionnaire.There were 341 valid questionnaires.Results:The mindfulness of the freshmen nursing students was at a medium level(3.03±0.28),their attitude to physical self(3.66±0.58)and academic possible selves(3.33±0.50)were positive.There were significant gender differences among coordination,physical activity,athletic ability,strength,endurance,observation,non-response,total physical self-score,and negative future academic possible selves.In the above factors,except negative future academic possible selves,the scores for boys were higher than that for girls(all P<0.05).There were significant positive relationships between physical self,mindfulness,and academic possible selves.Self-esteem,acting with awareness,endurance,and description were effective positive predictors of the academic possible selves,with a total explanation rate of 33.6%.Conclusion:There were close relationships among the physical self,the level of mindfulness,and the academic possible selves.Positive physical self-description and high level of mindfulness could help individuals develop a positive attitude toward their academic possible selves.

Physical Activity and Leisure in the Daily Life of Nursing Students

The aim of this paper was to describe the routine of Brazilian nursing students, identifying the activities that are part of their daily life, highlighting how much time they dedicate for physical activity practice in their leisure time. The participants of this cross-sectional study were 141 nursing students from a public university in the State of São Paulo. Data were collected using a sociodemographic questionnaire, three closed questions about physical activities and one open question in which the students described their daily life activities. For analysis, we used the chi-squared-test and content analysis. Although academic, household and work activities take up most of the students’ week, some dedicate a portion of their daily live to enjoy leisure periods with physical activities, sedentary behavior and sociocultural activities. Some options of activities seem to be related to Brazilian cultural aspects that are pointed out in this paper. Some recommendations were made, aiming at improving the health of students as well as the importance of a healthier school environment.

Physical restraint using,autonomy,ethics among psychiatric patients in nursing practice in China

The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s autonomy.This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy,beneficence,nonmaleficence,and ethical theories.Given that nursing workforce was limited and workload among psychiatric nurses was heavy,physical restraint was one of the coercive interventions managing aggressive behavior.In relation to address ethical dilemmas,it was proposed to acquire informed consent of physical restraint from the individuals and provide person‑centered care.Effective communication and negotiation with patients could help to strike a balance between patients’autonomy and nurses’accountability when using physical restraint.In addition,guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint.Finally,a collaboration among nurses,psychiatrists,and families is essential to protect patients’autonomy concerning physical restraint use.

Dilemmas Faced by Nurses Regarding the Physical Restraint of Elderly Patients with Dementia in Japan

This study aimed to clarify the dilemma of nurses working in general wards who face the ethical dilemma of restraining older people with dementia in Midwestern Japan. The study used the questionnaire method with an independently prepared questionnaire. The questionnaire was designed to ensure privacy and anonymity. The privacy and anonymity of study participants was assured. Of the 340 survey questionnaires distributed, 291 (85.6%) completed surveys were eligible number (12 additional surveys were returned without answers). An explanatory factor analysis revealed four dilemma factors among 15 items investigated (KMO value 0.84). These were: factor 1: “Execution of treatment and security,” α = 0.91;factor 2: “approach in the nursing of older people with dementia,” α = 0.93;factor 3: “A cooperative relationship in nursing of older people with dementia,” α = 0.87;and factor 4: “Priorities in nursing,” α = 0.81. The cumulative contribution ratio was 79.1%. We suggest that the program would enable nurses to cope with these dilemmas.

Evaluation and analysis of the effect of continuing education on nurses’physical restraint knowledge,attitude,and behavior

Objective:The objective of the study is to construct a training course for physical restraint(PR)evidence‑based practice project and apply it to verify its effect.Methods:A total of 162 nurses from five departments of a general hospital in Beijing were trained to compare the PR knowledge,attitudes,and behaviors of nurses before and after training.Results:The nurses were satisfied with the overall curriculum;the total scores of PR’knowledge,attitude and behavior of nurses after training were higher than before,and the difference was statistically significant(P<0.05);the total scores of nurses who received evidence‑related training before this training were higher than those of nurses who did not receive relevant training,and the difference was statistically significant(P<0.05).Conclusion:Continuing education can effectively improve nurses’knowledge,attitude,and behavior level of PR,ensure patient safety,and promote physical and psychological rehabilitation of patients.

Physical Activity and Health-Promoting Lifestyle of Student Nurses in Malaysia

Studies have indicated that lack of regular physical exercise and not adhering to a health-promot- ing lifestyle among student nurses are barriers to their encouraging patients to exercise. On the other hand, nurses who personally embrace physical activity are more likely to encourage their patients to improve their health through physical activity or diet. As a result, promoting an active and healthy lifestyle among student nurses is important because this has a crucial role in their subsequently encouraging healthy lifestyles among their patients. The aims of this study were to determine the physical activity levels and health-promoting lifestyles among student nurses in Malaysia, and to investigate whether there was a correlation between the physical activity levels of student nurses and their lifestyle habits. Further investigation was also carried out to correlate lifestyle habits with physical activity during weekdays and at the weekends. This study involved 189 student nurses who were pursuing Diplomas and Bachelor Degrees in local government universities. The Yamax Digi-Walker pedometer was used to measure physical activity, while the Health-Promoting Lifestyle Profile (HPLP) II questionnaire was used to assess the health-pro- moting lifestyles of the participants. The HPLP II consisted of six sub-scales which included health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management. According to the results on physical activity, the student nurses had a mean of 8275.97 ± 2210.174 steps per day and were thus categorised as somewhat active. Additionally, the student nurses were found to be more active during weekends (M = 8389.75, SD = 2689.12) as compared to weekdays (M = 8230.46, SD = 2353.97). According to previous studies, both step counts are classified in the “somewhat active” category. Overall, the results for HPLP II showed that student nurses students in Malaysia had a positive health-promoting lifestyle with a score of 2.58 ± 0.34 on a 4-point Likert scale. The highest score was reported in spiritual growth, with a score of 2.92 ± 0.43. Meanwhile, physical activity was observed to be the lowest, with a score of 1.74 ± 0.39. The results found no correlation between physical activity and overall health-promoting lifestyle among student nurses in Malaysia (r = 0.06, n = 189, p < 0.37). However, there was a significant relationship between physical activity (measured by the pedometer) and physical activity habit (measured through the questionnaire) among the student nurses (r = 0.24, n = 189, p < 0.01). According to the findings, when the participants indicated in the questionnaire that they were active physically, the pedometer readings also showed a corresponding similarity in terms of their daily physical activities.

Improving ICU Nurses’ Practices of Physical Restraints in Jordan: Effect of an Educational Program

Background: Physical Restraint (PR) has been widely used in the intensive care units, which aims to protect patients and maintain their safety. With all benefits of PR, there are many complications and risks from improper utilization. Further, no Jordanian studies have found to educate nurses regarding the proper PR utilization. Purpose: To evaluate the impact of an educational program on nurses’ knowledge, attitude and practice regarding PR use in ICUs. Methods: A pre-experiment with one-group pretest-posttest design was used among 40 ICU nurses. A self-administered questionnaire was used to evaluate nurses before the education program and two weeks after its completion. Results: After implementation of the program, nurses demonstrated a significant difference in knowledge scores between pretest (M = 10.35 ± 1.73) and posttest (M = 13.30 ± 1.47) (t = 9.92;df = 39;P = 0.000), attitudes scores (M = 27.90 ± 2.79 vs. M = 30.40 ± 2.32) (t = 4.61;df = 39;P = 0.000), and practice scores (M = 36.85 ± 1.98 vs. M = 40.52 ± 1.60) (t = 11.59;df = 39;P = 0.000). Conclusion: Service-education program can improve ICU nurses’ knowledge, and enhance their attitudes and practices towards physical restraint. Such improvement is expected to be reflected in improving the quality of care delivered to the patients, and decreasing complications of malpractice regarding physical restraint.

Physical assessment ability of nurses and midwives on maternal care in Mongolia

This study examined the physical assessment ability of Mongolian nurses and midwives engaged in maternal care and the factors that could influence this ability. We found that nurses and midwives from prefectural hospitals had higher scores than those from national and district (soum) hospitals. The latter group could not perform more than half of the 28 tested procedures on their own, even though most had over 10 years’ experience. Therefore, to decrease the Mongolian maternal mortality ratio, we argue that in-service training for nurses and midwives in both the capital city and peripheral areas is needed.

A Descriptive Cross-Sectional Study to Assess the Perception and Knowledge of Staff Nurses regarding Physical Restrains

Purpose: The purpose of this study was to examine the perceptions and knowledge regarding physical restraint used among registered nurses (RNs) and nursing assistants (NAs). Method and Sample: A descriptive cross-sectional design was used. A convenient sample was recruited from nursing staff from Palestinian and Saudi Hospitals. Perceptions of Restraint Use Questionnaire (PRUQ) were used [1]. Results: A total of 144 nursing staffs were included. Physical restraint use was perceived as more important in some circumstances than others. In the critical care unit/ICU, the most important perceived reason for physical restraint use was protecting from falling out of bed and preventing removing dressing. There were significant differences of overall score for the PRUQ among all nursing staff according to hospital, t (142) = 8.74, P = 0.001. The mean of Saudi Arabia hospitals group (M = 4.56) was higher than the mean of Palestinian hospital group (M = 3.67). At the same time, there were significant differences of overall score for the PRUQ among all nursing staff according to specialized education in geriatrics, t (40) = 3.60, P = 0.001. The mean of no specialized education in geriatrics group (M = 4.13) was higher than the mean of yes specialized education in geriatrics group (M = 3.69). Conclusion and Implications: Nursing staff showed positive attitudes towards restrains application with difference between Palestinian and Saudi Arabian nurses. Proper implementation and good awareness of the complications are prerequisite for application of physical restrains for patients.

Development of ethical dilemma scale Japanese nurse faced physical restraints to elderly patients with dementia

Purpose: This study aimed to develop an ethical dilemma scale for nurses faced with the use of physical restraint when caring for elderly patients with dementia. Methods: We used a previously established 20-item dilemma scale. The objective and method of the study were explained to the head of nursing at 17 selected hospitals, and 121 nurses working in the general wards of 14 hospitals (excluding emergency department wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms and intensive care units) who agreed to participate were enrolled in 2000. Seventy-six nurses from one of the hospitals were selected after eight years (2008) to provide a comparison. Ethical considerations: The study was conducted with the approval of the ethics committee at Meiji University of Integrative Medicine. Results and discussion: Four factors were compared between 2000 and 2008: “execution of treatment and security”, “characteristic features in nursing of elderly patients with dementia”, “cooperative relationship in nursing”, and “priorities in nursing”. The cumulative contribution ratio was 65.3% (KMO = 0.77, p = 0.000) in 2000 and 72.5% (KMO = 0.78, p = 0.000) in 2008. Therefore, the scale dilemma nurse faced physical restraints to elderly patients with dementia in Japan was developed 4 facoters from 17-delremmas items of 20 items.

Impacts of fighting against COVID-19 on critical care nurses'psychological and physical health:a literature review

Objective:To provide insight into the effects of the coronavirus disease(COVID-19)pandemic on the physical and psychological health of critical care nurses in adult units.Methods:A systematic search through the CINAHL,MEDLINE,and EMbase databases were performed.Studies that addressed“critical care nurses,”“COVID-19,”“physical effect,”and“psychological effect”from different perspectives were reviewed.Results:A total of 42 ar ticles were reviewed based on 2 aspects:critical care nurses'psychological and physical health.Negative emotions were the most common conditions:fear,anxiety,depression,and post-traumatic stress disorder(PTSD).Burnout,falling ill and having thoughts of self-harm,fatigue,physical burden,sleeping disorders,and chronic work overload also adversely affected the nurses'health.The nurses'health deteriorated because of the changes in the unfamiliar working environment and processes,colossal workload and chronic exhaustion,worries about themselves and their families,social response,and witnessing the death toll.Conclusions:Critical care nurses experienced adverse effects of the institutional reaction,social response,and individuals'reply to the COVID-19 pandemic upon their psychological and physical health.Suppor ting services and preparation for other unprecedented situations should be sustainably available.

Physical restraints:An ethical dilemma in mental health services in China

Given that physical restraints cause adverse effects to patients and nurses,their wide and frequent use has resulted in various clinical and ethical controversies in mental health services.The rate of physical restraints is significantly higher in China than in other countries.Some western and domestic media blamed relevant institutions for compromising the basic rights of psychiatric patients.Therefore,this study aims to collect and synthesize the relevant ethical evidence and to provide corresponding guidance for the nursing practice based on the current situation of the mainland of China.This study synthesized the ethical issue according to the ethical principle of autonomy,justice,beneficence,and nonmaleficence.Given the current situation where the nursing workforce is limited and the mental health service is under-developed in China,applying physical restraints in the psychiatric inpatients to guarantee the safety of patients and nurses is crucial.In regard to respect the basic rights of psychiatric patients,it is recommended to protect the their autonomy,and eliminate the adverse effects of physical restraint.This goal would be achieved by ensuring the informed consent,providing humane care,and regulating the implementation of physical restraints.

Characteristics of Patients with Decreased Cognitive Function Undergoing Treatment for Acute Exacerbation of Chronic Heart Failure—Basic Survey for Standardization of Nursing to Prevent Discontinuation of Treatment

The purpose of this study is to clarify the characteristics of patients with decreased cognitive function undergoing treatment for acute exacerbation phase of chronic heart failure as a basic survey with a view to the standardization of nursing to prevent discontinuation of treatment of patients with declining cognitive function in the acute exacerbation phase of chronic heart failure. As the first stage of the research, using the interview guide created based on the background of discontinuation of treatment and symptomatic monitoring from 33 target literature sources, seven certified chronic heart failure nurses and 15 certified dementia nurses were given semi-structured interviews. Data obtained from the interviews was analyzed by qualitative induction. As a result, we obtained opinions/views on 8 situations namely, “cognitive function at hospitalization”, “characteristics at hospitalization, “characteristics when receiving examinations, procedures or treatment”, “characteristics of course of treatment”, “characteristics related to difficulties in grasping the symptoms of chronic heart failure and indices of deterioration”, “characteristics when using diuretics”, “characteristics concerning compliance with dietary restrictions” and “support required for discharge from hospital” concerning patients with declining cognitive function. In the future, it is necessary to prepare nursing protocols incorporating these contents for standardization of nursing.

Exergames： neuroplastic hypothesis about cognitive improvement and biological effects on physical function of institutionalized older persons

Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive and physical functions due to exergames, the intrinsic mechanisms involved in these functional changes have still not been elucidated. The aims of the present study were（1） to demonstrate the known biological mechanisms of physical exercise regarding muscle adaptation and establish a relationship with exergames; and（2） to present a neurobiological hypothesis about the neuroplastic effects of exergames on the cognitive function of institutionalized older persons. These hypotheses are discussed.

Physical restraint use rate and total fall and injurious fall rates: An exploratory study in two US acute care hospitals

This exploratory study used archived hospital data to investigate the relationships between the percentage of patients with physical restraints and the total fall rate as well as the injurious fall rate per 1000 patient-days. The two tested research questions were 1) What is the relationship between the restraint use rate and the total fall rate? 2) What is the relationship between the restraint use rate and the injurious fall rate? The results showed that a higher restraint use rate was associated with a higher total fall rate, yet a lower injurious fall rate in adult inpatient acute care settings. In efforts for fall and injurious fall prevention, front-line managers need to balance the frequency and appropriateness of physical restraint use with optimizing patients’ physical activity. Future research should explore the cause–effect relationship between physical restraint use and consequent injurious fall incidents.

Evaluation on application effect of psychological nursing intervention on patients with traumatic endophthalmitis

Background:To explore the application effect of psychological nursing intervention in patients with traumatic endophthalmitis.Methods:A total of 90 patients with traumatic endophthalmitis admitted to our hospital from August 2018 to April 2019 were selected as study objects and randomly divided into observation group and control group,with 45 cases in each group.The control group received routine nursing care,and the observation group performed psychological nursing intervention on the basis of the control group.The scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)and nursing satisfaction degree were compared before and after nursing treatment in two groups.Results:The scores of SAS and SDS of the observation group were better than those of the control group.The score of the nursing satisfaction degree of the observation group was higher than that of the control group,showing statistically significant difference(P<0.05).Conclusions:Psychological nursing intervention can improve the physical and mental condition of patients with traumatic endophthalmitis,reduce their negative emotions such as anxiety and depression,and improve the satisfaction of nursing.It is worthy of clinical promotion.

Estimation of an Object＇s Physical Parameter by Force Sensors of a Dual-arm Robot

We are developing a nursing-care robot for physical care tasks. The concept of this robot is to promote the cared persons by the robot to activate their own motion ability as long as possible. This may lead to the improvement of the cared person＇s movement volition and movement abilities. In order to realize safe and human friendly robot care tasks, full body manipulation is an important technology, for which it is necessary to estimate the subject＇s center of gravity from the contact positions and forces with the robot＇s two arms. In this paper, we estimate the center of gravity of object based on the contact point and the contact force estimated by force sensor on both robot arms. The position of gravity center is important to realize care tasks stably. We performed experiments and simulations for the single point contact and dual points contact cases using a cylindrical object. As a result, it is found that although some errors were recognized in the experiments compared with the simulations, the relations between the contact positions and such errors were observed. Such experimental error mainly comes from the difference of shape between the real robot and the model of the robot in simulation.

Morpho-Physical and Psycho-Social Determinants of Low Back Pain in Midwives Population in Benin

Background: Low back pain is a real public health problem. Lots of studies have been done about it, but not in midwives group. The latter seem to be exposed to low back pain due to morphological, physical and psycho-social factors. We therefore study the place of these factors in the occurrence of low back pain in midwives. Method: Prospective, cross-sectional and analytical study, it is done with 102 midwives of university hospitals in Benin. They were interviewed and examined. An eventual link with their history of low back pain, for at least 3 months during the last 12 months before the study, was checked to their morphological aspects (spinal curvatures, BMI), physical examinations data (strength and muscular flexibility) and psycho-social factors (relationship with colleagues and either, stress, ...). The effect of these factors was assessed using relative risk (RR) with a 95% confidence interval. Results: Different morpho-physical and psychosocial disturbances were observed in midwives. 81% had a history of low back pain. The latter have a statistically significant relationship with the different factors studied. These were mostly exposure factors, but poor midwife relationship with their hierarchical superiors was a protective factor (RR = 0.69 and p = 0.0106). Discussion-Conclusion: In Benin, health workers and especially midwives are very exposed to low back pain. The latter are often associated with different morphological, physical and psycho-social disturbances. The knowledge of those parameters is interesting to reduce this high prevalence of low back pain in midwives.