A description of the Systems Dynamics paradigm is given and the reduced Qualitative System Dynamics (QSD) form explained. A simple example is given to illustrate the diagram construction. The principles of states (lev...A description of the Systems Dynamics paradigm is given and the reduced Qualitative System Dynamics (QSD) form explained. A simple example is given to illustrate the diagram construction. The principles of states (levels), rates and feedback loops are outlined. The QSD method is used to address the problem of accessibility by using human control of automation as an example, and applying the QSD method to evaluate the effects of the researcher and user in the de- sign of an accessible artefact. This simple automation model illustrates what can be found out from such a picture, in this indicating how the feedback from users has an influence on the time to deliver such designs.展开更多
Question: What are the experiences of adults using feedback-based technology to improve their physical function during rehabilitation? Design: A systematic review with meta-synthesis of qualitative studies is proposed...Question: What are the experiences of adults using feedback-based technology to improve their physical function during rehabilitation? Design: A systematic review with meta-synthesis of qualitative studies is proposed. Participants: Adults (aged ≥ 15 years) participating in neurological or aged care rehabilitation. Intervention: Feedback-based technology (technology providing feedback to the user about task performance or dose of practice) used as an intervention to improve physical function or physical activity levels. Outcomes: Experiences of using feedback-based technology (learning, accepting, adopting, practicing and progressing), as well as barriers and facilitators to use. Methods: Meta-synthesis of qualitative studies involving the following steps: 1) a systematic search of 10 electronic databases and grey literature, and hand-searching of reference lists of included studies, 2) screening of search results and abstracts for study selection, 3) data extraction, 4) quality appraisal of included studies using the Critical Appraisal Skills Programme (CASP) checklist, and 5) qualitative synthesis to identify common themes and concepts across studies. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement will be used to report study methods and results. Discussion: This meta-synthesis will provide new knowledge about how feedback-based technologies are currently being used in rehabilitation, and describe users’ experiences. Review registration: PROSPERO International prospective register of systematic reviews Registration No. CRD42015017119.展开更多
Aim: The aim of this review was to describe and systemize existing literature on patient-experiences in the context of obesity treatment. The review question was: How do patients describe their experiences after obesi...Aim: The aim of this review was to describe and systemize existing literature on patient-experiences in the context of obesity treatment. The review question was: How do patients describe their experiences after obesity treatment? Background: Obesity problems vary on a continuum of intensity and types of problems during different periods of life. An increasing amount of available treatment requires patients and professionals to make choices concerning the suitability of the individual patient to undergo certain types of treatment. Surgical treatment is considered sustainable and more successful for weight loss than other interventions. Alternatively, conservative treatment of obesity may be a matter of dealing with mental issues as well as diet and exercise. In a qualitative context, a deeper understanding related to patients’ own posttreatment experiences is needed. Methods: A systematic qualitative literature review was conducted for the period from 2006 to November 2016. The search was done in Medline, Embase and CINAHL using the words: Obesity, binge eating, patient, experience or perspective, treat or therap or surgery or cognitive, intervention, programme. Results and discussion: 15 studies were included and an overview of the qualitative designs was presented. From the content analysis, one main theme, Struggle for a meaningful life during transition related to obesity treatment, was developed. The main theme was derived from three themes related to the patients’ challenges when searching for positive self-existence, for relevant treatment-support, and for a balance to obtain inner and outer control. Clinical implications: Different types of obesity treatment create processes of transitions. However, it is crucial that clinicians are aware of the potential existential struggle after obesity treatment that is experienced by the individual patients. Clearly, some patients need interventions targeting mental challenges at different levels. Future interventions should take into account that physical and mental treatment must work together.展开更多
Qualitative algebraic equations are the basis of qualitative simulation,which are used to express the dynamic behavior of steady-state continuous processes.When the values and operation of qualitative variables are re...Qualitative algebraic equations are the basis of qualitative simulation,which are used to express the dynamic behavior of steady-state continuous processes.When the values and operation of qualitative variables are redefined,qualitative algebraic equations can be transformed into signed direct graphs,which are frequently used to predict the trend of dynamic changes.However,it is difficult to use traditional qualitative algebra methods based on artificial trial and error to solve a complex problem for dynamic trends.An important aspect of modern qualitative algebra is to model and characterize complex systems with the corresponding computer-aided automatic reasoning.In this study,a qualitative affection equation based on multiple conditions is proposed,which enables the signed di-rect graphs to describe complex systems better and improves the fault diagnosis resolution.The application to an industrial case shows that the method performs well.展开更多
A multi-objective intelligent coordinating optimization strategy based on qualitative and quantitative synthetic model for Pb-Zn sintering blending process was proposed to obtain optimal mixture ratio. The mechanism a...A multi-objective intelligent coordinating optimization strategy based on qualitative and quantitative synthetic model for Pb-Zn sintering blending process was proposed to obtain optimal mixture ratio. The mechanism and neural network quantitative models for predicting compositions and rule models for expert reasoning were constructed based on statistical data and empirical knowledge. An expert reasoning method based on these models were proposed to solve blending optimization problem, including multi-objective optimization for the first blending process and area optimization for the second blending process, and to determine optimal mixture ratio which will meet the requirement of intelligent coordination. The results show that the qualified rates of agglomerate Pb, Zn and S compositions are increased by 7.1%, 6.5% and 6.9%, respectively, and the fluctuation of sintering permeability is reduced by 7.0%, which effectively stabilizes the agglomerate compositions and the permeability.展开更多
Aims and Objectives: To report a synthesis of the literature on the meaning of trust in the context of patients’ experiences of nursing. The review question was “How do patients describe the meaning of trust in the ...Aims and Objectives: To report a synthesis of the literature on the meaning of trust in the context of patients’ experiences of nursing. The review question was “How do patients describe the meaning of trust in the nursing relationship?” Background: Trust is essential in nursing as it has the potential to create opportunities for the human being to gain faith, hope and meaning in life as well as open up for new experiences. Trust is an interpersonal and essential element of all patient-nurse relationships and requires nurses to create a trusting relationship with the patients. Design: Systematic qualitative literature review. Methods: Systematic searches were conducted for the period January 2002 to December 2012, updated in January 2014. 20 papers were included. Results: Four categories emerged: Attitudes related to trust, indicating that trust is fundamental and existential;Experiences of trust, concerning how trust can be sensed;The patient-nurse relationship, revealing the qualities of the person who creates trust;and Where trust occurs, illuminating the contextual relevancies of trust. Conclusions: Patients’ experiences of trust in nursing are dependent on the nurses’ knowledge, level of commitment in the dialogue to creating and developing the relationship and contextual issues. Implications for nursing practice: Reflection on a trusting relationship with the patient is necessary for a deeper conceptual understanding of trust in nursing. Clinical nurse researchers nurse supervisors, managers and nurse educatorsshould discuss different areas of trust during nursing supervision and focus-group meetings as well as with nursing graduates to ensure that nurses develop knowledge of how to create a trusting patient-nurse relationship.展开更多
Objective:Sub-Saharan Africa accounts for 66%of global maternal deaths.In Kenya,362 maternal deaths occur in every 100000 live births.Most of these deaths occur as a result of suboptimal quality care of mothers during...Objective:Sub-Saharan Africa accounts for 66%of global maternal deaths.In Kenya,362 maternal deaths occur in every 100000 live births.Most of these deaths occur as a result of suboptimal quality care of mothers during labor,delivery,or within 24h of delivery.This study explored barriers that nurse-midwives encounter in trying to provide high-quality obstetric care during these periods.Methods:A qualitative research design utilizing focus group discussion as part of a mixed method study was used to find out the participants'experiences.Data were collected between February and March 2022 in the maternity units of two regional teaching and referral hospitals in Kenya.Eligible participants were nurse-midwives in charge of the maternity unit.The discussion was conducted in English,tape-recorded,and transcribed verbatim,Data were analyzed thematically,following Braun and Clarke 6-step framework.Nvivo version 7.0 computer software was used to facilitate this process.Results:Two focused group discussions each involving seven participants were conducted.The participants agreed that maternal mortality due to postpartum hemorrhage and pregnancy-induced hypertension is a major health concern.Further,maternal care in the two hospitals was substandard.Themes that emerged as barriers were:inadequate supplies;inadequate obstetric knowledge and skills;shortage of nurse-midwives,and inadequate support supervision.The underlying factors include inadequate funding by the county government and high staff turnover.Conclusion:This study showed that nurse-midwives are working under very difficult circumstances which are hindering the provision of quality maternal care.This is mainly due to system failures and inadequate nursemidwife numbers.Targeted strategies need to be urgently implemented to mitigate these challenges to improve the quality of maternal health care.展开更多
Objectives:This study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve...Objectives:This study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve self-management preferences.Methods:A total of 10 patients with recurrent gout were recruited from the gout specialist outpatient clinic at a tertiary hospital in Shenyang,Liaoning Province,China.Semi-structured interviews were conducted with these patients,and the Kawakita Jiro(KJ)method was used to analyze the interview data.Results:After four rounds of screening by five researchers,35 codes were selected from an initial 132.After three rounds of discussion and induction,the KJ method identified seven domains of selfmanagement behavior preferences in patients with recurrent gout:1)extensive knowledge of gout,yet difficulty in distinguishing between accurate and inaccurate information;2)a passive attitude of“no pain,no management”;3)the challenge of changing entrenched daily habits;4)the optimistic but unrealistic belief of“self-delusion”;5)a tendency to seek medical attention late due to hopelessness of cure and familiarity with recurrences;6)preference for analgesics for gout recurrences while neglecting long-term urate-lowering therapy(ULT);and 7)gout-related stigma.Conclusion:The results of this study showed that the self-management behavior of patients with recurrent gout could be improved,especially in the aspects of medical seeking behavior,medication compliance,daily management and emotional management.At the same time,we found that gout stigma,difficulty in distinguishing true and false knowledge of gout and negative attitude of“ignoring pain”were significantly associated with self-management behavior.展开更多
Objectives:Newly graduated nurses commence night shifts during a phase of heightened vulnerability to reality shock,exacerbating the challenges faced by these graduates.Therefore,this study aimed to identify the chall...Objectives:Newly graduated nurses commence night shifts during a phase of heightened vulnerability to reality shock,exacerbating the challenges faced by these graduates.Therefore,this study aimed to identify the challenges experienced by newly graduated nurses when undertaking night shifts in order to help identify a strategy for supporting their adaptation to these shifts.Methods:Semi-structured personal interviews were used to collect data.Fifteen newly graduated nurses were selected to participate in the study by purposive sampling method from November 2021 to March 2022 in one of four general hospitals situated in the southwestern region of Japan.Semi-structured interviews were analyzed by using thematic analysis.Results:The analysis revealedfive central themes and nine subthemes:challenges in task efficiency(task organization challenges,challenges in time-constrained task performance),challenges in responding to patients’changing conditions(challenges in responding to patients’irregular conditions,challenges in responding to nighttime changes in patients’behaviors),challenges in independent practice(challenges in engaging in independent nursing practice,challenges in dealing with unexpected events),challenges in establishing collaborative relationships(challenges in working closely with other staff,challenges in establishing collaborative relationships during night shifts with limited resources),challenges in adapting to shift work(challenges in managing physical conditions for shift work).Conclusions:Newly graduated nurses often encounter challenges in performing their tasks during the transition period.When working night shifts,they face additional hurdles unique to nocturnal duties.Thefindings underscore the necessity for these graduates to develop night shift-specific readiness to effectively navigate the demands inherent in such work schedules.展开更多
Background:Antibiotic resistance is a major problem in every region of the globe and Sub-Saharan Africa(SSA)is no exception.Several systematic reviews have addressed the prevalence of resistant organisms but few have ...Background:Antibiotic resistance is a major problem in every region of the globe and Sub-Saharan Africa(SSA)is no exception.Several systematic reviews have addressed the prevalence of resistant organisms but few have examined the underlying causes in this region.This systematic review of qualitative literature aims to highlight barriers and facilitators to antimicrobial stewardship in SSA.Methods:A literature search of Embase and MEDLINE(R)was carried out.Studies were included if they were in English,conducted in SSA,and reported qualitative data on the barriers and facilitators of antimicrobial stewardship or on attitudes towards resistance promoting behaviours.Studies were screened with a simple critical appraisal tool.Secondary constructs were extracted and coded into concepts,which were then reviewed and grouped into themes in light of the complete dataset.Results:The literature search yielded 169 results,of which 14 studies from 11 countries were included in the final analysis.No studies were excluded as a result of the critical appraisal.Eight concepts emerged from initial coding,which were consolidated into five major themes:ineffective regulation,health system factors,clinical governance,patient factors and lack of resources.The ineffective regulation theme highlighted the balance between tightening drugstore regulation,reducing over-the-counter sale of antibiotics,and maintaining access to medicines for rural communities.Meanwhile,health system factors explored the tension between antimicrobial stewardship and the need of pharmacy workers to maintain profitable businesses.Additionally,a lack of resources,actions by patients and the day-to-day challenges of providing healthcare were shown to directly impede antimicrobial stewardship and exacerbate other factors which promote resistance.Conclusion:Antibiotic resistance in SSA is a multi-faceted issue and while limited resources contribute to the problem they should be viewed in the context of other factors.We identify several contextual factors that affect resistance and stewardship that should be considered by policy makers when planning interventions.This literature base is also incomplete,with only 11 nations accounted for and many studies being confined to regions within countries,so more research is needed.Specifically,further studies on implementing stewardship interventions,successful or not,would be beneficial to inform future efforts.展开更多
BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and...BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.展开更多
Background:The goal of this study was to conduct a meta-synthesis of advanced cancer patients’and their relatives’experiences with advanced care planning(ACP)and to provide evidence-based guidance for the developmen...Background:The goal of this study was to conduct a meta-synthesis of advanced cancer patients’and their relatives’experiences with advanced care planning(ACP)and to provide evidence-based guidance for the development and implementation of ACP in advanced cancer patients.Methods:We searched databases including China Knowledge Network,Wanfang database,VIP database,China Biomedical Literature Database,PubMed,Web of Science,Embase,Cochrane Library,and Cinahl from inception to April 2022 to collect qualitative studies on advanced cancer patients and families'experience about ACP.We use Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to evaluate the quality of literature.After quality assessment,meta-synthesis was used to summarize and explain the results.Results:Eleven qualitative studies were included involving 29 results and ten categories.Three integrated themes were extracted:facilitators and barriers to the implementation of advanced medical care programs as perceived by patients and families with advanced cancer;attitudes of patients with advanced cancer and their families towards pre-existing medical care programs;suggestions from patients with advanced cancer and their families on the implementation elements of the pre-existing medical care program.Conclusion:ACP is a complex social process and influenced by many factors.It requires joint efforts of different stakeholders to achieve high-quality and successful ACP.展开更多
The aromatic compounds,including o-xylene,m-xylene,p-xylene,and ethylbenzene,primarily originate from the catalytic reforming of crude oil,and have a wide variety of applications.However,because of similar physical an...The aromatic compounds,including o-xylene,m-xylene,p-xylene,and ethylbenzene,primarily originate from the catalytic reforming of crude oil,and have a wide variety of applications.However,because of similar physical and chemical properties,these compounds are difficult to be identified by gas chromatography(GC)without standard samples.With the development of modern nuclear magnetic resonance(NMR)techniques,NMR has emerged as a powerful and efficient tool for the rapid analysis of complex and crude mixtures without purification.In this study,the parameters of one-dimensional(1D)total correlation spectroscopy(TOCSY)NMR techniques,including 1D selective gradient TOCSY and 1D chemicalshift-selective filtration(CSSF)with TOCSY,were optimized to obtain comprehensive molecular structure information.The results indicate that the overlapped signals in NMR spectra of nonpolar aromatic compounds(including o-xylene,m-xylene,p-xylene and ethylbenzene),polar aromatic compounds(benzyl alcohol,benzaldehyde,benzoic acid),and aromatic compounds with additional conjugated bonds(styrene)can be resolved in 1D TOCSY.More importantly,full molecular structures can be clearly distinguished by setting appropriate mixing time in 1D TOCSY.This approach simplifies the NMR spectra,provides structural information of entire molecules,and can be applied for the analysis of other structural isomers.展开更多
BACKGROUND Older spine surgery patients have a high incidence of debilitation,which can be managed with certain exercises.AIM To investigate the current status and influencing factors related to the knowledge of exerc...BACKGROUND Older spine surgery patients have a high incidence of debilitation,which can be managed with certain exercises.AIM To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and professionals.METHODS Descriptive research methods were used to classify and summarize patients and professionals’perceptions and factors affecting exercise interventions.Data were analysed using the Colaizzi seven-step analysis method to distill and refine themes.RESULTS A total of 7 themes were identified:(1)The current status of patients'exercise is unsatisfactory;(2)patients'health literacy is low,coupled with a lack of social and family support;(3)there are numerous challenges with systematic exercise interventions;(4)healthcare professionals acknowledge the importance and need for exercise interventions;(5)there's a pronounced willingness among patients to participate in exercise intervention programs;(6)healthcare professionals believe that exercise interventions are beneficial;and(7)participants offered invaluable insights and suggestions on perioperative exercise during spinal surgery.CONCLUSION To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and the related healthcare professionals to provide a reference for the construction of exercise management programs for these patients.展开更多
This study explores the perspectives and challenges faced by family members providing mental support to cancer patients in Beijing,China.The primary objective is to understand the emotional and practical roles family ...This study explores the perspectives and challenges faced by family members providing mental support to cancer patients in Beijing,China.The primary objective is to understand the emotional and practical roles family members undertake and the difficulties they encounter.Utilizing a qualitative research design,data were collected through semi-structured interviews with family caregivers of cancer patients.Thematic analysis revealed several key themes:the dual burden of emotional support and caregiving responsibilities,the impact on daily life and personal well-being,the role and effectiveness of external support systems,perceptions of medical staff support,and the common challenges and conflicts faced in caregiving.The findings highlight the critical need for comprehensive support systems that address both the emotional and practical needs of family caregivers.Recommendations for enhancing family-centered support programs in oncology settings are discussed.展开更多
BACKGROUND This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses'abilities in managing critical and emergency conditions.With the transition of ...BACKGROUND This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses'abilities in managing critical and emergency conditions.With the transition of healthcare systems to the community,the evolution of nursing practices,and the attention from policies and practices,community nurses play a crucial role in the management of critical and emergency conditions.However,there is still a lack of comprehensive understanding regarding the factors that promote or hinder their capabilities in this area.AIM To understand the facilitators and barriers of community nurses in managing critical and emergency conditions,exploring the fundamental reasons and driving forces influencing their treatment capabilities.METHODS This study utilized the destination sampling method between May 2023 and July 2023.It employed a descriptive phenomenological approach within qualitative research methodologies.Through objective sampling,17 community nurses from 7 communities in Changning District,Shanghai,were selected as the study subjects.Semi-structured interviews were conducted to gather data,which were subsequently organized and analyzed using Colaizzi's seven-step analysis method,leading to the extraction of final themes.RESULTS The barrier factors identified from the interviews encompassed three topics:resource allocation,professional factors,and personal literacy.The facilitators comprised three themes:professionalism,management attention,and training and continuing education.We identified that the root causes of the barriers included the lack of practical treatment experience among community nurses,insufficient awareness of self-directed learning,and limited knowledge and technical proficiency.The professional quality of community nurses and management attention serve as motivation for them to enhance their treatment abilities.CONCLUSION To enhance the capability of community nurses in treating acute and critical patients,it is recommended to bolster training specifically tailored to acute and critical care,raise awareness of first aid practices,and elevate knowledge and skill levels.展开更多
BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperati...BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)patients.Previous studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel prepara-tion.However,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC patients.AIM To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up colonoscopy.METHODS Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November 2023.The phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the patients.Colaizzi's seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview data.RESULTS The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'knowledge of bowel preparation is not adequate,and they may encounter numerous difficulties and challenges during the process.Healthcare professionals should place great emphasis on providing instruction for their bowel preparation.展开更多
BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post...BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.展开更多
Background: COVID-19 had become much less virulent but still infectious, and China had loosened controls on its prevention after three years of zero-COVID policy. Nursing students were faced with infection. However, t...Background: COVID-19 had become much less virulent but still infectious, and China had loosened controls on its prevention after three years of zero-COVID policy. Nursing students were faced with infection. However, the symptoms of the vast majority of them were not serious. Objectives: To understand the feelings and thoughts of nursing undergraduates first infected with COVID-19 after implementing the policy of loosening controls on COVID-19 prevention in China. Methods: A semi-structured in-depth interview was adopted to collect data from 19 nursing undergraduates in a nursing school in China in January 2023, which were then analyzed using the Colaizzi analysis method. Results: Two main themes and seven sub-themes were induced: feelings after the diagnosis of being infected (feeling calm by professional confidence, feeling afraid of the consequences of being infected, feeling depressed, feeling relieved/lucky/happy), and thoughts brought by COVID-19 infection (becoming more active in learning, committed to a nursing career, and feeling shaken about becoming a nurse). Conclusions: Schools and hospitals should pay attention to infected nursing students’ mental reactions and changes in study motivation and professional intention. Targeted measures, such as education for epidemic prevention and education for cultivating the professional spirit, should be taken to promote their mental health and reserve their talents for nursing.展开更多
Purpose: This article investigates the critical importance of integrating surgeons’ direct input into the development of innovative technologies that address gaps in surgical care, including those aimed at reducing a...Purpose: This article investigates the critical importance of integrating surgeons’ direct input into the development of innovative technologies that address gaps in surgical care, including those aimed at reducing anastomotic leaks (AL), a major complication in gastrointestinal surgery. While traditional quantitative research methods are prevalent, they often overlook the invaluable insights of the surgeons who manage these complications firsthand. Subjects and Methods: This study employs a qualitative approach, utilizing semi-structured interviews with 40 surgeons from various specialties, including general, bariatric, colorectal, trauma, hepato-biliary, and thoracic surgery. The interviews were designed to probe the needs of surgeons, challenges currently faced, and gaps in clinical practice, research, and technology for detection and/or management of AL. The data were analyzed using thematic analysis, which revealed significant gaps in current technologies for early detection and prevention of leaks. Results: Surgeons expressed strong interest in FluidAI’s Stream™ Platform, a non-invasive medical device designed to monitor postoperative drainage fluid in real-time, providing continuous data on AL risk. The ability of this platform to offer early prediction through pH and electrical conductivity analysis was particularly appealing to participants, who emphasized the importance of timely interventions in improving patient outcomes. The study’s findings highlight not only the clinical challenges but also the emotional toll that AL takes on surgeons, underlining the need for innovations that are both data-driven and humanistic. Conclusion: By centering surgeons’ perspectives, this research advocates for a human-centered approach to technological advancement, ensuring that new tools are both clinically effective and aligned with the real-world needs of surgical practitioners.展开更多
文摘A description of the Systems Dynamics paradigm is given and the reduced Qualitative System Dynamics (QSD) form explained. A simple example is given to illustrate the diagram construction. The principles of states (levels), rates and feedback loops are outlined. The QSD method is used to address the problem of accessibility by using human control of automation as an example, and applying the QSD method to evaluate the effects of the researcher and user in the de- sign of an accessible artefact. This simple automation model illustrates what can be found out from such a picture, in this indicating how the feedback from users has an influence on the time to deliver such designs.
文摘Question: What are the experiences of adults using feedback-based technology to improve their physical function during rehabilitation? Design: A systematic review with meta-synthesis of qualitative studies is proposed. Participants: Adults (aged ≥ 15 years) participating in neurological or aged care rehabilitation. Intervention: Feedback-based technology (technology providing feedback to the user about task performance or dose of practice) used as an intervention to improve physical function or physical activity levels. Outcomes: Experiences of using feedback-based technology (learning, accepting, adopting, practicing and progressing), as well as barriers and facilitators to use. Methods: Meta-synthesis of qualitative studies involving the following steps: 1) a systematic search of 10 electronic databases and grey literature, and hand-searching of reference lists of included studies, 2) screening of search results and abstracts for study selection, 3) data extraction, 4) quality appraisal of included studies using the Critical Appraisal Skills Programme (CASP) checklist, and 5) qualitative synthesis to identify common themes and concepts across studies. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement will be used to report study methods and results. Discussion: This meta-synthesis will provide new knowledge about how feedback-based technologies are currently being used in rehabilitation, and describe users’ experiences. Review registration: PROSPERO International prospective register of systematic reviews Registration No. CRD42015017119.
文摘Aim: The aim of this review was to describe and systemize existing literature on patient-experiences in the context of obesity treatment. The review question was: How do patients describe their experiences after obesity treatment? Background: Obesity problems vary on a continuum of intensity and types of problems during different periods of life. An increasing amount of available treatment requires patients and professionals to make choices concerning the suitability of the individual patient to undergo certain types of treatment. Surgical treatment is considered sustainable and more successful for weight loss than other interventions. Alternatively, conservative treatment of obesity may be a matter of dealing with mental issues as well as diet and exercise. In a qualitative context, a deeper understanding related to patients’ own posttreatment experiences is needed. Methods: A systematic qualitative literature review was conducted for the period from 2006 to November 2016. The search was done in Medline, Embase and CINAHL using the words: Obesity, binge eating, patient, experience or perspective, treat or therap or surgery or cognitive, intervention, programme. Results and discussion: 15 studies were included and an overview of the qualitative designs was presented. From the content analysis, one main theme, Struggle for a meaningful life during transition related to obesity treatment, was developed. The main theme was derived from three themes related to the patients’ challenges when searching for positive self-existence, for relevant treatment-support, and for a balance to obtain inner and outer control. Clinical implications: Different types of obesity treatment create processes of transitions. However, it is crucial that clinicians are aware of the potential existential struggle after obesity treatment that is experienced by the individual patients. Clearly, some patients need interventions targeting mental challenges at different levels. Future interventions should take into account that physical and mental treatment must work together.
基金Supported by the National High Technology Research and Development Program of China(2009AA04Z133)
文摘Qualitative algebraic equations are the basis of qualitative simulation,which are used to express the dynamic behavior of steady-state continuous processes.When the values and operation of qualitative variables are redefined,qualitative algebraic equations can be transformed into signed direct graphs,which are frequently used to predict the trend of dynamic changes.However,it is difficult to use traditional qualitative algebra methods based on artificial trial and error to solve a complex problem for dynamic trends.An important aspect of modern qualitative algebra is to model and characterize complex systems with the corresponding computer-aided automatic reasoning.In this study,a qualitative affection equation based on multiple conditions is proposed,which enables the signed di-rect graphs to describe complex systems better and improves the fault diagnosis resolution.The application to an industrial case shows that the method performs well.
基金Project(2002CB312203) supported by the National Key Fundamental Research and Development Programof China pro-ject(60574030) supported bythe National Natural Science Foundation of China project(06FD026) supported bythe Natural Science Foun-dation of Hunan Province , China
文摘A multi-objective intelligent coordinating optimization strategy based on qualitative and quantitative synthetic model for Pb-Zn sintering blending process was proposed to obtain optimal mixture ratio. The mechanism and neural network quantitative models for predicting compositions and rule models for expert reasoning were constructed based on statistical data and empirical knowledge. An expert reasoning method based on these models were proposed to solve blending optimization problem, including multi-objective optimization for the first blending process and area optimization for the second blending process, and to determine optimal mixture ratio which will meet the requirement of intelligent coordination. The results show that the qualified rates of agglomerate Pb, Zn and S compositions are increased by 7.1%, 6.5% and 6.9%, respectively, and the fluctuation of sintering permeability is reduced by 7.0%, which effectively stabilizes the agglomerate compositions and the permeability.
文摘Aims and Objectives: To report a synthesis of the literature on the meaning of trust in the context of patients’ experiences of nursing. The review question was “How do patients describe the meaning of trust in the nursing relationship?” Background: Trust is essential in nursing as it has the potential to create opportunities for the human being to gain faith, hope and meaning in life as well as open up for new experiences. Trust is an interpersonal and essential element of all patient-nurse relationships and requires nurses to create a trusting relationship with the patients. Design: Systematic qualitative literature review. Methods: Systematic searches were conducted for the period January 2002 to December 2012, updated in January 2014. 20 papers were included. Results: Four categories emerged: Attitudes related to trust, indicating that trust is fundamental and existential;Experiences of trust, concerning how trust can be sensed;The patient-nurse relationship, revealing the qualities of the person who creates trust;and Where trust occurs, illuminating the contextual relevancies of trust. Conclusions: Patients’ experiences of trust in nursing are dependent on the nurses’ knowledge, level of commitment in the dialogue to creating and developing the relationship and contextual issues. Implications for nursing practice: Reflection on a trusting relationship with the patient is necessary for a deeper conceptual understanding of trust in nursing. Clinical nurse researchers nurse supervisors, managers and nurse educatorsshould discuss different areas of trust during nursing supervision and focus-group meetings as well as with nursing graduates to ensure that nurses develop knowledge of how to create a trusting patient-nurse relationship.
文摘Objective:Sub-Saharan Africa accounts for 66%of global maternal deaths.In Kenya,362 maternal deaths occur in every 100000 live births.Most of these deaths occur as a result of suboptimal quality care of mothers during labor,delivery,or within 24h of delivery.This study explored barriers that nurse-midwives encounter in trying to provide high-quality obstetric care during these periods.Methods:A qualitative research design utilizing focus group discussion as part of a mixed method study was used to find out the participants'experiences.Data were collected between February and March 2022 in the maternity units of two regional teaching and referral hospitals in Kenya.Eligible participants were nurse-midwives in charge of the maternity unit.The discussion was conducted in English,tape-recorded,and transcribed verbatim,Data were analyzed thematically,following Braun and Clarke 6-step framework.Nvivo version 7.0 computer software was used to facilitate this process.Results:Two focused group discussions each involving seven participants were conducted.The participants agreed that maternal mortality due to postpartum hemorrhage and pregnancy-induced hypertension is a major health concern.Further,maternal care in the two hospitals was substandard.Themes that emerged as barriers were:inadequate supplies;inadequate obstetric knowledge and skills;shortage of nurse-midwives,and inadequate support supervision.The underlying factors include inadequate funding by the county government and high staff turnover.Conclusion:This study showed that nurse-midwives are working under very difficult circumstances which are hindering the provision of quality maternal care.This is mainly due to system failures and inadequate nursemidwife numbers.Targeted strategies need to be urgently implemented to mitigate these challenges to improve the quality of maternal health care.
文摘Objectives:This study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve self-management preferences.Methods:A total of 10 patients with recurrent gout were recruited from the gout specialist outpatient clinic at a tertiary hospital in Shenyang,Liaoning Province,China.Semi-structured interviews were conducted with these patients,and the Kawakita Jiro(KJ)method was used to analyze the interview data.Results:After four rounds of screening by five researchers,35 codes were selected from an initial 132.After three rounds of discussion and induction,the KJ method identified seven domains of selfmanagement behavior preferences in patients with recurrent gout:1)extensive knowledge of gout,yet difficulty in distinguishing between accurate and inaccurate information;2)a passive attitude of“no pain,no management”;3)the challenge of changing entrenched daily habits;4)the optimistic but unrealistic belief of“self-delusion”;5)a tendency to seek medical attention late due to hopelessness of cure and familiarity with recurrences;6)preference for analgesics for gout recurrences while neglecting long-term urate-lowering therapy(ULT);and 7)gout-related stigma.Conclusion:The results of this study showed that the self-management behavior of patients with recurrent gout could be improved,especially in the aspects of medical seeking behavior,medication compliance,daily management and emotional management.At the same time,we found that gout stigma,difficulty in distinguishing true and false knowledge of gout and negative attitude of“ignoring pain”were significantly associated with self-management behavior.
基金supported by Japan Society for the Promotion of Science,Grants-in-Aid for Scientific Research[grant number 23K09804]The JSPS has had any roles in the survey's design,implementation,and analysis.
文摘Objectives:Newly graduated nurses commence night shifts during a phase of heightened vulnerability to reality shock,exacerbating the challenges faced by these graduates.Therefore,this study aimed to identify the challenges experienced by newly graduated nurses when undertaking night shifts in order to help identify a strategy for supporting their adaptation to these shifts.Methods:Semi-structured personal interviews were used to collect data.Fifteen newly graduated nurses were selected to participate in the study by purposive sampling method from November 2021 to March 2022 in one of four general hospitals situated in the southwestern region of Japan.Semi-structured interviews were analyzed by using thematic analysis.Results:The analysis revealedfive central themes and nine subthemes:challenges in task efficiency(task organization challenges,challenges in time-constrained task performance),challenges in responding to patients’changing conditions(challenges in responding to patients’irregular conditions,challenges in responding to nighttime changes in patients’behaviors),challenges in independent practice(challenges in engaging in independent nursing practice,challenges in dealing with unexpected events),challenges in establishing collaborative relationships(challenges in working closely with other staff,challenges in establishing collaborative relationships during night shifts with limited resources),challenges in adapting to shift work(challenges in managing physical conditions for shift work).Conclusions:Newly graduated nurses often encounter challenges in performing their tasks during the transition period.When working night shifts,they face additional hurdles unique to nocturnal duties.Thefindings underscore the necessity for these graduates to develop night shift-specific readiness to effectively navigate the demands inherent in such work schedules.
文摘Background:Antibiotic resistance is a major problem in every region of the globe and Sub-Saharan Africa(SSA)is no exception.Several systematic reviews have addressed the prevalence of resistant organisms but few have examined the underlying causes in this region.This systematic review of qualitative literature aims to highlight barriers and facilitators to antimicrobial stewardship in SSA.Methods:A literature search of Embase and MEDLINE(R)was carried out.Studies were included if they were in English,conducted in SSA,and reported qualitative data on the barriers and facilitators of antimicrobial stewardship or on attitudes towards resistance promoting behaviours.Studies were screened with a simple critical appraisal tool.Secondary constructs were extracted and coded into concepts,which were then reviewed and grouped into themes in light of the complete dataset.Results:The literature search yielded 169 results,of which 14 studies from 11 countries were included in the final analysis.No studies were excluded as a result of the critical appraisal.Eight concepts emerged from initial coding,which were consolidated into five major themes:ineffective regulation,health system factors,clinical governance,patient factors and lack of resources.The ineffective regulation theme highlighted the balance between tightening drugstore regulation,reducing over-the-counter sale of antibiotics,and maintaining access to medicines for rural communities.Meanwhile,health system factors explored the tension between antimicrobial stewardship and the need of pharmacy workers to maintain profitable businesses.Additionally,a lack of resources,actions by patients and the day-to-day challenges of providing healthcare were shown to directly impede antimicrobial stewardship and exacerbate other factors which promote resistance.Conclusion:Antibiotic resistance in SSA is a multi-faceted issue and while limited resources contribute to the problem they should be viewed in the context of other factors.We identify several contextual factors that affect resistance and stewardship that should be considered by policy makers when planning interventions.This literature base is also incomplete,with only 11 nations accounted for and many studies being confined to regions within countries,so more research is needed.Specifically,further studies on implementing stewardship interventions,successful or not,would be beneficial to inform future efforts.
基金The study was reviewed and approved by the Science and Research Office of Tong Ren Hospital(Shanghai), No. AF/SC-08/04.0.
文摘BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.
文摘Background:The goal of this study was to conduct a meta-synthesis of advanced cancer patients’and their relatives’experiences with advanced care planning(ACP)and to provide evidence-based guidance for the development and implementation of ACP in advanced cancer patients.Methods:We searched databases including China Knowledge Network,Wanfang database,VIP database,China Biomedical Literature Database,PubMed,Web of Science,Embase,Cochrane Library,and Cinahl from inception to April 2022 to collect qualitative studies on advanced cancer patients and families'experience about ACP.We use Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to evaluate the quality of literature.After quality assessment,meta-synthesis was used to summarize and explain the results.Results:Eleven qualitative studies were included involving 29 results and ten categories.Three integrated themes were extracted:facilitators and barriers to the implementation of advanced medical care programs as perceived by patients and families with advanced cancer;attitudes of patients with advanced cancer and their families towards pre-existing medical care programs;suggestions from patients with advanced cancer and their families on the implementation elements of the pre-existing medical care program.Conclusion:ACP is a complex social process and influenced by many factors.It requires joint efforts of different stakeholders to achieve high-quality and successful ACP.
基金We thank the Natural Science Foundation of Shanxi Province(202103021224439)National Natural Science Foundation of China(22075308)for financial support.
文摘The aromatic compounds,including o-xylene,m-xylene,p-xylene,and ethylbenzene,primarily originate from the catalytic reforming of crude oil,and have a wide variety of applications.However,because of similar physical and chemical properties,these compounds are difficult to be identified by gas chromatography(GC)without standard samples.With the development of modern nuclear magnetic resonance(NMR)techniques,NMR has emerged as a powerful and efficient tool for the rapid analysis of complex and crude mixtures without purification.In this study,the parameters of one-dimensional(1D)total correlation spectroscopy(TOCSY)NMR techniques,including 1D selective gradient TOCSY and 1D chemicalshift-selective filtration(CSSF)with TOCSY,were optimized to obtain comprehensive molecular structure information.The results indicate that the overlapped signals in NMR spectra of nonpolar aromatic compounds(including o-xylene,m-xylene,p-xylene and ethylbenzene),polar aromatic compounds(benzyl alcohol,benzaldehyde,benzoic acid),and aromatic compounds with additional conjugated bonds(styrene)can be resolved in 1D TOCSY.More importantly,full molecular structures can be clearly distinguished by setting appropriate mixing time in 1D TOCSY.This approach simplifies the NMR spectra,provides structural information of entire molecules,and can be applied for the analysis of other structural isomers.
文摘BACKGROUND Older spine surgery patients have a high incidence of debilitation,which can be managed with certain exercises.AIM To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and professionals.METHODS Descriptive research methods were used to classify and summarize patients and professionals’perceptions and factors affecting exercise interventions.Data were analysed using the Colaizzi seven-step analysis method to distill and refine themes.RESULTS A total of 7 themes were identified:(1)The current status of patients'exercise is unsatisfactory;(2)patients'health literacy is low,coupled with a lack of social and family support;(3)there are numerous challenges with systematic exercise interventions;(4)healthcare professionals acknowledge the importance and need for exercise interventions;(5)there's a pronounced willingness among patients to participate in exercise intervention programs;(6)healthcare professionals believe that exercise interventions are beneficial;and(7)participants offered invaluable insights and suggestions on perioperative exercise during spinal surgery.CONCLUSION To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and the related healthcare professionals to provide a reference for the construction of exercise management programs for these patients.
文摘This study explores the perspectives and challenges faced by family members providing mental support to cancer patients in Beijing,China.The primary objective is to understand the emotional and practical roles family members undertake and the difficulties they encounter.Utilizing a qualitative research design,data were collected through semi-structured interviews with family caregivers of cancer patients.Thematic analysis revealed several key themes:the dual burden of emotional support and caregiving responsibilities,the impact on daily life and personal well-being,the role and effectiveness of external support systems,perceptions of medical staff support,and the common challenges and conflicts faced in caregiving.The findings highlight the critical need for comprehensive support systems that address both the emotional and practical needs of family caregivers.Recommendations for enhancing family-centered support programs in oncology settings are discussed.
基金Supported by Key Joint Research Program of Scientific Research Project of Shanghai Changning District Health Commission in 2023,No.20234Y008.
文摘BACKGROUND This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses'abilities in managing critical and emergency conditions.With the transition of healthcare systems to the community,the evolution of nursing practices,and the attention from policies and practices,community nurses play a crucial role in the management of critical and emergency conditions.However,there is still a lack of comprehensive understanding regarding the factors that promote or hinder their capabilities in this area.AIM To understand the facilitators and barriers of community nurses in managing critical and emergency conditions,exploring the fundamental reasons and driving forces influencing their treatment capabilities.METHODS This study utilized the destination sampling method between May 2023 and July 2023.It employed a descriptive phenomenological approach within qualitative research methodologies.Through objective sampling,17 community nurses from 7 communities in Changning District,Shanghai,were selected as the study subjects.Semi-structured interviews were conducted to gather data,which were subsequently organized and analyzed using Colaizzi's seven-step analysis method,leading to the extraction of final themes.RESULTS The barrier factors identified from the interviews encompassed three topics:resource allocation,professional factors,and personal literacy.The facilitators comprised three themes:professionalism,management attention,and training and continuing education.We identified that the root causes of the barriers included the lack of practical treatment experience among community nurses,insufficient awareness of self-directed learning,and limited knowledge and technical proficiency.The professional quality of community nurses and management attention serve as motivation for them to enhance their treatment abilities.CONCLUSION To enhance the capability of community nurses in treating acute and critical patients,it is recommended to bolster training specifically tailored to acute and critical care,raise awareness of first aid practices,and elevate knowledge and skill levels.
文摘BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)patients.Previous studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel prepara-tion.However,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC patients.AIM To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up colonoscopy.METHODS Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November 2023.The phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the patients.Colaizzi's seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview data.RESULTS The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'knowledge of bowel preparation is not adequate,and they may encounter numerous difficulties and challenges during the process.Healthcare professionals should place great emphasis on providing instruction for their bowel preparation.
文摘BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.
文摘Background: COVID-19 had become much less virulent but still infectious, and China had loosened controls on its prevention after three years of zero-COVID policy. Nursing students were faced with infection. However, the symptoms of the vast majority of them were not serious. Objectives: To understand the feelings and thoughts of nursing undergraduates first infected with COVID-19 after implementing the policy of loosening controls on COVID-19 prevention in China. Methods: A semi-structured in-depth interview was adopted to collect data from 19 nursing undergraduates in a nursing school in China in January 2023, which were then analyzed using the Colaizzi analysis method. Results: Two main themes and seven sub-themes were induced: feelings after the diagnosis of being infected (feeling calm by professional confidence, feeling afraid of the consequences of being infected, feeling depressed, feeling relieved/lucky/happy), and thoughts brought by COVID-19 infection (becoming more active in learning, committed to a nursing career, and feeling shaken about becoming a nurse). Conclusions: Schools and hospitals should pay attention to infected nursing students’ mental reactions and changes in study motivation and professional intention. Targeted measures, such as education for epidemic prevention and education for cultivating the professional spirit, should be taken to promote their mental health and reserve their talents for nursing.
文摘Purpose: This article investigates the critical importance of integrating surgeons’ direct input into the development of innovative technologies that address gaps in surgical care, including those aimed at reducing anastomotic leaks (AL), a major complication in gastrointestinal surgery. While traditional quantitative research methods are prevalent, they often overlook the invaluable insights of the surgeons who manage these complications firsthand. Subjects and Methods: This study employs a qualitative approach, utilizing semi-structured interviews with 40 surgeons from various specialties, including general, bariatric, colorectal, trauma, hepato-biliary, and thoracic surgery. The interviews were designed to probe the needs of surgeons, challenges currently faced, and gaps in clinical practice, research, and technology for detection and/or management of AL. The data were analyzed using thematic analysis, which revealed significant gaps in current technologies for early detection and prevention of leaks. Results: Surgeons expressed strong interest in FluidAI’s Stream™ Platform, a non-invasive medical device designed to monitor postoperative drainage fluid in real-time, providing continuous data on AL risk. The ability of this platform to offer early prediction through pH and electrical conductivity analysis was particularly appealing to participants, who emphasized the importance of timely interventions in improving patient outcomes. The study’s findings highlight not only the clinical challenges but also the emotional toll that AL takes on surgeons, underlining the need for innovations that are both data-driven and humanistic. Conclusion: By centering surgeons’ perspectives, this research advocates for a human-centered approach to technological advancement, ensuring that new tools are both clinically effective and aligned with the real-world needs of surgical practitioners.