Evaluating the influence of a structured nursing protocol on targeted outcomes in rheumatoid arthritis patients

Objective:Rheumatoid arthritis(RA)requires comprehensive management.Structured nursing protocols may enhance outcomes,but evidence is limited.This study evaluated the effect of a structured nursing protocol on RA outcomes.Materials and Methods:In this one-group pre-post study,30 Egyptian RA patients completed assessments before and after a 12-week nursing protocol comprising education,psychosocial support,and self-management promotion.Assessments included clinical evaluation of joint counts,erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and patient-reported Arthritis Self-Efficacy Scale(ASES),Health Assessment Questionnaire(HAQ),Visual Analog Scale(VAS)for pain,and Hospital Anxiety and Depression Scale(HADS).Results:The study demonstrated significant improvements in both clinical-and patient-reported outcomes.Joint count decreased from 18.4±4.2 to 14.2±3.8(P<0.001),ESR from 30.1±6.8 mm/h to 25.5±6.8 mm/h(P<0.01),and CRP levels from 15.2±3.6 mg/L to 11.8±2.9 mg/L(P<0.01)postintervention.Patient-reported outcomes showed a marked increase in ASES score from 140±25 to 170±30(P<0.001)and reductions in HAQ from 1.6±0.4 to 1.3±0.3(P<0.01),VAS pain score from 7.8±1.7 to 6.2±1.2(P<0.001),and HADS anxiety and depression scores from 11±3 to 8±2(P<0.05)and 10±2 to 7±1(P<0.05),respectively.Conclusion:A structured nursing protocol significantly improved clinical disease activity,physical functioning,pain,self-efficacy,and emotional well-being in RA patients.A multifaceted nursing intervention appears beneficial for optimizing RA outcomes.

Nursing student volunteers and their level of involvement during the COVID-19 pandemic:a systematic review

Objective:Many strategic efforts were made to address nurses'shortage in controlling Coronavirus disease 2019(COVID-19),including recruiting student health volunteers.This review aimed to explore the contribution and involvement of nursing student volunteers during COVID-19.Methods:A systematic review was registered in PROSPERO International CRD42021283069.Electronic databases for ar ticle search included:SCOPUS,EBSCO MEDLINE,Pub Med,Pro Quest,Springer,Sage Pub,and hand searching.The critical appraisal study quality using The Joanna Briggs Institutes.Data extraction and synthesis used Population,Intervention,Comparison,Outcome,and Design(PICO and D)framework with thematic analysis.Results:Twelve studies were enrolled from 2545 retrieved,with 4 synthesized themes:(1)determinant of the involvement of nursing student volunteers during COVID-19,which includes 3 subthemes:motivations,perception,and barriers,(2)expectations and actual condition of nursing students as volunteers,(3)the need for nursing student volunteers,and(4)the impact and level of student volunteers'contribution.All student volunteers contribute to providing direct or indirect services to patients.Conclusions:This review provides an overview of nursing student volunteers'needs useful in developing competency frameworks and the role of culturally sensitive volunteers in education and training.In the future,student volunteers could choose the appropriate volunteer program and location according to their competence.

Prevalence of social media addiction among nursing students

Objective:The objective of this study was to assess the prevalence and level of social media addiction among nursing students in the Faculty of Nursing,Cairo University.Materials and Methods:A descriptive cross‑sectional research design was conducted on samples of 340 students at the Faculty of Nursing,Cairo University.Data were collected through demographic background information sheet and Social Networking Addiction Scale.Results:All the students were addicted as 6.76%were severely addicted and 60.59%and 32.65%were moderately and mildly addicted,respectively.Significant relations were found between social media addiction and students’age(χ^(2)=11.331,P=0.003),educational level(χ^(2)=20.239,P=0.003),and grade point average(χ^(2)=19.378,P=0.013).Conclusion:Internet addiction was prevalent among all students but at different levels,so early screening of students for Internet addiction using the Internet Addiction Scale is important to provide early treatment and prevent hazards to health.

Exploring internship nursing students’ perception of gerontological nursing competencies: A descriptive study at Cairo University Hospitals

Objective:This research study explores the perceptions of gerontological nursing competencies,attitudes toward older individuals,and the willingness to provide care for the elderly among internship nursing students.Materials and Methods:A convenience sample of 350 internship nursing students from Cairo University Faculty of Nursing participated in the study.Data were collected using a set of comprehensive tools,including personal data and work experience assessment,the Hartford geriatric nurse competency tool,Kogan’s attitudes toward old people scale,and the modified elderly patient care inventory.Results:Descriptive analysis revealed balanced gender representation,with 60%identifying as female.Seventy percent of participants reported prior experience in gerontological care.Self-assessed competency scores indicated moderate proficiency in communication,physiological changes,and functional status assessment.Areas such as pain management and restraint use demonstrated potential gaps in self-perceived skills.Attitudes toward older individuals were predominantly positive,and the willingness to provide care showed positive tendencies,with a minor degree of hesitation noted.Conclusion:The findings underscore the need for targeted interventions in nursing education to address competency gaps,enhance positive attitudes,and alleviate potential hesitations in caregiving for older individuals.As the elderly population continues to grow,nursing education programs must prepare future practitioners to deliver comprehensive and compassionate care tailored to the unique needs of older adults.

Dysphagia and daily oral fluids among cerebrovascular stroke patients:an theory-based nursing intervention protocol

Objective:To evaluate the improvement of dysphagia and the daily amounts of oral fluids served among people who had recently experienced a cerebrovascular stroke(CVS)after applying a nursing intervention protocol.Methods:A quasi-experimental design was used to examine 60 stroke patients who were randomly and alternatively divided equally into a study group and a control group.Gugging Swallowing Screen(GUSS)and fluid balance chart were used.Within the first 24 h of a patient’s admission,expert nurses were trained in nursing intervention protocol to manage dysphagia and daily oral fluids.Results:Post-nursing intervention,the severity of dysphagia decreased among the study group more than in the control group.Additionally,the study group began taking greater amounts of fluids by the oral route than before the nursing intervention.Conclusions:A standardized nursing intervention protocol is needed to decrease the severity of dysphagia after CVS and increase the amount of daily oral fluids.The presence of a structured theory-based nursing intervention protocol for dysphagia management will greatly contribute to decreasing the consequences of dysphagia after CVS,and can also be expected to attenuate the effects of aspiration pneumonia,dehydration,and malnutrition;further,it also increases adherence to the protocol by both nurses and patients.

Learning from the Film “Mitorishi (Transition Doula)”—Application to Understanding the End-of-Life in a Gerontological Nursing Practice Course in Japan

Purpose: This study aims to detail what nursing students learned from watching the film “Mitorishi”, which was used among the teaching materials in a gerontological nursing practice course in nursing education in Japan, and demonstrate the applicability of using the film as an element relevant to the teaching of end-of-life care in Japan. Methods: The participants were fourth-year nursing students at University A who had watched the film “Mitorishi” during the course, had submitted a report on what they learned, and provided informed consent to the study participation. The reports submitted by the participants were used as data and analyzed qualitatively using the content analysis approach. Results: The analysis identified the following five categories (number of codes): Characteristics of life during the final days (9), Importance of views on life and death (3), Importance of end-of-life care (3), Assistance in preparation for the final days of life (13), and Understanding the profession of transition doula (9). Discussion: The five categories show that the students have learned about the “role of nurses at the time of end-of-life care” while “visualizing end-of-life care” and learning “preparedness for end-of-life care”. These findings suggest that using the film “Mitorishi” in the teaching curriculum is effective for learning about end-of-life care for older people.

Vibration Frequency in Micro-Vibration Therapy in Nursing Care: A Cross-Sectional Study

This study investigated the vibration frequency in micro-vibration therapy (MVT) performed as a part of nursing care in Japan. We surveyed 31 nurses (25 women and 6 men) who performed MVT with accelerometers attached to the backs of their hands, and the data obtained were analyzed. The mean vibration frequency was 8.3 Hz (standard deviation [SD]: 1.9 Hz) bilaterally, with a left-right difference of 0.8 Hz (SD: 1.1 Hz, right > left). Furthermore, vibration frequency was correlated with duration of MVT use (rs = 0.5, P < 0.01). The vibration frequency was higher in men (9.2 Hz, SD: 2.4 Hz) than in women (8.1 Hz, SD: 1.8 Hz), but this difference was not significant (P = 0.34). The vibrations of MVT are of a lower frequency than those of other vibration therapies.

泰国老年人肌少症及相关因素的系统评价和meta分析

目的对泰国老年人肌少症的忠病率情况进行综述并确定相关因素。方法对PubMed、Embase、Scopus和泰国期刊引文索引(Thai-Journal Citation Index, TCI)数据库进行系统检索。检索文献的发表时间限定为2013年1月至2023年1月, 仅纳人观察性研究设计。使用澳大利亚乔安娜布里格斯研究所(Joanna BriggsInstitute, JBI)循证卫生保健研究中心关键评估工具评估研究质量。使用JBI SUMARI软件进行meta分析。该综述:方案已在PROSPERO注册(CRD42023420514)。结果共检索出308条文献,其中17项研究被纳人分析,共包括4 668名60岁及以上的老年人,男性1380名(29.6%),女性3 288名(70.4%)。泰国老年人肌少症的总体忠病率为20.7%(95%CI 14.4%~27.8%)。 基于研究场所的肌少症忠病率亚组分析显示,住院忠者为33.4%(95%CI 28.7%~38.3%), 门诊患者为23.2%(95%CI 12.5%-35.9%), 社区老年人为17.3%(95%CI 9.4%~26.8%)。高龄(0R 4.60 ,95% CI 3.07-6.91).男性(OR 2.30 ,95% CI 1.37-3.85). 低体重指数(OR 8.95 ,95%CI 6.05~ 13.25)和营养不良(OR 2.78,95% CI 2.09-3.70)是泰国老年人肌少症的关联因素。结论这项系统评价分析了文献中泰国老年人肌少症的总体忠病率和关联因素,对该国老年人肌少症的预防和管理具有重要参考意义。

老年人髋关节或膝关节置换术后延续护理对关节功能恢复的有效性及安全性:系统评价

目的系统评价延续护理促进老年人关节功能恢复的有效性及安全性。方法检索Cochrane Library、Web of Science、PubMed、Embase数据库中有关延续护理应用于老年关节置换患者的随机对照试验和队列研究,检索时间从建库到2023年10月25日。2名研究员独立完成文献筛选、数据提取,随机对照试验通过Cochrane偏倚风险工具进行文献偏倚分析,队列研究通过纽卡斯尔-渥太华标准进行文献质量评价。结果共纳入15篇文献,包括34186例膝关节和髋关节置换患者。促进老年髋关节置换患者功能改善的主要指标包括髋关节评分、出院后日常生活指数评分(Barthel Index)及生活质量;对老年膝关节置换患者进行延续护理明显改善的指标包括膝关节运动范围、骨关节炎指数、关节损伤和骨关节炎结果评分;延续护理对术后并发症并没有明显作用。文献质量评价显示纳入文献总体质量较高,但仅1项针对髋关节置换术后患者的研究运用了理论框架。结论延续护理在缓解膝关节疼痛、改善关节活动度及髋关节功能方面发挥了重要作用,但是对生活质量、患者满意度、经济、减少关节置换术后并发症和再次入院率方面的有效性尚需进一步明确。

重症监护疼痛观察工具印尼语版的跨文化调适及心理测量学分析

目的重症监护疼痛观察工具(Critical-care Pain Observation Tool, CPOT)是评估ICU危重症和/或意识水平下降患者疼痛最准确的方法之一。本研究旨在翻译印尼语版CPOT,并验证其效度和信度。方法研究包括初始翻译.综合翻译结果、回译、专家委员会验证.印尼语版工具验证5个步骤。2022年9月- -12月在印度尼西亚4所医院ICU中,对52例患者在翻身前、翻身过程中和翻身后15min进行疼痛评估。使用疼痛程度温度计(Faces Pain Thermometer, FPT)作 为金标准来评估CPOT的校标效度。采用内容效度和校标效度评估量表的效度;采用Cronbach's a系数和评分者之间- -致性评估工具的信度。结果 患者翻身过程中CPOT评分高于翻身前和翻身后。印尼语版CPOT条目水平内容效度指数为0.75~1.00,量表内容效度指数为0.93。患者CPOT与FPT评分呈正相关(0.877-0.983 ,P<0.01)。CPOT的Cronbach's a系数为0.82,评分者之间测量结果一致性水平均较高(k值范围0.739-0.834 ,P<0.01)。结论 印尼语版CPOT用于评估危重症和/或意识水平降低患者的疼痛是有效和可靠的。

Betalains protect various body organs through antioxidant and anti-inflammatory pathways

Betalains are natural coloring pigments with betalamic acid as the core structure of all subclasses.Besides their coloring properties,betalains exhibit various biological activities,including antioxidant and anti-inflammatory properties,which are highly imperative.Further in-vivo studies reported that betalains protect various body organs,leading to health enhancement.Body organs,including the heart,liver,kidney,lung,etc.,are important for a healthy life.However,these organs can be affected or damaged by various stress factors,toxicants,and harmful substances.Recent studies have claimed that betalains could protect all vital organs of the body through antioxidant and anti-inflammatory mechanisms.This review article described the in-vivo antioxidant and anti-inflammatory activities of betalains in various cell-line or animal models.A comprehensive discussion has been provided on the mechanism of action of betalains in protecting various body organs,including cardio-protective effect,hepato-protective ability,renal protection capacity,repro-protective ability,neuro-protective effect,lung protection,and gut protection ability.Finally,future research directions and conclusions have been outlined.

Oketani massage with jasmine oil improves breast milk production on postpartum days 1-3

Objective:This study aimed to determine the effect of Oketani massage with jasmine oil on improving breast milk production on days 1-3.Materials and Methods:This preexperimental one-group pretest-posttest design was conducted with 44 eligible respondents,selected using an incidental sampling technique.Oketani massage with jasmine oil was conducted once a day for 3 consecutive days.A total of 44 respondents were selected with incidental sampling.Sufficient breast milk production was observed through the frequency of baby urination in 24 h,the frequency of baby defecation in 24 h,the baby’s weight,and the length of time the baby slept or remained calm after breastfeeding.Results:Results showed that Oketani massage using jasmine oil impacted on increasing breast milk production in postpartum on days 1-3(Z=6.633,P=0.000).The baby’s weight in 3 days was increased after intervention compared with intervention before(2858.25±180.62 g vs.2881.66±180.96 g,t=55.33,P=0.000),the baby’s urination frequency was increased after intervention(4.55±0.50 vs.7.20±0.70,t=17.87,P=0.000),the breastfeeding frequency has decreased(10.27±1.42 vs.8.82±0.82,t=6.94,P=0.000),and the time of baby’s sleeping or calming state has increased(5.14±6.46 h vs.8.48±10.24 h,t=2.11,P=0.041).Conclusion:Oketani massage combined with jasmine oil has been shown to be effective on improving breast milk production on days 1-3.

Changes in acute and late toxicity and patient-reported health-related quality of life following radiotherapy in women with breast cancer:A 1-year longitudinal study

Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Methods:A total of 108 breast cancer women were recruited for this prospective study.Data were collected at various intervals;prior to,and 1,3,6 months,and 1 year after radiation therapy.The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer(EORTC)criteria.Our secondary outcome was QOL,measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale.We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year.Results:The early toxicities that are most commonly experienced include pharyngeal,skin,and mucous membrane toxicity.Late toxicities frequently involve skin and submucosal toxicity.To measure patient functionality,all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT.Symptoms of the patients,which were included in the QOL symptom scale,decreased during the follow-up period,except for fatigue;however,changes in pain,insomnia,and loss of appetite did not significantly change.We identified the analogous symptom profiles in Edmonton.Although patients’overall health scores declined in the 1st and 3rd months after radiotherapy(RT),they rebounded at 6 and 12 months.Conclusion:For breast cancer patients,RT did not adversely affect functional capacity or exacerbate symptoms,but persistent fatigue did increase during the observation period.Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.

Management strategies for common viral infections in pediatric renal transplant recipients

Viral infections have been considered as a major cause of morbidity and mortality after kidney transplantation in pediatric cohort.Children are at high risk of acquiring virus-related complications due to immunological immaturity and the enhanced alloreactivity risk that led to maintenance of high immunosuppressive regimes.Hence,prevention,early detection,and prompt treatment of such infections are of paramount importance.Among all viral infections,herpes viruses(herpes simplex virus,varicella zoster virus,Epstein-Barr virus,cytomegalovirus),hepatitis B and C viruses,BK polyomavirus,and respiratory viruses(respiratory syncytial virus,parainfluenza virus,influenza virus and adenovirus)are common in kidney transplant recipients.These viruses can cause systemic disease or allograft dysfunction affecting the clinical outcome.Recent advances in technology and antiviral therapy have improved management strategies in screening,monitoring,adoption of prophylactic or preemptive therapy and precise treatment in the immunocompromised host,with significant impact on the outcome.This review discusses the etiology,screening and monitoring,diagnosis,prevention,and treatment of common viral infections in pediatric renal transplant recipients.

Literature Review on Support for Children and Families Experiencing Parental Bereavement

Purpose: This study aimed to understand the actual nursing support in a wide perspective by reviewing overseas literature on support for children who have experienced parental bereavement and their families. The goal was to identify future challenges in nursing support in clinical practice in Japan. Method: Literature searchable as of May 2023 was retrieved using PubMed, resulting in 11 relevant articles. Result: The results revealed the following: 1) For support provided to children, 13 codes were condensed into 5 subcategories and 4 categories. 2) For support provided to families, 36 codes were condensed into 11 subcategories and 4 categories. Conclusion: Open communication was found to be essential for supporting children and their families who have experienced parental bereavement. Moreover, involvement of multiple professions facilitated the provision of specialized support to address diverse needs of children and families, playing a crucial role in overcoming grief. Additionally, the effectiveness of support systems for bereaved families highlighted the need for nursing professionals in Japan to gain knowledge through learning opportunities and to establish a multi-disciplinary approach to support, thus indicating future challenges in nursing support.

住院患者认知障碍识别和信息管理的整合性综述

目的旨在对目前提供急性照护的医院识别认知障碍患者以及在病历中记录和管理认知相关信息的实际情况及政策要求和推荐方法进行综述。方 法采用Whittemore和Knaf1的五步法,系统检索Medline,CINAHL和Scopus数据库,并检索了灰色文献来源。纳人了提供急性照护的医院已实施的患者认知障碍识别和认知信息管理相关的文献。采用混合方法评价工具和灰色文献质量评估清单对文章质量进行评价。采用主题分析法呈现和整合结果。该综述已在PROSPERO预注册(CRD42022343577)。结果 共22篇原始研究文献和10篇政府/行业文件被纳人分析。结果显示,实践和政策之间存在差距。尽管在政策层面上高度重视认知障碍的识别、认知相关信息的透明度,以及与患者、家属和照顾者(如适用)之间的互动,但有时在临床实践中,认知评估是非正式的,患者的认知相关信息未作记录,与患者、家属和照顾者的互动也存在不足。结 论.通过整合认知评估,利用信息技术开发信息管理综合系统,建立相关法律法规,提供教育与和培训,并采用国家层面的策略,有可能显著改善对认知障碍患者的识别和护理。

Factors influencing discharge readiness among patients with mild-to-moderate ischemic stroke:a cross-sectional study

Objective:To describe discharge readiness and determine whether self-efficacy,social support,and the quality of discharge teaching can predict discharge readiness among patients with mild-to-moderate ischemic stroke.Methods:A total of 120 patients with mild-to-moderate ischemic stroke were recruited using simple random sampling.Five instruments,namely,the Demographic Data Questionnaire,the Chinese version of the Readiness for Hospital Discharge Scale(RHDS_C),the SelfEfficacy for Managing Chronic Disease 6-Item Scale(SES6),the Perceived Social Support Scale(PSSS),and the Quality of Discharge Teaching Scale(QDTS),were used for data collection.Descriptive statistics and standard multiple linear regression were used for data analysis.Results:The mean score of discharge readiness among patients with mild-to-moderate ischemic stroke was at a moderate level(M=7.6,SD=0.92),and 75.8%of the participants felt ready for discharge.Standard multiple linear regression revealed that selfefficacy(β=0.62,P<0.001)and the quality of discharge teaching(β=0.28,P<0.001)were the influencing factors.However,social support could not predict discharge readiness significantly.All the factors combined explained 64.9%of the variance in discharge readiness.Conclusions:Intervention programs aimed at improving self-efficacy and the quality of discharge teaching may be helpful in promoting discharge readiness in patients with mild-to-moderate ischemic stroke,especially in coping ability.

Analysis of the Relationship between Eating and Swallowing Function and Lifestyle of the Elderly Living in the Community-A Secondary Publication

Objectives:The relationship between eating and swallowing function,and lifestyle among community-dwelling elderly people has not been extensively studied.This study aimed to analyze the characteristics of eating and swallowing function and their association with the lifestyle among the elderly.Methods:A self-administered questionnaire survey was conducted on 419 elderly people who participated in the oral function improvement project operated by the Community Comprehensive Support Center.A total of 288 valid responses(58 males,230 females,average age 73.6 years)were analyzed.The survey items included basic demographics,health status,lifestyle,and eating and swallowing functions.The chi-square(χ2)test was used to compare for a difference in the risk of dysphagia.Results:72 patients(25.0%)were judged to be at risk for dysphagia,and 216(75.0%)were judged to be not at risk for dysphagia using the revised dysphagia risk assessment scale.The mean score for oral preparatory dysphagia was the highest,while the mean score for pharyngeal dysphagia was the lowest.The group at risk of dysphagia had significant difficulty in chewing and had bad sleep quality as compared to the group that was not at risk.Conclusion:Concerning the risk of dysphagia,there is a need to maintain and improve masticatory function.In addition,improving the swallowing function of the elderly may prevent insomnia and improve sleep quality.

Education Programs for Invasive Procedures Involving Nurses: A Scoping Review

Background: Implementing invasive procedures is an important part of patient management by clinical nurses;however, there are gaps between nurses’ actual knowledge and skills and expected professional care capacity. Purpose: This scoping review aimed to map the existing literature related to recent institution-provided educational programs for invasive procedures involving clinical nurses. This study seeks to understand the contents of educational programs and the methods for assessing educational effects. Methods: This scoping review was completed using the following four databases: PubMed (MEDLINE), Embase, Cochrane Library, and Emcare for the period 2000-2022. We included studies that used all forms of educational approaches (e.g., didactic lectures, hands-on training, or on-the-job training). This scoping review considered peer-reviewed publications published in English using quantitative, qualitative, or mixed approaches. A total of 83 studies underwent in the final analysis. Results and Conclusion: A combination of didactic lectures and hands-on training was provided as an educational program in most studies. Contrary to our prediction, educational interventions with advanced technologies such as VR are extremely rare, suggesting that the effectiveness of advanced technologies in learning invasive procedures should be examined to facilitate and retain educational effects more efficiently in future studies. Regarding the assessment of educational effects, nurses’ cognitive (i.e., theoretical knowledge about procedures), psychomotor (i.e., implementing procedures), and psychological aspects (e.g., confidence and self-efficacy in procedures) were evaluated using questionnaires and observational methods. While most studies used a one-group pretest-posttest design, the ratio of randomized controlled trials (RCT) was relatively low. Thus, an RCT design should be introduced in future studies to test the validity of the developed educational program more accurately.

An Ethical Practice Intervention Program for Pediatric Nurses with Varied Nursing Experience

Aim: This study aimed to elucidate experience-related differences in the impact of an intervention program promoting ethical nursing practices among pediatric nurses with 0 - 5 years’ experience in varying settings. Methods: The pediatric nursing care model, defining 24 elements of pediatric nursing practice, was developed to educate nurses with pediatric nursing experience only, as well as those with experience in other settings, on ethical nursing practices toward pediatric patients and their families. Participants’ level of knowledge and frequency of application of these practices were assessed before, directly after and two months after the intervention, with a final follow-up three months post-intervention. Results: Results showed that among those who have experience in nursing areas other than pediatrics, the frequency of practicing items related to children’s rights and dignity significantly increased (p Conclusions: Participants showed an increased awareness of issues related to ethical pediatric nursing practice for patients’ and their parents.