Nursing culture assessment tool (NCAT): Empirical validation for use in long-term care

Background:Capturing general aspects of the occupational subculture of nursing is needed in long-term care(LTC)given its latent influence on the quality of care that residents receive and on the ability of nursing staff(licensed nurses and certified nursing assistants)to implement evidence-based practice innovations.The psychometrically validated Nursing Culture Assessment Tool(NCAT)provides a comprehensive assessment using six dimensions(teamwork,communication,satisfaction,professional commitment,behaviors,and expectations),and evaluation of these dimensions could help positively reshape the culture before any change implementation.Purpose:Aims were to:(1)assess the validity and reliability of the NCAT across nursing staff in a single type of clinical setting e LTC facilities,and(2)present a refined theoretical model of the interaction of culture and practice implementation.Methods:A cross-sectional,exploratory investigation of the NCAT in LTC settings was conducted.Empirical construct validity of the 19-item NCAT's six subscales was investigated by confirmatory factor analysis using a sample of licensed nurses and certified nursing assistants(n?318).Results:The model fit was judged using the comparative fit index(0.94)and standardized root mean-square residual(0.05).Cronbach's alpha correlation coefficients of items in each subscale and in the overall scale ranged from 0.76 to 0.94.Conclusion:A summary of the NCAT development and report on its psychometric properties when administered in LTC settings is provided,extending previous findings of the NCAT's enhanced stability when used in assessing nursing staff perceptions in LTC and by demonstrating that the NCAT is a reliable and valid psychometric screening tool for nursing culture.

Experiences of Social Isolation in Older Hospitalized Patients with COVID-19 and Their Close Relatives: A Qualitative Study

Background: Proximity between older patients and their close relatives is essential during hospitalisation. During the first wave of the pandemic, the Danish Patient Safety Authority restricted no hospital visitors. Aim: To explore how older patients with COVID-19 and their close relatives experienced physical separation during hospitalization. Method: A qualitative study using semi-structured interviews and thematic analysis was employed. Findings: Six interviews were conducted: three patients with a mean age of 81 years and three close relatives—two daughters and one spouse. The patients felt boredom, loneliness, and a sense of imprisonment, yet they felt safe and satisfied. Isolation was known beforehand from the media. Close relatives emphasised that information, involvement, and collaboration with hospital staff were crucial. Conclusion: Although older patients with COVID-19 and their close relatives widely accept their situation during hospitalization, they experience negative consequences from social isolation.

Incidence and Outcomes of Surgical Site Infections after Adult Cardiac Surgery: A Single-Center Experience

Background: Surgical site infections (SSIs) remain a challenging medical problem, especially in cardiac surgery patients. There is a lack of studies evaluating the rate of and outcomes of SSIs following cardiac surgeries in Saudi Arabia. Aims: This study aimed to determine the incidence of SSIs after adult cardiac surgeries that were done in Madinah Cardiac Center, Saudi Arabia. Further, to identify the outcomes and risk factors contributing to death among surgical site infection patients. Methods: This was a 6-year, single-center, retrospective cohort study that included 93 consecutive patients who underwent adult cardiac surgery between August 2016 and August 2022. All adult patients aged 18 years or older who had clinical evidence of postoperative surgical wound infection were included. Preoperative, operative, and postoperative data (early and late) were collected from medical records. Microbiological culture reports and clinical outcomes were also recorded. Results: The study revealed a 9.1% (93/1021) incidence rate of SSIs. Of the 93 patients with SSIs, 60 had superficial incisional infections and 33 had deep infections with incidence rates of 5.9% and 3.2%, respectively. In-hospital mortality due to SSI was recorded in 4 out of 93 patients with an incidence rate of 4.3%. There was a significant association between the in-hospital mortality and the type of SSIs (p = 0.014). All non-survivors had deep SSIs. The type of cardiac surgery also showed a significant association with the in-hospital mortality (p = 0.017). Furthermore, the median duration of antibiotic administration was significantly longer in the non-survivors than in the survivors (72.5 vs 17, respectively, p Conclusions: In conclusion, the incidence of surgical wound infections following cardiac surgery is not low (9.1%);of which 3.2% were deep infections. The in-hospital mortality rate after treatment of SSIs was fortunately low (4.3%), and all non-survivors had deep SSIs. The non- survivors showed a significantly longer duration of antibiotics administration than survivors. Combined CABG and valve procedures showed a higher mortality rate (75%) than the isolated procedures.

The effectiveness of mI SMART:A nurse practitioner led technology intervention for multiple chronic conditions in primary care

Aims:Used as integrated tools,technology may improve access and outcomes of care.A new intervention that integrates multiple technologies called mI SMART has been developed,implemented,and evaluated by Nurse Practitioners.The aim of this paper is to present the initial effectiveness of a webbased,structure of sensors and mobile devices designed to overcome the known health determinant of access to care for rural,chronically ill patients by using technology.Methods:The study was conducted at a community primary-care clinic that provides free healthcare to impoverished adults.Adults with at least one chronic condition,a minimum of 3rd grade reading level,and without dementia/psychosis were recruited.Participants were given a Nexus7 tablet and Bluetooth self-monitoring devices.The intervention lasted for 12 weeks.Blood glucose,blood pressure,and weight were collected using the provided Bluetooth devices and means were evaluated with paired-samples ttests before and after the intervention.Results:Thirty participants were majority female,white,married,high-school educated or less,earning less than$20,000 per annum,and had multiple chronic conditions.Pre-intervention glucose,systolic blood pressure,diastolic blood pressure,weight and Body Mass Index were all reduced after the 12-week intervention.Conclusions:The mI SMART intervention is efficacious for use in improvised adults living in rural areas with multiple chronic conditions.As previously reported,the intervention was also shown to be feasible and acceptable to patients.The next step is a larger randomized controlled trial.

不同治疗方式对急性心肌梗死患者疾病认知及二级预防结局的影响

目的确定接受不同治疗方式的急性心肌梗死患者的疾病认知及二级预防结局的差异。方法采用重复测量设计,对接受3种不同治疗方式的心肌梗死患者进行比较。3种治疗方式包括:对ST段抬高心肌梗死患者进行经皮冠状动脉介入治疗;对ST段抬高心肌梗死患者进行溶栓治疗;对非ST段抬高心肌梗死患者进行药物治疗。采用便利抽样法在安曼国际心脏研究所选取206例急性心肌梗死患者,他们均同意参加此次研究。在患者入院及出院6个月时收集其疾病认知、体力活动、人口统计学及临床资料。结果共有186例患者完成了此项研究。经皮冠状动脉介入治疗组与溶栓治疗组、非ST段抬高心肌梗死药物治疗组患者比较,具有较高的疾病敏感性(P=0.034),较低的自我管理(P=0.032),较高的治疗管理(P=0.025),较高的对疾病认知的一致性(P=0.022)。同时,经皮冠状动脉介入治疗组对血压控制较差(P=0.013),体力活动较少(P=0.001)。结论与溶栓治疗组及非ST段抬高心肌梗死药物治疗组患者比较,经皮冠状动脉介入治疗组患者出院6个月后具有消极的疾病认知及有限的行为改变。应进行更深入的研究了解延长随访时间和不同文化背景下治疗方式与心肌梗死患者疾病认知和二级预防的关系。

The making of a nurse scientist: A personal narrative

Why?The question every child incessantly asks started my journey to become a nurse scientist.This editorial is adapted from a keynote speech I delivered for the 6th Qilu International Young Nursing Scholars Forum sponsored by Shandong University School of Nursing and Rehabilitation.As you read,I ask you to keep in mind that the times and world in which I started my journey no longer exist.

The Influence of Culture on Analgesic Consumption: A Retrospective Study among Malaysian Patients after Breast Cancer Surgery

This study was carried out to determine the relationship between ethnicity/culture and analgesic consumption among patients from three main ethnic groups in Malaysia after breast cancer surgery. A retrospective study design was adopted, using medical records of 80 patients. The findings showed that the analgesic most consumed by the patients during the 48 hour post-operative period was morphine equivalents (85%), followed by non steroidal anti-inflammatory drugs (60%) and paracetamol (38%). No relationship was found between ethnicity/culture and the type or amount of analgesic consumption.

Anemia among Antenatal Mother in Urban Malaysia

An understanding of factors influencing haemoglobin (Hb) level among antenatal mothers can help healthcare providers assess, take appropriate action and manage anaemia in this risk group more effectively. A cross-sectional study was conducted in urban areas in Malaysia to determine the Hb levels of antenatal mothers and their association with various socio-economic characteristics. Data for this study were collected from pregnant women during their first antenatal check-up at three selected polyclinics in Malaysia. Anaemia in pregnancy was determined by the Hb level recorded during the first and the last antenatal visits. Determination of Hb was either by a photo calorimetric method or by the Sahliís method. A structured self-administered questionnaire was used to identify the factors influencing Hb level among the antenatal mothers. This study found that 73 out of 217 mothers (33%) were anaemic in that their Hb levels were below 11.00 g/dl. The findings also suggested that Hb levels among the antenatal mothers were influenced by various factors such as education level, occupation, and family income. Anaemia was generally more common among antenatal mothers who had a lower level of education and who were from a background of lower family income.

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

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

Effectiveness of digital psychotherapeutic intervention among perinatal women:A systematic review and meta-analysis of randomized controlled trials

BACKGROUND The perinatal period is a challenging time of substantial emotional,physiological,social,and relational changes.Depression,anxiety,and stress symptoms are common,and co-exist in the perinatal period.Digital technology continues to grow at an unprecedented pace with wide application,including psychotherapeutic intervention.A growing number of meta-analyses supported the application of digital psychotherapeutic intervention across different populations,but relatively few meta-and meta-regression analyses have concentrated on perinatal women.AIM To evaluate the effectiveness of digital psychotherapeutic intervention on improving psychological outcomes among perinatal women and identify its essential features.METHODS Randomized controlled trials(RCTs)were obtained from eight databases,including Cumulative Index to Nursing and Allied Health Literature,Cochrane Library,Embase,Scopus,PsycINFO,PubMed,Web of Science,and ProQuest Dissertation and Theses from inception up until November 24,2020.Comprehensive Meta-analysis 3.0 software was used to conduct meta-and metaregression analyses.The Cochrane risk-of-bias tool and the Grading of the Recommendation,Assessment,Development,and Evaluation system were adopted to assess the individual and overall qualities of the evidence,respectively.RESULTS A total of 25 RCTs that included 3239 women were identified.Meta-analyses revealed that intervention significantly improved depression(Hedges’s g=0.49),anxiety(g=0.25),and stress(g=0.47)symptoms compared to the control.Subgroup analyses demonstrated that a website platform with≥eight therapistguided sessions using the theoretical principle of cognitive behavioral therapy was more effective than other treatments in improving depression symptoms in postnatal women.Meta-regression analyses observed that the age of perinatal women and the type of psychotherapy also had statistically significant effects on depression symptoms.Egger’s regression asymmetry tests suggested that no publication biases occurred,but the overall quality of the evidence was very low.CONCLUSION This review suggests that digital psychotherapeutic intervention may be a potential solution to reduce psychological problems in perinatal women.Further high-quality RCTs with large sample sizes are needed.

Emotional intelligence and its impacts on the clinical performance of nurses in general public hospitals

Objectives:The nursing profession is considered to be at a high risk of workplace stress,workload,and burnout due to the high job demands.The nurses require the appropriate and prompt coping mechanisms to relieve the effects of stress.The nurses have to be emotionally intelligent to overcome the work-related stress to meet the clinical-based duties.But there is a paucity of the effect of emotional intelligence(EI)on the clinical performance of nurses in the literature.Therefore,the role of dimensions of EI in the improvement of clinical performance of nurses was explored in this study.Methods:A total of 194 nurses with different education levels and experiences were included from various clinical departments and shifts of public hospitals in Iraqi Kurdistan.Results:The mean age of the nurses was 29.44 years,with ages ranging from 23 years to 36 years.The nurses were men(56.70%),married(53.10%),non-smokers(86.10%),physically active(55.70%),and irregular physically active(63.90%).Nurses were able to appraise their own emotions but not the emotions of other nurses.They regulated their own emotions but were weak in regulating the emotions of other nurses.They did not utilize emotions in coming up with new ideas and facing obstacles in clinical settings.Generally,the nurses reported that a little clinical performance is required in medical settings.The levels of interpersonal communication and problem solving were improved with an increasing appraisal and regulating own emotions.The level of problem solving was improved with appraising own emotions and utilizing emotions in facing obstacles.Conclusions:Nurses need to know how to regulate others’emotions and utilize these emotions in coming up with new ideas and facing the obstacles positively in medical settings.

Men with prostate cancer and the accessibility to information—a literature review

Objective: To explore possible consequences of short stays in hospitals, as these short contacts reduce the patients’ time for information and support. Method: A literature survey was carried out to get an insight in possible consequences by summarizing the state of knowledge on how men with prostate cancer undergoing prostatec-tomy surgery experience their contacts with the healthcare professionals. Results: A consequence is that often men with prostate cancer, treated with prostatectomy surgery, do not receive the individualized support, infor-mation, and dialogue they need, which leads to feelings of uncertainty, insecurity, and loss of control. The men use the Internet in their search for information and support, which makes them able to stay in control and be active, responsible partners in their own course of treatment. Conclusion: For men to feel secure and certain the accessibility of the healthcare professionals and the healthcare professionals’ ability to individualize information and support are important aspects. Practice Implications: It is relevant to provide male cancer patients with tools that can underpin their contact to the healthcare professionals. Utilizing Web 2.0 technologies, Internet based tools can support exchange-ability, towards dialogue-based contacts, between men with prostate cancer and healthcare professionals.

Collaborating with Young Adults Diagnosed with Schizophrenia:A Participatory Design Study to Shape the Healthcare System

Introduction: Disengagement from mental health services in young adults with schizophrenia has been associated with dissatisfaction and unmet needs. Striving to improve engagement, we invited service users recently diagnosed with schizophrenia to be co-designers of a smartphone technology that will be responsive to their needs. Aim: This paper reports the first phase of a three-phased participatory design process. The objective was to identify needs of support in young adults recently diagnosed with schizophrenia and to generate ideas of how the needs could be accommodated using smartphone technology. Methods: Participatory design guided the research process and a qualitative approach was used to generate and analyse the data. Data were generated by means of participant observations (n = 45 hours) and interviews (n = 6) with young adults from a first episode psychosis program in Denmark. Findings: Low levels of knowledge and high levels of uncertainties are characteristic of young adults recently diagnosed with schizophrenia, bringing about a vast need of support in order for them to gain power over their new life situation. Our study suggests that the smartphone may be used to foster empowerment by guiding the young adult’s actions in situ, providing comprehensive and easily understood information on the go, allowing for recovery tracking, and notification of mental health changes, providing medication overview and giving easy access to healthcare providers. Conclusion: Young adults recently diagnosed with schizophrenia require comprehensive support in order to become empowered to confidently manage their new life situation. The smartphone holds this potential by offering flexible collaboration and timely access to self-management

Clinical Nurses’Research Capacity Building in Practice—A Systematic Review

The aim of this study was to identify and evaluate evidence of clinical nurses’ research capacity building in practice. A systematic review of studies of nurses’ research capacity building in practice was performed. The quality of the articles was evaluated and reflected on in accordance with the Quality Assessment and Validity Tool for Correlation Studies. The literature searches identified a total of 4748 abstracts and titles. Eight quantitative studies were included in the evaluation. Three themes emerged from the analysis: Failure to ensure research quality and standards, Developing a research culture and Collaboration and organization of research utilization. The first theme has one sub-theme: Lack of knowledge about how to increase research utilization. The second theme is based on three sub-themes: Ability to identify clinical problems, changing nurses’ attitudes to research and research supervision. Finally, the third theme has one sub-theme: Funding as a success factor. In conclusion, research capacity building requires the development of research competence to generate knowledge that enhances quality and patient safety. Nurse leaders are essential for establishing evidence-based practice and a research culture, thus enhancing nurses’ scientific attitudes and capacity.

Yoga and Qigong in the Psychological Prevention of Mental Health Disorders:A Conceptual Synthesis

The study proposes to explore two alternative medicine therapies--qigong and yoga for balanc- ing the essential duo of holistic mind-body and consequently offer a solution for stress, uncertainty, anxiety and depression. Qualitative research methods have been used to create a conceptual synthesis of yoga and qigong. It is suggested that an increased sense of control is the interface between these two modalitieso This conceptual congruence of qigong and yoga is thought to be a selective, curative method, a prescription for ideal living and a ground of human essence existence. Furthermore, this essence is thought to enhance the mind＇s self-regulatory processes and prevent mental health disorders. The two alternative therapies can prevent mental health disorders such as anxiety, depression and, minimize mental health disruptions such as stress and poor quality of life. It is suggested that patients and/or clients can benefit from this fusion.